Integrating dynamic fuzzy C-means, data envelopment analysis and artificial neural network to online prediction performance of companies in stock exchange

NASA Astrophysics Data System (ADS)

Jahangoshai Rezaee, Mustafa; Jozmaleki, Mehrdad; Valipour, Mahsa

2018-01-01

One of the main features to invest in stock exchange companies is their financial performance. On the other hand, conventional evaluation methods such as data envelopment analysis are not only a retrospective process, but are also a process, which are incomplete and ineffective approaches to evaluate the companies in the future. To remove this problem, it is required to plan an expert system for evaluating organizations when the online data are received from stock exchange market. This paper deals with an approach for predicting the online financial performance of companies when data are received in different time's intervals. The proposed approach is based on integrating fuzzy C-means (FCM), data envelopment analysis (DEA) and artificial neural network (ANN). The classical FCM method is unable to update the number of clusters and their members when the data are changed or the new data are received. Hence, this method is developed in order to make dynamic features for the number of clusters and clusters members in classical FCM. Then, DEA is used to evaluate DMUs by using financial ratios to provide targets in neural network. Finally, the designed network is trained and prepared for predicting companies' future performance. The data on Tehran Stock Market companies for six consecutive years (2007-2012) are used to show the abilities of the proposed approach.

Evaluation of the variability of wind speed at different heights and its impact on the receiver efficiency of central receiver systems

NASA Astrophysics Data System (ADS)

Delgado, A.; Gertig, C.; Blesa, E.; Loza, A.; Hidalgo, C.; Ron, R.

2016-05-01

Typical plant configurations for Central Receiver Systems (CRS) are comprised of a large field of heliostats which concentrate solar irradiation onto the receiver, which is elevated hundreds of meters above the ground. Wind speed changes with altitude above ground, impacting on the receiver thermal efficiency due to variations of the convective heat losses. In addition, the physical properties of air vary at high altitudes to a significant degree, which should be considered in the thermal losses calculation. DNV GL has long-reaching experience in wind energy assessment with reliable methodologies to reduce the uncertainty of the determination of the wind regime. As a part of this study, DNV GL estimates the wind speed at high altitude for different sites using two methods, a detailed estimation applying the best practices used in the wind energy sector based on measurements from various wind sensors and a simplified estimation applying the power law (1, 2) using only one wind measurement and a representative value for the surface roughness. As a result of the study, a comparison of the wind speed estimation considering both methods is presented and the impact on the receiver performance for the evaluated case is estimated.

Family planning advice and postpartum contraceptive use among low-income women in Mexico.

PubMed

Barber, Sarah L

2007-03-01

In Mexico, family planning advice has been incorporated into the clinical guidelines for prenatal care. However, the relationship between women's receipt of family planning advice during prenatal care and subsequent contraceptive use has not been evaluated. Data were collected in 2003 and 2004 in 17 Mexican states from 2,238 urban low-income women postpartum. Participating women reported on prenatal services received and contraceptive use. Logistic and multinomial logistic regression models evaluated whether receiving family planning advice during prenatal care predicted current contraceptive use, after quality of care in the community, service utilization, delivery characteristics, household socioeconomic characteristics, and maternal and infant characteristics were controlled for. Overall, 47% of women used a modern contraceptive method. Women who received family planning advice during prenatal care were more likely to use a contraceptive than were those who did not receive such advice (odds ratio, 2.2). Women who received family planning advice had a higher probability of using condoms (relative risk ratio, 2.3) and IUDs (5.2), and of undergoing sterilization (1.4), than of using no method. Integrating family planning advice into prenatal care may be an important strategy for reaching women when their demand for contraception is high.

Facilitating the Feedback Process on a Clinical Clerkship Using a Smartphone Application.

PubMed

Joshi, Aditya; Generalla, Jenilee; Thompson, Britta; Haidet, Paul

2017-10-01

This pilot study evaluated the effects of a smartphone-triggered method of feedback delivery on students' perceptions of the feedback process. An interactive electronic feedback form was made available to students through a smartphone app. Students were asked to evaluate various aspects of the feedback process. Responses from a previous year served as control. In the first three quarters of academic year 2014-2015 (pre-implementation), only 65% of responders reported receiving oral feedback and 40% reported receiving written feedback. During the pilot phase (transition), these increased to 80% for both forms. Following full implementation in academic year 2015-2016 (post-implementation), 97% reported receiving oral feedback, and 92% reported receiving written feedback. A statistically significant difference was noted pre- to post-implementation for both oral and written feedback (p < 0.01). A significant increase from pre-implementation to transition was noted for written feedback (p < 0.01) and from transition to post-implementation for oral feedback (p < 0.01). Ninety-one and 94% of responders reported ease of access and timeliness of the feedback, 75% perceived the quality of the feedback to be good to excellent; 64% felt receiving feedback via the app improved their performance; 69% indicated the feedback method as better compared to other methods. Students acknowledged the facilitation of conversation with supervisors and the convenience of receiving feedback, as well as the promptness with which feedback was provided. The use of a drop-down menu was thought to limit the scope of conversation. These data point to the effectiveness of this method to cue supervisors to provide feedback to students.

Evaluation and Ranking of Researchers – Bh Index

PubMed Central

Bharathi, D. Gnana

2013-01-01

Evaluation and ranking of every author is very crucial as it is widely used to evaluate the performance of the researcher. This article proposes a new method, called Bh-Index, to evaluate the researchers based on the publications and citations. The method is built on h-Index and only the h-core articles are taken into consideration. The method assigns value additions to those articles that receive significantly high citations in comparison to the h-Index of the researcher. It provides a wide range of values for a given h-Index and effective evaluation even for a short period. Use of Bh-Index along with the h-Index gives a powerful tool to evaluate the researchers. PMID:24349183

Ultrasonic stress wave characterization of composite materials

NASA Technical Reports Server (NTRS)

Duke, J. C., Jr.; Henneke, E. G., II; Stinchcomb, W. W.

1986-01-01

The work reported covers three simultaneous projects. The first project was concerned with: (1) establishing the sensitivity of the acousto-ultrasonic method for evaluating subtle forms of damage development in cyclically loaded composite materials, (2) establishing the ability of the acousto-ultrasonic method for detecting initial material imperfections that lead to localized damage growth and final specimen failure, and (3) characteristics of the NBS/Proctor sensor/receiver for acousto-ultrasonic evaluation of laminated composite materials. The second project was concerned with examining the nature of the wave propagation that occurs during acoustic-ultrasonic evaluation of composite laminates and demonstrating the role of Lamb or plate wave modes and their utilization for characterizing composite laminates. The third project was concerned with the replacement of contact-type receiving piezotransducers with noncontacting laser-optical sensors for acousto-ultrasonic signal acquisition.

Electroacoustic Evaluation of Frequency-Modulated Receivers Interfaced with Personal Hearing Aids

ERIC Educational Resources Information Center

Schafer, Erin C.; Thibodeau, Linda M.; Whalen, Holly S.; Overson, Gary J.

2007-01-01

Purpose: The purpose of this study was to compare the electroacoustic outputs of frequency-modulated (FM) systems coupled to hearing aids. Method: Electroacoustic performance of FM systems coupled to hearing aids was determined for 3 FM receivers: body-worn with neck loop, ear-level nonprogrammable, and ear-level programmable. Systems were…

Food Insecurity and Food Choices in Rural Older Adults with Diabetes Receiving Nutrition Education via Telemedicine

ERIC Educational Resources Information Center

Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.

2010-01-01

Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…

78 FR 69650 - Meeting of the Defense Advisory Committee on Women in the Services (DACOWITS)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

..., the Committee will receive a briefing from the National Guard Bureau on same-sex benefits. The... Battalion and the Combat Fitness Test. The Committee will receive a briefing from TRADOC on gender neutral... Implementation Methods on Evaluation of Commander's Performance --Briefing--National Guard Same Sex Benefits...

On the Use of a Signal Quality Index Applying at Tracking Stage Level to Assist the RAIM System of a GNSS Receiver.

PubMed

Berardo, Mattia; Lo Presti, Letizia

2016-07-02

In this work, a novel signal processing method is proposed to assist the Receiver Autonomous Integrity Monitoring (RAIM) module used in a receiver of Global Navigation Satellite Systems (GNSS) to improve the integrity of the estimated position. The proposed technique represents an evolution of the Multipath Distance Detector (MPDD), thanks to the introduction of a Signal Quality Index (SQI), which is both a metric able to evaluate the goodness of the signal, and a parameter used to improve the performance of the RAIM modules. Simulation results show the effectiveness of the proposed method.

Advantage of population pharmacokinetic method for evaluating the bioequivalence and accuracy of parameter estimation of pidotimod.

PubMed

Huang, Jihan; Li, Mengying; Lv, Yinghua; Yang, Juan; Xu, Ling; Wang, Jingjing; Chen, Junchao; Wang, Kun; He, Yingchun; Zheng, Qingshan

2016-09-01

This study was aimed at exploring the accuracy of population pharmacokinetic method in evaluating the bioequivalence of pidotimod with sparse data profiles and whether this method is suitable for bioequivalence evaluation in special populations such as children with fewer samplings. Methods In this single-dose, two-period crossover study, 20 healthy male Chinese volunteers were randomized 1 : 1 to receive either the test or reference formulation, with a 1-week washout before receiving the alternative formulation. Noncompartmental and population compartmental pharmacokinetic analyses were conducted. Simulated data were analyzed to graphically evaluate the model and the pharmacokinetic characteristics of the two pidotimod formulations. Various sparse sampling scenarios were generated from the real bioequivalence clinical trial data and evaluated by population pharmacokinetic method. The 90% confidence intervals (CIs) for AUC0-12h, AUC0-∞, and Cmax were 97.3 - 118.7%, 96.9 - 118.7%, and 95.1 - 109.8%, respectively, within the 80 - 125% range for bioequivalence using noncompartmental analysis. The population compartmental pharmacokinetics of pidotimod were described using a one-compartment model with first-order absorption and lag time. In the comparison of estimations in different dataset, the estimation of random three- and< fixed four-point sampling strategies can provide results similar to those obtained through rich sampling. The nonlinear mixed-effects model requires fewer data points. Moreover, compared with the noncompartmental analysis method, the pharmacokinetic parameters can be more accurately estimated using nonlinear mixed-effects model. The population pharmacokinetic modeling method was used to assess the bioequivalence of two pidotimod formulations with relatively few sampling points and further validated the bioequivalence of the two formulations. This method may provide useful information for regulating bioequivalence evaluation in special populations.

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

Advanced receiver autonomous integrity monitoring using triple frequency data with a focus on treatment of biases

NASA Astrophysics Data System (ADS)

El-Mowafy, Ahmed

2017-04-01

Most current Advanced Receiver Autonomous Integrity Monitoring (ARAIM) methods are designed to use dual-frequency ionosphere-free observations. These methods assume that receiver bias is absorbed in the common receiver clock offset and bound satellite biases by nominal values. However, most multi-constellation Global Navigation Satellite Systems (GNSS) can offer triple frequency data that can be used for civilian applications in the future, which can improve observation redundancy, solution precision and detection of faults. In this contribution, we explore the use of this type of observations from GPS, Galileo and BeiDou in ARAIM. Nevertheless, the use of triple frequency data introduces receiver differential biases that have to be taken into consideration. To demonstrate the significance of these additional biases we first present a method to quantify them at stations of known coordinates and using available products from the International GNSS service (IGS). To deal with the additional receiver biases, we use a between-satellite single difference (BSSD) observation model that eliminates their effect. A pilot test was performed to evaluate ARAIM availability for Localizer Performance with Vertical guidance down to 200 feet (LPV-200) when using the triple-frequency observations. Real data were collected for one month at stations of known coordinates located in regions of different satellite coverage characteristics. The BSSD triple-frequency model was evaluated to give early indication about its feasibility, where the implementation phase still requires further comprehensive studies. The vertical position error was always found to be bounded by the protection level proven initial validity of the proposed integrity model.

Low-complexity video encoding method for wireless image transmission in capsule endoscope.

PubMed

Takizawa, Kenichi; Hamaguchi, Kiyoshi

2010-01-01

This paper presents a low-complexity video encoding method applicable for wireless image transmission in capsule endoscopes. This encoding method is based on Wyner-Ziv theory, in which side information available at a transmitter is treated as side information at its receiver. Therefore complex processes in video encoding, such as estimation of the motion vector, are moved to the receiver side, which has a larger-capacity battery. As a result, the encoding process is only to decimate coded original data through channel coding. We provide a performance evaluation for a low-density parity check (LDPC) coding method in the AWGN channel.

Evaluation of Supplemental Nutrition Assistance Program Education: Application of Behavioral Theory and Survey Validation

ERIC Educational Resources Information Center

Wyker, Brett A.; Jordan, Patricia; Quigley, Danielle L.

2012-01-01

Objective: Application of the Transtheoretical Model (TTM) to Supplemental Nutrition Assistance Program Education (SNAP-Ed) evaluation and development and validation of an evaluation tool used to measure TTM constructs is described. Methods: Surveys were collected from parents of children receiving food at Summer Food Service Program sites prior…

USE OF ZEOLITE FOR REMOVING AMMONIA AND AMMONIA-CAUSED TOXCITY IN MARINE TOXICITY IDENTIFCATION EVALUATIONS (TIES)

EPA Science Inventory

Ammonia occurs in marine waters including effluents, receiving waters, and sediment interstitial waters. At sufficiently high concentrations, ammonia can be toxic to aquatic species. Toxicity identification evaluation (TIE) methods provide researchers with tools for identifyi...

EVALUATION OF FADROZOLE AS AN ENDOCRINE DISRUPTOR IN FATHEAD MINNOW (PIMEPHALES PROMELAS)

EPA Science Inventory

The EPA has received a legislative mandate to develop and implement standardized screening and testing methods to identify and assess potential endocrine disrupting chemicals (EDCs). The objective of this research was to evaluate a short-term EDC screening/testing assay which ass...

Probabilistic Evaluation of Three-Dimensional Reconstructions from X-Ray Images Spanning a Limited Angle

PubMed Central

Frost, Anja; Renners, Eike; Hötter, Michael; Ostermann, Jörn

2013-01-01

An important part of computed tomography is the calculation of a three-dimensional reconstruction of an object from series of X-ray images. Unfortunately, some applications do not provide sufficient X-ray images. Then, the reconstructed objects no longer truly represent the original. Inside of the volumes, the accuracy seems to vary unpredictably. In this paper, we introduce a novel method to evaluate any reconstruction, voxel by voxel. The evaluation is based on a sophisticated probabilistic handling of the measured X-rays, as well as the inclusion of a priori knowledge about the materials that the object receiving the X-ray examination consists of. For each voxel, the proposed method outputs a numerical value that represents the probability of existence of a predefined material at the position of the voxel while doing X-ray. Such a probabilistic quality measure was lacking so far. In our experiment, false reconstructed areas get detected by their low probability. In exact reconstructed areas, a high probability predominates. Receiver Operating Characteristics not only confirm the reliability of our quality measure but also demonstrate that existing methods are less suitable for evaluating a reconstruction. PMID:23344378

Skills methods to prevent smoking.

PubMed

Schinke, S P; Gilchrist, L D; Schilling, R F; Snow, W H; Bobo, J K

1986-01-01

School health educators have devoted much attention to cigarette smoking. Recent years have seen the testing of interventions to prevent smoking. To date, controlled studies have not evaluated the added value of skills methods for preventing smoking. This article describes such an evaluation with sixth-grade students from two schools. Subjects were pretested and randomly assigned to receive conventional health education methods or to receive skills intervention. Both conditions included films, peer testimonials, discussions, and homework. Health education condition subjects additionally participated in oral quizzes, games, and debates. Skills condition subjects additionally learned problem-solving, self-instruction, and interpersonal communication methods. At postintervention, skills condition subjects, more than health education condition subjects, had better scores on measures of smoking-related knowledge, attitudes, and intentions. In addition, reported cigarette use, validated by biochemical data collection, was lower in the skills condition than in the health education condition at all postintervention measurements, including a 24-month follow-up. The article discusses the strengths, limits, and implications of the study for other smoking prevention efforts in schools.

Monitoring of concentrated radiation beam for photovoltaic and thermal solar energy conversion applications.

PubMed

Parretta, Antonio; Privato, Carlo; Nenna, Giuseppe; Antonini, Andrea; Stefancich, Marco

2006-10-20

Methods for evaluating the light intensity distribution on receivers of concentrated solar radiation systems are described. They are based on the use of Lambertian diffusers in place of the illuminated receiver and on the acquisition of the scattered light, in reflection or transmission mode, by a CCD camera. The spatial distribution of intensity radiation is then numerically derived from the recorded images via a proprietary code. The details of the method are presented and a short survey of the main applications of the method in the photovoltaic and thermal solar energy conversion field is proposed. Methods for investigating the Lambertian character of commercial diffusers are also discussed.

Evaluation of team-based learning in a doctor of physical therapy curriculum in the United States.

PubMed

Lein, Donald H; Lowman, John D; Eidson, Christopher A; Yuen, Hon K

2017-01-01

The purpose of this retrospective study was to evaluate students' academic outcomes after implementation of the team-based learning (TBL) approach in patient/client management courses in an entry-level doctor of physical therapy (DPT) curriculum. The research design of this study involved comparing written and practical exam scores from DPT student cohorts taught with the traditional instructional methods (lecture-based) to those of students from subsequent cohorts taught using the TBL approach in two patient/client management courses: basic skills and cardiopulmonary. For this comparison, the exams used, the number of contact hours and labs, and the instructors who taught these courses remained the same during the transition between these two instructional methods (traditional vs. TBL). The average of all individual course exam scores was used for data analysis. In both courses, there were no meaningful differences in the mean exam scores among students across years of cohorts receiving the same instructional method, which allowed clustering students from different years of cohorts in each course receiving the same instructional method into one group. For both courses, the mean exam score was significantly higher in the TBL group than in the traditional instruction group: basic skills course (P<0.001) and cardiopulmonary course (P<0.001). Student cohorts taught using the TBL approach academically outperformed those who received the traditional instructional method in both entry-level DPT patient/client management courses.

Comparison of effects of seven treatment methods for distal radius fracture on minimizing complex regional pain syndrome

PubMed Central

Sun, Tao

2016-01-01

Introduction Using network meta-analysis, we evaluated the adverse effects of the seven most common treatment methods, i.e., bridging external fixation, non-bridging external fixation, K-wire fixation, plaster fixation, dorsal plating, volar plating, and dorsal and volar plating, by their associated risk of developing complex regional pain syndrome (CRPS) in distal radius fracture (DRF) patients. Material and methods Following an exhaustive search of scientific literature databases for high quality studies, randomized controlled trials (RCTs) related to our study topic were screened and selected based on stringent predefined inclusion and exclusion criteria. Data extracted from the selected studies were used for statistical analyses using Stata 12.0 software. Results A total of 17 RCTs, including 1658 DRF patients, were enrolled in this network meta-analysis. Among the 1658 DRF patients, 452 received bridging external fixation, 525 received non-bridging external fixation, 154 received K-wire fixation, 84 received plaster fixation, 132 received dorsal plating, 123 received volar plating, and 188 received dorsal and volar plating. When compared to bridging external fixation patients, there was no marked difference in the CRPS risk in DRF patients receiving different treatments (all p > 0.05). However, the surface under the cumulative ranking curves (SUCRA) for plaster fixation (77.0%) and non-bridging external fixation (71.3%) were significantly higher compared with the other five methods. Conclusions Our findings suggest that compared with bridging external fixation, K-wire fixation, dorsal plating, volar plating, dorsal and volar plating, plaster fixation and non-bridging external fixation might be the better treatment methods to reduce the risk of CRPS in DRF patients. PMID:28144268

PNF and manual therapy treatment results of patients with cervical spine osteoarthritis.

PubMed

Maicki, Tomasz; Bilski, Jan; Szczygieł, Elżbieta; Trąbka, Rafał

2017-09-22

The aim of this study was to evaluate the effectiveness of PNF and manual therapy methods in the treatment of patients with cervical spine osteoarthritis, especially their efficacy in reducing pain and improving functionality in everyday life. Long-term results were also compared in order to determine which method of treatment is more effective. Eighty randomly selected females aged 45-65 were included in the study. They were randomly divided into two groups of 40 persons. One group received PNF treatment and the other received manual therapy (MAN.T). To evaluate functional capabilities, the Functional Rating Index was used. To evaluate changes in pain, a shortened version of the McGill Questionnaire was used. The PNF group achieved a greater reduction in pain than the MAN.T group. The PNF group showed a greater improvement in performing daily activities such as sleeping, personal care, travelling, work, recreation, lifting, walking and standing as well as decreased intensity and frequency of pain compared to the MAN.T group. The PNF method proved to be more effective in both short (after two weeks) and long (after three months) term.

45 CFR 2522.700 - How does evaluation differ from performance measurement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... progress, evaluation uses scientifically-based research methods to assess the effectiveness of programs by... the reading ability of students in a program over time to a similar group of students not... example, a performance measure for a literacy program may include the percentage of students receiving...

Implementation of EPA's Worker Protection Standard training for agricultural laborers: an evaluation using North Carolina data.

PubMed Central

Arcury, T A; Quandt, S A; Austin, C K; Preisser, J; Cabrera, L F

1999-01-01

The US Environmental Protection Agency has promulgated a Worker Protection Standard which requires that farmworkers receive pesticide safety training. The implementation of these regulations has not been evaluated. Using data collected through personal interviews with 270 Hispanic farmworkers recruited from 35 labor sites in an eight-county area, the authors analyzed the extent to which farmworkers received pesticide safety training, characteristics of the training, and variations in knowledge and safety behavior. Approximately a third of the farmworkers reported having ever received information or training on pesticide safety, and 25.6% reported having received training in the year in which they were interviewed. Workers with H2A visas were significantly more likely to have received training than workers without these visas. The training received varied in location, duration, and language. Most included the use of a video, as well as verbal presentation, and most included printed materials. However, few workers knew the ways in which they could be exposed to pesticides or reported using any method to protect themselves from pesticide exposure. PMID:10590768

A Statistical Method for Reducing Sidelobe Clutter for the Ku-Band Precipitation Radar on Board the GPM Core Observatory

NASA Technical Reports Server (NTRS)

Kubota, Takuji; Iguchi, Toshio; Kojima, Masahiro; Liao, Liang; Masaki, Takeshi; Hanado, Hiroshi; Meneghini, Robert; Oki, Riko

2016-01-01

A statistical method to reduce the sidelobe clutter of the Ku-band precipitation radar (KuPR) of the Dual-Frequency Precipitation Radar (DPR) on board the Global Precipitation Measurement (GPM) Core Observatory is described and evaluated using DPR observations. The KuPR sidelobe clutter was much more severe than that of the Precipitation Radar on board the Tropical Rainfall Measuring Mission (TRMM), and it has caused the misidentification of precipitation. The statistical method to reduce sidelobe clutter was constructed by subtracting the estimated sidelobe power, based upon a multiple regression model with explanatory variables of the normalized radar cross section (NRCS) of surface, from the received power of the echo. The saturation of the NRCS at near-nadir angles, resulting from strong surface scattering, was considered in the calculation of the regression coefficients.The method was implemented in the KuPR algorithm and applied to KuPR-observed data. It was found that the received power from sidelobe clutter over the ocean was largely reduced by using the developed method, although some of the received power from the sidelobe clutter still remained. From the statistical results of the evaluations, it was shown that the number of KuPR precipitation events in the clutter region, after the method was applied, was comparable to that in the clutter-free region. This confirms the reasonable performance of the method in removing sidelobe clutter. For further improving the effectiveness of the method, it is necessary to improve the consideration of the NRCS saturation, which will be explored in future work.

Subtle Emotional Process in Early Childhood Pedagogy: Evaluating the Contribution of the Tavistock Observation Method

ERIC Educational Resources Information Center

Elfer, Peter

2017-01-01

Nursery experience is now common for young children and their families. Questions of quality have focussed mainly on safety and early learning. The roles of subtle emotional processes in daily pedagogic interactions have received surprisingly little attention. This paper discusses the Tavistock Observation Method (TOM), a naturalistic method of…

Linear combination methods to improve diagnostic/prognostic accuracy on future observations

PubMed Central

Kang, Le; Liu, Aiyi; Tian, Lili

2014-01-01

Multiple diagnostic tests or biomarkers can be combined to improve diagnostic accuracy. The problem of finding the optimal linear combinations of biomarkers to maximise the area under the receiver operating characteristic curve has been extensively addressed in the literature. The purpose of this article is threefold: (1) to provide an extensive review of the existing methods for biomarker combination; (2) to propose a new combination method, namely, the nonparametric stepwise approach; (3) to use leave-one-pair-out cross-validation method, instead of re-substitution method, which is overoptimistic and hence might lead to wrong conclusion, to empirically evaluate and compare the performance of different linear combination methods in yielding the largest area under receiver operating characteristic curve. A data set of Duchenne muscular dystrophy was analysed to illustrate the applications of the discussed combination methods. PMID:23592714

Receiver Statistics for Cognitive Radios in Dynamic Spectrum Access Networks

DTIC Science & Technology

2012-02-28

SNR) are employed by many protocols and processes in direct-sequence ( DS ) spread-spectrum packet radio networks, including soft-decision decoding...adaptive modulation protocols, and power adjustment protocols. For DS spread spectrum, we have introduced and evaluated SNR estimators that employ...obtained during demodulation in a binary CDMA receiver. We investigated several methods to apply the proposed metric to the demodulator’s soft-decision

Process Evaluation of a Workers' Health Surveillance Program for Meat Processing Workers.

PubMed

van Holland, Berry J; Brouwer, Sandra; de Boer, Michiel R; Reneman, Michiel F; Soer, Remko

2017-09-01

Objective To evaluate the implementation process of a workers' health surveillance (WHS) program in a Dutch meat processing company. Methods Workers from five plants were eligible to participate in the WHS program. The program consisted of four evaluative components and an intervention component. Qualitative and quantitative methods were used to evaluate seven process aspects. Data were gathered by interviews with stakeholders, participant questionnaires, and from registries of the company and occupational health service. Results Two recruitment strategies were used: open invitation or automatic participation. Of the 986 eligible workers, 305 participated in the program. Average reach was 53 %. Two out of five program components could not be assessed on dose delivered, dose received and fidelity. If components were assessable, 85-100 % of the components was delivered, 66-100 % of the components was received by participants, and fidelity was 100 %. Participants were satisfied with the WHS program (mean score 7.6). Contextual factors that facilitated implementation were among others societal developments and management support. Factors that formed barriers were program novelty and delayed follow-up. Conclusion The WHS program was well received by participants. Not all participants were offered the same number of program components, and not all components were performed according to protocol. Deviation from protocol is an indication of program failure and may affect program effectiveness.

Evaluation of a social marketing campaign targeting preschool children.

PubMed

Johnson, Susan L; Bellows, Laura; Beckstrom, Leslie; Anderson, Jennifer

2007-01-01

To determine the effectiveness of a pilot social marketing program to increase preschoolers' willingness to try new foods. Four Head Start centers participated (2 experimental, 2 control) in a study using a quasi-experimental design. Experimental sites received a 12-week intervention developed using social marketing techniques. The program was evaluated via preference assessments, classroom observations, and teacher surveys. Increased preference for and willingness to try new foods were observed in children from the experimental sites (P<0.05). The program was positively received by Head Start staff. A social marketing campaign is an effective method to reduce children's neophobia.

Using Microanalytical Simulation Methods in Educational Evaluation: An Exploratory Study

ERIC Educational Resources Information Center

Sondergeld, Toni A.; Beltyukova, Svetlana A.; Fox, Christine M.; Stone, Gregory E.

2012-01-01

Scientifically based research used to inform evidence based school reform efforts has been required by the federal government in order to receive grant funding since the reenactment of No Child Left Behind (2002). Educational evaluators are thus faced with the challenge to use rigorous research designs to establish causal relationships. However,…

Paradigms of Evaluation in Natural Language Processing: Field Linguistics for Glass Box Testing

ERIC Educational Resources Information Center

Cohen, Kevin Bretonnel

2010-01-01

Although software testing has been well-studied in computer science, it has received little attention in natural language processing. Nonetheless, a fully developed methodology for glass box evaluation and testing of language processing applications already exists in the field methods of descriptive linguistics. This work lays out a number of…

Randomized, Controlled Trial of CBT Training for PTSD Providers

DTIC Science & Technology

2015-10-01

design, implement and evaluate a cost effective, web based self paced training program to provide skills-oriented continuing education for mental...but has received little systematic evaluation to date. Noting the urgency and high priority of this issue, Fairburn and Cooper (2011) have... evaluate scalable and cost-effective new methods for training of mental health clinicians providing treatment services to veterans with PTSD. The

An Improved Time-Frequency Analysis Method in Interference Detection for GNSS Receivers

PubMed Central

Sun, Kewen; Jin, Tian; Yang, Dongkai

2015-01-01

In this paper, an improved joint time-frequency (TF) analysis method based on a reassigned smoothed pseudo Wigner–Ville distribution (RSPWVD) has been proposed in interference detection for Global Navigation Satellite System (GNSS) receivers. In the RSPWVD, the two-dimensional low-pass filtering smoothing function is introduced to eliminate the cross-terms present in the quadratic TF distribution, and at the same time, the reassignment method is adopted to improve the TF concentration properties of the auto-terms of the signal components. This proposed interference detection method is evaluated by experiments on GPS L1 signals in the disturbing scenarios compared to the state-of-the-art interference detection approaches. The analysis results show that the proposed interference detection technique effectively overcomes the cross-terms problem and also preserves good TF localization properties, which has been proven to be effective and valid to enhance the interference detection performance of the GNSS receivers, particularly in the jamming environments. PMID:25905704

A New Reassigned Spectrogram Method in Interference Detection for GNSS Receivers.

PubMed

Sun, Kewen; Jin, Tian; Yang, Dongkai

2015-09-02

Interference detection is very important for Global Navigation Satellite System (GNSS) receivers. Current work on interference detection in GNSS receivers has mainly focused on time-frequency (TF) analysis techniques, such as spectrogram and Wigner-Ville distribution (WVD), where the spectrogram approach presents the TF resolution trade-off problem, since the analysis window is used, and the WVD method suffers from the very serious cross-term problem, due to its quadratic TF distribution nature. In order to solve the cross-term problem and to preserve good TF resolution in the TF plane at the same time, in this paper, a new TF distribution by using a reassigned spectrogram has been proposed in interference detection for GNSS receivers. This proposed reassigned spectrogram method efficiently combines the elimination of the cross-term provided by the spectrogram itself according to its inherent nature and the improvement of the TF aggregation property achieved by the reassignment method. Moreover, a notch filter has been adopted in interference mitigation for GNSS receivers, where receiver operating characteristics (ROCs) are used as metrics for the characterization of interference mitigation performance. The proposed interference detection method by using a reassigned spectrogram is evaluated by experiments on GPS L1 signals in the disturbing scenarios in comparison to the state-of-the-art TF analysis approaches. The analysis results show that the proposed interference detection technique effectively overcomes the cross-term problem and also keeps good TF localization properties, which has been proven to be valid and effective to enhance the interference Sensors 2015, 15 22168 detection performance; in addition, the adoption of the notch filter in interference mitigation has shown a significant acquisition performance improvement in terms of ROC curves for GNSS receivers in jamming environments.

A New Reassigned Spectrogram Method in Interference Detection for GNSS Receivers

PubMed Central

Sun, Kewen; Jin, Tian; Yang, Dongkai

2015-01-01

Interference detection is very important for Global Navigation Satellite System (GNSS) receivers. Current work on interference detection in GNSS receivers has mainly focused on time-frequency (TF) analysis techniques, such as spectrogram and Wigner–Ville distribution (WVD), where the spectrogram approach presents the TF resolution trade-off problem, since the analysis window is used, and the WVD method suffers from the very serious cross-term problem, due to its quadratic TF distribution nature. In order to solve the cross-term problem and to preserve good TF resolution in the TF plane at the same time, in this paper, a new TF distribution by using a reassigned spectrogram has been proposed in interference detection for GNSS receivers. This proposed reassigned spectrogram method efficiently combines the elimination of the cross-term provided by the spectrogram itself according to its inherent nature and the improvement of the TF aggregation property achieved by the reassignment method. Moreover, a notch filter has been adopted in interference mitigation for GNSS receivers, where receiver operating characteristics (ROCs) are used as metrics for the characterization of interference mitigation performance. The proposed interference detection method by using a reassigned spectrogram is evaluated by experiments on GPS L1 signals in the disturbing scenarios in comparison to the state-of-the-art TF analysis approaches. The analysis results show that the proposed interference detection technique effectively overcomes the cross-term problem and also keeps good TF localization properties, which has been proven to be valid and effective to enhance the interference detection performance; in addition, the adoption of the notch filter in interference mitigation has shown a significant acquisition performance improvement in terms of ROC curves for GNSS receivers in jamming environments. PMID:26364637

Pulse-Echo Ultrasonic Imaging Method for Eliminating Sample Thickness Variation Effects

NASA Technical Reports Server (NTRS)

Roth, Don J. (Inventor)

1997-01-01

A pulse-echo, immersion method for ultrasonic evaluation of a material which accounts for and eliminates nonlevelness in the equipment set-up and sample thickness variation effects employs a single transducer and automatic scanning and digital imaging to obtain an image of a property of the material, such as pore fraction. The nonlevelness and thickness variation effects are accounted for by pre-scan adjustments of the time window to insure that the echoes received at each scan point are gated in the center of the window. This information is input into the scan file so that, during the automatic scanning for the material evaluation, each received echo is centered in its time window. A cross-correlation function calculates the velocity at each scan point, which is then proportionalized to a color or grey scale and displayed on a video screen.

Seismic joint analysis for non-destructive testing of asphalt and concrete slabs

USGS Publications Warehouse

Ryden, N.; Park, C.B.

2005-01-01

A seismic approach is used to estimate the thickness and elastic stiffness constants of asphalt or concrete slabs. The overall concept of the approach utilizes the robustness of the multichannel seismic method. A multichannel-equivalent data set is compiled from multiple time series recorded from multiple hammer impacts at progressively different offsets from a fixed receiver. This multichannel simulation with one receiver (MSOR) replaces the true multichannel recording in a cost-effective and convenient manner. A recorded data set is first processed to evaluate the shear wave velocity through a wave field transformation, normally used in the multichannel analysis of surface waves (MASW) method, followed by a Lambwave inversion. Then, the same data set is used to evaluate compression wave velocity from a combined processing of the first-arrival picking and a linear regression. Finally, the amplitude spectra of the time series are used to evaluate the thickness by following the concepts utilized in the Impact Echo (IE) method. Due to the powerful signal extraction capabilities ensured by the multichannel processing schemes used, the entire procedure for all three evaluations can be fully automated and results can be obtained directly in the field. A field data set is used to demonstrate the proposed approach.

Effects of Intensive Voice Treatment (the Lee Silverman Voice Treatment [LSVT]) on Vowel Articulation in Dysarthric Individuals with Idiopathic Parkinson Disease: Acoustic and Perceptual Findings

ERIC Educational Resources Information Center

Sapir, Shimon; Spielman, Jennifer L.; Ramig, Lorraine O.; Story, Brad H.; Fox, Cynthia

2007-01-01

Purpose: To evaluate the effects of intensive voice treatment targeting vocal loudness (the Lee Silverman Voice Treatment [LSVT]) on vowel articulation in dysarthric individuals with idiopathic Parkinson's disease (PD). Method: A group of individuals with PD receiving LSVT (n = 14) was compared to a group of individuals with PD not receiving LSVT…

LABORATORY AND FIELD EVALUATION OF CRYSTALLIZED DOW 704 OIL ON THE PERFORMANCE OF THE WINS PM2.5 FRACTIONATOR

EPA Science Inventory

Subsequent to the 1997 promulgation of the Federal Reference Method (FRM) for monitoring PM2.5 in ambient air, the United States Environmental Protection Agency (USEPA) received reports that the Dow 704 diffusion oil used in the method's WINS fractionator would occasionally cry...

Implication of Posture Analysing Software to Evaluate the Postural Changes after Corrective Exercise Strategy on Subjects with Upper Body Dysfunction-A Randomized Controlled Trial

PubMed Central

Sudhakar, S; Porcelvan, S; Francis, T.G. Tilak; Rathnamala, D; Radhakrishnan, R

2017-01-01

Introduction The postural adaptation is very common now a days in school going children, office desk oriented job, computer users and frequent mobile users, and in all major industrial workers. Several studies have documented a high incidence of postural abnormalities in a given population; however, methods of postural measurement were poorly defined. The implication of postural pro software to analyse the postural imbalance of upper body dysfunction is very rare and literature studies says that the kinematic changes in particular segment will produce pain/discomfort and thereby lesser productivity of subjects. Aim To evaluate the postural changes in subjects with upper body dysfunction after a corrective exercise strategy using postural analysis software and pectoralis minor muscle length testing. Materials and Methods After explaining the procedure and benefits, informed consent was taken from the participating subjects (age 25-55 years). Subjects with upper body dysfunction were randomly allocated into two groups (each group 30 subjects). The Group–A received the corrective exercise strategy and Group-B received the conventional exercise for eight weeks of study duration (15 reps each exercise, total duration of 40 min; four days/week. Pre and Post posture analysis were analysed using posture pro software along with flexibility of pectoralis minor was assessed using ruler scale method. Results After interpretation of data, both the group showed the postural alteration and pectoralis minor muscle length changes, p-value (p<0.01) of both group showed highly significant changes. But comparing the both groups, the subjects who received the corrective exercise strategy shown more percentage of improvement in posture alteration (56.25%), pectoralis minor muscle length changes (68.69%) than the conventional exercise received subjects in posture alteration (24.86%) and pectoralis minor muscle length changes (21.9%). Conclusion Altered postural changes and pectoralis minor muscle flexibility before and after the corrective exercise strategy evaluated by postural analysis software method shown to be a significant tool in clinical practice, which is easier and reproducible method. PMID:28893030

Optically Based Rapid Screening Method for Proven Optimal Treatment Strategies before Treatment Begins

DTIC Science & Technology

2014-08-01

tumor size, measured by mammography, MRI, or ultrasound. These methods evaluate the regimen that the patient received. Molecular changes induced by...photon counting electronics (SPC-150, Becker and Hickl) and a GaAsP PMT (H7422P-40, Hamamatsu). Photon count rates were maintained above 5x10 5...conditions (33), thus making them an attractive system to evaluate tumor response to drugs. We used OMI to assess the response of primary breast tumor

The Role of Academic Psychiatry Faculty in the Treatment and Subsequent Evaluation and Promotion of Medical Students: An Ethical Conundrum

ERIC Educational Resources Information Center

Kavan, Michael G.; Malin, Paula Jo; Wilson, Daniel R.

2008-01-01

Objectives: This article explores ethical and practical issues associated with the Liaison Committee on Medical Education (LCME) provision that states health professionals who provide psychiatric/psychological care to medical students must have no involvement in the academic evaluation or promotion of students receiving those services. Method: The…

Core Self-Evaluations as a Mediator between Functional Disability and Life Satisfaction in College Students with Disabilities Majoring in Science and Technology

ERIC Educational Resources Information Center

Smedema, Susan Miller; Pfaller, Joseph S.; Yaghmaian, Rana A.; Weaver, Hayley; da Silva Cardoso, Elizabeth; Chan, Fong

2015-01-01

Purpose: To examine the mediational effect of core self-evaluations (CSE) on the relationship between functional disability and life satisfaction. Methods: A quantitative descriptive design using multiple regression analysis. The participants were 97 college students with disabilities receiving services through Hunter College's Minority-Disability…

Initial alignment method for free space optics laser beam

NASA Astrophysics Data System (ADS)

Shimada, Yuta; Tashiro, Yuki; Izumi, Kiyotaka; Yoshida, Koichi; Tsujimura, Takeshi

2016-08-01

The authors have newly proposed and constructed an active free space optics transmission system. It is equipped with a motor driven laser emitting mechanism and positioning photodiodes, and it transmits a collimated thin laser beam and accurately steers the laser beam direction. It is necessary to introduce the laser beam within sensible range of the receiver in advance of laser beam tracking control. This paper studies an estimation method of laser reaching point for initial laser beam alignment. Distributed photodiodes detect laser luminescence at respective position, and the optical axis of laser beam is analytically presumed based on the Gaussian beam optics. Computer simulation evaluates the accuracy of the proposed estimation methods, and results disclose that the methods help us to guide the laser beam to a distant receiver.

a Method Using Gnss Lh-Reflected Signals for Soil Roughness Estimation

NASA Astrophysics Data System (ADS)

Jia, Y.; Li, W.; Chen, Y.; Lv, H.; Pei, Y.

2018-04-01

Global Navigation Satellite System Reflectometry (GNSS-R) is based on the concept of receiving GPS signals reflected by the ground using a passive receiver. The receiver can be on the ground or installed on a small aircraft or UAV and collects the electromagnetic field scattered from the surface of the Earth. The received signals are then analyzed to determine the characteristics of the surface. Many research has been reported showing the capability of the GNSS-R technique. However, the roughness of the surface impacts the phase and amplitude of the received signals, which is still a worthwhile study. This paper presented a method can be used by GNSS-R to estimate the surface roughness. First, the data was calculated in the specular reflection with the assumption of a flat surface with different permittivity. Since the power reflectivity can be evaluated as the ratio of left-hand (LH) reflected signal to the direct right-hand (RH) signal. Then a semi-empirical roughness model was applied to the data for testing. The results showed the method can distinguish the water and the soil surface. The sensitivity of the parameters was also analyzed. It indicates this method for soil roughness estimation can be used by GNSS-R LH reflected signals. In the next step, several experiments need to be done for improving the model and exploring the way of the estimation.

Are students' impressions of improved learning through active learning methods reflected by improved test scores?

PubMed

Everly, Marcee C

2013-02-01

To report the transformation from lecture to more active learning methods in a maternity nursing course and to evaluate whether student perception of improved learning through active-learning methods is supported by improved test scores. The process of transforming a course into an active-learning model of teaching is described. A voluntary mid-semester survey for student acceptance of the new teaching method was conducted. Course examination results, from both a standardized exam and a cumulative final exam, among students who received lecture in the classroom and students who had active learning activities in the classroom were compared. Active learning activities were very acceptable to students. The majority of students reported learning more from having active-learning activities in the classroom rather than lecture-only and this belief was supported by improved test scores. Students who had active learning activities in the classroom scored significantly higher on a standardized assessment test than students who received lecture only. The findings support the use of student reflection to evaluate the effectiveness of active-learning methods and help validate the use of student reflection of improved learning in other research projects. Copyright © 2011 Elsevier Ltd. All rights reserved.

Performance Analysis of a New Coded TH-CDMA Scheme in Dispersive Infrared Channel with Additive Gaussian Noise

NASA Astrophysics Data System (ADS)

Hamdi, Mazda; Kenari, Masoumeh Nasiri

2013-06-01

We consider a time-hopping based multiple access scheme introduced in [1] for communication over dispersive infrared links, and evaluate its performance for correlator and matched filter receivers. In the investigated time-hopping code division multiple access (TH-CDMA) method, the transmitter benefits a low rate convolutional encoder. In this method, the bit interval is divided into Nc chips and the output of the encoder along with a PN sequence assigned to the user determines the position of the chip in which the optical pulse is transmitted. We evaluate the multiple access performance of the system for correlation receiver considering background noise which is modeled as White Gaussian noise due to its large intensity. For the correlation receiver, the results show that for a fixed processing gain, at high transmit power, where the multiple access interference has the dominant effect, the performance improves by the coding gain. But at low transmit power, in which the increase of coding gain leads to the decrease of the chip time, and consequently, to more corruption due to the channel dispersion, there exists an optimum value for the coding gain. However, for the matched filter, the performance always improves by the coding gain. The results show that the matched filter receiver outperforms the correlation receiver in the considered cases. Our results show that, for the same bandwidth and bit rate, the proposed system excels other multiple access techniques, like conventional CDMA and time hopping scheme.

Invited commentary: Evaluating epidemiologic research methods--the importance of response rate calculation.

PubMed

Harris, M Anne

2010-09-15

Epidemiologic research that uses administrative records (rather than registries or clinical surveys) to identify cases for study has been increasingly restricted because of concerns about privacy, making unbiased population-based research less practicable. In their article, Nattinger et al. (Am J Epidemiol. 2010;172(6):637-644) present a method for using administrative data to contact participants that has been well received. However, the methods employed for calculating and reporting response rates require further consideration, particularly the classification of untraceable cases as ineligible. Depending on whether response rates are used to evaluate the potential for bias to influence study results or to evaluate the acceptability of the method of contact, different fractions may be considered. To improve the future study of epidemiologic research methods, a consensus on the calculation and reporting of study response rates should be sought.

Computerized ultrasound risk evaluation system

DOEpatents

Duric, Nebojsa; Littrup, Peter J.; Holsapple, III, Earle; Barter, Robert Henry; Moore, Thomas L.; Azevedo, Stephen G.; Ferguson, Sidney W.

2007-10-23

A method and system for examining tissue are provided in which the tissue is maintained in a position so that it may be insonified with a plurality of pulsed spherical or cylindrical acoustic waves. The insonifying acoustic waves are scattered by the tissue so that scattered acoustic radiation including a mix of reflected and transmitted acoustic waves is received. A representation of a portion of the tissue is then derived from the received scattered acoustic radiation.

Pulse-echo ultrasonic imaging method for eliminating sample thickness variation effects

NASA Technical Reports Server (NTRS)

Roth, Don J. (Inventor)

1995-01-01

A pulse-echo, immersion method for ultrasonic evaluation of a material is discussed. It accounts for and eliminates nonlevelness in the equipment set-up and sample thickness variation effects employs a single transducer, automatic scanning and digital imaging to obtain an image of a property of the material, such as pore fraction. The nonlevelness and thickness variation effects are accounted for by pre-scan adjusments of the time window to insure that the echoes received at each scan point are gated in the center of the window. This information is input into the scan file so that, during the automatic scanning for the material evaluation, each received echo is centered in its time window. A cross-correlation function calculates the velocity at each scan point, which is then proportionalized to a color or grey scale and displayed on a video screen.

Equalization and detection for digital communication over nonlinear bandlimited satellite communication channels. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Gutierrez, Alberto, Jr.

1995-01-01

This dissertation evaluates receiver-based methods for mitigating the effects due to nonlinear bandlimited signal distortion present in high data rate satellite channels. The effects of the nonlinear bandlimited distortion is illustrated for digitally modulated signals. A lucid development of the low-pass Volterra discrete time model for a nonlinear communication channel is presented. In addition, finite-state machine models are explicitly developed for a nonlinear bandlimited satellite channel. A nonlinear fixed equalizer based on Volterra series has previously been studied for compensation of noiseless signal distortion due to a nonlinear satellite channel. This dissertation studies adaptive Volterra equalizers on a downlink-limited nonlinear bandlimited satellite channel. We employ as figure of merits performance in the mean-square error and probability of error senses. In addition, a receiver consisting of a fractionally-spaced equalizer (FSE) followed by a Volterra equalizer (FSE-Volterra) is found to give improvement beyond that gained by the Volterra equalizer. Significant probability of error performance improvement is found for multilevel modulation schemes. Also, it is found that probability of error improvement is more significant for modulation schemes, constant amplitude and multilevel, which require higher signal to noise ratios (i.e., higher modulation orders) for reliable operation. The maximum likelihood sequence detection (MLSD) receiver for a nonlinear satellite channel, a bank of matched filters followed by a Viterbi detector, serves as a probability of error lower bound for the Volterra and FSE-Volterra equalizers. However, this receiver has not been evaluated for a specific satellite channel. In this work, an MLSD receiver is evaluated for a specific downlink-limited satellite channel. Because of the bank of matched filters, the MLSD receiver may be high in complexity. Consequently, the probability of error performance of a more practical suboptimal MLSD receiver, requiring only a single receive filter, is evaluated.

Remission induction and maintenance effect of probiotics on ulcerative colitis: A meta-analysis

PubMed Central

Sang, Li-Xuan; Chang, Bing; Zhang, Wen-Liang; Wu, Xiao-Mei; Li, Xiao-Hang; Jiang, Min

2010-01-01

AIM: To evaluate the induction of remission and maintenance effects of probiotics for ulcerative colitis. METHODS: Information was retrieved from MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The induction of remission and promotion of maintenance were compared between probiotics treatment and non-probiotics treatment in ulcerative colitis. RESULTS: Thirteen randomized controlled studies met the selection criteria. Seven studies evaluated the remission rate, and eight studies estimated the recurrence rate; two studies evaluated both remission and recurrence rates. Compared with the non-probiotics group, the remission rate for ulcerative colitis patients who received probiotics was 1.35 (95% CI: 0.98-1.85). Compared with the placebo group, the remission rate of ulcerative colitis who received probiotics was 2.00 (95% CI: 1.35-2.96). During the course of treatment, in patients who received probiotics for less than 12 mo compared with the group treated by non-probiotics, the remission rate of ulcerative colitis was 1.36 (95% CI: 1.07-1.73). Compared with the non-probiotics group, the recurrence rate of ulcerative colitis patients who received probiotics was 0.69 (95% CI: 2.47-1.01). In the mild to moderate group who received probiotics, compared to the group who did not receive probiotics, the recurrence rate was 0.25 (95% CI: 0.12-0.51). The group who received Bifidobacterium bifidum treatment had a recurrence rate of 0.25 (95% CI: 0.12-0.50) compared with the non-probiotics group. CONCLUSION: Probiotic treatment was more effective than placebo in maintaining remission in ulcerative colitis. PMID:20397271

A comparison of sampling methods for a standing tree acoustic device

Treesearch

Jerry M. Mahon, Jr.; Lewis Jordan; Lawrence R. Schimleck; Alexander Clark, III; Richard F. Daniels

2009-01-01

One method of evaluating potential product performance is the use of acoustic tools for identifying trees with high stiffness. Acoustic velocities for 100 standing loblolly pine (Pinus taeda) trees, obtained with the transmitting and receiving probes placed on the same face and opposite faces, were compared. Significant differences in velocity between the two...

The mini-O, a digital superhet, or a truly low-cost Omega navigation receiver

NASA Technical Reports Server (NTRS)

Burhans, R. W.

1975-01-01

A quartz tuning fork filter circuit and some unique CMOS clock logic methods provide a very simple OMEGA-VLF receiver with true hyperbolic station pair phase difference outputs. An experimental system was implemented on a single battery-operated circuit board requiring only an external antenna preamplifier, and LOP output recorder. A bench evaluation and preliminary navigation tests indicate the technique is viable and can provide very low-cost OMEGA measurement systems. The method is promising for marine use with small boats in the present form, but might be implemented in conjunction with digital microprocessors for airborne navigation aids.

Assessment of Program Impact Through First Grade, Volume I: The Context, Conceptual Approach and Methods of the Evaluation. An Evaluation of Project Developmental Continuity. Interim Report X.

ERIC Educational Resources Information Center

Rosario, Jose; And Others

This volume is the first of a series reporting evaluation findings on the impact of Project Developmental Continuity (PDC) on institutions, classroom staff, parents and children from the time the children entered Head Start through the first grade. PDC was begun in 1974 with the purpose of ensuring that disadvantaged children receive continuous…

Effect of patient selection method on provider group performance estimates.

PubMed

Thorpe, Carolyn T; Flood, Grace E; Kraft, Sally A; Everett, Christine M; Smith, Maureen A

2011-08-01

Performance measurement at the provider group level is increasingly advocated, but different methods for selecting patients when calculating provider group performance have received little evaluation. We compared 2 currently used methods according to characteristics of the patients selected and impact on performance estimates. We analyzed Medicare claims data for fee-for-service beneficiaries with diabetes ever seen at an academic multispeciality physician group in 2003 to 2004. We examined sample size, sociodemographics, clinical characteristics, and receipt of recommended diabetes monitoring in 2004 for the groups of patients selected using 2 methods implemented in large-scale performance initiatives: the Plurality Provider Algorithm and the Diabetes Care Home method. We examined differences among discordantly assigned patients to determine evidence for differential selection regarding these measures. Fewer patients were selected under the Diabetes Care Home method (n=3558) than the Plurality Provider Algorithm (n=4859). Compared with the Plurality Provider Algorithm, the Diabetes Care Home method preferentially selected patients who were female, not entitled because of disability, older, more likely to have hypertension, and less likely to have kidney disease and peripheral vascular disease, and had lower levels of predicted utilization. Diabetes performance was higher under Diabetes Care Home method, with 67% versus 58% receiving >1 A1c tests, 70% versus 65% receiving ≥1 low-density lipoprotein (LDL) test, and 38% versus 37% receiving an eye examination. The method used to select patients when calculating provider group performance may affect patient case mix and estimated performance levels, and warrants careful consideration when comparing performance estimates.

Effectiveness evaluation of simulative workshops for newly licensed drivers.

PubMed

Rosenbloom, Tova; Eldror, Ehud

2014-02-01

The current study set to examine the effects of simulator use in driving instruction on newly licensed drivers, comparing the road safety knowledge and reported intended behavior, as well as the actual driving performance of new drivers. Participants consisted of 280 newly licensed driver, of which 140 whose drivers license training included additional simulator-based lessons, and 140 drivers whose training precluded simulator-based lessons. All drivers answered questionnaires pertaining to their intended safe driving behaviors (according to Ajzen's (2000) theory of planned behavior), and to their traffic safety knowledge. Of the initial sample, 40 drivers received actual driving performance evaluation by an expert driving instructor, as well as by in-vehicle data recorders (IVDRs). We assumed that safer drivers report safer driving intentions, demonstrate greater traffic safety knowledge, evaluated as safer drivers by the driving instructor, and display lower and stable driving parameters on the IVDRs. We hypothesized that theoretical driving studies combined with practical training on simulators will elevate the safety level of novices driving. Hierarchical regression analyses on driving intentions indicated that drivers who did not receive simulator-based lessons demonstrated safer driving intentions compared to drivers who received simulator-based lessons. This pattern possibly indicating the drivers who received simulator-based lessons felt more confident in their driving abilities compared to drivers who did not receive simulated training. No significant difference was found in traffic safety knowledge, or in the evaluation of the expert driving instructor. IDVR data comparisons indicated drivers who received simulator-based lessons braked more often and were less prone to headway events, suggesting a more responsive driving style. These findings do not point to any significant advantage or disadvantage of the current simulator-based driving training over other driving training methods. Copyright © 2013 Elsevier Ltd. All rights reserved.

A comparison of four methods of analgesia in cats following ovariohysterectomy.

PubMed

Tobias, Karen M; Harvey, Ralph C; Byarlay, Judy M

2006-11-01

To evaluate the effectiveness of preoperative administration of oral carprofen, subcutaneous ketoprofen, and local nerve block with bupivacaine in preventing postoperative pain-associated behavior in cats after ovariohysterectomy. Fifty-two female intact cats. Materials and methods Cats received butorphanol (0.44 mg kg(-1) IM), carprofen (2.2 mg kg(-1) PO), ketoprofen (2.2 mg kg(-1) SQ), or bupivacaine infiltration block (1.1 mg kg(-1) SQ) before surgery. Cortisol and drug concentrations and visual analog scale (VAS) and interactive visual analog scale (IVAS) pain-associated behavior scores were measured 2 hours before and 0, 1, 2, 4, 8, 12, and 24 hours after ovariohysterectomy. Cats receiving butorphanol had significantly increased IVAS scores 2 hours after surgery compared with baseline measurements. Cats receiving carprofen, ketoprofen, and bupivacaine had significant increases from baseline in VAS and IVAS scores 1 and 2 hours after surgery. VAS and IVAS scores for cats receiving bupivacaine were significantly greater 1 and 2 hours after surgery than for cats that received butorphanol. Cats receiving carprofen had significant increases in cortisol 1 hour after surgery and significant decreases 24 hours after surgery compared with baseline measurements. Preoperative carprofen and ketoprofen have effects on pain-associated behavior similar to butorphanol in cats undergoing ovariohysterectomy. Cats receiving bupivacaine blocks may require additional analgesics immediately after surgery.

THE PRODUCTION AND EVALUATION OF THREE COMPUTER-BASED ECONOMICS GAMES FOR THE SIXTH GRADE. FINAL REPORT.

ERIC Educational Resources Information Center

WING, RICHARD L.; AND OTHERS

THE PURPOSE OF THE EXPERIMENT WAS TO PRODUCE AND EVALUATE 3 COMPUTER-BASED ECONOMICS GAMES AS A METHOD OF INDIVIDUALIZING INSTRUCTION FOR GRADE 6 STUDENTS. 26 EXPERIMENTAL SUBJECTS PLAYED 2 ECONOMICS GAMES, WHILE A CONTROL GROUP RECEIVED CONVENTIONAL INSTRUCTION ON SIMILAR MATERIAL. IN THE SUMERIAN GAME, STUDENTS SEATED AT THE TYPEWRITER TERMINALS…

Aerial Refueling Test Methods

DTIC Science & Technology

2015-04-13

and receiver optimal lighting configuration should be determined and evaluated in dusk, twilight and full dark lunar illumination periods. Degraded...should consist of sunset to nautical twilight . These conditions provide poor illumination for visible cameras, but high for IR ones.  Night conditions

Using multiple pharmacoeconomic methods to conduct a cost-effectiveness analysis of histamine H2-receptor antagonists.

PubMed

McCoy, S; Blayney-Chandramouli, J; Mutnick, A

1998-12-15

A formulary decision at a health care institution was studied by using two pharmacoeconomic methods. A pharmacoeconomic study was undertaken to assess the impact of a 1995 formulary decision to designate cimetidine as the primary histamine H2-receptor antagonist (H2RA) and to restrict the use of famotidine. Consecutive patients receiving either i.v. cimetidine or famotidine for stress ulcer prophylaxis were reviewed during a two-month period in 1997, and information on demographics, dosage and duration of H2RA therapy, admission date, laboratory test values, and adverse drug reactions was collected. Data for 62 patients (43 cimetidine recipients and 19 famotidine recipients) were evaluated. Therapy was categorized as successful or failed, and the data were then evaluated by decision analysis to evaluate the cost-effectiveness of the agents and by multiattribute utility theory (MAUT) to incorporate a humanistic evaluation of the treatments, namely, the number of doses administered and the number of times dosages were changed. The decision tree revealed that the average cost of receiving cimetidine was $82.01 and the average cost of famotidine therapy was $92.45. The MAUT analysis showed that cimetidine was the preferred agent as long as cost was valued at greater than 60% of the decision-making process and efficacy remained equal between the two agents. Two pharmacoeconomic methods lent support to a formulary decision at a health care institution.

Mentally disordered women in jail: who receives services?

PubMed Central

Teplin, L A; Abram, K M; McClelland, G M

1997-01-01

OBJECTIVES: Many jail inmates have severe psychiatric disorders (e.g., schizophrenia, major affective disorders). The courts have mandated that detainees have a constitutional right to treatment. We investigated what proportion of female jail detainees needed mental health services, what proportion received services, and what variables predicted who received services. METHODS: Trained interviewers administered a psychiatric evaluation (the NIMH Diagnostic Interview Schedule) to 1272 randomly selected female jail detainees during jail intake in a large Midwestern city. Project staff then documented whether women subsequently received services, using records and case files. RESULTS: Of the women who needed services, 23.5% received them while they were in jail. Type of disorder, treatment history, and socio-demographic variables all affected the odds of a mentally ill woman's receiving services. CONCLUSIONS: Correctional health care is a growing national public health problem. The magnitude of mental health service needs far exceeds current resources. PMID:9146439

Pain management in home hospice patients: A retrospective descriptive study.

PubMed

Campbell, Cathy L; Kelly, Meghan; Rovnyak, Virginia

2017-09-01

The development and evaluation of evidence-based, safe, and effective home-based pain management models for caregivers implementation is receiving greater attention in the literature because of international initiatives intended to increase the number of people who receive end-of-life care in home-based settings. The purpose of this "retrospective descriptive design" study was to describe pharmacological pain management and outcomes for 40 cancer and non-cancer patients receiving hospice care at home. While the median pain score was higher at admission in the cancer group than in the hospice care at home group, the difference was not significant at or within 48 hour of admission. Overall, there was a significant decrease in pain from the first measurement to the second. Within the last seven days of life, the majority of participants were not able to provide a pain severity score when asked to evaluate the effectiveness of pain management, thus their caregiver provided a proxy evaluation. Pain management was effective in the home setting. More research is needed on the best methods to teach lay caregivers to assess pain and evaluate the effectiveness of pharmacological modalities to manage pain. © 2017 John Wiley & Sons Australia, Ltd.

Evaluating opportunities for text message communication: a survey of parents and teens.

PubMed

Ahlers-Schmidt, Carolyn R; Jones, Jordan T; Chesser, Amy; Weeks, Kerri

2013-09-01

Text messaging is a widespread, cost-effective method for communicating. It is widely used by both parents and teens. The study objective was to survey teens and their parents to assess the capability and willingness of teens to receive healthcare-related text messages from their physician. Parents and teens (12-17 years old) at an adolescent clinic were asked to complete surveys. Surveys were available in hard copy or electronically (via Survey Monkey) using computer kiosks in the waiting room. Approval was received from two local Institutional Review Boards. Of the 93 pairs who began the survey, 47 pairs (51%) qualified and completed both the teen and parent surveys. Over 85% of teens were willing to receive texts from their doctor. Teens were most interested in appointment reminders (81%), immunization reminders (53%), and general test results (for example, strep [53%]). Parents' willingness to allow teens to receive text messages directly varied by content. Many parents preferred to also receive a copy of any text message sent to their teen. Both parents and teens endorse using text messages for appointment reminders. Parents appear willing for their teens to receive some health information directly. Future research should evaluate the efficacy of using text messages for communication with teens to improve care and utilization of services for adolescents.

Concentrated solar-flux measurements at the IEA-SSPS solar-central-receiver power plant, Tabernas - Lameria (Spain)

NASA Astrophysics Data System (ADS)

Vontobel, G.; Schelders, C.; Real, M.

A flux analyzing system (F.A.S.) was installed at the central receiver system of the SSPS project to determine the relative flux distribution of the heliostat field and to measure the entire optical solar flux reflected from the heliostat field into the receiver cavity. The functional principles of the F.A.S. are described. The raw data and the evaluation of the measurements of the entire helistat field are given, and an approach to determine the actual fluxes which hit the receiver tube bundle is presented. A method is described to qualify the performance of each heliostat using a computer code. The data of the measurements of the direct radiation are presented.

Effects of tacrolimus and erythropoietin in experimental spinal cord lesion in rats: functional and histological evaluation

PubMed Central

de Mesquita Coutinho, P R; Cristante, A F; de Barros Filho, T E P; Ferreira, R; dos Santos, G B

2016-01-01

Study design: Experimental study with rats. Objective: To evaluate functional and histological effects of tacrolimus (FK 506) and erythropoietin (EPO) after experimental spinal cord contusion injury (SCI). Setting: Brazil. Methods: Wistar rats (n=60) were submitted to SCI with the NYU Impactor system. The control group received saline; the EPO group received EPO; the group EPO+FK 506 received EPO associated with tacrolimus and the group FK 506 received tacrolimus only. The Sham group underwent SCI, but did not receive any drug. Locomotor function was evaluated after SCI by BBB (Basso, Beattie and Bresnahan) weekly and by the motor-evoked potential test in 42 days. The spinal cord was histologically evaluated. Results: There was a significant difference between treated and the control groups from the seventh day on for BBB scores, with no difference between the groups EPO and EPO+FK 506 by the end of the study. There were significant differences between groups for necrosis and bleeding, but not for hiperemia, degeneration and cellular infiltrate. Axon neuron count was different between all groups (P=0.001), between EPO+FK 506 and FK 506 (P=0.011) and between EPO+FK 506 and Sham (P=0.002). Amplitude was significantly different between all groups except between control and sham. For latency, there was no difference. Conclusions: This study did not reveal significant differences in the recovery of locomotor function, or in the histological and electrophysiological analysis in animals treated with EPO and tacrolimus after thoracic SCI. PMID:26481712

Statistical methods for the quality control of steam cured concrete : final report.

DOT National Transportation Integrated Search

1971-01-01

Concrete strength test results from three prestressing plants utilizing steam curing were evaluated statistically in terms of the concrete as received and the effectiveness of the plants' steaming procedures. Control charts were prepared to show tren...

Conditions That Facilitate Music Learning among Students with Special Needs: A Mixed-Methods Inquiry

ERIC Educational Resources Information Center

Gerrity, Kevin W.; Hourigan, Ryan M.; Horton, Patrick W.

2013-01-01

The purpose of this mixed-methods study was to identify and define the conditions that facilitate learning in music among students with special needs. Children with special needs met once a week for 10 consecutive weeks and received instruction in primarily music as well as the other arts. The children completed pre- and posttest evaluations that…

Evaluation of methods for attaching PIT tags and biotelemetry devices to freshwater mussels

USGS Publications Warehouse

Young, S.P.; Isely, J.J.

2008-01-01

We evaluated methods to attach PIT tags and transmitters to freshwater mussels. Mussels received externally-mounted PIT tags using cyanoacrylate or underwater epoxy, and a sub-group of those with PIT tags attached using cyanoacrylate also received dummy transmitters. Tag retention and survival were 100% after a 30 day laboratory observation period for each method. During the subsequent 18 months of field observation, underwater epoxy and cyanoacrylate proved to be adequate adhesives for attaching PIT tags and transmitters. Epoxy performed best with 100% PIT tag retention. Cyanoacrylate also provided high retention rates of PIT tags and transmitters, >90%. Mortality was minimal at 4.7% for all relocated mussels over 18 months. All mortalities were those tagged with cyanoacrylate. Three of the mortalities occurred among mussels fitted with dummy transmitters, and seven among PIT tags only. Percent recapture of the different tag/adhesive combinations ranged from 48 - 77.5% during 6- and 18-month surveys. Results suggest both adhesives provide a reliable method for external attachment of tags during freshwater mussel research; however, epoxy may be better suited because of slightly higher tag retention and reduced emersion times during attachment. Copyright ?? 2008 Malacological Society of Australasia.

SU-E-T-36: An Investigation of the Margin From CTV to PTV Using Retraction Method for Cervical Carcinoma

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

Wu, D; Chen, J; Hao, Y

Purpose: This work employs the retraction method to compute and evaluate the margin from CTV to PTV based on the influence of target dosimetry of setup errors during cervical carcinoma patients treatment. Methods: Sixteen patients with cervical cancer were treated by Elekta synergy and received a total of 305 KV-CBCT images. The iso-center of the initial plans were changed according to the setup errors to simulate radiotherapy and then recalculated the dose distribution using leaf sequences and MUs for individual plans. The margin from CTV to PTV will be concluded both by the method of retracting (Fixed the PTV ofmore » the original plan, and retract PTV a certain distance defined as simulative organization CTVnx. The minimum distance value from PTV to CTVnx which get specified doses, namely guarantee at least 99% CTV volume can receive the dose of 95%, is the margin CTV to PTV we found) and the former formula method. Results: (1)The setup errors of 16 patients in X, Y and Z directions were(1.13±2.94) mm,(−1.63±7.13) mm,(−0.65±2.25) mm. (2) The distance between CTVx and PTV was 5, 9 and 3mm in X, Y and Z directions According to 2.5+0.7σ. (3) Transplantation plans displayed 99% of CTVx10- CTVx7 and received 95% of prescription dose, but CTVx6- CTVx3 departed from standard of clinic.In order to protect normal tissues, we selected 7mm as the minimum value of the margin from CTV to PTV. Conclusion: We have test an retraction method for the margin from CTV to PTV evaluation. The retraction method is more reliable than the formula method for calculating the margin from the CTV to the PTV, because it represented practice of treatment, and increasing a new method in this field.« less

Advantages of the net benefit regression framework for economic evaluations of interventions in the workplace: a case study of the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders.

PubMed

Hoch, Jeffrey S; Dewa, Carolyn S

2014-04-01

Economic evaluations commonly accompany trials of new treatments or interventions; however, regression methods and their corresponding advantages for the analysis of cost-effectiveness data are not well known. To illustrate regression-based economic evaluation, we present a case study investigating the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders. We implement net benefit regression to illustrate its strengths and limitations. Net benefit regression offers a simple option for cost-effectiveness analyses of person-level data. By placing economic evaluation in a regression framework, regression-based techniques can facilitate the analysis and provide simple solutions to commonly encountered challenges. Economic evaluations of person-level data (eg, from a clinical trial) should use net benefit regression to facilitate analysis and enhance results.

Going One-to-One in Urban Schools: An Evaluation of the XO Champions Initiative in Project LIFT Elementary Schools

ERIC Educational Resources Information Center

Beaver, Jessica K.; Englander, Katie; Leow, Christine; Barnes, Marvin

2015-01-01

Beginning in spring 2013, students in seven elementary schools throughout the Project LIFT zone in Charlotte, North Carolina began to receive XO laptops provided by the organization One Laptop Per Child (OLPC) for use both within their classroom and at home. This report details Research for Action's (RFA) mixed-method evaluation of the first year…

Affordability Tradeoffs Under Uncertainty Using Epoch-Era Analysis

DTIC Science & Technology

2013-09-30

Procedia Computer Science , Retrieved from: http://www.elsevier.com Bobinis, J., Haimowitz, J., Tuttle, P., & Garrison, C. (2012, October). Affordability...commercial products. Dr. Rhodes received her PhD in Systems Science from the T.J. Watson School of Engineering at Binghamton University. She serves on...components, evaluate feedback, and be adaptive to evolving system behaviors . As affordability is a concept evaluated over time, such a method can

A Randomized Intervention Study to Evaluate Whether Electronic Messaging Can Increase Human Papillomavirus Vaccine Completion and Knowledge among College Students

ERIC Educational Resources Information Center

Richman, Alice R.; Maddy, LaDonna; Torres, Essie; Goldberg, Ellen J.

2016-01-01

Objective: To evaluate an intervention aimed at increasing human papillomavirus (HPV) vaccine completion of the 3-dose series and knowledge. Participants: Two hundred sixty-four male and female US college students 18-26 years old who were receiving HPV vaccine dose 1. Methods: Students were randomly assigned to the intervention or control group.…

A pilot study evaluating alternative approaches of academic detailing in rural family practice clinics

PubMed Central

2012-01-01

Background Academic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting. Methods We conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN). Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction. Results Each clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered. Conclusions We found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural family practice settings. PMID:23276303

The calculation of average error probability in a digital fibre optical communication system

NASA Astrophysics Data System (ADS)

Rugemalira, R. A. M.

1980-03-01

This paper deals with the problem of determining the average error probability in a digital fibre optical communication system, in the presence of message dependent inhomogeneous non-stationary shot noise, additive Gaussian noise and intersymbol interference. A zero-forcing equalization receiver filter is considered. Three techniques for error rate evaluation are compared. The Chernoff bound and the Gram-Charlier series expansion methods are compared to the characteristic function technique. The latter predicts a higher receiver sensitivity

Method for automatically evaluating a transition from a batch manufacturing technique to a lean manufacturing technique

DOEpatents

Ivezic, Nenad; Potok, Thomas E.

2003-09-30

A method for automatically evaluating a manufacturing technique comprises the steps of: receiving from a user manufacturing process step parameters characterizing a manufacturing process; accepting from the user a selection for an analysis of a particular lean manufacturing technique; automatically compiling process step data for each process step in the manufacturing process; automatically calculating process metrics from a summation of the compiled process step data for each process step; and, presenting the automatically calculated process metrics to the user. A method for evaluating a transition from a batch manufacturing technique to a lean manufacturing technique can comprise the steps of: collecting manufacturing process step characterization parameters; selecting a lean manufacturing technique for analysis; communicating the selected lean manufacturing technique and the manufacturing process step characterization parameters to an automatic manufacturing technique evaluation engine having a mathematical model for generating manufacturing technique evaluation data; and, using the lean manufacturing technique evaluation data to determine whether to transition from an existing manufacturing technique to the selected lean manufacturing technique.

Multi-Laboratory Validation of Estrone (E1) ELISA Methods

EPA Science Inventory

This project is a round-robin evaluation of commercially available Enzyme-Linked Immunosorbent Assay (ELISA) technology to quantitatively or qualitatively measure the hormone estrone (E1) in combined animal feeding operation (CAFO) receiving streams. ELISA is meant to be a simpl...

Evaluation of Three Instructional Methods for Teaching General Chemistry.

ERIC Educational Resources Information Center

Jackman, Lance E.; And Others

1987-01-01

Reports on a study designed to determine the relative effectiveness of different instructional approaches on chemistry laboratory achievement. Investigated differences in achievement in spectrophotometry among college freshmen who received either traditional, learning cycle, or computer simulation instruction. Results indicated that students…

Travel behavior of blind individuals before and after receiving orientation and mobility training.

DOT National Transportation Integrated Search

2016-09-08

In this pilot study, we devised, tested, and refined a protocol for evaluating the travel behavior of blind individuals. Preliminary analyses of our pilot study data suggest that our new method involving Global Positioning Systems (GPS), acceleromete...

Health trainer-led motivational intervention plus usual care for people under community supervision compared with usual care alone: a study protocol for a parallel-group pilot randomised controlled trial (STRENGTHEN)

PubMed Central

Thompson, Tom P; Callaghan, Lynne; Hazeldine, Emma; Quinn, Cath; Walker, Samantha; Byng, Richard; Wallace, Gary; Creanor, Siobhan; Green, Colin; Hawton, Annie; Annison, Jill; Sinclair, Julia; Senior, Jane; Taylor, Adrian H

2018-01-01

Introduction People with experience of the criminal justice system typically have worse physical and mental health, lower levels of mental well-being and have less healthy lifestyles than the general population. Health trainers have worked with offenders in the community to provide support for lifestyle change, enhance mental well-being and signpost to appropriate services. There has been no rigorous evaluation of the effectiveness and cost-effectiveness of providing such community support. This study aims to determine the feasibility and acceptability of conducting a randomised trial and delivering a health trainer intervention to people receiving community supervision in the UK. Methods and analysis A multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1:1 individual allocation to receive support from a health trainer and usual care or usual care alone, with mixed methods process evaluation. Participants receive community supervision from an offender manager in either a Community Rehabilitation Company or the National Probation Service. If they have served a custodial sentence, then they have to have been released for at least 2 months. The supervision period must have at least 7 months left at recruitment. Participants are interested in receiving support to change diet, physical activity, alcohol use and smoking and/or improve mental well-being. The primary outcome is mental well-being with secondary outcomes related to smoking, physical activity, alcohol consumption and diet. The primary outcome will inform sample size calculations for a definitive trial. Ethics and dissemination The study has been approved by the Health and Care Research Wales Ethics Committee (REC reference 16/WA/0171). Dissemination will include publication of the intervention development process and findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals. Results will also be disseminated to stakeholders and trial participants. Trial registration numbers ISRCTN80475744; Pre-results. PMID:29866736

Floating Ultrasonic Transducer Inspection System and Method for Nondestructive Evaluation

NASA Technical Reports Server (NTRS)

Johnston, Patrick H. (Inventor); Zalameda, Joseph N. (Inventor)

2016-01-01

A method for inspecting a structural sample using ultrasonic energy includes positioning an ultrasonic transducer adjacent to a surface of the sample, and then transmitting ultrasonic energy into the sample. Force pulses are applied to the transducer concurrently with transmission of the ultrasonic energy. A host machine processes ultrasonic return pulses from an ultrasonic pulser/receiver to quantify attenuation of the ultrasonic energy within the sample. The host machine detects a defect in the sample using the quantified level of attenuation. The method may include positioning a dry couplant between an ultrasonic transducer and the surface. A system includes an actuator, an ultrasonic transducer, a dry couplant between the transducer the sample, a scanning device that moves the actuator and transducer, and a measurement system having a pulsed actuator power supply, an ultrasonic pulser/receiver, and a host machine that executes the above method.

Integrated Methods for Pupils To Reinforce Occupational and Verbal Effectiveness (Project IMPROVE). Final Evaluation Report, 1992-93. OREA Report.

ERIC Educational Resources Information Center

Guadalupe, Deana R.

Integrated Methods for Pupils to Reinforce Occupational and Vocational Effectiveness (Project IMPROVE) was a federally funded project in its second year of operation in two Manhattan (New York) high schools in 1992-93. It served limited-English-proficient students, 186 Latino and 13 Asian-American, in grades 9-12. Students received instruction in…

Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States.

PubMed

Fraser, John J; Glaviano, Neal R; Hertel, Jay

2017-02-01

Study Design Retrospective observational study. Background Plantar fasciitis is responsible for 1 million ambulatory patient care visits annually in the United States. Few studies have investigated practice patterns in the treatment of patients with plantar fasciitis. Objective To assess physical therapist utilization and employment of manual therapy and supervised rehabilitation in the treatment of patients with plantar fasciitis. Methods A retrospective review of the PearlDiver patient record database was used to evaluate physical therapist utilization and use of manual therapy and supervised rehabilitation in patients with plantar fasciitis between 2007 and 2011. An International Classification of Diseases code (728.71) was used to identify plantar fasciitis, and Current Procedural Terminology codes were used to identify evaluations (97001), manual therapy (97140), and rehabilitation services (97110, 97530, 97112). Results A total of 819 963 unique patients diagnosed with plantar fasciitis accounted for 5 739 737 visits from 2007 to 2011, comprising 2.7% of all patients in the database. Only 7.1% (95% confidence interval: 7.0%, 7.1%) of patients received a physical therapist evaluation. Of the 57 800 patients evaluated by a physical therapist (59.8% female), 50 382 (87.2% ± 0.4%) received manual therapy, with significant increases in utilization per annum. A large proportion (89.5% ± 0.4%) received rehabilitation following physical therapist evaluation. Conclusion Despite plantar fasciitis being a frequently occurring musculoskeletal condition, a small proportion of patients with plantar fasciitis were seen by physical therapists. Most patients who were evaluated by a physical therapist received manual therapy and a course of supervised rehabilitation as part of their plan of care. Level of Evidence Treatment, level 2a. J Orthop Sports Phys Ther 2017;47(2):49-55. doi:10.2519/jospt.2017.6999.

A simple method to obtain low density marrow cells for human marrow transplantation.

PubMed

de Witte, T; Plas, A; Vet, J; Koekman, E; Preyers, F; Wessels, J

1987-01-01

Removal of more than 99% of the erythrocytes and 74% of the nucleated cells from marrow grafts was achieved by density floatation separation in Percoll gradients with a density of 1.070 g/ml in eight 250-ml tubes, containing up to 3 X 10(9) nucleated cells per gradient. More than 90% of the myeloid and erythroid progenitor cells were recovered in the low density fraction. It appeared mandatory to use a centrifuge with the possibility of a gradual acceleration and deceleration. Twenty-five patients received a marrow graft from a histocompatible sibling after additional lymphocyte depletion by counterflow centrifugation, and 5 patients with T lymphoblastic malignancies received an autograft after in vitro purging with immunotoxins. All evaluable patients engrafted within normal limits, except 1 patient with an autoimmune pancytopenia who responded to steroids and 1 patient with a CMV infection. Four patients died too early for complete evaluation. The described separation method is easy, cheap and requires only 2 h for the complete processing of a marrow graft.

Evaluating College Students' Evaluations of a Professor's Teaching Effectiveness across Time and Instruction Mode (Online vs. Face-to-Face) Using a Multilevel Growth Modeling Approach

ERIC Educational Resources Information Center

Carle, Adam C.

2009-01-01

Aims: Do college students' ratings of a professor's teaching effectiveness suggest that a professor's teaching improves with time? Does anything predict which instructors receive the highest ratings or improve the fastest? And, importantly, do the correlates of change differ across face-to-face and online courses? Methods: I used data from 10,392…

A better way to evaluate remote monitoring programs in chronic disease care: receiver operating characteristic analysis.

PubMed

Brown Connolly, Nancy E

2014-12-01

This foundational study applies the process of receiver operating characteristic (ROC) analysis to evaluate utility and predictive value of a disease management (DM) model that uses RM devices for chronic obstructive pulmonary disease (COPD). The literature identifies a need for a more rigorous method to validate and quantify evidence-based value for remote monitoring (RM) systems being used to monitor persons with a chronic disease. ROC analysis is an engineering approach widely applied in medical testing, but that has not been evaluated for its utility in RM. Classifiers (saturated peripheral oxygen [SPO2], blood pressure [BP], and pulse), optimum threshold, and predictive accuracy are evaluated based on patient outcomes. Parametric and nonparametric methods were used. Event-based patient outcomes included inpatient hospitalization, accident and emergency, and home health visits. Statistical analysis tools included Microsoft (Redmond, WA) Excel(®) and MedCalc(®) (MedCalc Software, Ostend, Belgium) version 12 © 1993-2013 to generate ROC curves and statistics. Persons with COPD were monitored a minimum of 183 days, with at least one inpatient hospitalization within 12 months prior to monitoring. Retrospective, de-identified patient data from a United Kingdom National Health System COPD program were used. Datasets included biometric readings, alerts, and resource utilization. SPO2 was identified as a predictive classifier, with an optimal average threshold setting of 85-86%. BP and pulse were failed classifiers, and areas of design were identified that may improve utility and predictive capacity. Cost avoidance methodology was developed. RESULTS can be applied to health services planning decisions. Methods can be applied to system design and evaluation based on patient outcomes. This study validated the use of ROC in RM program evaluation.

Intraoperative Computed Tomography (CT) for Treating Giant Carotid Intracavernous Aneurysms

PubMed Central

Xue, Zhe; Wang, Fuyu; Sun, Zhenghui; Zhang, Hui; Wu, Chen; Kong, Dongsheng; Xu, Bainan

2017-01-01

Background Giant carotid intracavernous aneurysm refers to those lesions larger than 2.5 cm and derived from a cavernous segment, accounting for about 30% of all intracranial tumors. Dynamic CT perfusion imaging (PCT) is a common method recently employed to evaluate cerebral perfusion. This study investigated the efficacy and clinical application of intraoperative CT in the surgery for giant symptomatic carotid intracavernous aneurysm. Material/Methods A retrospective analysis was performed on 23 cases with giant symptomatic carotid intracavernous aneurysm. BTO testing was performed before surgery. Differential treatments were performed based on the condition of aneurysm, and some patients received intraoperative PCT. Postoperative anti-coagulation was given with DSA or CTA follow-up examinations at 3–6 months, 1 year, and 2 years after surgery. Results A total of 17 patients received aneurysm isolation coupled with high-flow bypass surgery. Among those, 9 developed early-onset neurological function after surgery, with gradual recover within 6 months. One coma patient died 25 months after discharge. One patient had aneurysm isolation with clapping of anterior communicating artery, and the other 5 cases received artery clapping only. In those patients, 4 had improvement at early phase, while 1 patient had numbness of the oculomotor nerve. Six patients received surgery in the CT room, including 5 cases with single proximal ligation of the internal carotid artery plus 1 aneurysm isolation combined with high-flow bypass surgery. Conclusions Intraoperative PCT can provide objective evidence and effective evaluation of cerebral perfusion. PMID:28640793

Evaluation and optimization of the optical performance of low-concentrating dielectric compound parabolic concentrator using ray-tracing methods.

PubMed

Sarmah, Nabin; Richards, Bryce S; Mallick, Tapas K

2011-07-01

We present a detailed design concept and optical performance evaluation of stationary dielectric asymmetric compound parabolic concentrators (DiACPCs) using ray-tracing methods. Three DiACPC designs, DiACPC-55, DiACPC-66, and DiACPC-77, of acceptance half-angles (0° and 55°), (0° and 66°), and (0° and 77°), respectively, are designed in order to optimize the concentrator for building façade photovoltaic applications in northern latitudes (>55 °N). The dielectric concentrator profiles have been realized via truncation of the complete compound parabolic concentrator profiles to achieve a geometric concentration ratio of 2.82. Ray-tracing simulation results show that all rays entering the designed concentrators within the acceptance half-angle range can be collected without escaping from the parabolic sides and aperture. The maximum optical efficiency of the designed concentrators is found to be 83%, which tends to decrease with the increase in incidence angle. The intensity is found to be distributed at the receiver (solar cell) area in an inhomogeneous pattern for a wide range of incident angles of direct solar irradiance with high-intensity peaks at certain points of the receiver. However, peaks become more intense for the irradiation incident close to the extreme acceptance angles, shifting the peaks to the edge of the receiver. Energy flux distribution at the receiver for diffuse radiation is found to be homogeneous within ±12% with an average intensity of 520 W/m².

Non-destructive evaluation method employing dielectric electrostatic ultrasonic transducers

NASA Technical Reports Server (NTRS)

Yost, William T. (Inventor); Cantrell, Jr., John H. (Inventor)

2003-01-01

An acoustic nonlinearity parameter (.beta.) measurement method and system for Non-Destructive Evaluation (NDE) of materials and structural members novelly employs a loosely mounted dielectric electrostatic ultrasonic transducer (DEUT) to receive and convert ultrasonic energy into an electrical signal which can be analyzed to determine the .beta. of the test material. The dielectric material is ferroelectric with a high dielectric constant .di-elect cons.. A computer-controlled measurement system coupled to the DEUT contains an excitation signal generator section and a measurement and analysis section. As a result, the DEUT measures the absolute particle displacement amplitudes in test material, leading to derivation of the nonlinearity parameter (.beta.) without the costly, low field reliability methods of the prior art.

The average receiver operating characteristic curve in multireader multicase imaging studies

PubMed Central

Samuelson, F W

2014-01-01

Objective: In multireader, multicase (MRMC) receiver operating characteristic (ROC) studies for evaluating medical imaging systems, the area under the ROC curve (AUC) is often used as a summary metric. Owing to the limitations of AUC, plotting the average ROC curve to accompany the rigorous statistical inference on AUC is recommended. The objective of this article is to investigate methods for generating the average ROC curve from ROC curves of individual readers. Methods: We present both a non-parametric method and a parametric method for averaging ROC curves that produce a ROC curve, the area under which is equal to the average AUC of individual readers (a property we call area preserving). We use hypothetical examples, simulated data and a real-world imaging data set to illustrate these methods and their properties. Results: We show that our proposed methods are area preserving. We also show that the method of averaging the ROC parameters, either the conventional bi-normal parameters (a, b) or the proper bi-normal parameters (c, da), is generally not area preserving and may produce a ROC curve that is intuitively not an average of multiple curves. Conclusion: Our proposed methods are useful for making plots of average ROC curves in MRMC studies as a companion to the rigorous statistical inference on the AUC end point. The software implementing these methods is freely available from the authors. Advances in knowledge: Methods for generating the average ROC curve in MRMC ROC studies are formally investigated. The area-preserving criterion we defined is useful to evaluate such methods. PMID:24884728

Surgical modalities in gunshot wounds of the face.

PubMed

Firat, Cemal; Geyik, Yilmaz

2013-07-01

Maxillofacial traumas caused by gunshot wounds may cause quite varied defects. The objective of this study was to evaluate the reconstruction methods in 12 patients with gunshot wound-related mandibular and maxillofacial bony and soft tissue defects. Twelve patients who were operated on for maxillofacial gunshot wounds at our clinic between 2002 and 2012 were included in the study. Seven patients were wounded in a suicide attempt, and 5 were wounded as a result of an accident or in assaults. Two patients underwent reconstruction using free fibula osteocutaneous flap, 4 patients received the free radial forearm osteocutaneous flap, 2 patients received costal bone graft, and 3 patients received iliac bone grafts. Satisfactory functional and aesthetic outcomes were achieved in cases where staged secondary reconstruction, balloon treatment, and consecutive fat and steroid injections into the depressed scar areas were applied. In conclusion, the basic goal in maxillofacial reconstruction is the functional and aesthetic reconstruction of the contours. Because it is not easy to get perfect results with only 1 clinical approach or 1 method, the proper timing and reconstruction method should be selected.

Precise timing correlation in telemetry recording and processing systems

NASA Technical Reports Server (NTRS)

Pickett, R. B.; Matthews, F. L.

1973-01-01

Independent PCM telemetry data signals received from missiles must be correlated to within + or - 100 microseconds for comparison with radar data. Tests have been conducted to determine RF antenna receiving system delays; delays associated with wideband analog tape recorders used in the recording, dubbing and repdocuing processes; and uncertainties associated with computer processed time tag data. Several methods used in the recording of timing are evaluated. Through the application of a special time tagging technique, the cumulative timing bias from all sources is determined and the bias removed from final data. Conclusions show that relative time differences in receiving, recording, playback and processing of two telemetry links can be accomplished with a + or - 4 microseconds accuracy. In addition, the absolute time tag error (with respect to UTC) can be reduced to less than 15 microseconds. This investigation is believed to be the first attempt to identify the individual error contributions within the telemetry system and to describe the methods of error reduction within the telemetry system and to describe the methods of error reduction and correction.

Real-Time Point Positioning Performance Evaluation of Single-Frequency Receivers Using NASA's Global Differential GPS System

NASA Technical Reports Server (NTRS)

Muellerschoen, Ronald J.; Iijima, Byron; Meyer, Robert; Bar-Sever, Yoaz; Accad, Elie

2004-01-01

This paper evaluates the performance of a single-frequency receiver using the 1-Hz differential corrections as provided by NASA's global differential GPS system. While the dual-frequency user has the ability to eliminate the ionosphere error by taking a linear combination of observables, the single-frequency user must remove or calibrate this error by other means. To remove the ionosphere error we take advantage of the fact that the magnitude of the group delay in range observable and the carrier phase advance have the same magnitude but are opposite in sign. A way to calibrate this error is to use a real-time database of grid points computed by JPL's RTI (Real-Time Ionosphere) software. In both cases we evaluate the positional accuracy of a kinematic carrier phase based point positioning method on a global extent.

In vitro evaluation of an alternative method to bond molar tubes

PubMed Central

PINZAN-VERCELINO, Célia Regina Maio; PINZAN, Arnaldo; GURGEL, Júlio de Araújo; BRAMANTE, Fausto Silva; PINZAN, Luciana Maio

2011-01-01

Despite the advances in bonding materials, many clinicians today still prefer to place bands on molar teeth. Molar bonding procedures need improvement to be widely accepted clinically. Objective The purpose of this study was to evaluate the shear bond strength when an additional adhesive layer was applied on the occlusal tooth/tube interface to provide reinforcement to molar tubes. Material and methods Sixty third molars were selected and allocated to the 3 groups: group 1 received a conventional direct bond followed by the application of an additional layer of adhesive on the occlusal tooth/tube interface, group 2 received a conventional direct bond, and group 3 received a conventional direct bond and an additional cure time of 10 s. The specimens were debonded in a universal testing machine. The results were analyzed statistically by ANOVA and Tukey’s test (α=0.05). Results Group 1 had a significantly higher (p<0.05) shear bond strength compared to groups 2 and 3. No difference was detected between groups 2 and 3 (p>0.05). Conclusions The present in vitro findings indicate that the application of an additional layer of adhesive on the tooth/tube interface increased the shear bond strength of the bonded molar tubes. PMID:21437468

Coupled optical/thermal/fluid analysis and design requirements for operation and testing of a supercritical CO 2 solar receiver.

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

Khivsara, Sagar

Recent studies have evaluated closed-loop supercritical carbon dioxide (s-CO 2) Brayton cycles to be a higher energy-density system in comparison to conventional superheated steam Rankine systems. At turbine inlet conditions of 923K and 25 MPa, high thermal efficiency (~50%) can be achieved. Achieving these high efficiencies will make concentrating solar power (CSP) technologies a competitive alternative to current power generation methods. To incorporate a s-CO 2 Brayton power cycle in a solar power tower system, the development of a solar receiver capable of providing an outlet temperature of 923 K (at 25 MPa) is necessary. To satisfy the temperature requirementsmore » of a s-CO 2 Brayton cycle with recuperation and recompression, it is required to heat s-CO 2 by a temperature of ~200 K as it passes through the solar receiver. Our objective was to develop an optical-thermal-fluid model to design and evaluate a tubular receiver that will receive a heat input ~1 MWth from a heliostat field. We also undertook the documentation of design requirements for the development, testing and safe operation of a direct s-CO 2 solar receiver. The main purpose of this document is to serve as a reference and guideline for design and testing requirements, as well as to address the technical challenges and provide initial parameters for the computational models that will be employed for the development of s-CO 2 receivers.« less

Evaluation of a group based cognitive behavioural therapy programme for menstrual pain management in young women with intellectual disabilities: protocol for a mixed methods controlled clinical trial

PubMed Central

2014-01-01

Background Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities. The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. Methods/Design The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12 – 30 years who have a Mild - Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. Discussion Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. Trial registration Current Controlled Trials ISRCTN75567759 PMID:25201648

Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures

PubMed Central

Colla, Carrie H.; Carmichael, Donald; Tosteson, Anna N. A.; Tosteson, Tor D.; Bell, John-Erik; Cantu, Robert V.; Lurie, Jonathan D.; Bynum, Julie P. W.

2017-01-01

Abstract Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods: Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna (“wrist”) fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007–2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. Results: There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Limitations: Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. Conclusions: A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. PMID:28340130

Developing, implementing and evaluating an end of life care intervention.

PubMed

Cox, Anna; Arber, Anne; Bailey, Fiona; Dargan, Sue; Gannon, Craig; Lisk, Radcliffe; Quinn, Barry; Samarasinghe, Jane; Wrigley, Martha; Gallagher, Ann

2017-01-31

Aim To develop, implement and evaluate a collaborative intervention in care homes seeking to increase the confidence and competence of staff in end of life care and enable more people to receive end of life care in their usual place of residence. Method A two-phase exploratory mixed methods design was used, evaluating the effect of an end of life care toolkit and associated training in care homes, facilitated by a specialist palliative care team. Six care homes in England were recruited to the intervention; 24 staff participated in discussion groups; 54 staff attended at least one training session; and pre- and post-intervention questionnaires were completed by 78 and 103 staff respectively. Results Staff confidence in receiving emotional and clinical support and managing end of life care symptoms increased post-intervention, but confidence in discussing death and dying with residents and relatives decreased. Audit data indicate greater reduction in the number of residents from participating care homes dying in hospital than those from comparison homes. Conclusion Collaborative end of life care interventions support care home staff to manage end of life and may enable residents to have choice about their place of death.

A History and Evaluation of Parent Education

ERIC Educational Resources Information Center

Croake, James W.; Glover, Kenneth E.

1977-01-01

This paper traces the history of parent education, the purposive learning activity of parents attempting to change methods of interaction with their children. Parent education will almost certainly receive increasing attention and emphasis within a variety of programs especially in the fields of education and mental health. (Author)

Teaching Introductory Chemistry with Videocassette Presentations.

ERIC Educational Resources Information Center

Enger, John; And Others

Reported here is the development and evaluation of an extensive series of video-cassette presentations developed for introductory chemical education. In measures of course achievement, students instructed by the video-cassette-discussion format received higher average scores than those taught by live lecture methods. A survey showed that the…

Neuroprotective Treatment of Laser-Induced Retinal Injuries

DTIC Science & Technology

2000-10-01

to evaluate the neuroprotective effect of memantine in our rat model of laser-induced retinal-lesions. Methods: Argon laser retinal lesions were...inflicted in the eyes of 36 pigmented rats. The treated group received memantine 10 mg/kg dissolved in saline, immediately after exposure to laser and then

Modeling convection-diffusion-reaction systems for microfluidic molecular communications with surface-based receivers in Internet of Bio-Nano Things

PubMed Central

Akan, Ozgur B.

2018-01-01

We consider a microfluidic molecular communication (MC) system, where the concentration-encoded molecular messages are transported via fluid flow-induced convection and diffusion, and detected by a surface-based MC receiver with ligand receptors placed at the bottom of the microfluidic channel. The overall system is a convection-diffusion-reaction system that can only be solved by numerical methods, e.g., finite element analysis (FEA). However, analytical models are key for the information and communication technology (ICT), as they enable an optimisation framework to develop advanced communication techniques, such as optimum detection methods and reliable transmission schemes. In this direction, we develop an analytical model to approximate the expected time course of bound receptor concentration, i.e., the received signal used to decode the transmitted messages. The model obviates the need for computationally expensive numerical methods by capturing the nonlinearities caused by laminar flow resulting in parabolic velocity profile, and finite number of ligand receptors leading to receiver saturation. The model also captures the effects of reactive surface depletion layer resulting from the mass transport limitations and moving reaction boundary originated from the passage of finite-duration molecular concentration pulse over the receiver surface. Based on the proposed model, we derive closed form analytical expressions that approximate the received pulse width, pulse delay and pulse amplitude, which can be used to optimize the system from an ICT perspective. We evaluate the accuracy of the proposed model by comparing model-based analytical results to the numerical results obtained by solving the exact system model with COMSOL Multiphysics. PMID:29415019

Modeling convection-diffusion-reaction systems for microfluidic molecular communications with surface-based receivers in Internet of Bio-Nano Things.

PubMed

Kuscu, Murat; Akan, Ozgur B

2018-01-01

We consider a microfluidic molecular communication (MC) system, where the concentration-encoded molecular messages are transported via fluid flow-induced convection and diffusion, and detected by a surface-based MC receiver with ligand receptors placed at the bottom of the microfluidic channel. The overall system is a convection-diffusion-reaction system that can only be solved by numerical methods, e.g., finite element analysis (FEA). However, analytical models are key for the information and communication technology (ICT), as they enable an optimisation framework to develop advanced communication techniques, such as optimum detection methods and reliable transmission schemes. In this direction, we develop an analytical model to approximate the expected time course of bound receptor concentration, i.e., the received signal used to decode the transmitted messages. The model obviates the need for computationally expensive numerical methods by capturing the nonlinearities caused by laminar flow resulting in parabolic velocity profile, and finite number of ligand receptors leading to receiver saturation. The model also captures the effects of reactive surface depletion layer resulting from the mass transport limitations and moving reaction boundary originated from the passage of finite-duration molecular concentration pulse over the receiver surface. Based on the proposed model, we derive closed form analytical expressions that approximate the received pulse width, pulse delay and pulse amplitude, which can be used to optimize the system from an ICT perspective. We evaluate the accuracy of the proposed model by comparing model-based analytical results to the numerical results obtained by solving the exact system model with COMSOL Multiphysics.

Prophylactic role of coenzyme Q10 and Cynara scolymus L on doxorubicin-induced toxicity in rats: Biochemical and immunohistochemical study

PubMed Central

Mustafa, Hesham N.; El Awdan, Sally A.; Hegazy, Gehan A.; Abdel Jaleel, Gehad A.

2015-01-01

Objective: The study aims to evaluate the protective effects of coenzyme Q10 (CoQ10) and Cynara scolymus L (CS) on doxorubicin (dox)-induced toxicity. Materials and Methods: Sixty male rats were divided into six groups. Group 1 as a control. Group 2 received dox (10 mg/kg) intraperitoneally. Group 3 received CoQ10 (200 mg/kg). Group 4 received CS (500 mg/kg). Group 5 received CoQ10 (200 mg/kg) and dox (10 mg/kg). Group 6 received CS (500 mg/kg) and dox (10 mg/kg). The rats were then evaluated biochemically and immunohistochemically. Results: Dox produced a significant deterioration of hepatic and renal functional parameters. Moreover, an upsurge of oxidative stress and nitrosative stress markers. The expression of alpha-smooth muscle actin (α-SMA) was increased and proliferating cell nuclear antigen (PCNA) expression was decreased. Administration of CoQ10 and CS resulted in a significant improvement of hepatic and renal functional parameters, and an improvement of both α-SMA and PCNA. Conclusion: It is concluded that pretreatment with CoQ10 and CS is associated with up-regulation of favorable protective enzymes and down-regulation of oxidative stress. That can be advised as a supplement to dox-treated patients. PMID:26729958

Testing and optical modeling of novel concentrating solar receiver geometries to increase light trapping and effective solar absorptance

NASA Astrophysics Data System (ADS)

Yellowhair, Julius; Ho, Clifford K.; Ortega, Jesus D.; Christian, Joshua M.; Andraka, Charles E.

2015-09-01

Concentrating solar power receivers are comprised of panels of tubes arranged in a cylindrical or cubical shape on top of a tower. The tubes contain heat-transfer fluid that absorbs energy from the concentrated sunlight incident on the tubes. To increase the solar absorptance, black paint or a solar selective coating is applied to the surface of the tubes. However, these coatings degrade over time and must be reapplied, which reduces the system performance and increases costs. This paper presents an evaluation of novel receiver shapes and geometries that create a light-trapping effect, thereby increasing the effective solar absorptance and efficiency of the solar receiver. Several prototype shapes were fabricated from Inconel 718 and tested in Sandia's solar furnace at an irradiance of ~30 W/cm2. Photographic methods were used to capture the irradiance distribution on the receiver surfaces. The irradiance profiles were compared to results from raytracing models. The effective solar absorptance was also evaluated using the ray-tracing models. Results showed that relative to a flat plate, the new geometries could increase the effective solar absorptance from 86% to 92% for an intrinsic material absorptance of 86%, and from 60% to 73% for an intrinsic material absorptance of 60%.

Evaluating the appropriateness of antimicrobial treatment in hospitalized patients: a comparison of three methods.

PubMed

Reisfeld, S; Assaly, M; Tannous, E; Amarney, K; Stein, M

2018-06-01

Approximately 20-50% of antimicrobial therapy in hospitalized patients is considered inappropriate, which may be associated with increased morbidity and mortality. The best method for evaluation of appropriateness is not well defined. To evaluate the rate of appropriate antimicrobial therapy in a secondary hospital using three different methods, and determine the rate of agreement between the different methods. A point prevalence study included all adult hospitalized patients receiving systemic antimicrobial therapy during 2016, screened on a single day. Clinical, laboratory and therapeutic data were collected from patient files, and appropriateness was rated with a qualitative evaluation by expert opinion. In addition, a quantitative evaluation was performed according to 11 quality indicators (QIs) rated for each patient. A strict definition of appropriateness was fulfilled if six essential QIs were met, and a lenient definition was fulfilled if at least five QIs were met. Agreement between methods was analysed using kappa statistic. Among 106 patients included, rates of appropriateness of antimicrobial therapy ranged from 20% to 75%, depending on the method of evaluation. Very low agreement was found between the strict definition and expert opinion (kappa=0.068), and medium agreement was found between the lenient definition and expert opinion (kappa=0.45). Rates of appropriateness of antimicrobial therapy varied between evaluation methods, with low to moderate agreement between the different methods. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

An approach for land suitability evaluation using geostatistics, remote sensing, and geographic information system in arid and semiarid ecosystems.

PubMed

Emadi, Mostafa; Baghernejad, Majid; Pakparvar, Mojtaba; Kowsar, Sayyed Ahang

2010-05-01

This study was undertaken to incorporate geostatistics, remote sensing, and geographic information system (GIS) technologies to improve the qualitative land suitability assessment in arid and semiarid ecosystems of Arsanjan plain, southern Iran. The primary data were obtained from 85 soil samples collected from tree depths (0-30, 30-60, and 60-90 cm); the secondary information was acquired from the remotely sensed data from the linear imaging self-scanner (LISS-III) receiver of the IRS-P6 satellite. Ordinary kriging and simple kriging with varying local means (SKVLM) methods were used to identify the spatial dependency of soil important parameters. It was observed that using the data collected from the spectral values of band 1 of the LISS-III receiver as the secondary variable applying the SKVLM method resulted in the lowest mean square error for mapping the pH and electrical conductivity (ECe) in the 0-30-cm depth. On the other hand, the ordinary kriging method resulted in a reliable accuracy for the other soil properties with moderate to strong spatial dependency in the study area for interpolation in the unstamped points. The parametric land suitability evaluation method was applied on the density points (150 x 150 m(2)) instead of applying on the limited representative profiles conventionally, which were obtained by the kriging or SKVLM methods. Overlaying the information layers of the data was used with the GIS for preparing the final land suitability evaluation. Therefore, changes in land characteristics could be identified in the same soil uniform mapping units over a very short distance. In general, this new method can easily present the squares and limitation factors of the different land suitability classes with considerable accuracy in arbitrary land indices.

Scheduled Peripheral Component Interconnect Arbiter

NASA Technical Reports Server (NTRS)

Nixon, Scott Alan (Inventor)

2015-01-01

Systems and methods are described for arbitrating access of a communication bus. In one embodiment, a method includes performing steps on one or more processors. The steps include: receiving an access request from a device of the communication bus; evaluating a bus schedule to determine an importance of the device based on the access request; and selectively granting access of the communication bus to the device based on the importance of the device.

Method and Apparatus for Evaluating Multilayer Objects for Imperfections

NASA Technical Reports Server (NTRS)

Heyman, Joseph S. (Inventor); Abedin, Nurul (Inventor); Sun, Kuen J. (Inventor)

1999-01-01

A multilayer object having multiple layers arranged in a stacking direction is evaluated for imperfections such as voids, delaminations and microcracks. First. an acoustic wave is transmitted into the object in the stacking direction via an appropriate transducer/waveguide combination. The wave propagates through the multilayer object and is received by another transducer/waveguide combination preferably located on the same surface as the transmitting combination. The received acoustic wave is correlated with the presence or absence of imperfections by, e.g., generating pulse echo signals indicative of the received acoustic wave. wherein the successive signals form distinct groups over time. The respective peak amplitudes of each group are sampled and curve fit to an exponential curve. wherein a substantial fit of approximately 80-90% indicates an absence of imperfections and a significant deviation indicates the presence of imperfections. Alternatively, the time interval between distinct groups can be measured. wherein equal intervals indicate the absence of imperfections and unequal intervals indicate the presence of imperfections.

Method and apparatus for evaluating multilayer objects for imperfections

NASA Technical Reports Server (NTRS)

Heyman, Joseph S. (Inventor); Abedin, Nurul (Inventor); Sun, Kuen J. (Inventor)

1997-01-01

A multilayer object having multiple layers arranged in a stacking direction is evaluated for imperfections such as voids, delaminations and microcracks. First, an acoustic wave is transmitted into the object in the stacking direction via an appropriate transducer/waveguide combination. The wave propagates through the multilayer object and is received by another transducer/waveguide combination preferably located on the same surface as the transmitting combination. The received acoustic wave is correlated with the presence or absence of imperfections by, e.g., generating pulse echo signals indicative of the received acoustic wave, wherein the successive signals form distinct groups over time. The respective peak amplitudes of each group are sampled and curve fit to an exponential curve, wherein a substantial fit of approximately 80-90% indicates an absence of imperfections and a significant deviation indicates the presence of imperfections. Alternatively, the time interval between distinct groups can be measured, wherein equal intervals indicate the absence of imperfections and unequal intervals indicate the presence of imperfections.

Process evaluation of a randomised controlled trial of a diabetes prevention intervention in Dutch primary health care: the SLIMMER study.

PubMed

van Dongen, Ellen Ji; Duijzer, Geerke; Jansen, Sophia C; Ter Beek, Josien; Huijg, Johanna M; Leerlooijer, Joanne N; Hiddink, Gerrit J; Feskens, Edith Jm; Haveman-Nies, Annemien

2016-11-01

To investigate (i) how the SLIMMER intervention was delivered and received in Dutch primary health care and (ii) how this could explain intervention effectiveness. A randomised controlled trial was conducted and subjects were randomly allocated to the intervention (10-month combined dietary and physical activity intervention) or the control group. A process evaluation including quantitative and qualitative methods was conducted. Data on process indicators (recruitment, reach, dose received, acceptability, implementation integrity and applicability) were collected via semi-structured interviews with health-care professionals (n 45) and intervention participant questionnaires (n 155). SLIMMER was implemented in Dutch primary health care in twenty-five general practices, eleven dietitians, nine physiotherapist practices and fifteen sports clubs. Subjects at increased risk of developing type 2 diabetes were included. It was possible to recruit the intended high-risk population (response rate 54 %) and the SLIMMER intervention was very well received by both participants and health-care professionals (mean acceptability rating of 82 and 80, respectively). The intervention programme was to a large extent implemented as planned and was applicable in Dutch primary health care. Higher dose received and participant acceptability were related to improved health outcomes and dietary behaviour, but not to physical activity behaviour. The present study showed that it is feasible to implement a diabetes prevention intervention in Dutch primary health care. Higher dose received and participant acceptability were associated with improved health outcomes and dietary behaviour. Using an extensive process evaluation plan to gain insight into how an intervention is delivered and received is a valuable way of identifying intervention components that contribute to implementation integrity and effective prevention of type 2 diabetes in primary health care.

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

Lin, M; Saboury, B

Purpose: Selective-internal-radiation-therapy (SIRT) and transarterial-chemoembolization (TACE) are commonly used for treatment of liver tumors. The use of TACE, which is macroembolic, prior to SIRT may cause hemodynamic changes in tumor vasculature that impair yttrium-90 (90Y) microsphere delivery to the targeted lesions. This work aims to quantify dosimetric tumor coverage using 90Y positron emission tomography (PET) dosimetry after SIRT alone compared to TACE followed by SIRT. Methods: A total of 40 consecutive hepatocellular carcinoma (HCC) SIRT patients who had a post-SIRT 90Y PET/CT scan were evaluated. The patient-specific-3D-dose was reconstructed from the PET images. Patients were categorized into two groups: patientsmore » received TACE prior SIRT procedure (n=18) and patient received SIRT alone (n=22). The lesions and liver were delineated by a senior radiologist. We evaluated both the lesion-specific dose-volume-histogram (DVH) and the selectivity index (SI) defined as the ratio of the average dose inside the total lesion(s) and the average dose of the normal liver. The SI values of patients were compared based on whether TACE was previously used. Results: A wide spectrum was observed in the lesion-specific DVH-evaluation and SI appeared to be suitable of evaluating the quality of each SIRT infusion. The average SI of the entire patient group was 3.0, i.e. targeted lesion receiving three times higher dose than normal liver. The average SI was 1.8 for patients who had prior TACE and 3.9 for patients who did not have prior TACE (p=0.008). 85% of the patients with prior TACE demonstrated poor 90Y-microsphere delivery (SI <2) while none demonstrated excellent delivery (SI >4). On the other hand, the incidence SI >4 among patients with no prior TACE was 37%. Conclusion: 3D dose evaluation using post-SIRT PET suggests that 90Y microsphere delivery to liver tumors is impaired among patients who received prior TACE compared to those who receive SIRT alone.« less

Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature

PubMed Central

Bot, S; Terwee, C; van der Windt, D A W M; Bouter, L; Dekker, J; de Vet, H C W

2004-01-01

Methods: Systematic literature searches were performed to identify self administered shoulder disability questionnaires. A checklist was developed to evaluate and compare the clinimetric quality of the instruments. Results: Two reviewers identified and evaluated 16 questionnaires by our checklist. Most studies were found for the Disability of the Arm, Shoulder, and Hand scale (DASH), the Shoulder Pain and Disability Index (SPADI), and the American Shoulder and Elbow Surgeons Standardised Shoulder Assessment Form (ASES). None of the questionnaires demonstrated satisfactory results for all properties. Most questionnaires claim to measure several domains (for example, pain, physical, emotional, and social functioning), yet dimensionality was studied in only three instruments. The internal consistency was calculated for seven questionnaires and only one received an adequate rating. Twelve questionnaires received positive ratings for construct validity, although depending on the population studied, four of these questionnaires received poor ratings too. Seven questionnaires were shown to have adequate test-retest reliability (ICC >0.70), but five questionnaires were tested inadequately. In most clinimetric studies only small sample sizes (n<43) were used. Nearly all publications lacked information on the interpretation of scores. Conclusion: The DASH, SPADI, and ASES have been studied most extensively, and yet even published validation studies of these instruments have limitations in study design, sample sizes, or evidence for dimensionality. Overall, the DASH received the best ratings for its clinimetric properties. PMID:15020324

Automation of Military Civil Engineering and Site Design Functions: Software Evaluation

DTIC Science & Technology

1989-09-01

promising advantage over manual methods, USACERL is to evaluate available software to determine which, if any, is best suited to the type of civil...moved. Therefore, original surface data were assembled by scaling the northing and easting distances of field elevations and entering them manually into...in the software or requesting an update or addition to the software or manuals . Responses to forms submitted during the test were received at

Outcomes of cancer therapy administered to treatment-naïve lung cancer patients in the intensive care unit

PubMed Central

Chen, Yen-Fu; Lin, Jou-Wei; Ho, Chao-Chi; Yang, Ching-Yao; Chang, Chia-Hao; Huang, Tao-Min; Chen, Chung-Yu; Chen, Kuan-Yu; Shih, Jin-Yuan; Yu, Chong-Jen

2017-01-01

Objectives: Therapy outcomes for newly diagnosed, critically ill lung cancer patients have seldom been evaluated. This study evaluated therapy outcomes for treatment-naïve lung cancer patients in the intensive care unit (ICU). Materials and Methods: Patients were excluded if they had previously received lung cancer treatment, such as systemic chemotherapy, targeted therapy, radiotherapy, or surgical lung resection before ICU admission. The therapeutic strategies for the treatment-naïve patients were determined while they were in the ICU. The patients' demographic data, clinical outcomes, and treatment-related toxicities were analyzed. Results: Newly diagnosed lung cancer patients (n = 72) who did not receive any anticancer treatment before ICU admission were included. Most patients had locally advanced disease, and 61 (84.7%) required intensive care due to cancer-related events. In the ICU, 24 (33.3%) patients received chemotherapy, 24 (33.3%) received epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy and 24 (33.3%) received best supportive care (BSC). Patients receiving chemotherapy or EGFR-TKIs in the ICU demonstrated better ICU (p = 0.011) and in-hospital (p = 0.034) survival than those receiving BSC only. Among patients requiring mechanical ventilation, those receiving chemotherapy had higher weaning rates than those receiving EGFR-TKIs or BSC (p = 0.002). In multivariate analysis, receipt of chemotherapy (hazard ratio [HR], 0.443; p = 0.083) and mechanical ventilation (HR, 0.270; p = 0.022) were significantly associated with longer ICU survival after adjusting for clinical factors. Conclusions: Anticancer therapy in the ICU might provide better short-term ICU survival for treatment-naïve, critically ill lung cancer patients. PMID:28819399

Outcomes of cancer therapy administered to treatment-naïve lung cancer patients in the intensive care unit.

PubMed

Chen, Yen-Fu; Lin, Jou-Wei; Ho, Chao-Chi; Yang, Ching-Yao; Chang, Chia-Hao; Huang, Tao-Min; Chen, Chung-Yu; Chen, Kuan-Yu; Shih, Jin-Yuan; Yu, Chong-Jen

2017-01-01

Objectives: Therapy outcomes for newly diagnosed, critically ill lung cancer patients have seldom been evaluated. This study evaluated therapy outcomes for treatment-naïve lung cancer patients in the intensive care unit (ICU). Materials and Methods: Patients were excluded if they had previously received lung cancer treatment, such as systemic chemotherapy, targeted therapy, radiotherapy, or surgical lung resection before ICU admission. The therapeutic strategies for the treatment-naïve patients were determined while they were in the ICU. The patients' demographic data, clinical outcomes, and treatment-related toxicities were analyzed. Results: Newly diagnosed lung cancer patients (n = 72) who did not receive any anticancer treatment before ICU admission were included. Most patients had locally advanced disease, and 61 (84.7%) required intensive care due to cancer-related events. In the ICU, 24 (33.3%) patients received chemotherapy, 24 (33.3%) received epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy and 24 (33.3%) received best supportive care (BSC). Patients receiving chemotherapy or EGFR-TKIs in the ICU demonstrated better ICU (p = 0.011) and in-hospital (p = 0.034) survival than those receiving BSC only. Among patients requiring mechanical ventilation, those receiving chemotherapy had higher weaning rates than those receiving EGFR-TKIs or BSC (p = 0.002). In multivariate analysis, receipt of chemotherapy (hazard ratio [HR], 0.443; p = 0.083) and mechanical ventilation (HR, 0.270; p = 0.022) were significantly associated with longer ICU survival after adjusting for clinical factors. Conclusions: Anticancer therapy in the ICU might provide better short-term ICU survival for treatment-naïve, critically ill lung cancer patients.

[Delivery of twins by Cesarean section with the Misgav Ladach method].

PubMed

Oleszczuk, J; Leszczyńska-Gorzelak, B; Michalak, B; Pietras, G

2000-11-01

Between September 1998 and July 1999, 34 patients with twin pregnancy (79.1%) underwent cesarean section with Misgav Ladach method in the Department of Obstetrics and Perinatology of the Medical Academy in Lublin. The aim of this study was to evaluate safety and other advantages of the Misgav Ladach method. Body temperature, usage of antibiotics, analgesics, hematinics, and postoperative complications were evaluated in the postoperative course. No postoperative complications were noted at 32 patients (94.1%). 67.6% of patients did not receive antibiotics. Stitches were removed on the fourth p.o. day at 70.6% of patients. This study highlights the safety of the Misgav Ladach method, and points out some advantages like reduction of postoperative pain, speeded recovery, and no indication for transfusion.

Performance prediction evaluation of ceramic materials in point-focusing solar receivers

NASA Technical Reports Server (NTRS)

Ewing, J.; Zwissler, J.

1979-01-01

A performance prediction was adapted to evaluate the use of ceramic materials in solar receivers for point focusing distributed applications. System requirements were determined including the receiver operating environment and system operating parameters for various engine types. Preliminary receiver designs were evolved from these system requirements. Specific receiver designs were then evaluated to determine material functional requirements.

Design and evaluation of a high temperature/pressure supercritical carbon dioxide direct tubular receiver for concentrating solar power applications

NASA Astrophysics Data System (ADS)

Ortega, Jesus Daniel

This work focuses on the development of a solar power thermal receiver for a supercritical-carbon dioxide (sCO2), Brayton power-cycle to produce ~1 MWe. Closed-loop sCO2 Brayton cycles are being evaluated in combination with concentrating solar power to provide higher thermal-to-electric conversion efficiencies relative to conventional steam Rankine cycles. High temperatures (923--973 K) and pressures (20--25 MPa) are required in the solar receiver to achieve thermal efficiencies of ~50%, making concentrating solar power (CSP) technologies a competitive alternative to current power generation methods. In this study, the CSP receiver is required to achieve an outlet temperature of 923 K at 25 MPa or 973 K at 20 MPa to meet the operating needs. To obtain compatible receiver tube material, an extensive material review was performed based the ASME Boiler and Pressure Vessel Code, ASME B31.1 and ASME B313.3 codes respectively. Subsequently, a thermal-structural model was developed using a commercial computational fluid (CFD) dynamics and structural mechanics software for designing and analyzing the tubular receiver that could provide the heat input for a ~2 MWth plant. These results were used to perform an analytical cumulative damage creep-fatigue analysis to estimate the work-life of the tubes. In sequence, an optical-thermal-fluid model was developed to evaluate the resulting thermal efficiency of the tubular receiver from the NSTTF heliostat field. The ray-tracing tool SolTrace was used to obtain the heat-flux distribution on the surfaces of the receiver. The K-ω SST turbulence model and P-1 radiation model used in Fluent were coupled with SolTrace to provide the heat flux distribution on the receiver surface. The creep-fatigue analysis displays the damage accumulated due to the cycling and the permanent deformation of the tubes. Nonetheless, they are able to support the required lifetime. The receiver surface temperatures were found to be within the safe operational limit while exhibiting a receiver thermal efficiency of ~85%. Future work includes the completion of a cyclic loading analysis to be performed using the Larson-Miller creep model in nCode Design Life to corroborate the structural integrity of the receiver over the desired lifetime of ~10,000 cycles.

Green Tea Catechin Consumption Enhances Exercise-Induced Abdominal Fat Loss

USDA-ARS?s Scientific Manuscript database

Aim: This study evaluated the influence of a green tea catechin beverage on body composition and fat distribution in overweight and obese adults during exercised-induced weight loss. Methods: Participants (N=132) were randomly assigned to receive a 500 mL beverage containing approximately 625 mg of...

A Field Study Program in Analytical Chemistry for College Seniors.

ERIC Educational Resources Information Center

Langhus, D. L.; Flinchbaugh, D. A.

1986-01-01

Describes an elective field study program at Moravian College (Pennsylvania) in which seniors in analytical chemistry obtain first-hand experience at Bethlehem Steel Corporation. Discusses the program's planning phase, some method development projects done by students, experiences received in laboratory operations, and the evaluation of student…

Quantifying Evaporation and Evaluating Runoff Estimation Methods in a Permeable Pavement System

EPA Science Inventory

The U.S. Environmental Protection Agency constructed a 0.4-ha parking lot in Edison, New Jersey, that incorporated permeable pavement in the parking lanes which were designed to receive run-on from the impervious hot-mix asphalt driving lanes. Twelve lined permeable pavement sec...

Evaluation of a Social Marketing Campaign Targeting Preschool Children

ERIC Educational Resources Information Center

Johnson, Susan L.; Bellows, Laura; Beckstrom, Leslie; Anderson, Jennifer

2007-01-01

Objectives: To determine the effectiveness of a pilot social marketing program to increase preschoolers' willingness to try new foods. Methods: Four Head Start centers participated (2 experimental, 2 control) in a study using a quasi-experimental design. Experimental sites received a 12-week intervention developed using social marketing…

Parental Attributions for Success in Managing the Behavior of Children with ADHD

ERIC Educational Resources Information Center

Coles, Erika K.; Pelham, William E.; Gnagy, Elizabeth M.

2010-01-01

Objective: The current study evaluated the effects of differing intensities of behavior modification and medication on parents' self-reported success in managing their child's misbehavior and the attributions parents gave for success or failure. Method: Children were randomized to receive in counterbalanced orders different levels of behavior…

Parents with Intellectual Disabilities Experiencing Challenging Child Routines: A Pilot Study Using Embedded Self-Determination Practices

ERIC Educational Resources Information Center

Knowles, Christen; Blakely, Allison; Hansen, Sarah; Machalicek, Wendy

2017-01-01

Background: Practices to facilitate self-determination have not received appropriate attention in research concerning parents with intellectual disabilities (ID). Likewise, parenting interventions for adults with intellectual disabilities have seldom observed both parent and child behavioural outcomes. Methods: This study evaluated the…

48 CFR 715.303-70 - Responsibilities of USAID evaluation committees.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INTERNATIONAL DEVELOPMENT CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 715..., a representative of the contracting office (who shall be a non-voting member of the committee), and... contracting officer will receive all proposals and provide to the chair a listing and copies of the technical...

Dietary Habits Prone to Lifestyle-Related Disease

ERIC Educational Resources Information Center

Nagai, M.; Uyama, O.; Kaji, H.

2013-01-01

Objective: To evaluate relations among dietary habits, bone mineral density (BMD), visceral fat area (VFA), and arterial stiffness and recommend better dietary habits. Methods: One hundred and six men and 381 women (aged 18-84) received a health checkup and answered questionnaires, with subsequent measurements of BMD (speed of sound), VFA…

Dosimetric Evaluation of Intensity Modulated Radiotherapy and 4-Field 3-D Conformal Radiotherapy in Prostate Cancer Treatment

PubMed Central

Uysal, Bora; Beyzadeoğlu, Murat; Sager, Ömer; Dinçoğlan, Ferrat; Demiral, Selçuk; Gamsız, Hakan; Sürenkök, Serdar; Oysul, Kaan

2013-01-01

Objective: The purpose of this dosimetric study is the targeted dose homogeneity and critical organ dose comparison of 7-field Intensity Modulated Radiotherapy (IMRT) and 3-D 4-field conformal radiotherapy. Study Design: Cross sectional study. Material and Methods: Twenty patients with low and moderate risk prostate cancer treated at Gülhane Military Medical School Radiation Oncology Department between January 2009 and December 2009 are included in this study. Two seperate dosimetric plans both for 7-field IMRT and 3D-CRT have been generated for each patient to comparatively evaluate the dosimetric status of both techniques and all the patients received 7-field IMRT. Results: Dose-comparative evaluation of two techniques revealed the superiority of IMRT technique with statistically significantly lower femoral head doses along with reduced critical organ dose-volume parameters of bladder V60 (the volume receiving 60 Gy) and rectal V40 (the volume receiving 40 Gy) and V60. Conclusion: It can be concluded that IMRT is an effective definitive management tool for prostate cancer with improved critical organ sparing and excellent dose homogenization in target organs of prostate and seminal vesicles. PMID:25207069

Comparison of GPS and GLONASS common-view time transfers

NASA Technical Reports Server (NTRS)

Lewandowski, W.; Petit, G.; Thomas, C.; Cherenkov, G. T.; Koshelyaevsky, N. B.; Pushkin, S. B.

1993-01-01

It was already shown than even with a simple daily averaging of GLONASS data at each site, continental GLONASS time transfer can be achieved at a level of several tens of nanoseconds. A further step is to carry out observations of GLONASS satellites by the common-view method. A comparison of GPS and GLONASS common-view time transfers between Russia and Western Europe are reported. At each site, a GPS receiver and a GLONASS receiver are connected to the same atomic clock. Both GPS receivers are of NBS type and the GLONASS receivers are of type A-724. As GPS common-view time transfer between Sevres and Mendeleevo is accomplished at a level of a few nanoseconds in precision, it gives an excellent reference with which to evaluate the performance of GLONASS common-view time transfer.

Detection of buried targets using a new enhanced very early time electromagnetic (VETEM) prototype system

USGS Publications Warehouse

Cui, T.J.; Chew, W.C.; Aydiner, A.A.; Wright, D.L.; Smith, D.V.

2001-01-01

In this paper, numerical simulations of a new enhanced very early time electromagnetic (VETEM) prototype system are presented, where a horizontal transmitting loop and two horizontal receiving loops are used to detect buried targets, in which three loops share the same axis and the transmitter is located at the center of receivers. In the new VETEM system, the difference of signals from two receivers is taken to eliminate strong direct-signals from the transmitter and background clutter and furthermore to obtain a better SNR for buried targets. Because strong coupling exists between the transmitter and receivers, accurate analysis of the three-loop antenna system is required, for which a loop-tree basis function method has been utilized to overcome the low-frequency breakdown problem. In the analysis of scattering problem from buried targets, a conjugate gradient (CG) method with fast Fourier transform (FFT) is applied to solve the electric field integral equation. However, the convergence of such CG-FFT algorithm is extremely slow at very low frequencies. In order to increase the convergence rate, a frequency-hopping approach has been used. Finally, the primary, coupling, reflected, and scattered magnetic fields are evaluated at receiving loops to calculate the output electric current. Numerous simulation results are given to interpret the new VETEM system. Comparing with other single-transmitter-receiver systems, the new VETEM has better SNR and ability to reduce the clutter.

Evaluation of the validity of treatment decisions based on surrogate country models before introduction of the Polish FRAX and recommendations in comparison to current practice

PubMed Central

Narloch, Jerzy; Glinkowska, Bożena; Bandura, Małgorzata

2016-01-01

Introduction Patients diagnosed before the Polish FRAX was introduced may require re-evaluation and treatment changes if the diagnosis was established according to a surrogate country FRAX score. The aim of the study was to evaluate the validity of treatment decisions based on the surrogate country model before introduction of the Polish FRAX and to provide recommendations based on the current practice. Material and methods We evaluated a group of 142 postmenopausal women (70.7 ±8.9 years) who underwent bone mineral density measurements. We used 22 country-specific FRAX models and compared these to the Polish model. Results The mean risk values for hip and major osteoporotic fractures within 10 years were 4.575 (from 0.82 to 8.46) and 12.47% (from 2.18 to 21.65), respectively. In the case of a major fracture, 94.4% of women would receive lifestyle advice, and 5.6% would receive treatment according to the Polish FRAX using the guidelines of the National Osteoporosis Foundation (NOF). Polish treatment thresholds would implement pharmacotherapy in 32.4% of the study group. In the case of hip fractures, 45% of women according to the NOF would require pharmacotherapy but only 9.8% of women would qualify according to Polish guidelines. Nearly all surrogate FRAX calculator scores proved significantly different form Polish (p > 0.05). Conclusions More patients might have received antiresorptive medication before the Polish FRAX. This study recommends re-evaluation of patients who received medical therapy before the Polish FRAX was introduced and a review of the recommendations, considering the side effects of antiresorptive medication. PMID:29593808

Dipyrone has no effects on bone healing of tibial fractures in rats

PubMed Central

Gali, Julio Cesar; Sansanovicz, Dennis; Ventin, Fernando Carvalho; Paes, Rodrigo Henrique; Quevedo, Francisco Carlos; Caetano, Edie Benedito

2014-01-01

OBJECTIVE: To evaluate the effect of dipyrone on healing of tibial fractures in rats. METHODS: Fourty-two Wistar rats were used, with mean body weight of 280g. After being anesthetized, they were submitted to closed fracture of the tibia and fibula of the right posterior paw through manual force. The rats were randomly divided into three groups: the control group that received a daily intraperitoneal injection of saline solution; group D-40, that received saline injection containing 40mg/Kg dipyrone; and group D-80, that received saline injection containing 80mg/Kg dipyrone. After 28 days the rats were sacrificed and received a new label code that was known by only one researcher. The fractured limbs were then amputated and X-rayed. The tibias were disarticulated and subjected to mechanical, radiological and histological evaluation. For statistical analysis the Kruskal-Wallis test was used at a significance level of 5%. RESULTS: There wasn't any type of dipyrone effect on healing of rats tibial fractures in relation to the control group. CONCLUSION: Dipyrone may be used safely for pain control in the treatment of fractures, without any interference on bone healing. Level of Evidence II, Controlled Laboratory Study. PMID:25246852

Efficacy of Trimetazidine Dihydrochloride for Relieving Chronic Tinnitus: A Randomized Double-Blind Study

PubMed Central

Kumral, Tolgar Lütfi; Yıldırım, Güven; Berkiten, Güler; Saltürk, Ziya; Ataç, Enes; Atar, Yavuz; Uyar, Yavuz

2016-01-01

Objectives. To evaluate the efficacy of trimetazidine dihydrochloride as a treatment for chronic tinnitus. Methods. A total of 97 chronic tinnitus patients were evaluated in this randomized, prospective, double-blind, placebo-controlled trial. After assessing for eligibility, 82 patients were randomly assigned into placebo or trimetazidine groups according to the medication. The trimetazidine group received 20×3 mg/day per oral trimetazidine dihydrochloride and the placebo group received 20×3 mg/day per oral placebo for 3 months. Tinnitus handicap inventory (THI), visual analogue scale (VAS) questionnaires and audiometric results were used to determine the effectiveness of trimetazidine treatment. Results. The study group comprised 82 tinnitus subjects, 42 (51%) of whom received trimetazidine dihydrochloride and 40 (49%) who received placebo. There was no significant difference between placebo and trimetazidine groups in THI grade and VAS (both pre- and posttreatment scores) (P>0.05) and no significant improvement was observed in subjective loudness score in either group (P>0.05). Additionally there was no significant difference between groups in pre- and posttreatment pure tone hearing thresholds at all measured frequencies (P>0.05). Conclusion. Trimetazidine dihydrochloride therapy was ineffective for relieving chronic tinnitus. PMID:27230273

Evaluation of the Risk of Grade 3 Oral and Pharyngeal Dysphagia Using Atlas-Based Method and Multivariate Analyses of Individual Patient Dose Distributions

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

Otter, Sophie; Schick, Ulrike; Gulliford, Sarah

Purpose: The study aimed to apply the atlas of complication incidence (ACI) method to patients receiving radical treatment for head and neck squamous cell carcinomas (HNSCC), to generate constraints based on dose-volume histograms (DVHs), and to identify clinical and dosimetric parameters that predict the risk of grade 3 oral mucositis (g3OM) and pharyngeal dysphagia (g3PD). Methods and Materials: Oral and pharyngeal mucosal DVHs were generated for 253 patients who received radiation (RT) or chemoradiation (CRT). They were used to produce ACI for g3OM and g3PD. Multivariate analysis (MVA) of the effect of dosimetry, clinical, and patient-related variables was performed usingmore » logistic regression and bootstrapping. Receiver operating curve (ROC) analysis was also performed, and the Youden index was used to find volume constraints that discriminated between volumes that predicted for toxicity. Results: We derived statistically significant dose-volume constraints for g3OM over the range v28 to v70. Only 3 statistically significant constraints were derived for g3PD v67, v68, and v69. On MVA, mean dose to the oral mucosa predicted for g3OM and concomitant chemotherapy and mean dose to the inferior constrictor (IC) predicted for g3PD. Conclusions: We have used the ACI method to evaluate incidences of g3OM and g3PD and ROC analysis to generate constraints to predict g3OM and g3PD derived from entire individual patient DVHs. On MVA, the strongest predictors were radiation dose (for g3OM) and concomitant chemotherapy (for g3PD).« less

Simulations using patient data to evaluate systematic errors that may occur in 4D treatment planning: a proof of concept study.

PubMed

St James, Sara; Seco, Joao; Mishra, Pankaj; Lewis, John H

2013-09-01

The purpose of this work is to present a framework to evaluate the accuracy of four-dimensional treatment planning in external beam radiation therapy using measured patient data and digital phantoms. To accomplish this, 4D digital phantoms of two model patients were created using measured patient lung tumor positions. These phantoms were used to simulate a four-dimensional computed tomography image set, which in turn was used to create a 4D Monte Carlo (4DMC) treatment plan. The 4DMC plan was evaluated by simulating the delivery of the treatment plan over approximately 5 min of tumor motion measured from the same patient on a different day. Unique phantoms accounting for the patient position (tumor position and thorax position) at 2 s intervals were used to represent the model patients on the day of treatment delivery and the delivered dose to the tumor was determined using Monte Carlo simulations. For Patient 1, the tumor was adequately covered with 95.2% of the tumor receiving the prescribed dose. For Patient 2, the tumor was not adequately covered and only 74.3% of the tumor received the prescribed dose. This study presents a framework to evaluate 4D treatment planning methods and demonstrates a potential limitation of 4D treatment planning methods. When systematic errors are present, including when the imaging study used for treatment planning does not represent all potential tumor locations during therapy, the treatment planning methods may not adequately predict the dose to the tumor. This is the first example of a simulation study based on patient tumor trajectories where systematic errors that occur due to an inaccurate estimate of tumor motion are evaluated.

Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico

PubMed Central

2012-01-01

Background Several low and middle-income countries are implementing electronic health records (EHR). In the near future, EHRs could become an efficient tool to evaluate healthcare performance if appropriate indicators are developed. The aims of this study are: a) to develop quality of care indicators (QCIs) for type 2 diabetes (T2DM) in the Mexican Institute of Social Security (IMSS) health system; b) to determine the feasibility of constructing QCIs using the IMSS EHR data; and c) to evaluate the quality of care (QC) provided to IMSS patients with T2DM. Methods We used a three-stage mixed methods approach: a) development of QCIs following the RAND-UCLA method; b) EHR data extraction and construction of indicators; c) QC evaluation using EHR data from 25,130 T2DM patients who received care in 2009. Results We developed 18 QCIs, of which 14 were possible to construct using available EHR data. QCIs comprised both process of care and health outcomes. Several flaws in the EHR design and quality of data were identified. The indicators of process and outcomes of care suggested areas for improvement. For example, only 13.0% of patients were referred to an ophthalmologist; 3.9% received nutritional counseling; 63.2% of overweight/obese patients were prescribed metformin, and only 23% had HbA1c <7% (or plasma glucose ≤130 mg/dl). Conclusions EHR data can be used to evaluate QC. The results identified both strengths and weaknesses in the electronic information system as well as in the process and outcomes of T2DM care at IMSS. This information can be used to guide targeted interventions to improve QC. PMID:22672471

Optimum quantum receiver for detecting weak signals in PAM communication systems

NASA Astrophysics Data System (ADS)

Sharma, Navneet; Rawat, Tarun Kumar; Parthasarathy, Harish; Gautam, Kumar

2017-09-01

This paper deals with the modeling of an optimum quantum receiver for pulse amplitude modulator (PAM) communication systems. The information bearing sequence {I_k}_{k=0}^{N-1} is estimated using the maximum likelihood (ML) method. The ML method is based on quantum mechanical measurements of an observable X in the Hilbert space of the quantum system at discrete times, when the Hamiltonian of the system is perturbed by an operator obtained by modulating a potential V with a PAM signal derived from the information bearing sequence {I_k}_{k=0}^{N-1}. The measurement process at each time instant causes collapse of the system state to an observable eigenstate. All probabilities of getting different outcomes from an observable are calculated using the perturbed evolution operator combined with the collapse postulate. For given probability densities, calculation of the mean square error evaluates the performance of the receiver. Finally, we present an example involving estimating an information bearing sequence that modulates a quantum electromagnetic field incident on a quantum harmonic oscillator.

PAPR reduction and receiver sensitivity improvement in 16QAM-OFDM RoF system using DMT modulation and BTN-PS technique

NASA Astrophysics Data System (ADS)

Shao, Yufeng

2016-03-01

In this letter, we present the generation, the peak-to average power ratio (PAPR) reduction, the heterodyne detection, the self-mixing reception, and the transmission performance evaluation of 16QAM-OFDM signals in 60 GHz radio over fiber (RoF) system using Discrete multitone (DMT) modulation and Better Than Nyquist pulse shaping (BTN-PS) technique. DMT modulation is introduced in the RoF system, in-phase and quadrature (IQ) will not be required using BTN-PS method, and the computation complexity is much lower than other published techniques for reduced PAPR in the RoF system. In the experiment, 5 Gb/s 16QAM-OFDM downlink signals are transmitted over 42 km SMF-28 and a 0.4 m wireless channel. The experimental results show that the receiver sensitivity is effectively enhanced using this method. Therefore, the introduced BTN-PS technique and its application is a competitive scheme for reducing PAPR, and enhancing the receiver sensitivity in future RoF system.

Sensitivity to imputation models and assumptions in receiver operating characteristic analysis with incomplete data

PubMed Central

Karakaya, Jale; Karabulut, Erdem; Yucel, Recai M.

2015-01-01

Modern statistical methods using incomplete data have been increasingly applied in a wide variety of substantive problems. Similarly, receiver operating characteristic (ROC) analysis, a method used in evaluating diagnostic tests or biomarkers in medical research, has also been increasingly popular problem in both its development and application. While missing-data methods have been applied in ROC analysis, the impact of model mis-specification and/or assumptions (e.g. missing at random) underlying the missing data has not been thoroughly studied. In this work, we study the performance of multiple imputation (MI) inference in ROC analysis. Particularly, we investigate parametric and non-parametric techniques for MI inference under common missingness mechanisms. Depending on the coherency of the imputation model with the underlying data generation mechanism, our results show that MI generally leads to well-calibrated inferences under ignorable missingness mechanisms. PMID:26379316

The effectiveness of a training method using self-modeling webcam photos for reducing musculoskeletal risk among office workers using computers.

PubMed

Taieb-Maimon, Meirav; Cwikel, Julie; Shapira, Bracha; Orenstein, Ido

2012-03-01

An intervention study was conducted to examine the effectiveness of an innovative self-modeling photo-training method for reducing musculoskeletal risk among office workers using computers. Sixty workers were randomly assigned to either: 1) a control group; 2) an office training group that received personal, ergonomic training and workstation adjustments or 3) a photo-training group that received both office training and an automatic frequent-feedback system that displayed on the computer screen a photo of the worker's current sitting posture together with the correct posture photo taken earlier during office training. Musculoskeletal risk was evaluated using the Rapid Upper Limb Assessment (RULA) method before, during and after the six weeks intervention. Both training methods provided effective short-term posture improvement; however, sustained improvement was only attained with the photo-training method. Both interventions had a greater effect on older workers and on workers suffering more musculoskeletal pain. The photo-training method had a greater positive effect on women than on men. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

A comparison of 2 methods of endoscopic laryngeal sensory testing: a preliminary study.

PubMed

Kaneoka, Asako; Krisciunas, Gintas P; Walsh, Kayo; Raade, Adele S; Langmore, Susan E

2015-03-01

This study examined the association between laryngeal sensory deficits and penetration or aspiration. Two methods of testing laryngeal sensation were carried out to determine which was more highly correlated with Penetration-Aspiration Scale (PAS) scores. Healthy participants and patients with dysphagia received an endoscopic swallowing evaluation including 2 sequential laryngeal sensory tests-air pulse followed by touch method. Normal/impaired responses were correlated with PAS scores. Fourteen participants completed the endoscopic swallowing evaluation and both sensory tests. The air pulse method identified sensory impairment with greater frequency than the touch method (P<.0001). However, the impairment identified by the air pulse method was not associated with abnormal PAS scores (P=.46). The sensory deficits identified by the touch method were associated with abnormal PAS scores (P=.05). Sensory impairment detected by the air pulse method does not appear to be associated with risk of penetration/aspiration. Significant laryngeal sensory loss revealed by the touch method is associated with compromised airway protection. © The Author(s) 2014.

Comparison of postinfusion phlebitis in intravenous push versus intravenous piggyback cefazolin.

PubMed

Biggar, Constance; Nichols, Cynthia

2012-01-01

Reducing health care costs without adversely affecting patient safety is a constant challenge for health care institutions. Cefazolin prophylaxis via intravenous push (IVP) is more cost-effective than via intravenous piggyback (IVPB). The purpose of this study was to determine whether patient safety would be compromised (ie, an increased rate of phlebitis) with a change to the IVP method. Rates of phlebitis in orthopedic surgical patients receiving cefazolin prophylaxis via IVP versus IVPB were evaluated in a prospective quasi-experimental design of 240 patients. The first 120 subjects received cefazolin via IVPB, and the second 120 subjects received it via IVP. Results indicated no statistically significant difference in phlebitis rates in the IVPB (3.4%) versus the IVP groups (3.3%).

Evaluating care from a care ethical perspective:: A pilot study.

PubMed

Kuis, Esther E; Goossensen, Anne

2017-08-01

Care ethical theories provide an excellent opening for evaluation of healthcare practices since searching for (moments of) good care from a moral perspective is central to care ethics. However, a fruitful way to translate care ethical insights into measurable criteria and how to measure these criteria has as yet been unexplored: this study describes one of the first attempts. To investigate whether the emotional touchpoint method is suitable for evaluating care from a care ethical perspective. An adapted version of the emotional touchpoint interview method was used. Touchpoints represent the key moments to the experience of receiving care, where the patient recalls being touched emotionally or cognitively. Participants and research context: Interviews were conducted at three different care settings: a hospital, mental healthcare institution and care facility for older people. A total of 31 participants (29 patients and 2 relatives) took part in the study. Ethical considerations: The research was found not to be subject to the (Dutch) Medical Research Involving Human Subjects Act. A three-step care ethical evaluation model was developed and described using two touchpoints as examples. A focus group meeting showed that the method was considered of great value for partaking institutions in comparison with existing methods. Reflection and discussion: Considering existing methods to evaluate quality of care, the touchpoint method belongs to the category of instruments which evaluate the patient experience. The touchpoint method distinguishes itself because no pre-defined categories are used but the values of patients are followed, which is an essential issue from a care ethical perspective. The method portrays the insider perspective of patients and thereby contributes to humanizing care. The touchpoint method is a valuable instrument for evaluating care; it generates evaluation data about the core care ethical principle of responsiveness.

[The value of lidocaine through different routes of administration in the treatment of tinnitus: a Meta-analysis].

PubMed

Li, Hui; Li, Ming; Zhang, Jianning; Li, Xiangcui; Tan, Junying; Ji, Bobo

2016-01-01

To evaluate the clinical value of lidocain in the treatment of tinnitus through three routes of administration (intravenous, intratympanic and acupoint injection) by analyzing literatures. Articles were collected through Hownet, Wanfang, VIP, Pubmed, SciVerse ScienceDirect, Springer and OVID, etc. The articles were strictly evaluated based on their quality. The Meta-analysis was performed to evaluate the outcomes by RevMan 5. 2 software. A total of 16 articles with 1203 patients were enrolled in the analysis. Their tinnitus history ranged from 7 hours to 20 years. Assessment methods include tinnitus loudness levels, severity scales and subjective feelings. None of articles refer to maintaining time, instead of "short-term", "short" and so on. A total of 133 cases received intravenous injection and the effective rate was 73.4% (98 cases). 50 cases and 332 cases received intratympanic and acupoint injection respectively and their effective rates were 74.0% and 87.7%, respectively. The effective rate ranged from 42.4% to 58.3% in control group. Meta-analysis results indicate that all three routes of lidocaine administrations are more effective than conventional methods (P < 0.05). Different routes of lidocaine administration have a good but short time effects on the tinnitus control. It can effectively reduce the time of tinnitus habituation as a complementary treatment. But its value still needs further evaluation.

Fracture of mandibular condyle—to open or not to open: an attempt to settle the controversy.

PubMed

Rastogi, Sanjay; Sharma, Siddharth; Kumar, Sanjeev; Reddy, Mahendra P; Niranjanaprasad Indra, B

2015-06-01

To compare the outcome of the open method versus the closed method of treatment for mandibular condylar fracture. Fifty patients with fractures of the mandibular condylar processes were evaluated. All fractures were displaced, with a degree of deviation between the condylar fragment and the ascending ramus of 10 to 45 degrees (mediolaterally). The patients were randomly divided into two groups, with group 1 receiving open reduction internal fixation and group 2 receiving closed reduction. The follow-up was done over the period of 6 months. Statistically significant improvement was seen in group 1 compared with group 2 in terms of anatomic reduction of the condyle, shortening of the ascending ramus, occlusal status, and deviation on mouth opening. A statistically significant difference was seen in the patients treated with the open method, with improved temporomandibular joint functions and fewer short- and long-term complications compared with those treated with the closed method. Copyright © 2015 Elsevier Inc. All rights reserved.

An analysis of fosaprepitant-induced venous toxicity in patients receiving highly emetogenic chemotherapy

PubMed Central

Leal, Alexis D.; Grendahl, Darryl C.; Seisler, Drew K.; Sorgatz, Kristine M.; Anderson, Kari J.; Hilger, Crystal R.; Loprinzi, Charles L.

2015-01-01

Purpose Fosaprepitant is an antiemetic used for chemotherapy-induced nausea and vomiting. We recently reported increased infusion site adverse events (ISAE) in a cohort of breast cancer patients receiving chemotherapy with doxorubicin and cyclophosphamide (AC). In this current study, we evaluated the venous toxicity of fosaprepitant use with non-anthracycline platinum-based antineoplastic regimens. Methods A retrospective review was conducted of the first 81 patients initiated on fosaprepitant among patients receiving highly emetogenic chemotherapy, on or after January 1, 2011 at Mayo Clinic Rochester. None of these regimens included an anthracycline. Data collected included baseline demographics, chemotherapy regimen, type of intravenous access and type, and severity of ISAE. Data from these patients were compared to previously collected data from patients who had received AC. Statistical analysis using χ2 and univariate logistic regression was used to evaluate the association between treatment regimen, fosaprepitant, and risk of ISAE. Results Among these 81 patients, the incidence of ISAE was 7.4 % in the non-anthracycline platinum group. The most commonly reported ISAE were swelling (3 %), extravasation (3 %), and phlebitis (3 %). When stratified by regimen, fosaprepitant was associated with a statistically significant increased risk of ISAE in the anthracycline group (OR 8.1; 95 % CI 2.0–31.9) compared to the platinum group. Conclusions Fosaprepitant antiemetic therapy causes significant ISAE that are appreciably higher than previous reports. Patients receiving platinum-based chemotherapy appear to have less significant ISAE than do patients who receive anthracycline-based regimens. PMID:24964876

Economic evaluation in collaborative hospital drug evaluation reports.

PubMed

Ortega, Ana; Fraga, María Dolores; Marín-Gil, Roberto; Lopez-Briz, Eduardo; Puigventós, Francesc; Dranitsaris, George

2015-09-01

economic evaluation is a fundamental criterion when deciding a drug's place in therapy. The MADRE method (Method for Assistance in making Decisions and Writing Drug Evaluation Reports) is widely used for drug evaluation. This method was developed by the GENESIS group of the Spanish Society of Hospital Pharmacy (SEFH), including economic evaluation. We intend to improve the economic aspects of this method. As for the direction to take, we have to first analyze our previous experiences with the current methodology and propose necessary improvements. economic evaluation sections in collaboratively conducted drug evaluation reports (as the scientific society, SEFH) with the MADRE method were reviewed retrospectively. thirty-two reports were reviewed, 87.5% of them included an economic evaluation conducted by authors and 65.6% contained published economic evaluations. In 90.6% of the reports, a Budget impact analysis was conducted. The cost per life year gained or per Quality Adjusted Life Year gained was present in 14 reports. Twenty-three reports received public comments regarding the need to improve the economic aspect. Main difficulties: low quality evidence in the target population, no comparative studies with a relevant comparator, non-final outcomes evaluated, no quality of life data, no fixed drug price available, dosing uncertainty, and different prices for the same drug. proposed improvements: incorporating different forms of aid for non-drug costs, survival estimation and adapting published economic evaluations; establishing criteria for drug price selection, decision-making in conditions of uncertainty and poor quality evidence, dose calculation and cost-effectiveness thresholds depending on different situations. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients.

PubMed

Mittal, M; Kumar, A; Srivastava, D; Sharma, P; Sharma, S

2015-01-01

Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups.

Radiation Field Design in the ACOSOG Z0011 (Alliance) Trial

PubMed Central

Jagsi, Reshma; Chadha, Manjeet; Moni, Janaki; Ballman, Karla; Laurie, Fran; Buchholz, Thomas A.; Giuliano, Armando; Haffty, Bruce G.

2014-01-01

Purpose ACOSOG Z0011 established that axillary lymph node dissection (ALND) is unnecessary in patients with breast cancer with one to two positive sentinel lymph nodes (SLNs) who undergo lumpectomy, radiotherapy (RT), and systemic therapy. We sought to ascertain RT coverage of the regional nodes in that trial. Methods We evaluated case report forms completed 18 months after enrollment. From 2012 to 2013, we collected all available detailed RT records for central review. Results Among 605 patients with completed case report forms, 89% received whole-breast RT. Of these, 89 (15%) were recorded as also receiving treatment to the supraclavicular region. Detailed RT records were obtained for 228 patients, of whom 185 (81.1%) received tangent-only treatment. Among 142 with sufficient records to evaluate tangent height, high tangents (cranial tangent border ≤ 2 cm from humeral head) were used in 50% of patients (33 of 66) randomly assigned to ALND and 52.6% (40 of 76) randomly assigned to SLND. Of the 228 patients with records reviewed, 43 (18.9%) received directed regional nodal RT using ≥ three fields: 22 in the ALND arm and 21 in the SLND arm. Those receiving directed nodal RT had greater nodal involvement (P < .001) than those who did not. Overall, there was no significant difference between treatment arms in the use of protocol-prohibited nodal fields. Conclusion Most patients treated in Z0011 received tangential RT alone, and some received no RT at all. Some patients received directed nodal irradiation via a third field. Further research is necessary to determine the optimal RT approach in patients with low-volume axillary disease treated with SLND alone. PMID:25135994

Differences in skeletal muscle loss caused by cytotoxic chemotherapy and molecular targeted therapy in patients with advanced non‐small cell lung cancer

PubMed Central

Tsuruoka, Hazime; Morikawa, Kei; Furuya, Naoki; Inoue, Takeo; Miyazawa, Teruomi; Mineshita, Masamichi

2017-01-01

Background Recent studies have revealed a reduction in the skeletal muscle area in patients with advanced non‐small cell lung cancer (NSCLC) after chemotherapy. EGFR and ALK tyrosine kinase inhibitor (TKI)‐based therapies are less cytotoxic than chemotherapy, but differences in skeletal muscle mass between patients receiving EGFR and ALK TKI therapies and patients receiving cytotoxic chemotherapy have not yet been reported. Methods Data of pathologically proven NSCLC patients were reviewed, and chest computed tomography and/or positron emission tomography‐computed tomography images obtained from January 2012 to December 2014 were selected. Patients were divided into two groups: cytotoxic chemotherapy (CG) and molecular targeted (MG). Muscle mass was measured with a single cross‐sectional area of the muscle at the third lumber vertebra (L3MA). To estimate skeletal muscle changes during chemotherapy, we defined the following L3 skeletal muscle index (L3SMI) ratio: post L3SMI/pre L3SMI. Differences in the SMI ratio between the groups were evaluated using the Wilcoxon signed‐rank test. Results Sixty‐five patients were included in this study: 44 patients received cytotoxic chemotherapy and 21 received molecular targeted therapy (EGFR and ALK TKI). The loss of L3MA in the CG was higher than in the MG (P = 0.03). In the CG, the L3SMI ratio defined to evaluate skeletal muscle mass changes was significantly lower than in the MG (P = 0.0188). Conclusion Our results suggest that skeletal muscle loss during first‐line therapy was significantly different between patients receiving cytotoxic chemotherapy and those receiving TKIs. Specifically, skeletal muscle loss was lower in patients receiving TKIs than in patients receiving cytotoxic chemotherapy. PMID:29067769

Randomized Selection Design Trial Evaluating CD8+-Enriched Versus Unselected Tumor-Infiltrating Lymphocytes for Adoptive Cell Therapy for Patients With Melanoma

PubMed Central

Dudley, Mark E.; Gross, Colin A.; Somerville, Robert P.T.; Hong, Young; Schaub, Nicholas P.; Rosati, Shannon F.; White, Donald E.; Nathan, Debbie; Restifo, Nicholas P.; Steinberg, Seth M.; Wunderlich, John R.; Kammula, Udai S.; Sherry, Richard M.; Yang, James C.; Phan, Giao Q.; Hughes, Marybeth S.; Laurencot, Carolyn M.; Rosenberg, Steven A.

2013-01-01

Purpose Adoptive cell therapy (ACT) with autologous tumor-infiltrating lymphocytes (TILs) and high-dose interleukin-2 (IL-2) administered to lymphodepleted patients with melanoma can cause durable tumor regressions. The optimal TIL product for ACT is unknown. Patients and Methods Patients with metastatic melanoma were prospectively assigned to receive unselected young TILs versus CD8+-enriched TILs. All patients received lymphodepleting chemotherapy and high-dose IL-2 therapy and were assessed for response, toxicity, survival, and immunologic end points. Results Thirty-four patients received unselected young TILs with a median of 8.0% CD4+ lymphocytes, and 35 patients received CD8+-enriched TILs with a median of 0.3% CD4+ lymphocytes. One month after TIL infusion, patients who received CD8+-enriched TILs had significantly fewer CD4+ peripheral blood lymphocytes (P = .01). Twelve patients responded to therapy with unselected young TILs (according to Response Evaluation Criteria in Solid Tumors [RECIST]), and seven patients responded to CD8+-enriched TILs (35% v 20%; not significant). Retrospective studies showed a significant association between response to treatment and interferon gamma secretion by the infused TILs in response to autologous tumor (P = .04), and in the subgroup of patients who received TILs from subcutaneous tumors, eight of 15 patients receiving unselected young TILs responded but none of eight patients receiving CD8+-enriched TILs responded. Conclusion A randomized selection design trial was feasible for improving individualized TIL therapy. Since the evidence indicates that CD8+-enriched TILs are not more potent therapeutically and they are more laborious to prepare, future studies should focus on unselected young TILs. PMID:23650429

Continuing evidence for poorer treatment outcomes for single male patients: retreatment data from RTOG 97-14.

PubMed

Konski, Andre; Desilvio, Michelle; Hartsell, William; Watkins-Bruner, Deborah; Coyne, James; Scarantino, Charles; Janjan, Nora

2006-09-01

The specific aim of this study was to evaluate outcome differences by gender and partner status for patients treated on Radiation Therapy Oncology Group (RTOG) protocol 97-14. RTOG 97-14 randomized patients with metastatic breast or prostate cancer to bone to receive 8 Gy in 1 fraction or 30 Gy in 10 fractions. Retreatment rates and overall survival were made based upon gender, marital status, and Karnofsky Performance Status (KPS). The cumulative incidence method was used to estimate retreatment time at 36 months from enrollment, and Gray's test was used to test for treatment differences within the same groupings. Marital status, gender, KPS, and treatment were variables tested in a univariate Cox model evaluating the time to retreatment. Married men and women and single women receiving 30 Gy had significantly longer time to retreatment, p = 0.0067, p = 0.0052, and p = 0.0009 respectively. We failed to show a difference in retreatment rates over time in single men receiving either 30 Gy or 8 Gy. Univariate analysis of the entire group determined patients receiving 30 Gy in 10 fractions significantly less likely to receive retreatment, p < 0.0001, with a trend toward single patients less likely to be re-treated, p = 0.07. Non-disease-related variables, such as social support, might influence the results of clinical trials with subjective endpoints such as retreatment rates. The statistically nonsignificant difference in the 36-month retreatment rates observed in single male patients receiving 8 Gy may be a result of inadequate social support systems in place to facilitate additional care. Patients receiving 8 Gy in a single fraction had significantly higher retreatment rates compared with patients receiving 30 Gy in 10 fractions.

Gender Bias in Nurse Evaluations of Residents in Obstetrics and Gynecology.

PubMed

Galvin, Shelley L; Parlier, Anna Beth; Martino, Ellen; Scott, Kacey Ryan; Buys, Elizabeth

2015-10-01

We examined the evaluations given by nurses to obstetrics and gynecology residents to estimate whether gender bias was evident. Women receive more negative feedback and evaluations than men-from both sexes. Some suggest that, to be successful in traditionally male roles such as surgeon, women must manifest a warmth-related (communal) rather than competence-related (agentic) demeanor. Compared with male residents, female residents experience more interpersonal difficulties and less help from female nurses. We examined feedback provided to residents by female nurses. We examined Professional Associate Questionnaires (2006-2014) using a mixed-methods design. We compared scores per training year by gender using Mann-Whitney and linear regression adjusting for resident and nurse cohorts. Using grounded theory analysis, we developed a coding system for blinded comments based on principles of effective feedback, medical learners' evaluation, and impression management. χ examined the proportions of negative and positive and communal and agentic comments between genders. We examined 2,202 evaluations: 397 (18%) for 10 men and 1,805 (82%) for 34 women. Twenty-three compliments (eg, "Great resident!") were excluded. Evaluations per training year varied: men n=77-134; women n=384-482. Postgraduate year (PGY)-1, PGY-2, and PGY-4 women had lower mean ratings (P<.035); when adjusted, the difference remained significant in PGY-2 (MWomen=1.5±0.6 compared with MMen=1.7±0.5; P=.001). Postgraduate year-1 women received disproportionately fewer positive and more negative agentic comments than PGY-1 men (positive=17.3% compared with 40%, negative=17.3% compared with 3.3%, respectively; P=.041). Evidence of gender bias in evaluations emerged; albeit subtle, women received harsher feedback as lower-level residents than men. Training in effective evaluation and gender bias management is warranted.

Analysis of Multi-Antenna GNSS Receiver Performance under Jamming Attacks.

PubMed

Vagle, Niranjana; Broumandan, Ali; Lachapelle, Gérard

2016-11-17

Although antenna array-based Global Navigation Satellite System (GNSS) receivers can be used to mitigate both narrowband and wideband electronic interference sources, measurement distortions induced by array processing methods are not suitable for high precision applications. The measurement distortions have an adverse effect on the carrier phase ambiguity resolution, affecting the navigation solution. Depending on the array attitude information availability and calibration parameters, different spatial processing methods can be implemented although they distort carrier phase measurements in some cases. This paper provides a detailed investigation of the effect of different array processing techniques on array-based GNSS receiver measurements and navigation performance. The main novelty of the paper is to provide a thorough analysis of array-based GNSS receivers employing different beamforming techniques from tracking to navigation solution. Two beamforming techniques, namely Power Minimization (PM) and Minimum Power Distortionless Response (MPDR), are being investigated. In the tracking domain, the carrier Doppler, Phase Lock Indicator (PLI), and Carrier-to-Noise Ratio (C/N₀) are analyzed. Pseudorange and carrier phase measurement distortions and carrier phase position performance are also evaluated. Performance analyses results from simulated GNSS signals and field tests are provided.

Medical Literature Evaluation Education at US Schools of Pharmacy

PubMed Central

Phillips, Jennifer; Demaris, Kendra

2016-01-01

Objective. To determine how medical literature evaluation (MLE) is being taught across the United States and to summarize methods for teaching and assessing MLE. Methods. An 18-question survey was administered to faculty members whose primary responsibility was teaching MLE at schools and colleges of pharmacy. Results. Responses were received from 90 (71%) US schools of pharmacy. The most common method of integrating MLE into the curriculum was as a stand-alone course (49%). The most common placement was during the second professional year (43%) or integrated throughout the curriculum (25%). The majority (77%) of schools used a team-based approach. The use of active-learning strategies was common as was the use of multiple methods of evaluation. Responses varied regarding what role the course director played in incorporating MLE into advanced pharmacy practice experiences (APPEs). Conclusion. There is a trend toward incorporating MLE education components throughout the pre-APPE curriculum and placement of literature review/evaluation exercises into therapeutics practice skills laboratories to help students see how this skill integrates into other patient care skills. Several pre-APPE educational standards for MLE education exist, including journal club activities, a team-based approach to teaching and evaluation, and use of active-learning techniques. PMID:26941431

Estimating costs of quality improvement for outpatient healthcare organisations: a practical methodology.

PubMed

Brown, Sydney E S; Chin, Marshall H; Huang, Elbert S

2007-08-01

Outpatient healthcare organisations worldwide participate in quality improvement (QI) programmes. Despite the importance of understanding the financial impact of such programmes, there are no established standard methods for empirically assessing QI programme costs and their consequences for small outpatient healthcare organisations. The costs and cost consequences were evaluated for a diabetes QI programme implemented throughout the USA in federally qualified community health centres. For five case study centres, survey instruments and methods for data analysis were developed. Two types of cost/revenue were evaluated. Direct costs/revenues, such as personnel time, items purchased and grants received, were evaluated using self-administered surveys. Cost/revenue consequences, which were cost/revenue changes that may have occurred due to changes in patient utilisation or physician behaviour, were evaluated using electronic billing data. Other methods for evaluating cost/revenue consequences if electronic billing data are not available are also discussed. This paper describes a practical taxonomy and method for assessing the costs and revenues of QI programmes for outpatient organisations. Results of such analyses will be useful for healthcare organisations implementing QI programmes and also for policy makers designing incentives for QI participation.

An innovative method for offshore wind farm site selection based on the interval number with probability distribution

NASA Astrophysics Data System (ADS)

Wu, Yunna; Chen, Kaifeng; Xu, Hu; Xu, Chuanbo; Zhang, Haobo; Yang, Meng

2017-12-01

There is insufficient research relating to offshore wind farm site selection in China. The current methods for site selection have some defects. First, information loss is caused by two aspects: the implicit assumption that the probability distribution on the interval number is uniform; and ignoring the value of decision makers' (DMs') common opinion on the criteria information evaluation. Secondly, the difference in DMs' utility function has failed to receive attention. An innovative method is proposed in this article to solve these drawbacks. First, a new form of interval number and its weighted operator are proposed to reflect the uncertainty and reduce information loss. Secondly, a new stochastic dominance degree is proposed to quantify the interval number with a probability distribution. Thirdly, a two-stage method integrating the weighted operator with stochastic dominance degree is proposed to evaluate the alternatives. Finally, a case from China proves the effectiveness of this method.

Needle-less local anesthesia: clinical evaluation of the effectiveness of the jet anesthesia Injex in local anesthesia in dentistry.

PubMed

Dabarakis, Nikolaos N; Alexander, Veis; Tsirlis, Anastasios T; Parissis, Nikolaos A; Nikolaos, Maroufidis

2007-01-01

To clinically evaluate the jet injection Injex (Rösch AG Medizintechnik) using 2 different anesthetic solutions, and to compare the jet injection and the standard needle injection techniques. Of the 32 patients in the study, 10 received mepivacaine 3% anesthetic solution by means of the jet injection technique, while the remaining 22 patients received lidocaine 2% with epinephrine 1:80,000 by the same method. The 14 patients in whom pulp anesthesia was achieved were selected for an additional evaluation of the pulp reaction using standard needle injection anesthesia. The differences between the 2 compounds with Injex were statistically evaluated by means of independent-samples t test analysis. The differences between subgroups receiving both jet injection and needle injection anesthesia were evaluated by means of paired t test analysis. The administration of mepivacaine 3% using Injex did not achieve pulp anesthesia in any of the 10 patients, although the soft tissue anesthesia was successful. The administration of lidocaine with epinephrine using Injex resulted in pulp anesthesia in only 14 patients; soft tissue anesthesia was observed in all patients of this group. There was no statistically significant difference between Injex and the needle injection technique in onset of anesthesia. However, the duration of anesthesia was significantly longer for the needle infiltration group than for the Injex injection group. The anesthetic solution should be combined with a vasoconstriction agent when the Injex technique is implemented.

Millon Clinical Multiaxial Inventory-III Subtypes of Opioid Dependence: Validity and Matching to Behavioral Therapies

ERIC Educational Resources Information Center

Ball, Samuel A.; Nich, Charla; Rounsaville, Bruce J.; Eagan, Dorothy; Carroll, Kathleen M.

2004-01-01

The concurrent and predictive validity of 2 different methods of Millon Clinical Multiaxial Inventory-III subtyping (protocol sorting, cluster analysis) was evaluated in 125 recently detoxified opioid-dependent outpatients in a 12-week randomized clinical trial. Participants received naltrexone and relapse prevention group counseling and were…

Avoiding the Struggle: Instruction That Supports Students' Motivation in Reading and Writing about Content Material

ERIC Educational Resources Information Center

Mason, Linda H.; Meadan, Hedda; Hedin, Laura R.; Cramer, Anne Mong

2012-01-01

We conducted a mixed methods study to evaluate motivation among 20 fourth-grade students who struggle with reading and writing prior to and after receiving either self-regulated strategy development (SRSD) instruction for expository reading comprehension or SRSD instruction for expository reading comprehension plus informative writing. We…

Testing a passive revegetation approach for restoring coastal plain depression wetlands

Treesearch

Diane De Steven; Rebecca R. Sharitz; Julian H. Singer; Christopher D. Barton

2006-01-01

Restoration of coastal plain depressions, a biologically significant and threatened wetland type of the southeastern United States, has received little systematic research. Within the context of an experimental project designed to evaluate several restoration approaches, we tested whether successful revegetation can be achieved by passive methods (recruitment from seed...

Cost, production and effectiveness of masticated fireline.

Treesearch

Elizabeth Dodson; Dana Mitchell

2016-01-01

Fire managers are continuously looking for improved methods to construct fireline with minimal resource damage. One option for fireline construction that has so far received limited attention is the use of mastication equipment. This study evaluated a masticating disk mounted on a self-leveling feller- buncher for the cost, speed, and adherence to fireline...

Water quality and nitrogen mass loss from anaerobic lagoon columns receiving pretreated influent

USDA-ARS?s Scientific Manuscript database

Control methods are needed to abate ammonia losses from swine anaerobic lagoons to reduce contribution of confined swine operations to air pollution. In a 15-month meso-scale column study, we evaluated the effect of manure pretreatment on water quality, reduction of N losses, and sludge accumulation...

76 FR 7694 - Airworthiness Directives; PIAGGIO AERO INDUSTRIES S.p.A Model PIAGGIO P-180 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... Airworthiness Directives; PIAGGIO AERO INDUSTRIES S.p.A Model PIAGGIO P-180 Airplanes AGENCY: Federal Aviation... Piaggio service bulletin number specified in the Alternative Methods of Compliance (AMOCs) section is..., except Federal holidays. The AD docket contains this AD, the regulatory evaluation, any comments received...

Using Repeated Reading to Improve Reading Speed and Comprehension in Students with Visual Impairments

ERIC Educational Resources Information Center

Savaiano, Mackenzie E.; Hatton, Deborah D.

2013-01-01

Introduction: This study evaluated whether children with visual impairments who receive repeated reading instruction exhibit an increase in their oral reading rate and comprehension and a decrease in oral reading error rates. Methods: A single-subject, changing-criterion design replicated across three participants was used to demonstrate the…

Sleep Hygiene and Melatonin Treatment for Children and Adolescents with ADHD and Initial Insomnia

ERIC Educational Resources Information Center

Weiss, Margaret D.; Wasdell, Michael B.; Bomben, Melissa M.; Rea, Kathleen J.; Freeman, Roger D.

2006-01-01

Objective: To evaluate the efficacy of sleep hygiene and melatonin treatment for initial insomnia in children with attention-deficit/hyperactivity disorder (ADHD). Method: Twenty-seven stimulant-treated children (6-14 years of age) with ADHD and initial insomnia (greater than 60 minutes) received sleep hygiene intervention. Nonresponders were…

Randomized, Controlled Trial of Atomoxetine for Attention-Deficit/Hyperactivity Disorder in Adolescents with Substance Use Disorder

ERIC Educational Resources Information Center

Thurstone, Christian; Riggs, Paula D.; Salomonsen-Sautel, Stacy; Mikulich-Gilbertson, Susan K.

2010-01-01

Objective: To evaluate the effect of atomoxetine hydrochloride versus placebo on attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) in adolescents receiving motivational interviewing/cognitive behavioral therapy (MI/CBT) for SUD. Method: This single-site, randomized, controlled trial was conducted between December…

Comparing Intervention Strategies among Rural, Low SES, Young Adult Tobacco Users

ERIC Educational Resources Information Center

Zanis, David A.; Hollm, Ronald E.; Derr, Daniel; Ibrahim, Jennifer K.; Collins, Bradley N.; Coviello, Donna; Melochick, Jennifer Ryan

2011-01-01

Objective: To evaluate 3-month tobacco quit rates of young adult tobacco users randomized to 2 intervention conditions. Methods: Overall 192 non-treatment-seeking 18-to-24-year-old tobacco users received educational information and advice to quit smoking. Participants were then block randomized to 2 brief intervention conditions: (1) a telephone…

Application of signal detection theory to optics. [image evaluation and restoration

NASA Technical Reports Server (NTRS)

Helstrom, C. W.

1973-01-01

Basic quantum detection and estimation theory, applications to optics, photon counting, and filtering theory are studied. Recent work on the restoration of degraded optical images received at photoelectrically emissive surfaces is also reported, the data used by the method are the numbers of electrons ejected from various parts of the surface.

Calcium absorption in very low birth weight infants with and without bronchopulmonary dysplasia

USDA-ARS?s Scientific Manuscript database

Our objective was to evaluate the effects of early bronchopulmonary dysplasia (BPD) on calcium (Ca) metabolism and growth in very low birth weight (VLBW) infants. A dual-tracer, stable isotope method was used to assess Ca absorption in VLBW infants. Infants with early BPD received energy-dense feedi...

Effect of Receiver Choosing on Point Positions Determination in Network RTK

NASA Astrophysics Data System (ADS)

Bulbul, Sercan; Inal, Cevat

2016-04-01

Nowadays, the developments in GNSS technique allow to determinate point positioning in real time. Initially, point positioning was determined by RTK (Real Time Kinematic) based on a reference station. But, to avoid systematic errors in this method, distance between the reference points and rover receiver must be shorter than10 km. To overcome this restriction in RTK method, the idea of setting more than one reference point had been suggested and, CORS (Continuously Operations Reference Systems) was put into practice. Today, countries like ABD, Germany, Japan etc. have set CORS network. CORS-TR network which has 146 reference points has also been established in 2009 in Turkey. In CORS-TR network, active CORS approach was adopted. In Turkey, CORS-TR reference stations covering whole country are interconnected and, the positions of these stations and atmospheric corrections are continuously calculated. In this study, in a selected point, RTK measurements based on CORS-TR, were made with different receivers (JAVAD TRIUMPH-1, TOPCON Hiper V, MAGELLAN PRoMark 500, PENTAX SMT888-3G, SATLAB SL-600) and with different correction techniques (VRS, FKP, MAC). In the measurements, epoch interval was taken as 5 seconds and measurement time as 1 hour. According to each receiver and each correction technique, means and differences between maximum and minimum values of measured coordinates, root mean squares in the directions of coordinate axis and 2D and 3D positioning precisions were calculated, the results were evaluated by statistical methods and the obtained graphics were interpreted. After evaluation of the measurements and calculations, for each receiver and each correction technique; the coordinate differences between maximum and minimum values were measured to be less than 8 cm, root mean squares in coordinate axis directions less than ±1.5 cm, 2D point positioning precisions less than ±1.5 cm and 3D point positioning precisions less than ±1.5 cm. In the measurement point, it has been concluded that VRS correction technique is generally better than other corrections techniques.

Diuretic Activity of Ethanolic Root Extract of Mimosa Pudica in Albino Rats

PubMed Central

SL, Shruthi; PS, Vaibhavi; VH, Pushpa; AM, Satish; Sibgatullah, Mohammad

2015-01-01

Introducation Diuretics are the drugs which increase the urine output. This property is useful in various pathological conditions of fluid overload. The presently available diuretics have lot of adverse effects. Our study has evaluated the diuretic activity of ethanolic root extract of Mimosa pudica as an alternative/new drug which may induce diuresis. Aim To evaluate the diuretic activity of ethanolic root extract of Mimosa pudicaa in albino rats. Materials and Methods Ethanolic root extract of Mimosa pudica (EEMP) was prepared using soxhlet’s apparatus. Albino rats were divided into 5 groups of 6 rats each. Group-I (Control) received distilled water 25ml/kg orally. Group-II (Standard) received Furosemide 20mg/kg orally. Group-III received EEMP 100 mg/kg, Group-IV received EEMP 200 mg/kg and Group-V received EEMP 400 mg/kg. The urine samples were collected for all the groups upto 5 hours after dosing and urine volume was measured. Urine was analysed for electrolytes (Na+, K+ and Cl-). ANOVA, Dunnet’s test and p-values were measured and data was analysed. Results EEMP exhibited significant diuretic activity by increasing urine volume and also by enhancing elimination of Sodium (Na+), Potassium (K+) and Chloride (Cl-) at doses of 100 and 200mg/kg. Conclusion EEMP possesses significant diuretic activity and has a beneficial role in volume overload conditions. PMID:26870704

The Protective Effects of Alpha-Lipoic Acid and Coenzyme Q10 Combination on Ovarian Ischemia-Reperfusion Injury: An Experimental Study.

PubMed

Tuncer, Ahmet Ali; Bozkurt, Mehmet Fatih; Koken, Tulay; Dogan, Nurhan; Pektaş, Mine Kanat; Baskin Embleton, Didem

2016-01-01

Objective. This study aims to evaluate whether alpha-lipoic acid and/or coenzyme Q10 can protect the prepubertal ovarian tissue from ischemia-reperfusion injury in an experimental rat model of ovarian torsion. Materials and Methods. Forty-two female preadolescent Wistar-Albino rats were divided into 6 equal groups randomly. The sham group had laparotomy without torsion; the other groups had torsion/detorsion procedure. After undergoing torsion, group 2 received saline, group 3 received olive oil, group 4 received alpha-lipoic acid, group 5 received coenzyme Q10, and group 6 received both alpha-lipoic acid and coenzyme Q10 orally. The oxidant-antioxidant statuses of these groups were compared using biochemical measurement of oxidized/reduced glutathione, glutathione peroxidase and malondialdehyde, pathological evaluation of damage and apoptosis within the ovarian tissue, and immunohistochemical assessment of nitric oxide synthase. Results. The left ovaries of the alpha-lipoic acid + coenzyme Q10 group had significantly lower apoptosis scores and significantly higher nitric oxide synthase content than the left ovaries of the control groups. The alpha-lipoic acid + coenzyme Q10 group had significantly higher glutathione peroxidase levels and serum malondialdehyde concentrations than the sham group. Conclusions. The combination of alpha-lipoic acid and coenzyme Q10 has beneficial effects on oxidative stress induced by ischemia-reperfusion injury related to ovarian torsion.

Assessing hospital disaster preparedness: a comparison of an on-site survey, directly observed drill performance, and video analysis of teamwork.

PubMed

Kaji, Amy H; Langford, Vinette; Lewis, Roger J

2008-09-01

There is currently no validated method for assessing hospital disaster preparedness. We determine the degree of correlation between the results of 3 methods for assessing hospital disaster preparedness: administration of an on-site survey, drill observation using a structured evaluation tool, and video analysis of team performance in the hospital incident command center. This was a prospective, observational study conducted during a regional disaster drill, comparing the results from an on-site survey, a structured disaster drill evaluation tool, and a video analysis of teamwork, performed at 6 911-receiving hospitals in Los Angeles County, CA. The on-site survey was conducted separately from the drill and assessed hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity, decontamination capability, and pharmaceutical stockpiles. The drill evaluation tool, developed by Johns Hopkins University under contract from the Agency for Healthcare Research and Quality, was used to assess various aspects of drill performance, such as the availability of the hospital disaster plan, the geographic configuration of the incident command center, whether drill participants were identifiable, whether the noise level interfered with effective communication, and how often key information (eg, number of available staffed floor, intensive care, and isolation beds; number of arriving victims; expected triage level of victims; number of potential discharges) was received by the incident command center. Teamwork behaviors in the incident command center were quantitatively assessed, using the MedTeams analysis of the video recordings obtained during the disaster drill. Spearman rank correlations of the results between pair-wise groupings of the 3 assessment methods were calculated. The 3 evaluation methods demonstrated qualitatively different results with respect to each hospital's level of disaster preparedness. The Spearman rank correlation coefficient between the results of the on-site survey and the video analysis of teamwork was -0.34; between the results of the on-site survey and the structured drill evaluation tool, 0.15; and between the results of the video analysis and the drill evaluation tool, 0.82. The disparate results obtained from the 3 methods suggest that each measures distinct aspects of disaster preparedness, and perhaps no single method adequately characterizes overall hospital preparedness.

On the Piezoelectric Detection of Guided Ultrasonic Waves

PubMed Central

2017-01-01

In order to quantify the wave motion of guided ultrasonic waves, the characteristics of piezoelectric detectors, or ultrasonic transducers and acoustic emission sensors, have been evaluated systematically. Such guided waves are widely used in structural health monitoring and nondestructive evaluation, but methods of calibrating piezoelectric detectors have been inadequate. This study relied on laser interferometry for the base displacement measurement of bar waves, from which eight different guided wave test set-ups are developed with known wave motion using piezoelectric transmitters. Both plates and bars of 12.7 and 6.4 mm thickness were used as wave propagation media. The upper frequency limit was 2 MHz. Output of guided wave detectors were obtained on the test set-ups and their receiving sensitivities were characterized and averaged. While each sensitivity spectrum was noisy for a detector, the averaged spectrum showed a good convergence to a unique receiving sensitivity. Twelve detectors were evaluated and their sensitivity spectra determined in absolute units. Generally, these showed rapidly dropping sensitivity with increasing frequency due to waveform cancellation on their sensing areas. This effect contributed to vastly different sensitivities to guided wave and to normally incident wave for each one of the 12 detectors tested. Various other effects are discussed and recommendations on methods of implementing the approach developed are provided. PMID:29156579

Motivational Interviewing for Incarcerated Adolescents: Effects of Depressive Symptoms on Reducing Alcohol and Marijuana Use After Release*

PubMed Central

Stein, L. A. R.; Lebeau, Rebecca; Colby, Suzanne M.; Barnett, Nancy P.; Golembeske, Charles; Monti, Peter M.

2011-01-01

Objective: Motivational interviewing to reduce alcohol and marijuana use among incarcerated adolescents was evaluated. Method: Adolescents (N = 162, 84% male; M = 17.10 years old) were randomly assigned to receive motivational interviewing or relaxation training, with follow-up assessment 3 months after release. Results: Compared with those who received relaxation training, adolescents who received motivational interviewing had lower rates of alcohol and marijuana use at follow-up, with some evidence for moderating effects of depression. At low levels of depression, adolescents who received motivational interviewing had lower rates of use. Adolescents who received relaxation training and who had high levels of depressive symptoms early in incarceration showed less use at follow-up than those low in depressive symptoms who received relaxation training. Conclusions: This brief motivational interviewing intervention during incarceration reduces alcohol and marijuana use after release. In addition, depressive symptoms early in incarceration should be considered in treating these adolescents, but more work is needed to extend follow-up period and account for the impact of depression on outcomes. PMID:21513687

The effectiveness of lavender essence on strernotomy related pain intensity after coronary artery bypass grafting

PubMed Central

Heidari Gorji, Mohammad Ali; Ashrastaghi, Om Golsum; Habibi, Valiollah; Charati, Jamshid Yazdani; Ebrahimzadeh, Mohammad Ali; Ayasi, Mitra

2015-01-01

Background: Considering the side effects of pharmacological methods, there has been a suggestion to use nonpharmacological methods such Aromatherapy following coronary artery bypass grafting (CABG). This study aims to evaluate the effectiveness of lavender 2% aromatherapy on sternotomy pain intensity after coronary artery bypass graft surgery in patients who have undergone surgery. Materials and Methods: During this clinical trial, 50 patients who were candidates for CABG, were randomly divided into two equal groups, that is, the control group (n = 25) and the case group (n = 25). Following CABG, the case group received two drops of 2% lavender oil every 15 minutes with supplemental oxygen and the control group received only supplemental oxygen through a face mask. The data collection tools comprised of the demographic check list and visual analog scale (VAS) for evaluating the pain intensity. The pain intensity were assessed pre- and five, 30, and 60 minutes post aromatherapy. The final data were analyzed by the t-test and chi-squared test. Results: The findings showed that the pain perception intensity in the case group was lower than that in the control group at the 30- and 60-minute phases after intervention (P < 0.0001). Conclusion: The result indicated that aromatherapy can be used as a complementary method in postoperative pain reduction, as it reduced pain. The patients require two sedative drugs, and moreover, it avoids expenses of treatment. PMID:26261829

Innovative evaluation of local injective gel of curcumin on the orthodontic tooth movement in rats

PubMed Central

Asefi, Sohrab; Seifi, Massoud; Fard, Ghazal Hatami; Lotfi, Ali

2018-01-01

Background: Curcumin is the most active compound in turmeric. It can suppress the nuclear factor kappa-light-chain-enhancer of activated B cells pathway and prevent the osteoclastogenesis procedure. This study aimed to be the first to evaluate the effect of curcumin on the rate of orthodontic tooth movement (OTM). Materials and Methods: Forty rats were used as follows in each group: (1) negative control: Did not receive any appliance or injection; (2) positive control: received 0.03 cc normal saline and appliance; (3) gelatin plus curcumin (G): Received 0.03 cc hydrogel and appliance; and (4) chitosan plus curcumin (Ch): Received 0.03 cc hydrogel and appliance. They were anesthetized and closed nickel-titanium coil springs were installed between the first molars and central incisors unilaterally as the orthodontic appliance. After 21 days, the rats were decapitated, and the distance between the first and second molars was measured by a leaf gauge. Howship's lacunae, blood vessels, osteoclast-like cells, and root resorption lacunae were evaluated in the histological analysis. Data were analyzed by one-way ANOVA, Tukey's test, and t-test (P < 0.05 consider significant). Results: No significant difference was found in OTM between groups delivered orthodontic forces. Curcumin inhibited root and bone resorption, osteoclastic recruitment, and angiogenesis significantly. Conclusion: Curcumin had no significant inhibitory effect on OTM. While it had a significant role on decreasing bone or root resorption (P > 0.05). PMID:29497446

The Strathclyde Evaluation of Children's Active Travel (SE-CAT): study rationale and methods

PubMed Central

2011-01-01

Background The school commute is a prime opportunity to increase children's physical activity levels. However, active commuting has decreased over the past 40 years. Strategies that increase walking to school are therefore needed. Travelling Green (TG) is a school-based active travel resource aimed at increasing children's walking to school. The resource consists of a curriculum-based program of lessons and goal setting activities. A previous study found that children who received the TG intervention increased self-reported distance travelled to school by active modes and reduced the distance travelled by inactive modes. This study was limited by self-reported outcome measures, a small sample, and no follow-up measures. A more robust evaluation of TG is required to address these limitations. This paper describes the rationale and methods for such an evaluation of Travelling Green, and describes the piloting of various active commuting measures in primary school children. Methods/Design Measures of active commuting were piloted in a sample of 26 children (aged 8-9 years) over one school week. These measures were subsequently used in an 18-month quasi-experimental design to evaluate the effect of TG on commuting behaviour. Participants were 166 children (60% male) aged 8-9 years from 5 primary schools. Two schools (n = 79 children) received TG in September/October 2009. Three schools (n = 87 children) acted as a comparison group, and subsequently received TG at a later date. Physical activity was measured using Actigraph GT1M accelerometers. Personal and environmental determinants of active commuting were measured via parent and child questionnaires, as were factors related to the Theory of Planned Behaviour and the construct of habit. Measures were taken pre- and post-intervention and at 5 and 12 months follow-up. Discussion The piloted protocol was practical and feasible and piloted measures were reliable and valid. All study data, including 5 and 12 month follow-up, have been collected and processed. Data analysis is ongoing. Results will indicate whether TG successfully increases active commuting in a sample of Scottish school children and will inform future efforts in school active travel promotion. PMID:22208498

Human factors evaluation of TSO-C129A GPS receivers

DOT National Transportation Integrated Search

1998-10-22

This report documents an evaluation of the usability of TSO-C129a-certified Global Positioning System (GPS) receivers. Bench and flight tests were conducted on six GPS receivers. The evaluations covered 23 flight tasks. Both subjective and objective ...

Response evaluation after primary systemic therapy of Her2 positive breast cancer – an observational cross-sectional study.

PubMed

Tőkés, Tímea; Szentmártoni, Gyöngyvér; Torgyík, László; Kajáry, Kornélia; Lengyel, Zsolt; Györke, Tamás; Molnár, Béla Á; Tőkés, Anna-Mária; Kulka, Janina; Dank, Magdolna

2015-04-01

To evaluate (I) trastuzumab-containing primary systemic therapy (PST) in human epidermal growth factor receptor 2 (Her2) overexpressing breast carcinomas.; (II) compare the patients who achieved and those who did not achieve pathological complete remission (pCR), and (III) analyze the accuracy of different clinical-imaging modalities in tumor response monitoring. 188 patients who received PST between 2008 and 2014 were reviewed and 43 Her2 overexpressing breast cancer patients (28 Luminal B/Her2-positive and 15 Her2-positive) were enrolled. 26 patients received mostly taxane-based PST without trastuzumab (Group 1) and 17 patients received trastuzumab-containing PST (Group 2). We compared the concordance between pCR and complete remission (CR) defined by breast-ultrasound, CR defined by standard 18F-fluoro-deoxy-glucose positron emission tomography and computerized tomography (FDG-PET/CT) criteria (Method 1) and CR defined by a novel, breast cancer specific FDG-PET/CT criteria (Method 2). Sensitivity (sens), specificity (spec), and positive (PPV) and negative predictive values (NPV) were calculated. Ten patients (38.5%) in Group 1 and eight (47%) in Group 2 achieved pCR. pCR was significantly more frequent in Her2-positive than in Luminal B/Her2-positive tumors in both Group 1: (P=0.043) and Group 2: (P=0.029). PET/CT evaluated by the breast cancer specific criteria (Method 2) differentiated pCR from non-pCR more accurately in both groups (Group 1: sens=77.8%, spec=%, PPV=100%, NPV=71.4%; Group 2: sens=87.5%, spec=62.5%, PPV=70%, NPV=83.3%) than standard PET/CT criteria (Method 1) (Group 1: sens=22.2% spec=100% PPV=100% NPV=41.7%; in Group 2: sens=37.5%, spec=87.5%, PPV=75% NPV=58.3%) or breast ultrasound (Group 1, sens=83.3% spec=25% PPV=62.5% NPV=50%; Group 2, sens=100% spec=12.5% PPV=41.6% NPV=100%). The benefit of targeted treatment with trastuzumab-containing PST in Her2 overexpressing breast cancer was defined in terms of pCR rate. Luminal B/Her2-positive subtype needs further subdivision to identify patients who would benefit from PST. Combined evaluation of tumor response by our novel, breast cancer specific FDG-PET/CT criteria accurately differentiated pCR from non-pCR patients.

The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results

PubMed Central

2012-01-01

Background In 2006, the Vermont Oxford Network (VON) established the Neonatal Encephalopathy Registry (NER) to characterize infants born with neonatal encephalopathy, describe evaluations and medical treatments, monitor hypothermic therapy (HT) dissemination, define clinical research questions, and identify opportunities for improved care. Methods Eligible infants were ≥ 36 weeks with seizures, altered consciousness (stupor, coma) during the first 72 hours of life, a 5 minute Apgar score of ≤ 3, or receiving HT. Infants with central nervous system birth defects were excluded. Results From 2006–2010, 95 centers registered 4232 infants. Of those, 59% suffered a seizure, 50% had a 5 minute Apgar score of ≤ 3, 38% received HT, and 18% had stupor/coma documented on neurologic exam. Some infants experienced more than one eligibility criterion. Only 53% had a cord gas obtained and only 63% had a blood gas obtained within 24 hours of birth, important components for determining HT eligibility. Sixty-four percent received ventilator support, 65% received anticonvulsants, 66% had a head MRI, 23% had a cranial CT, 67% had a full channel encephalogram (EEG) and 33% amplitude integrated EEG. Of all infants, 87% survived. Conclusions The VON NER describes the heterogeneous population of infants with NE, the subset that received HT, their patterns of care, and outcomes. The optimal routine care of infants with neonatal encephalopathy is unknown. The registry method is well suited to identify opportunities for improvement in the care of infants affected by NE and study interventions such as HT as they are implemented in clinical practice. PMID:22726296

Adjusting for partial verification or workup bias in meta-analyses of diagnostic accuracy studies.

PubMed

de Groot, Joris A H; Dendukuri, Nandini; Janssen, Kristel J M; Reitsma, Johannes B; Brophy, James; Joseph, Lawrence; Bossuyt, Patrick M M; Moons, Karel G M

2012-04-15

A key requirement in the design of diagnostic accuracy studies is that all study participants receive both the test under evaluation and the reference standard test. For a variety of practical and ethical reasons, sometimes only a proportion of patients receive the reference standard, which can bias the accuracy estimates. Numerous methods have been described for correcting this partial verification bias or workup bias in individual studies. In this article, the authors describe a Bayesian method for obtaining adjusted results from a diagnostic meta-analysis when partial verification or workup bias is present in a subset of the primary studies. The method corrects for verification bias without having to exclude primary studies with verification bias, thus preserving the main advantages of a meta-analysis: increased precision and better generalizability. The results of this method are compared with the existing methods for dealing with verification bias in diagnostic meta-analyses. For illustration, the authors use empirical data from a systematic review of studies of the accuracy of the immunohistochemistry test for diagnosis of human epidermal growth factor receptor 2 status in breast cancer patients.

Bandwidth efficient channel estimation method for airborne hyperspectral data transmission in sparse doubly selective communication channels

NASA Astrophysics Data System (ADS)

Vahidi, Vahid; Saberinia, Ebrahim; Regentova, Emma E.

2017-10-01

A channel estimation (CE) method based on compressed sensing (CS) is proposed to estimate the sparse and doubly selective (DS) channel for hyperspectral image transmission from unmanned aircraft vehicles to ground stations. The proposed method contains three steps: (1) the priori estimate of the channel by orthogonal matching pursuit (OMP), (2) calculation of the linear minimum mean square error (LMMSE) estimate of the received pilots given the estimated channel, and (3) estimate of the complex amplitudes and Doppler shifts of the channel using the enhanced received pilot data applying a second round of a CS algorithm. The proposed method is named DS-LMMSE-OMP, and its performance is evaluated by simulating transmission of AVIRIS hyperspectral data via the communication channel and assessing their fidelity for the automated analysis after demodulation. The performance of the DS-LMMSE-OMP approach is compared with that of two other state-of-the-art CE methods. The simulation results exhibit up to 8-dB figure of merit in the bit error rate and 50% improvement in the hyperspectral image classification accuracy.

Reducing Physical Risk Factors in Construction Work Through a Participatory Intervention: Protocol for a Mixed-Methods Process Evaluation.

PubMed

Ajslev, Jeppe; Brandt, Mikkel; Møller, Jeppe Lykke; Skals, Sebastian; Vinstrup, Jonas; Jakobsen, Markus Due; Sundstrup, Emil; Madeleine, Pascal; Andersen, Lars Louis

2016-05-26

Previous research has shown that reducing physical workload among workers in the construction industry is complicated. In order to address this issue, we developed a process evaluation in a formative mixed-methods design, drawing on existing knowledge of the potential barriers for implementation. We present the design of a mixed-methods process evaluation of the organizational, social, and subjective practices that play roles in the intervention study, integrating technical measurements to detect excessive physical exertion measured with electromyography and accelerometers, video documentation of working tasks, and a 3-phased workshop program. The evaluation is designed in an adapted process evaluation framework, addressing recruitment, reach, fidelity, satisfaction, intervention delivery, intervention received, and context of the intervention companies. Observational studies, interviews, and questionnaires among 80 construction workers organized in 20 work gangs, as well as health and safety staff, contribute to the creation of knowledge about these phenomena. At the time of publication, the process of participant recruitment is underway. Intervention studies are challenging to conduct and evaluate in the construction industry, often because of narrow time frames and ever-changing contexts. The mixed-methods design presents opportunities for obtaining detailed knowledge of the practices intra-acting with the intervention, while offering the opportunity to customize parts of the intervention.

Indoor visible light communication localization system utilizing received signal strength indication technique and trilateration method

NASA Astrophysics Data System (ADS)

Mousa, Farag I. K.; Almaadeed, Noor; Busawon, Krishna; Bouridane, Ahmed; Binns, Richard; Elliot, Ian

2018-01-01

Visible light communication (VLC) based on light-emitting diodes (LEDs) technology not only provides higher data rate for indoor wireless communications and offering room illumination but also has the potential for indoor localization. VLC-based indoor positioning using the received optical power levels from emitting LEDs is investigated. We consider both scenarios of line-of-sight (LOS) and LOS with non-LOS (LOSNLOS) positioning. The performance of the proposed system is evaluated under both noisy and noiseless channel as is the impact of different location codes on positioning error. The analytical model of the system with noise and the corresponding numerical evaluation for a range of signal-to-noise ratio (SNR) are presented. The results show that an accuracy of <10 cm on average is achievable at an SNR>12 dB.

Investigation of Mechanical Properties and Fracture Simulation of Solution-Treated AA 5754

NASA Astrophysics Data System (ADS)

Kumar, Pankaj; Singh, Akhilendra

2017-10-01

In this work, mechanical properties and fracture toughness of as-received and solution-treated aluminum alloy 5754 (AA 5754) are experimentally evaluated. Solution heat treatment of the alloy is performed at 530 °C for 2 h, and then, quenching is done in water. Yield strength, ultimate tensile strength, impact toughness, hardness, fatigue life, brittle fracture toughness (K_{Ic} ) and ductile fracture toughness (J_{Ic} ) are evaluated for as-received and solution-treated alloy. Extended finite element method has been used for the simulation of tensile and fracture behavior of material. Heaviside function and asymptotic crack tip enrichment functions are used for modelling of the crack in the geometry. Ramberg-Osgood material model coupled with fracture energy is used to simulate the crack propagation. Fracture surfaces obtained from various mechanical tests are characterized by scanning electron microscopy.

The influence of an audience response system on knowledge retention: an application to resident education.

PubMed

Pradhan, Archana; Sparano, Dina; Ananth, Cande V

2005-11-01

The purpose of the study was to compare delivery methods of lecture material regarding contraceptive options by either traditional or interactive lecture style with the use of an audience response system with obstetrics and gynecology residents. A prospective, randomized controlled trial that included 17 obstetrics and gynecology residents was conducted. Group differences and comparison of pre/posttest scores to evaluate efficacy of lecture styles were performed with the Student t test. Each participant completed an evaluation to assess usefulness of the audience response system. Residents who received audience response system interactive lectures showed a 21% improvement between pretest and posttest scores; residents who received the standard lecture demonstrated a 2% improvement (P = .018). The evaluation survey showed that 82% of residents thought that the audience response system was a helpful learning aid. The results of this randomized controlled trial demonstrate the effectiveness of audience response system for knowledge retention, which suggests that it may be an efficient teaching tool for residency education.

Evaluation of a web-based lifestyle coach designed to maintain a healthy bodyweight.

PubMed

Kelders, Saskia M; van Gemert-Pijnen, Julia E W C; Werkman, Andrea; Seydel, Erwin R

2010-01-01

We evaluated a web-based intervention, the Healthy Weight Assistant (HWA), which was designed to help people with a healthy bodyweight, or those who are slightly overweight, to achieve and maintain a healthy weight. Four evaluation methods were used: (1) pre- and post-test questionnaires; (2) real time usability-tests; (3) log-file analysis; (4) qualitative analysis of forum posts, email messages and free-text responses in the questionnaires. A total of 703 respondents received access to the HWA. Six weeks after receiving access, 431 respondents completed a second questionnaire. The enthusiastic responses showed that many people were interested in using an interactive online application to support achieving and maintaining a healthy weight. The preliminary results suggest that improvements with respect to motivation may lead to large effects, yet require only small changes in the design of the HWA. Sending automatic tailored reminders may enhance motivation to keep using the application. Motivation to change behaviour may be enhanced by emphasizing goal setting and visualizing progress.

MIMO channel estimation and evaluation for airborne traffic surveillance in cellular networks

NASA Astrophysics Data System (ADS)

Vahidi, Vahid; Saberinia, Ebrahim

2018-01-01

A channel estimation (CE) procedure based on compressed sensing is proposed to estimate the multiple-input multiple-output sparse channel for traffic data transmission from drones to ground stations. The proposed procedure consists of an offline phase and a real-time phase. In the offline phase, a pilot arrangement method, which considers the interblock and block mutual coherence simultaneously, is proposed. The real-time phase contains three steps. At the first step, it obtains the priori estimate of the channel by block orthogonal matching pursuit; afterward, it utilizes that estimated channel to calculate the linear minimum mean square error of the received pilots. Finally, the block compressive sampling matching pursuit utilizes the enhanced received pilots to estimate the channel more accurately. The performance of the CE procedure is evaluated by simulating the transmission of traffic data through the communication channel and evaluating its fidelity for car detection after demodulation. Simulation results indicate that the proposed CE technique enhances the performance of the car detection in a traffic image considerably.

Apparatus for monitoring high temperature ultrasonic characterization

DOEpatents

Lanagan, Michael T.; Kupperman, David S.; Yaconi, George A.

1998-01-01

A method and an apparatus for nondestructive detecting and evaluating chas in the microstructural properties of a material by employing one or more magnetostrictive transducers linked to the material by means of one or more sonic signal conductors. The magnetostrictive transducer or transducers are connected to a pulser/receiver which in turn is connected to an oscilloscope. The oscilloscope is connected to a computer which employs an algorithm to evaluate changes in the velocity of a signal transmitted to the material sample as function of time and temperature.

Beef customer satisfaction: USDA quality grade and marination effects on consumer evaluations of top round steaks.

PubMed

Behrends, J M; Goodson, K J; Koohmaraie, M; Shackelford, S D; Wheeler, T L; Morgan, W W; Reagan, J O; Gwartney, B L; Wise, J W; Savell, J W

2005-03-01

An in-home beef study evaluated consumer ratings of top round steaks (semimembranosus) as influenced by USDA quality grade (top Choice or high Select), city (Chicago or Philadelphia), consumer segment (beef loyalists = heavy consumers of beef; budget rotators = cost-driven and split meat consumption between beef and chicken; and variety rotators = higher incomes and education and split meat consumption among beef, poultry, and other foods), degree of doneness, cooking method, and marination. Consumers evaluated each steak for overall like, tenderness, juiciness, flavor like, and flavor amount using 10-point scales (1 = dislike extremely, not at all tender, not at all juicy, dislike extremely, and none at all to 10 = like extremely, extremely tender, extremely juicy, like extremely, and an extreme amount of flavor, respectively). Quality grade affected several consumer sensory traits, with top Choice receiving higher (P < or = 0.004) tenderness, juiciness, and flavor like scores than high Select. Consumers in Chicago rated steaks cooked "medium and less" higher for overall like, tenderness, juiciness, flavor like, and flavor amount than those in Philadelphia (city x degree of doneness; P < or = 0.020). Steaks braised by customers in Philadelphia received among the highest scores for overall like, tenderness, juiciness, flavor like, and flavor amount compared with any cooking method used by customers in Chicago (cooking method x city; P < or = 0.026). Overall like and flavor amount ratings were least (P < 0.05) for steaks that were marinated and cooked to "medium and less" degree of doneness (marination x degree of doneness; P < or = 0.014). Braised steaks received among the highest values for overall like, tenderness, juiciness, flavor like, and flavor amount when cooked to "medium and less" or "medium well and more" (cooking method x degree of doneness; P < or = 0.008). Correlation and stepwise regression analysis indicated that flavor like was pivotal in customers' satisfaction with top round steaks, and was the sensory trait most highly correlated to overall like, followed by tenderness, flavor amount, and juiciness. Preparation of top round steaks was crucial in consumers' likes and dislikes, and by improving flavor, higher consumer satisfaction may be achieved.

Determining Electrical Properties Based on B1 Fields Measured in an MR Scanner Using a Multi-channel Transmit/Receive Coil: a General Approach

PubMed Central

Liu, Jiaen; Zhang, Xiaotong; Van de Moortele, Pierre-Francois; Schmitter, Sebastian

2013-01-01

Electrical Property Tomography (EPT) is a recently developed noninvasive technology to image the electrical conductivity and permittivity of biological tissues at Larmor frequency in Magnetic Resonance (MR) scanners. The absolute phase of the complex radio-frequency (RF) magnetic field (B1) is necessary for electrical property calculation. However, due to the lack of practical methods to directly measure the absolute B1 phases, current EPT techniques have been achieved with B1 phase estimation based on certain assumptions on object anatomy, coil structure and/or electromagnetic wave behavior associated with the main magnetic field, limiting EPT from a larger variety of applications. In this study, using a multi-channel transmit/receive coil, the framework of a new general approach for EPT has been introduced, which is independent on the assumptions utilized in previous studies. Using a human head model with realistic geometry, a series of computer simulations at 7T were conducted to evaluate the proposed method under different noise levels. Results showed that the proposed method can be used to reconstruct the conductivity and permittivity images with noticeable accuracy and stability. The feasibility of this approach was further evaluated in a phantom experiment at 7T. PMID:23743673

Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach?

PubMed Central

Lorgelly, Paula K.; Lawson, Kenny D.; Fenwick, Elisabeth A.L.; Briggs, Andrew H.

2010-01-01

Public health interventions have received increased attention from policy makers, and there has been a corresponding increase in the number of economic evaluations within the domain of public health. However, methods to evaluate public health interventions are less well established than those for medical interventions. Focusing on health as an outcome measure is likely to underestimate the impact of many public health interventions. This paper provides a review of outcome measures in public health; and describes the benefits of using the capability approach as a means to developing an all encompassing outcome measure. PMID:20623024

Evaluation of a community based childhood injury prevention program.

PubMed Central

Bablouzian, L.; Freedman, E. S.; Wolski, K. E.; Fried, L. E.

1997-01-01

OBJECTIVES: This pilot study evaluates the effectiveness of a community based childhood injury prevention program on the reduction of home hazards. METHODS: High risk pregnant women, who were enrolled in a home visiting program that augments existing health and human services, received initial home safety assessments. Clients received education about injury prevention practices, in addition to receiving selected home safety supplies. Fourteen questions from the initial assessment tool were repeated upon discharge from the program. Matched analyses were conducted to evaluate differences from initial assessment to discharge. RESULTS: A significantly larger proportion of homes were assessed as safe at discharge, compared with the initial assessment, for the following hazards: children riding unbuckled in all auto travel, Massachusetts Poison Center sticker on the telephone, outlet plugs in all unused electrical outlets, safety latches on cabinets and drawers, and syrup of ipecac in the home. CONCLUSIONS: A community based childhood injury prevention program providing education and safety supplies to clients significantly reduced four home hazards for which safety supplies were provided. Education and promotion of the proper use of child restraint systems in automobiles significantly reduced a fifth hazard, children riding unbuckled in auto travel. This program appears to reduce the prevalence of home hazards and, therefore, to increase home safety. PMID:9113841

271 Evaluation of Adverse Events Associated to Administration of Omalizumab

PubMed Central

Gomez, R. Maximiliano; Vinuesa, Miguel; Teijeiro, Alvaro; Ivancevich, Juan Carlos; Jares, Edgardo; Baena-Cagnani, Carlos E.

2012-01-01

Background Anti IgE therapy is the ultimate therapeutic option for severe atopic conditions, not controlled by conventional treatment. Its efficacy and safety was described in several peer reviewed publications. Here we report on the events temporally related to the administration of almost 4 hundred doses of the only monoclonal Anti IgE antibody approved in our country for the treatment of severe asthma. Methods Descriptive retrospective analysis of clinical charts of patients receiving omalizumab because of Severe Uncontrolled Asthma, considering those events presented in the 72 hours after administration of it, which was not present before the procedure or as a concomitant condition of the patient. Vital signs, respiratory and cardiovascular evaluation, and dermatological inspection were performed in the hour after administration of corresponding doses. Patients having any kind of complaint were evaluated in unscheduled visits. Results 384 doses of 150 mg omalizumab were given to from April 2007 to June 2011, to nine severe asthmatic patients. One of them received treatment for over 4 years, and two for over 3 years. Conclusions Our records from patients receiving omalizumab have not registered severe adverse events in almost four hundred doses given. The moderate adverse events of nausea and tachycardia resulted in discontinuation of treatment in this unique patient. Overall, omalizumab demonstrated a very acceptable safety profile in our patients.

Identifying Drivers of Overall Satisfaction in Patients Receiving HIV Primary Care: A Cross-Sectional Study

PubMed Central

Dang, Bich N.; Westbrook, Robert A.; Rodriguez-Barradas, Maria C.; Giordano, Thomas P.

2012-01-01

Objective This study seeks to understand the drivers of overall patient satisfaction in a predominantly low-income, ethnic-minority population of HIV primary care patients. The study’s primary aims were to determine 1) the component experiences which contribute to patients’ evaluations of their overall satisfaction with care received, and 2) the relative contribution of each component experience in explaining patients’ evaluation of overall satisfaction. Methods We conducted a cross-sectional study of 489 adult patients receiving HIV primary care at two clinics in Houston, Texas, from January 13–April 21, 2011. The participation rate among eligible patients was 94%. The survey included 15 questions about various components of the care experience, 4 questions about the provider experience and 3 questions about overall care. To ensure that the survey was appropriately tailored to our clinic population and the list of component experiences reflected all aspects of the care experience salient to patients, we conducted in-depth interviews with key providers and clinic staff and pre-tested the survey instrument with patients. Results Patients’ evaluation of their provider correlated the strongest with their overall satisfaction (standardized β = 0.445, p<0.001) and accounted for almost half of the explained variance. Access and availability, like clinic hours and ease of calling the clinic, also correlated with overall satisfaction, but less strongly. Wait time and parking, despite receiving low patient ratings, did not correlate with overall satisfaction. Conclusions The patient-provider relationship far exceeds other component experiences of care in its association with overall satisfaction. Our study suggests that interventions to improve overall patient satisfaction should focus on improving patients’ evaluation of their provider. PMID:22912770

Localized time-lapse elastic waveform inversion using wavefield injection and extrapolation: 2-D parametric studies

NASA Astrophysics Data System (ADS)

Yuan, Shihao; Fuji, Nobuaki; Singh, Satish; Borisov, Dmitry

2017-06-01

We present a methodology to invert seismic data for a localized area by combining source-side wavefield injection and receiver-side extrapolation method. Despite the high resolving power of seismic full waveform inversion, the computational cost for practical scale elastic or viscoelastic waveform inversion remains a heavy burden. This can be much more severe for time-lapse surveys, which require real-time seismic imaging on a daily or weekly basis. Besides, changes of the structure during time-lapse surveys are likely to occur in a small area rather than the whole region of seismic experiments, such as oil and gas reservoir or CO2 injection wells. We thus propose an approach that allows to image effectively and quantitatively the localized structure changes far deep from both source and receiver arrays. In our method, we perform both forward and back propagation only inside the target region. First, we look for the equivalent source expression enclosing the region of interest by using the wavefield injection method. Second, we extrapolate wavefield from physical receivers located near the Earth's surface or on the ocean bottom to an array of virtual receivers in the subsurface by using correlation-type representation theorem. In this study, we present various 2-D elastic numerical examples of the proposed method and quantitatively evaluate errors in obtained models, in comparison to those of conventional full-model inversions. The results show that the proposed localized waveform inversion is not only efficient and robust but also accurate even under the existence of errors in both initial models and observed data.

Do Pediatric Hematology/Oncology (PHO) Fellows Receive Communication Training?

PubMed Central

File, Wilson; Bylund, Carma L.; Kesselheim, Jennifer; Leonard, David; Leavey, Patrick

2017-01-01

Purpose The Accreditation Council for Graduate Medical Education (ACGME) has established communication as a core competency for physicians in training. However, data suggest that most pediatric residents perceive inadequate training in the delivery of bad news and the majority of former trainees in pediatric oncology received no formal training in the delivery of bad news during fellowship. The study examines communication training in ACGME accredited US pediatric hematology-oncology (PHO) fellowship programs. Methods An online survey was distributed to 315 PHO fellows in training via the American Society of Pediatric Hematology/Oncology (ASPHO) fellow email registry. Each fellow received an initial request to participate and 2 reminders, while participation was encouraged through a random incentive drawing. Results One hundred and ten fellows (35%) responded. Eighty percent of respondents perceived communication training to be important to fellow education, however only 32% reported receiving communication training (other than direct observation). The most common reported teaching method of fellowship communication training was formal lecture (42%). Twenty-three percent of respondents reported neither communication training nor frequent feedback on their communication skills from faculty observation. This same group was the least satisfied with their programs’ approach to teaching communication (P < 0.001). Conclusions There is limited communication training in PHO fellowships despite ACGME requirements and fellows’ interest in this training. Didactic learning remains the most frequently described training method, yet educational theory identifies the limitation of didactic lectures alone. Communication training employing novel teaching methods and emphasizing communication challenges identified by fellows should be developed and evaluated. PMID:24039096

Changes in Quality of Life in 7 Older Adult Patients Receiving Activator Methods Chiropractic Technique

PubMed Central

Russell, David G.; Kimura, Melissa N.; Cowie, Harriet R.; de Groot, Caroline M.M.; McMinn, Elise A.P.; Sherson, Matthew W.

2016-01-01

Objective The purpose of this case series is to report on symptomatic and quality of life (QoL) changes in 7 older adult chiropractic patients who were receiving care using Activator Methods Chiropractic Technique (AMCT). Clinical Features Seven patients were selected from 2 chiropractic offices in Auckland, New Zealand. Patients were included if they were older adults receiving AMCT care and for whom at least 2 QoL assessments had been performed. The patients, aged 69-80 years, primarily received care for a variety of musculoskeletal complaints. Intervention and Outcomes The patients reported improvements in their presenting complaints as well as a number of nonmusculoskeletal symptoms. Each patient demonstrated clinical improvements in their RAND 36-Item Short Form Health Survey (SF-36) results. The average improvement in QoL measured using a SF-36 questionnaire was 8.0 points in the physical component and 4.1 points in the mental component. Four cases had a second progress evaluation using the SF-36 and showed an overall improvement of 5.2 in the physical and 9.8 in the mental components from baseline. Conclusion This case series describes an improvement in QoL, as measured by the SF-36 instrument, as well as subjectively reported improvements in both musculoskeletal and nonmusculoskeletal symptoms in 7 older adults receiving chiropractic care. PMID:27069434

Unprogrammed Deworming in the Kibera Slum, Nairobi: Implications for Control of Soil-Transmitted Helminthiases

PubMed Central

Harris, Julie R.; Worrell, Caitlin M.; Davis, Stephanie M.; Odero, Kennedy; Mogeni, Ondari D.; Deming, Michael S.; Mohammed, Aden; Montgomery, Joel M.; Njenga, Sammy M.; Fox, LeAnne M.; Addiss, David G.

2015-01-01

Background Programs for control of soil-transmitted helminth (STH) infections are increasingly evaluating national mass drug administration (MDA) interventions. However, “unprogrammed deworming” (receipt of deworming drugs outside of nationally-run STH control programs) occurs frequently. Failure to account for these activities may compromise evaluations of MDA effectiveness. Methods We used a cross-sectional study design to evaluate STH infection and unprogrammed deworming among infants (aged 6–11 months), preschool-aged children (PSAC, aged 1–4 years), and school-aged children (SAC, aged 5–14 years) in Kibera, Kenya, an informal settlement not currently receiving nationally-run MDA for STH. STH infection was assessed by triplicate Kato-Katz. We asked heads of households with randomly-selected children about past-year receipt and source(s) of deworming drugs. Local non-governmental organizations (NGOs) and school staff participating in school-based deworming were interviewed to collect information on drug coverage. Results Of 679 children (18 infants, 184 PSAC, and 477 SAC) evaluated, 377 (55%) reported receiving at least one unprogrammed deworming treatment during the past year. PSAC primarily received treatments from chemists (48.3%) or healthcare centers (37.7%); SAC most commonly received treatments at school (55.0%). Four NGOs reported past-year deworming activities at 47 of >150 schools attended by children in our study area. Past-year deworming was negatively associated with any-STH infection (34.8% vs 45.4%, p = 0.005). SAC whose most recent deworming medication was sourced from a chemist were more often infected with Trichuris (38.0%) than those who received their most recent treatment from a health center (17.3%) or school (23.1%) (p = 0.05). Conclusion Unprogrammed deworming was received by more than half of children in our study area, from multiple sources. Both individual-level treatment and unprogrammed preventive chemotherapy may serve an important public health function, particularly in the absence of programmed deworming; however, they may also lead to an overestimation of programmed MDA effectiveness. A standardized, validated tool is needed to assess unprogrammed deworming. PMID:25763577

Store-operate-coherence-on-value

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

Chen, Dong; Heidelberger, Philip; Kumar, Sameer

A system, method and computer program product for performing various store-operate instructions in a parallel computing environment that includes a plurality of processors and at least one cache memory device. A queue in the system receives, from a processor, a store-operate instruction that specifies under which condition a cache coherence operation is to be invoked. A hardware unit in the system runs the received store-operate instruction. The hardware unit evaluates whether a result of the running the received store-operate instruction satisfies the condition. The hardware unit invokes a cache coherence operation on a cache memory address associated with the receivedmore » store-operate instruction if the result satisfies the condition. Otherwise, the hardware unit does not invoke the cache coherence operation on the cache memory device.« less

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education.

PubMed

Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

2015-01-01

There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001). The top three highest average satisfaction scores in the new EM curriculum group were trauma workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

Dependent, but not Perfectionistic, Dysfunctional Attitudes Predict Worsened Mood and Appraisals after Emotional Support from a Romantic Partner

PubMed Central

Felix, Steven A. M.; Hooker, Christine I.

2016-01-01

Background: Receiving emotional support from a romantic partner often leads to emotional costs via negative appraisals about the self and one's relationship, but it is unclear whether certain individuals are more susceptible to these costs. We evaluate whether the presence of perfectionistic and dependent dysfunctional attitudes leads to more negative effects of receiving emotional support from a romantic partner. Methods: Twenty-nine couples (27 men, 31 women; mean age 24.5) completed the Dysfunctional Attitudes Scale and then a daily online questionnaire by recording their mood, appraisals, and received emotional support. Mixed-effects regressions were used to evaluate whether perfectionistic and dependent dysfunctional attitudes moderated the relationship between emotional support receipt and subsequent mood and appraisals. Results: Perfectionism did not interact with emotional support but exerted a main effect of increasing negative moods and appraisals. Dependency interacted with emotional support such that those with more dependent attitudes reported greater negative next-day moods and appraisals as a function of emotional support. Conclusions: Individuals with dependent, but not perfectionistic, dysfunctional attitudes are more likely to experience emotional and cognitive costs after receiving emotional support. These costs may stem from activation or exacerbation of the attitudes specific to dependency, including need for acceptance, support, and approval of others. PMID:27790161

Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery.

PubMed

Jacobsen, Paul B; DeRosa, Antonio P; Henderson, Tara O; Mayer, Deborah K; Moskowitz, Chaya S; Paskett, Electra D; Rowland, Julia H

2018-05-18

Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan (SCP) comprising a treatment summary and follow-up care plans. Among current barriers to implementation are providers' concerns about the strength of evidence that SCPs improve outcomes. This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors. Methods Randomized and nonrandomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Data extracted by independent raters were summarized on the basis of qualitative synthesis. Results Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed. Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs. Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being); findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care. Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes. Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care.

Evaluation of the dose received in the tissues of the neck during quantification of iodine in the thyroid by X-ray fluorescence spectrometry

NASA Astrophysics Data System (ADS)

Portararo, Antonio; Licour, Caroline; Gerardy, Isabelle; Pozuelo Navarro, Fausto

2018-04-01

The determination of the iodine content in the thyroid is of great interest for many investigations of this gland. The conventional scintigraphic method, using radionuclides, is efficient but delivers a significant dose to the patient. The X-ray fluorescence spectrometry could give information about the iodine content in the thyroid. The measured signal is obtained after stimulation of the stable iodine contained in the gland by X-rays. The advantage of this technique is the complete absence of radioactive isotope injected into the patient body. By applying this, a decrease in effective dose to the patient should be obtained. In this work, the study of the dose received by a thyroid phantom (surrounded by the different tissues of the neck) was performed. The phantom is made of PLA. The dose is measured in optimised conditions defined for the analytical technique. A total head-neck phantom was also used in order to consider the absorbed dose in each different tissues and organs as spinal cord or eyes. Thermo-luminescence dosimeters were chosen for their small size, their sensitivity and the easy positioning on the surface of the phantom but also inside of it to evaluate dose to internal organs. Those LiF 100 dosimeters have been calibrated within the X-ray beam also used for the analysis of iodine. The repeatability and reproducibility of the method has been evaluated. The influence of parameters as concentration of iodine in the thyroid, distance between the X-ray generator and the neck, thickness of the tissues surrounding the thyroid, has been investigated in terms of modifying parameters of the dose received by different tissues situated in the neck and the head.

The impact of early psychosocial intervention on self-efficacy of care recipient/carer dyads living with early stage dementia - A mixed methods study.

PubMed

Stockwell-Smith, G; Moyle, W; Kellett, U

2018-05-13

To evaluate the effect of a targeted community-based psychosocial intervention on self-efficacy outcomes for care recipient/carer dyads living with early-stage dementia. There is increasing interest in the role of self-efficacy and self-management structures in determining positive outcomes for people with dementia. The assumption is that care recipient/carer dyads who receive early support to identify and adjust to dementia related changes will cope better in the long-term. An explanatory sequential mixed-method design was employed. Primarily quantitative with qualitative data providing a supportive secondary role to expand on and illuminate the quantitative findings. 88 dyads were recruited and allocated on a regional basis to an intervention or control group. Intervention group dyads received the Early Diagnosis Dyadic Intervention. Control group dyads received two information manuals. Quantitative data were collected at three time-points. Qualitative data were collected via evaluation questionnaires and semi-structured interviews. Intervention structure, content and delivery were acceptable to the dyads but few quantitative self-efficacy findings reached statistical significance. Improvements in self-efficacy were evident in the post-intervention evaluation qualitative responses where dyads expressed greater confidence in identifying and accessing community support. There is an urgent need for effective psychosocial interventions to help reduce the impact of dementia symptoms on patients, carers and society. This study makes an important contribution to our understanding of the capacity of psychosocial interventions to improve self-efficacy outcomes for care recipient/carer dyads with early-stage dementia while also illustrating the challenges associated with measuring self-efficacy in the early stages of the condition. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Web-Based Tailored Intervention for Preparation of Parents and Children for Outpatient Surgery (WebTIPS): Formative Evaluation and Randomized Controlled Trial

PubMed Central

Fortier, Michelle A.; Bunzli, Elizabeth; Walthall, Jessica; Olshansky, Ellen; Saadat, Haleh; Santistevan, Ricci; Mayes, Linda; Kain, Zeev N.

2015-01-01

Background The purpose of this two-phase project was to conduct formative evaluation and test the preliminary efficacy of a newly developed web-based, tailored behavioral preparation program (WebTIPS) for children undergoing outpatient surgery and their parents Methods Phase I enrolled 13 children aged 2–7 years undergoing outpatient elective surgery and their parents for formative evaluation of WebTIPS. Parent participation focus groups which are common in qualitative research and are a method of asking research participants about their perceptions and attitudes regarding a product or concept. In phase II, children age 2–7 years in two medical centers were randomly assigned to receive the WebTIPS program (n = 38) compared to children receiving standard of care (n = 44). The primary outcome of phase II was child and parent preoperative anxiety. Results In phase I, parents reported WebTIPS to be both helpful (p < 0.001) and easy to use (p < 0.001). In phase II, children in the WebTIPS group (36.2 ± 14.1) were less anxious than children in the standard of care group (46.0 ± 19.0) at entrance to the operating room (p = 0.02; Cohen’s d = 0.59) and introduction of the anesthesia mask (43.5 ± 21.7 vs. 57.0 ± 21.2, respectively, p = 0.01; Cohen’s d = 0.63). Parents in the WebTIPS group (32.1 ± 7.4) also experienced less anxiety compared to parents in the control group (36.8 ± 7.1) in the preoperative holding area (p = 0.004; Cohen’s d = 0.65). Conclusions WebTIPS was well received by parents and children and led to reductions in preoperative anxiety. PMID:25790213

A new numerical method for calculating extrema of received power for polarimetric SAR

USGS Publications Warehouse

Zhang, Y.; Zhang, Jiahua; Lu, Z.; Gong, W.

2009-01-01

A numerical method called cross-step iteration is proposed to calculate the maximal/minimal received power for polarized imagery based on a target's Kennaugh matrix. This method is much more efficient than the systematic method, which searches for the extrema of received power by varying the polarization ellipse angles of receiving and transmitting polarizations. It is also more advantageous than the Schuler method, which has been adopted by the PolSARPro package, because the cross-step iteration method requires less computation time and can derive both the maximal and minimal received powers, whereas the Schuler method is designed to work out only the maximal received power. The analytical model of received-power optimization indicates that the first eigenvalue of the Kennaugh matrix is the supremum of the maximal received power. The difference between these two parameters reflects the depolarization effect of the target's backscattering, which might be useful for target discrimination. ?? 2009 IEEE.

Caring for Others: Internet Video-Conferencing Group Intervention for Family Caregivers of Older Adults with Neurodegenerative Disease

ERIC Educational Resources Information Center

Marziali, Elsa; Donahue, Peter

2006-01-01

Purpose: The aim of this pilot feasibility study was to evaluate the effects of an innovative, Internet-based psychosocial intervention for family caregivers of older adults with neurodegenerative disease. Design and Methods: After receiving signed informed consent from each participant, we randomly assigned 66 caregivers to an Internet-based…

Evaluating Twitter and Its Impact on Student Learning in Principles of Economics Courses

ERIC Educational Resources Information Center

Al-Bahrani, Abdullah; Patel, Darshak; Sheridan, Brandon J.

2017-01-01

Ever since Becker and Watts (1996) found that economic educators rely heavily on "chalk and talk" as a primary teaching method, economic educators have been seeking new ways to engage students and improve learning outcomes. Recently, the use of social media as a pedagogical tool in economics has received increasing interest. The authors…

Evaluation of Bias Correction Methods for "Worst-case" Selective Non-participation in NAEP

ERIC Educational Resources Information Center

McLaughlin, Don; Gallagher, Larry; Stancavage, Fran

2004-01-01

With the advent of No Child Left Behind (NCLB), the context for NAEP participation is changing. Whereas in the past participation in NAEP has always been voluntary, participation is now mandatory for some grade and subjects among schools receiving Title I funds. While this will certainly raise school-level participation rates in the mandated…

How to Find Good Apps: An Evaluation Rubric for Instructional Apps for Teaching Students with Learning Disabilities

ERIC Educational Resources Information Center

Ok, Min Wook; Kim, Min Kyung; Kang, Eun Young; Bryant, Brian R.

2016-01-01

Computers can be an effective teaching method for students with learning disabilities (LD). The use of mobile devices as education tools for students with disabilities has received considerable attention in special education recently. Parents, teachers, and professionals look for effective applications (i.e., apps) that meet the needs of their…

Venlafaxine ER for the Treatment of Pediatric Subjects with Depression: Results of Two Placebo-Controlled Trials

ERIC Educational Resources Information Center

Emslie, Graham J.; Findling, Robert L.; Yeung, Paul P.; Kunz, Nadia R.; Li, Yunfeng

2007-01-01

Objective: The safety, efficacy, and tolerability of venlafaxine extended release (ER) in subjects ages 7 to 17 years with major depressive disorder were evaluated in two multicenter, randomized, double-blind, placebo-controlled trials conducted between October 1997 and August 2001. Method: Participants received venlafaxine ER (flexible dose,…

Intercultural Encounters as a "Mind Body" Experience: A Case Study in Jerusalem

ERIC Educational Resources Information Center

Bar Shalom, Yehuda; Grebelsy-Lichtman, Tsfira; Alayan, Fatima

2018-01-01

This study presents new techniques for teaching diversity, when dealing with the challenges of multicultural society. We present a course model, which incorporates methods that have been developed by the Center for Mind-Body Medicine (CMBM), and continue to disclose and analyse some of the reactions and evaluations we received from the…

Improved water quality and reduction of odorous compounds in anaerobic lagoon columns receiving pre-treated pig wastewater

USDA-ARS?s Scientific Manuscript database

Large volumes of wastewater from confined pig production are stored in anaerobic lagoons. Control methods are needed to reduce air pollution by foul odors released from these lagoons. In a pilot-scale experiment, we evaluated the effect of pig wastewater pre-treatment on reducing the concentration o...

Clinical Features of Psychogenic Voice Disorder and the Efficiency of Voice Therapy and Psychological Evaluation.

PubMed

Tezcaner, Zahide Çiler; Gökmen, Muhammed Fatih; Yıldırım, Sibel; Dursun, Gürsel

2017-11-06

The aim of this study was to define the clinical features of psychogenic voice disorder (PVD) and explore the treatment efficiency of voice therapy and psychological evaluation. Fifty-eight patients who received treatment following the PVD diagnosis and had no organic or other functional voice disorders were assessed retrospectively based on laryngoscopic examinations and subjective and objective assessments. Epidemiological characteristics, accompanying organic and psychological disorders, preferred methods of treatment, and previous treatment outcomes were examined for each patient. A comparison was made based on voice disorders and responses to treatment between patients who received psychotherapy and patients who did not. Participants in this study comprised 58 patients, 10 male and 48 female. Voice therapy was applied in all patients, 54 (93.1%) of whom had improvement in their voice. Although all patients were advised to undergo psychological assessment, only 60.3% (35/58) of them underwent psychological assessment. No statistically significant difference was found between patients who did receive psychological support concerning their treatment responses and patients who did not. Relapse occurred in 14.7% (5/34) of the patients who applied for psychological assessment and in 50% (10/20) of those who did not. There was a statistically significant difference in relapse rates, which was higher among patients who did not receive psychological support (P < 0.005). Voice therapy is an efficient treatment method for PVD. However, in the long-term follow-up, relapse of the disease is observed to be higher among patients who failed to follow up on the recommendation for psychological assessment. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Process Evaluation of a Blended Web-Based Intervention on Return to Work for Sick-Listed Employees with Common Mental Health Problems in the Occupational Health Setting.

PubMed

Volker, D; Zijlstra-Vlasveld, M C; Brouwers, E P M; van der Feltz-Cornelis, C M

2017-06-01

Purpose A blended web-based intervention, "eHealth module embedded in collaborative occupational health care" (ECO), aimed at return to work, was developed and found effective in sick-listed employees with common mental disorders. In order to establish the feasibility of ECO, a process evaluation was conducted. Methods Seven process components were investigated: recruitment, reach, dose delivered, dose received, fidelity, satisfaction and context. Quantitative and qualitative methods were used to collect data: an online questionnaire for the employees, website data, telephonic interviews with occupational physicians (OPs) and observations of the researchers. Results Recruitment was uncomplicated for the employees, but required several steps for the OPs. Reach was 100 % at the OP level and 76.3 % at the employee level. Dose delivered and received for OPs: 91.6 % received minimally one email message. Dose delivered and received for the employees: finishing of the different modules of ECO varied between 13 and 90 %. Fidelity: the support of the OP to the employee in ECO was lower than anticipated. Satisfaction: both employees and OPs were satisfied with the intervention. However, employees reported a need for more support in ECO. The context showed that OPs had limited time to support the employees and it was impossible for the employee to contact the OP outside their regular contacts. Conclusion Feasibility of ECO and satisfaction of employees and OPs with ECO were good. Fidelity of OPs was limited. For further implementation in the occupational health setting, especially contextual barriers regarding time limitation and accessibility of OPs for employees should be addressed.

PCVs Estimation and their Impacts on Precise Orbit Determination of LEOs

NASA Astrophysics Data System (ADS)

Chunmei, Z.; WANG, X.

2017-12-01

In the last decade the precise orbit determination (POD) based on GNSS, such as GPS, has been considered as one of the efficient methods to derive orbits of Low Earth Orbiters (LEOs) that demand accuracy requirements. The Earth gravity field recovery and its related researches require precise dynamic orbits of LEOs. With the improvements of GNSS satellites' orbit and clock accuracy, the algorithm optimization and the refinement of perturbation force models, the antenna phase-center variations (PCVs) of space-borne GNSS receiver have become an increasingly important factor that affects POD accuracy. A series of LEOs such as HY-2, ZY-3 and FY-3 with homebred space-borne GNSS receivers have been launched in the past several years in China. Some of these LEOs load dual-mode GNSS receivers of GPS and BDS signals. The reliable performance of these space-borne receivers has been establishing an important foundation for the future launches of China gravity satellites. Therefore, we first evaluate the data quality of on-board GNSS measurement by examining integrity, multipath error, cycle slip ratio and other quality indices. Then we determine the orbits of several LEOs at different altitudes by the reduced dynamic orbit determination method. The corresponding ionosphere-free carrier phase post-fit residual time series are obtained. And then we establish the PCVs model by the ionosphere-free residual approach and analyze the effects of antenna phase-center variation on orbits. It is shown that orbit accuracy of LEO satellites is greatly improved after in-flight PCV calibration. Finally, focus on the dual-mode receiver of FY-3 satellite we analyze the quality of onboard BDS data and then evaluate the accuracy of the FY-3 orbit determined using only BDS measurement onboard. The accuracy of LEO satellites orbit based on BDS would be well improved with the global completion of BDS by 2020.

Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement

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

Bingham, Brian; Orton, Andrew; Boothe, Dustin

Purpose: To evaluate the survival benefit of adding vaginal brachytherapy (BT) to pelvic external beam radiation therapy (EBRT) in women with stage III endometrial cancer. Methods and Materials: The National Cancer Data Base was used to identify patients with stage III endometrial cancer from 2004 to 2013. Only women who received adjuvant EBRT were analyzed. Women were grouped according to receipt of BT. Logistic regression modeling was used to identify predictors of receiving BT. Log–rank statistics were used to compare survival outcomes. Cox proportional hazards modeling was used to evaluate the effect of BT on survival. A propensity score–matched analysismore » was also conducted among women with cervical involvement. Results: We evaluated 12,988 patients with stage III endometrial carcinoma, 39% of whom received EBRT plus BT. Women who received BT were more likely to have endocervical or cervical stromal involvement (odds ratios 2.03 and 1.77; P<.01, respectively). For patients receiving EBRT alone, the 5-year survival was 66% versus 69% with the addition of BT at 5 years (P<.01). Brachytherapy remained significantly predictive of decreased risk of death (hazard ratio 0.86; P<.01) on multivariate Cox regression. The addition of BT to EBRT did not affect survival among women without cervical involvement (P=.84). For women with endocervical or cervical stromal invasion, the addition of BT significantly improved survival (log–rank P<.01). Receipt of EBRT plus BT was associated with improved survival in women with positive and negative surgical margins, and receiving chemotherapy did not alter the benefit of BT. Propensity score–matched analysis results confirmed the benefit of BT among women with cervical involvement (hazard ratio 0.80; P=.01). Conclusions: In this population of women with stage III endometrial cancer the addition of BT to EBRT was associated with an improvement in survival for women with endocervical or cervical stromal invasion.« less

Antiallergic effect of the atomized extract of rhizome of Curcuma longa, flowers of Cordia lutea and leaves of Annona muricata

PubMed Central

Arroyo-Acevedo, Jorge; Franco-Quino, Cesar; Ruiz-Ramirez, Eliberto; Chávez-Asmat, Roberto; Anampa-Guzmán, Andrea; Raéz-González, Ernesto; Cabanillas-Coral, José

2016-01-01

Introduction Allergies are a problem that greatly affects the population, and hence the use of antiallergic medications is fairly widespread. However, these drugs have many adverse effects. The use of medicinal plants could be an option, but they need to be evaluated. Objective This study was designed to evaluate the antiallergic effect of the atomized extract of rhizome of Curcuma longa, flowers of Cordia lutea, and leaves of Annona muricata. Materials and methods Twenty-four New Zealand white albino rabbits were randomized into 2 groups. Group A received the atomized extract diluted in physiological saline (APS) and group B received it diluted in Freund’s adjuvant (FA). Then, the back of each rabbit was divided into 4 quadrants. The A-I quadrant received only physiological saline. The A-I quadrants of each rabbit conformed the PS group. The following 3 quadrants received the APS in 10 μg/mL, 100 μg/mL, and 1,000 μg/mL, respectively. The B-I quadrant received only FA. The B-I quadrants of each rabbit conformed the FA group. The following 3 quadrants received the AFA in 10 μg/mL, 100 μg/mL, and 1,000 μg/mL, respectively. The occurrence of erythema and edema was recorded according to the Draize scoring system and the primary irritation index. After 72 hours, biopsies were performed. Results The AFA group presented significantly less erythema and edema compared to the FA group (P<0.05). The histopathologic evaluation at 72 hours showed normal characteristics in the APS group. Conclusion Considering the clinical and histopathological signs, we conclude that the administration of the atomized extract of rhizome of C. longa, flowers of C. lutea, and leaves of A. muricata lacks antigenic effect but could have an antiallergenic effect in a model of dermal irritation in rabbits. PMID:27877047

Evaluation of Quality of Life Following Placement of Self-Expanding Plastic Stents as a Bridge to Surgery in Patients Receiving Neoadjuvant Therapy for Esophageal Cancer

PubMed Central

Cannon, Robert M.; Brown, Russell E.; Ellis, Susan F.; Williams, Sharon; Scoggins, C.R.; Abbas, Abbas E.

2014-01-01

Purpose. To determine whether self-expanding plastic stent (SEPS) placement significantly improves quality of life and maintains optimal nutrition while allowing full-dose neoadjuvant therapy (NAT) in patients with esophageal cancer. Patients and Methods. A prospective, dual-institution, single-arm, phase II (http://ClinicalTrials.gov: NCT00727376) evaluation of esophageal cancer patients undergoing NAT prior to resection. All patients had a self-expanding polymer stent placed prior to NAT. The European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25, Functional Assessment of Cancer Therapy–Anorexia, and Functional Assessment of Cancer Therapy–General surveys were administered prior to stenting, within 1 week post-stent placement, and at the completion of neoadjuvant therapy. Results. Fifty-two patients were enrolled; 3 (5.8%) had stent migrations requiring replacement. There were no instances of esophageal erosion or perforation. All patients received some form of neoadjuvant therapy. Thirty-six (69%) received chemoradiation; 34 (93%) of these patients received the planned dose of chemotherapy, and 27 (75%) received the full planned dose of radiotherapy. There were 16 (31%) patients receiving chemotherapy alone; 12 (74%) of patients in the chemotherapy-alone group completed the planned dose of therapy. Conclusion. Placement of SEPS appears to provide significant improvement in quality of life related to dysphagia and eating restriction in patients with esophageal cancer undergoing neoadjuvant therapy. Consideration of SEPS instead of percutaneous feeding tube should be initiated as a first line in dysphagia palliation and NAT nutritional support. PMID:24567281

Fusion of multiscale wavelet-based fractal analysis on retina image for stroke prediction.

PubMed

Che Azemin, M Z; Kumar, Dinesh K; Wong, T Y; Wang, J J; Kawasaki, R; Mitchell, P; Arjunan, Sridhar P

2010-01-01

In this paper, we present a novel method of analyzing retinal vasculature using Fourier Fractal Dimension to extract the complexity of the retinal vasculature enhanced at different wavelet scales. Logistic regression was used as a fusion method to model the classifier for 5-year stroke prediction. The efficacy of this technique has been tested using standard pattern recognition performance evaluation, Receivers Operating Characteristics (ROC) analysis and medical prediction statistics, odds ratio. Stroke prediction model was developed using the proposed system.

BeiDou inter-satellite-type bias evaluation and calibration for mixed receiver attitude determination.

PubMed

Nadarajah, Nandakumaran; Teunissen, Peter J G; Raziq, Noor

2013-07-22

The Chinese BeiDou system (BDS), having different types of satellites, is an important addition to the ever growing system of Global Navigation Satellite Systems (GNSS). It consists of Geostationary Earth Orbit (GEO) satellites, Inclined Geosynchronous Satellite Orbit (IGSO) satellites and Medium Earth Orbit (MEO) satellites. This paper investigates the receiver-dependent bias between these satellite types, for which we coined the name "inter-satellite-type bias" (ISTB), and its impact on mixed receiver attitude determination. Assuming different receiver types may have different delays/biases for different satellite types, we model the differential ISTBs among three BeiDou satellite types and investigate their existence and their impact on mixed receiver attitude determination. Our analyses using the real data sets from Curtin's GNSS array consisting of different types of BeiDou enabled receivers and series of zero-baseline experiments with BeiDou-enabled receivers reveal the existence of non-zero ISTBs between different BeiDou satellite types. We then analyse the impact of these biases on BeiDou-only attitude determination using the constrained (C-)LAMBDA method, which exploits the knowledge of baseline length. Results demonstrate that these biases could seriously affect the integer ambiguity resolution for attitude determination using mixed receiver types and that a priori correction of these biases will dramatically improve the success rate.

Effects of error covariance structure on estimation of model averaging weights and predictive performance

USGS Publications Warehouse

Lu, Dan; Ye, Ming; Meyer, Philip D.; Curtis, Gary P.; Shi, Xiaoqing; Niu, Xu-Feng; Yabusaki, Steve B.

2013-01-01

When conducting model averaging for assessing groundwater conceptual model uncertainty, the averaging weights are often evaluated using model selection criteria such as AIC, AICc, BIC, and KIC (Akaike Information Criterion, Corrected Akaike Information Criterion, Bayesian Information Criterion, and Kashyap Information Criterion, respectively). However, this method often leads to an unrealistic situation in which the best model receives overwhelmingly large averaging weight (close to 100%), which cannot be justified by available data and knowledge. It was found in this study that this problem was caused by using the covariance matrix, CE, of measurement errors for estimating the negative log likelihood function common to all the model selection criteria. This problem can be resolved by using the covariance matrix, Cek, of total errors (including model errors and measurement errors) to account for the correlation between the total errors. An iterative two-stage method was developed in the context of maximum likelihood inverse modeling to iteratively infer the unknown Cek from the residuals during model calibration. The inferred Cek was then used in the evaluation of model selection criteria and model averaging weights. While this method was limited to serial data using time series techniques in this study, it can be extended to spatial data using geostatistical techniques. The method was first evaluated in a synthetic study and then applied to an experimental study, in which alternative surface complexation models were developed to simulate column experiments of uranium reactive transport. It was found that the total errors of the alternative models were temporally correlated due to the model errors. The iterative two-stage method using Cekresolved the problem that the best model receives 100% model averaging weight, and the resulting model averaging weights were supported by the calibration results and physical understanding of the alternative models. Using Cek obtained from the iterative two-stage method also improved predictive performance of the individual models and model averaging in both synthetic and experimental studies.

Probabilistic classifiers with high-dimensional data

PubMed Central

Kim, Kyung In; Simon, Richard

2011-01-01

For medical classification problems, it is often desirable to have a probability associated with each class. Probabilistic classifiers have received relatively little attention for small n large p classification problems despite of their importance in medical decision making. In this paper, we introduce 2 criteria for assessment of probabilistic classifiers: well-calibratedness and refinement and develop corresponding evaluation measures. We evaluated several published high-dimensional probabilistic classifiers and developed 2 extensions of the Bayesian compound covariate classifier. Based on simulation studies and analysis of gene expression microarray data, we found that proper probabilistic classification is more difficult than deterministic classification. It is important to ensure that a probabilistic classifier is well calibrated or at least not “anticonservative” using the methods developed here. We provide this evaluation for several probabilistic classifiers and also evaluate their refinement as a function of sample size under weak and strong signal conditions. We also present a cross-validation method for evaluating the calibration and refinement of any probabilistic classifier on any data set. PMID:21087946

An Implanted Upper-Extremity Neuroprosthesis Using Myoelectric Control

PubMed Central

Kilgore, Kevin L.; Hoyen, Harry A.; Bryden, Anne M.; Hart, Ronald L.; Keith, Michael W.; Peckham, P. Hunter

2009-01-01

Purpose The purpose of this study was evaluate the potential of a second-generation implantable neuroprosthesis that provides improved control of hand grasp and elbow extension for individuals with cervical level spinal cord injury. The key feature of this system is that users control their stimulated function through electromyographic (EMG) signals. Methods The second-generation neuroprosthesis consists of 12 stimulating electrodes, 2 EMG signal recording electrodes, an implanted stimulator-telemeter device, an external control unit, and a transmit/receive coil. The system was implanted in a single surgical procedure. Functional outcomes for each subject were evaluated in the domains of body functions and structures, activity performance, and societal participation. Results Three individuals with C5/C6 spinal cord injury received system implantation with subsequent prospective evaluation for a minimum of 2 years. All 3 subjects demonstrated that EMG signals can be recorded from voluntary muscles in the presence of electrical stimulation of nearby muscles. Significantly increased pinch force and grasp function was achieved for each subject. Functional evaluation demonstrated improvement in at least 5 activities of daily living using the Activities of Daily Living Abilities Test. Each subject was able to use the device at home. There were no system failures. Two of 6 EMG electrodes required surgical revision because of suboptimal location of the recording electrodes. Conclusions These results indicate that a neuroprosthesis with implanted myoelectric control is an effective method for restoring hand function in midcervical level spinal cord injury. Type of study/level of evidence Therapeutic IV. PMID:18406958

A primitive study on unsupervised anomaly detection with an autoencoder in emergency head CT volumes

NASA Astrophysics Data System (ADS)

Sato, Daisuke; Hanaoka, Shouhei; Nomura, Yukihiro; Takenaga, Tomomi; Miki, Soichiro; Yoshikawa, Takeharu; Hayashi, Naoto; Abe, Osamu

2018-02-01

Purpose: The target disorders of emergency head CT are wide-ranging. Therefore, people working in an emergency department desire a computer-aided detection system for general disorders. In this study, we proposed an unsupervised anomaly detection method in emergency head CT using an autoencoder and evaluated the anomaly detection performance of our method in emergency head CT. Methods: We used a 3D convolutional autoencoder (3D-CAE), which contains 11 layers in the convolution block and 6 layers in the deconvolution block. In the training phase, we trained the 3D-CAE using 10,000 3D patches extracted from 50 normal cases. In the test phase, we calculated abnormalities of each voxel in 38 emergency head CT volumes (22 abnormal cases and 16 normal cases) for evaluation and evaluated the likelihood of lesion existence. Results: Our method achieved a sensitivity of 68% and a specificity of 88%, with an area under the curve of the receiver operating characteristic curve of 0.87. It shows that this method has a moderate accuracy to distinguish normal CT cases to abnormal ones. Conclusion: Our method has potentialities for anomaly detection in emergency head CT.

Mirror therapy enhances upper extremity motor recovery in stroke patients.

PubMed

Mirela Cristina, Luca; Matei, Daniela; Ignat, Bogdan; Popescu, Cristian Dinu

2015-12-01

The purpose of this study was to evaluate the effects of mirror therapy program in addition with physical therapy methods on upper limb recovery in patients with subacute ischemic stroke. 15 subjects followed a comprehensive rehabilitative treatment, 8 subjects received only control therapy (CT) and 7 subjects received mirror therapy (MT) for 30 min every day, five times a week, for 6 weeks in addition to the conventional therapy. Brunnstrom stages, Fugl-Meyer Assessment (upper extremity), the Ashworth Scale, and Bhakta Test (finger flexion scale) were used to assess changes in upper limb motor recovery and motor function after intervention. After 6 weeks of treatment, patients in both groups showed significant improvements in the variables measured. Patients who received MT showed greater improvements compared to the CT group. The MT treatment results included: improvement of motor functions, manual skills and activities of daily living. The best results were obtained when the treatment was started soon after the stroke. MT is an easy and low-cost method to improve motor recovery of the upper limb.

Development of a screening tool to predict malnutrition among children under two years old in Zambia

PubMed Central

Hasegawa, Junko; Ito, Yoichi M; Yamauchi, Taro

2017-01-01

ABSTRACT Background: Maternal and child undernutrition is an important issue, particularly in low- and middle-income countries. Children at high risk of malnutrition should be prioritized to receive necessary interventions to minimize such risk. Several risk factors have been proposed; however, until now, there has been no appropriate evaluation method to identify these children. In sub-Saharan Africa, children commonly receive regular check-ups from community health workers. A simple and easy nutrition assessment method is therefore needed for use by semi-professional health workers. Objectives: The aim of this study was to develop and test a practical screening tool for community use in predicting growth stunting in children under two years in rural Zambia. Methods: Field research was conducted from July to August 2014 in Southern Province, Zambia. Two hundred and sixty-four mother-child pairs participated in the study. Anthropometric measurements were performed on all children and mothers, and all mothers were interviewed. Risk factors for the screening test were estimated by using least absolute shrinkage and selection operator analysis. After re-evaluating all participants using the new screening tool, a receiver operating characteristic curve was drawn to set the cut-off value. Sensitivity and specificity were also calculated. Results: The screening tool included age, weight-for-age Z-score status, birth weight, feeding status, history of sibling death, multiple birth, and maternal education level. The total score ranged from 0 to 22, and the cut-off value was eight. Sensitivity and specificity were 0.963 and 0.697 respectively. Conclusions: A screening tool was developed to predict children at high risk of malnutrition living in Zambia. Further longitudinal studies are needed to confirm the test’s validity in detecting future stunting and to investigate the effectiveness of malnutrition treatment. PMID:28730929

Satellite Antenna Pointing Procedure Driven by the Ground Service Quality

NASA Astrophysics Data System (ADS)

Yasui, Yoshitsugu

A satellite antenna alignment technique is proposed to ensure terrestrial service quality for users. The antenna bore sight orientation is calculated directly from measured data acquired from general ground receivers, which intercept the communication radio waves from any position on the earth's surface. The method coordinates the satellite pointing parameters with signal strength at the receivers while considering location-specific geographical and antenna radiation characteristics and control accuracy. The theoretical development and its validity are examined in the course of equation derivation. Actual measured data of an existing satellite at the maneuver was applied to the method, and the capability was demonstrated and verified. With the wide diversity of satellite usage, such as for mobile communications, temporary network deployment or post-launch positioning accommodations, the proposed method provides a direct evaluation of satellite communication performance at the service level, in conjunction with using high frequency spot beam antennas, which are highly susceptible to pointing gain. This can facilitate swift and flexible satellite service planning and deployment for operators.

Highly precise acoustic calibration method of ring-shaped ultrasound transducer array for plane-wave-based ultrasound tomography

NASA Astrophysics Data System (ADS)

Terada, Takahide; Yamanaka, Kazuhiro; Suzuki, Atsuro; Tsubota, Yushi; Wu, Wenjing; Kawabata, Ken-ichi

2017-07-01

Ultrasound computed tomography (USCT) is promising for a non-invasive, painless, operator-independent and quantitative system for breast-cancer screening. Assembly error, production tolerance, and aging-degradation variations of the hardwire components, particularly of plane-wave-based USCT systems, may hamper cost effectiveness, precise imaging, and robust operation. The plane wave is transmitted from a ring-shaped transducer array for receiving the signal at a high signal-to-noise-ratio and fast aperture synthesis. There are four signal-delay components: response delays in the transmitters and receivers and propagation delays depending on the positions of the transducer elements and their directivity. We developed a highly precise calibration method for calibrating these delay components and evaluated it with our prototype plane-wave-based USCT system. Our calibration method was found to be effective in reducing delay errors. Gaps and curves were eliminated from the plane wave, and echo images of wires were sharpened in the entire imaging area.

Multifunction waveform generator for EM receiver testing

NASA Astrophysics Data System (ADS)

Chen, Kai; Jin, Sheng; Deng, Ming

2018-01-01

In many electromagnetic (EM) methods - such as magnetotelluric, spectral-induced polarization (SIP), time-domain-induced polarization (TDIP), and controlled-source audio magnetotelluric (CSAMT) methods - it is important to evaluate and test the EM receivers during their development stage. To assess the performance of the developed EM receivers, controlled synthetic data that simulate the observed signals in different modes are required. In CSAMT and SIP mode testing, the waveform generator should use the GPS time as the reference for repeating schedule. Based on our testing, the frequency range, frequency precision, and time synchronization of the currently available function waveform generators on the market are deficient. This paper presents a multifunction waveform generator with three waveforms: (1) a wideband, low-noise electromagnetic field signal to be used for magnetotelluric, audio-magnetotelluric, and long-period magnetotelluric studies; (2) a repeating frequency sweep square waveform for CSAMT and SIP studies; and (3) a positive-zero-negative-zero signal that contains primary and secondary fields for TDIP studies. In this paper, we provide the principles of the above three waveforms along with a hardware design for the generator. Furthermore, testing of the EM receiver was conducted with the waveform generator, and the results of the experiment were compared with those calculated from the simulation and theory in the frequency band of interest.

Adaptive Array for Weak Interfering Signals: Geostationary Satellite Experiments. M.S. Thesis

NASA Technical Reports Server (NTRS)

Steadman, Karl

1989-01-01

The performance of an experimental adaptive array is evaluated using signals from an existing geostationary satellite interference environment. To do this, an earth station antenna was built to receive signals from various geostationary satellites. In these experiments the received signals have a frequency of approximately 4 GHz (C-band) and have a bandwidth of over 35 MHz. These signals are downconverted to a 69 MHz intermediate frequency in the experimental system. Using the downconverted signals, the performance of the experimental system for various signal scenarios is evaluated. In this situation, due to the inherent thermal noise, qualitative instead of quantitative test results are presented. It is shown that the experimental system can null up to two interfering signals well below the noise level. However, to avoid the cancellation of the desired signal, the use a steering vector is needed. Various methods to obtain an estimate of the steering vector are proposed.

Method and apparatus for monitoring dynamic cardiovascular function using n-dimensional representatives of critical functions

NASA Technical Reports Server (NTRS)

Syroid, Noah (Inventor); Westinskow, Dwayne (Inventor); Agutter, James (Inventor); Albert, Robert (Inventor); Strayer, David (Inventor); Wachter, S. Blake (Inventor); Drews, Frank (Inventor)

2010-01-01

A method, system, apparatus and device for the monitoring, diagnosis and evaluation of the state of a dynamic pulmonary system is disclosed. This method and system provides the processing means for receiving sensed and/or simulated data, converting such data into a displayable object format and displaying such objects in a manner such that the interrelationships between the respective variables can be correlated and identified by a user. This invention provides for the rapid cognitive grasp of the overall state of a pulmonary critical function with respect to a dynamic system.

HyperCard to SPSS: improving data integrity.

PubMed

Gostel, R

1993-01-01

This article describes a database design that captures responses in a HyperCard stack and moves the data to SPSS for the Macintosh without the need to rekey data. Pregnant women used an interactive computer application with a touch screen to answer questions and receive educational information about fetal alcohol syndrome. A database design was created to capture survey responses through interaction with a computer by a sample of prenatal women during formative evaluation trials. The author does not compare this method of data collection to other methods. This article simply describes the method of data collection as a useful research tool.

LED phototherapy to prevent mucositis: a case report.

PubMed

Lang-Bicudo, Leticia; Eduardo, Fernanda De Paula; Eduardo, Carlos De Paula; Zezell, Denise Maria

2008-12-01

The purpose of this case report was to evaluate the efficacy of phototherapy using light-emitting diodes (LEDs) to prevent oral mucositis in a Hodgkin's disease patient treated with the ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine) chemotherapy regimen. Mucositis is a common dose-limiting complication of cancer treatment, and if severe it can lead to alterations in treatment planning or suspension of cancer therapy, with serious consequences for tumor response and survival. Therefore, low-power lasers and more recently LEDs, have been used for oral mucositis prevention and management, with good results. In this study, a 34-year-old man received intraoral irradiation with an infrared LED array (880 nm, 3.6 J/cm2, 74 mW) for five consecutive days, starting on chemotherapy day 1. In each chemotherapy cycle, he received the ABVD protocol on days 1 and 15, and received LED treatment for 5 d during each cycle. To analyze the results, the World Health Organization (WHO) scale was used to grade his mucositis, and a visual analogue scale (VAS) was used for pain evaluation, on days 1, 3, 7, 10, and 13 post-chemotherapy. The results showed that the patient did not develop oral mucositis during the five chemotherapy cycles, and he had no pain symptoms. LED therapy was a safe and effective method for preventing oral mucositis in this case report. However, further randomized studies with more patients are needed to prove the efficacy of this method.

Beyond the verbal: Pregnant women's preferences for receiving influenza and Tdap vaccine information from their obstetric care providers.

PubMed

Ellingson, Mallory; Chamberlain, Allison T

2018-03-04

Prenatal providers are pregnant women's most trusted sources of health information, and a provider's recommendation is a strong predictor of maternal vaccine receipt. However, other ways women prefer receiving vaccine-related information from prenatal providers, aside from face-to-face conversations, is unclear. This study explores what secondary communication methods are preferred for receiving maternal vaccine-related information. Obstetric patients at four prenatal clinics around Atlanta, Georgia received a 27-item survey between May 5th, 2016 and June 15th, 2016. Participants were asked about sources they currently use to obtain prenatal health information and their preferences for receiving vaccine-related information from providers. Descriptive statistics were calculated and chi-square tests were used to evaluate associations between participant characteristics and outcomes. Women primarily reported using the CDC website (57.7%) and pregnancy-related websites (53.0%) to obtain vaccine information. Apart from clinical conversations, educational brochures (64.9%) and e-mails (54.7%) were the preferred methods of receiving vaccine information from providers, followed by their provider's practice website (42.1%). Communication preferences and interest in maternal immunization varied by race/ethnicity, age and education; white women were twice as likely to want information on a provider's practice website compared to African-American women (OR = 2.06; 95% CI: 1.31, 3.25). Pregnant women use the Internet for information about vaccines, but they still value input from their providers. While e-mails and brochures were the preferred secondary modes of receiving information, a provider's existing practice website offers a potential communications medium that capitalizes on women's information seeking behaviors and preferences while limiting burden on providers.

[Land use and land cover charnge (LUCC) and landscape service: Evaluation, mapping and modeling].

PubMed

Song, Zhang-jian; Cao, Yu; Tan, Yong-zhong; Chen, Xiao-dong; Chen, Xian-peng

2015-05-01

Studies on ecosystem service from landscape scale aspect have received increasing attention from researchers all over the world. Compared with ecosystem scale, it should be more suitable to explore the influence of human activities on land use and land cover change (LUCC), and to interpret the mechanisms and processes of sustainable landscape dynamics on landscape scale. Based on comprehensive and systematic analysis of researches on landscape service, this paper firstly discussed basic concepts and classification of landscape service. Then, methods of evaluation, mapping and modeling of landscape service were analyzed and concluded. Finally, future trends for the research on landscape service were proposed. It was put forward that, exploring further connotation and classification system of landscape service, improving methods and quantitative indicators for evaluation, mapping and modelling of landscape service, carrying out long-term integrated researches on landscape pattern-process-service-scale relationships and enhancing the applications of theories and methods on landscape economics and landscape ecology are very important fields of the research on landscape service in future.

Design, construction, and evaluation of a 1:8 scale model binaural manikin.

PubMed

Robinson, Philip; Xiang, Ning

2013-03-01

Many experiments in architectural acoustics require presenting listeners with simulations of different rooms to compare. Acoustic scale modeling is a feasible means to create accurate simulations of many rooms at reasonable cost. A critical component in a scale model room simulation is a receiver that properly emulates a human receiver. For this purpose, a scale model artificial head has been constructed and tested. This paper presents the design and construction methods used, proper equalization procedures, and measurements of its response. A headphone listening experiment examining sound externalization with various reflection conditions is presented that demonstrates its use for psycho-acoustic testing.

Study to investigate and evaluate means of optimizing the Ku-band communication function for the space shuttle

NASA Technical Reports Server (NTRS)

Simon, M. K.; Udalov, S.; Huth, G. K.

1976-01-01

The forward link of the overall Ku-band communication system consists of the ground- TDRS-orbiter communication path. Because the last segment of the link is directed towards a relatively low orbiting shuttle, a PN code is used to reduce the spectral density. A method is presented for incorporating code acquisition and tracking functions into the orbiter's Ku-band receiver. Optimization of a three channel multiplexing technique is described. The importance of Costas loop parameters to provide false lock immunity for the receiver, and the advantage of using a sinusoidal subcarrier waveform, rather than square wave, are discussed.

Nursing students' mathematic calculation skills.

PubMed

Rainboth, Lynde; DeMasi, Chris

2006-12-01

This mixed method study used a pre-test/post-test design to evaluate the efficacy of a teaching strategy in improving beginning nursing student learning outcomes. During a 4-week student teaching period, a convenience sample of 54 sophomore level nursing students were required to complete calculation assignments, taught one calculation method, and mandated to attend medication calculation classes. These students completed pre- and post-math tests and a major medication mathematic exam. Scores from the intervention student group were compared to those achieved by the previous sophomore class. Results demonstrated a statistically significant improvement from pre- to post-test and the students who received the intervention had statistically significantly higher scores on the major medication calculation exam than did the students in the control group. The evaluation completed by the intervention group showed that the students were satisfied with the method and outcome.

Usual Course of Treatment and Predictors of Treatment Utilization for Patients with Posttraumatic Stress Disorder

PubMed Central

Nobles, Carrie J.; Valentine, Sarah E.; Zepeda, E. David; Ahles, Emily M.; Shtasel, Derri L.; Marques, Luana

2017-01-01

Objective Posttraumatic stress disorder (PTSD) is a debilitating psychiatric illness that frequently remains undiagnosed and untreated. While extensive research has been conducted among veterans, little research has evaluated course of treatment for PTSD in a general hospital setting. Method We utilized data from the Partners Healthcare Research Patient Database Registry to evaluate mental health treatment utilization, including psychotherapy and pharmacotherapy, by patients with recently diagnosed primary PTSD following Diagnostic and Statistical Manual IV criteria between January 1, 2002 and June 30, 2011. We additionally evaluated predictors of treatment utilization 6 months post-diagnosis. Results Among 2,475 patients with recently diagnosed prim ary PTSD, approximately half (55.7%) had any therapy visit and 10% at least 12 therapy visits in the 6 months following diagnosis. Approximately half (47.0%) received a psychiatric prescription, with 29.3% receiving a selective serotonin reuptake inhibitor (SSRI), 11.8% an atypical antipsychotic and 24.4% a benzodiazepine. Latinos were 25% more likely to have an SSRI prescription, 35% more likely to have an atypical antipsychotic prescription and 28% more likely to have any psychotherapy. Men were 96% more likely to have an atypical antipsychotic prescription. Patients with Medicare were 20% less likely to have any psychotherapy, and patients with Medicaid were 35% less likely to have 12 or more therapy visits. Conclusion Many patients with a primary diagnosis of PTSD do not receive psychotherapy, and psychiatric prescriptions, including atypical antipsychotics and benzodiazepines, are common. Future research is needed to determine quality of care received and explore sub-population specific barriers limiting access to care. PMID:28570794

Confident body, confident child: A randomized controlled trial evaluation of a parenting resource for promoting healthy body image and eating patterns in 2- to 6-year old children.

PubMed

Hart, Laura M; Damiano, Stephanie R; Paxton, Susan J

2016-05-01

Body image and eating patterns develop in early childhood and are influenced by the family environment. This research evaluated Confident Body, Confident Child (CBCC), an intervention for parents of 2- to 6-year-old children, designed to promote body satisfaction, healthy eating, and weight management in early childhood. A randomized controlled trial compared four groups: (A) received the CBCC resource pack and a workshop, (B) received the CBCC resource pack only, (C) received a nutrition-only resource and (D) received no interventions until all questionnaires were completed (i.e., functioned as waitlist control). Measures of parenting variables relevant to child body image and eating patterns, parent-report of child weight, and evaluation questions about the resource, were implemented pre- and post-intervention. At 6-weeks post-intervention, the CBCC resource was associated with significant reductions in parents' intentions to use behaviors that increase the risk of negative body attitudes or unhealthy eating in their children, in parents' use of feeding practices associated with childhood overweight, and in television watching during family meals. Significant increases in parents' intentions to use positive behaviors and knowledge of child body image and healthy eating patterns were also found. Superior results were found for the CBCC resource + workshop condition, suggesting it is the preferred delivery method. CBCC positively impacts parenting variables associated with childhood risk for body dissatisfaction, unhealthy eating and weight. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:458-472). © 2016 Wiley Periodicals, Inc.

Transformation-invariant and nonparametric monotone smooth estimation of ROC curves.

PubMed

Du, Pang; Tang, Liansheng

2009-01-30

When a new diagnostic test is developed, it is of interest to evaluate its accuracy in distinguishing diseased subjects from non-diseased subjects. The accuracy of the test is often evaluated by receiver operating characteristic (ROC) curves. Smooth ROC estimates are often preferable for continuous test results when the underlying ROC curves are in fact continuous. Nonparametric and parametric methods have been proposed by various authors to obtain smooth ROC curve estimates. However, there are certain drawbacks with the existing methods. Parametric methods need specific model assumptions. Nonparametric methods do not always satisfy the inherent properties of the ROC curves, such as monotonicity and transformation invariance. In this paper we propose a monotone spline approach to obtain smooth monotone ROC curves. Our method ensures important inherent properties of the underlying ROC curves, which include monotonicity, transformation invariance, and boundary constraints. We compare the finite sample performance of the newly proposed ROC method with other ROC smoothing methods in large-scale simulation studies. We illustrate our method through a real life example. Copyright (c) 2008 John Wiley & Sons, Ltd.

Agreement of Tracing and Direct Viewing Techniques for Cervical Vertebral Maturation Assessment.

PubMed

Wiwatworakul, Opas; Manosudprasit, Montian; Pisek, Poonsak; Chatrchaiwiwatana, Supaporn; Wangsrimongkol, Tasanee

2015-08-01

This study aimed to evaluate agreement among three methods for cervical vertebral maturation (CVM) assessment, comprising direct viewing, tracing only, and tracing with digitized points. Two examiners received training and tests of reliability with each CVM method before evaluation of agreement among methods. The subjects were 96 female-cleft lateral cephalometric radiographs (films of eight subjects for each age ranged from seven to 18 years). The examiners interpreted CVM stages of the subjects with four-week interval between uses of each method. The range of weighted kappa values for paired comparisons among the three methods were: 0.96-0.98 for direct viewing and tracing only comparison; 0.93-0.94 for direct viewing and tracing with digitized points comparison; and 0.96-0.97 for tracing only and tracing with digitized points comparison. The intraclass correlation coefficient (ICC) value among the three methods was 0.95. These results indicated very good agreement among methods. Use of direct viewing is suitable for CVM assessment without spending more time for tracing. However, the three methods might be used interchangeably.

Strontium coating by electrochemical deposition improves implant osseointegration in osteopenic models

PubMed Central

LIANG, YONGQIANG; LI, HAOYAN; XU, JIANG; LI, XIN; LI, XINCHANG; YAN, YUTING; QI, MENGCHUN; HU, MIN

2015-01-01

Osteopenia, a preclinical state of osteoporosis, restricts the application of adult orthodontic implant anchorage and tooth implantation. Strontium (Sr) is able to promote bone formation and inhibit bone absorption. The aim of the present study was to evaluate a new method for improving the success rate of dental implantation. In this study, an electrochemical deposition (ECD) method was used to prepare a Sr coating on a titanium implant. The coating composition was investigated by energy dispersive X-ray spectroscopy and X-ray diffraction, and the surface morphology of the coating was studied using scanning electron microscopy. A total of 24 Sprague-Dawley rats received bilateral ovariectomy (OVX) and an additional 12 rats underwent a sham surgery. All rats were then implanted in the bilateral tibiae with titanium mini-implants with or without a Sr coating. The results of histological examination and a fluorescence double labeling assay showed strong new bone formation with a wider zone between the double labels, a higher rate of bone mineralization and better osseointegration in the OVX rats that received Sr-coated implants compared with the OVX rats that received uncoated implants. The study indicates that Sr coatings are easily applied by an ECD method, and that Sr coatings have a promoting effect on implant osseointegration in animals with osteopenia. PMID:25452797

How group education impacts female factory workers' behavior and readiness to receive mammography and Pap smear.

PubMed

Seven, Memnun; Bahar, Mine; Akyüz, Aygül; Erdoğan, Hatice

2015-01-01

The workplace has been deemed a suitable location for educating many women at once about cancer screening. To determine how group education about early diagnostic methods for breast and cervical cancer effects women's behavior and readiness to receive mammography and Pap smear. This semi-interventional study was conducted at a textile factory in Istanbul, Turkey. Female workers (n= 125) were included in the study. A participant identification form and knowledge evaluation form developed for this study, along with the transtheoretical model, were used to collect data. A 45-min interactive group education was given to the participants. Upon contacting participants 3 months after group education, 15.4% (n = 11) stated that they had since received a mammogram and 9.8% (n = 7) a Pap smear. As suggested by the transtheoretical model, group education increased participants' readiness to receive cancer screening, along with their knowledge of breast and cervical cancer. Group education positively impacted women's knowledge of cancer and their readiness to receive mammography and Pap smear. Group education can potentially create awareness of cancer screening tests among women and improve their readiness to receive such tests.

The Feasibility of an E-Mail-Delivered Intervention to Improve Nutrition and Physical Activity Behaviors in African American College Students

ERIC Educational Resources Information Center

Mackey, Eleanor; Schweitzer, Amy; Hurtado, Maria Eugenia; Hathway, Joanne; DiPietro, Loretta; Lei, Kai Y.; Klein, Catherine J.

2015-01-01

Objectives: To evaluate the feasibility and acceptability of an e-mail-delivered program to promote nutrition and physical activity in African American college students. Participants: Forty-seven students (76% female, aged 18-20 years). Methods: Students participated in a 24-week randomized controlled trial, receiving either general health…

Which Sexual Abuse Victims Receive a Forensic Medical Examination?: The Impact of Children's Advocacy Centers

ERIC Educational Resources Information Center

Walsh, Wendy A.; Cross, Theodore P.; Jones, Lisa M.; Simone, Monique; Kolko, David J.

2007-01-01

Objective: This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. Methods: This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of…

Randomized Controlled Trial of Osmotic-Release Methylphenidate with Cognitive-Behavioral Therapy in Adolescents with Attention-Deficit/Hyperactivity Disorder and Substance Use Disorders

ERIC Educational Resources Information Center

Riggs, Paula D.; Winhusen, Theresa; Davies, Robert D.; Leimberger, Jeffrey D.; Mikulich-Gilbertson, Susan; Klein, Constance; Macdonald, Marilyn; Lohman, Michelle; Bailey, Genie L.; Haynes, Louise; Jaffee, William B.; Haminton, Nancy; Hodgkins, Candace; Whitmore, Elizabeth; Trello-Rishel, Kathlene; Tamm, Leanne; Acosta, Michelle C.; Royer-Malvestuto, Charlotte; Subramaniam, Geetha; Fishman, Marc; Holmes, Beverly W.; Kaye, Mary Elyse; Vargo, Mark A.; Woody, George E.; Nunes, Edward V.; Liu, David

2011-01-01

Objective: To evaluate the efficacy and safety of osmotic-release methylphenidate (OROS-MPH) compared with placebo for attention-deficit/hyperactivity disorder (ADHD), and the impact on substance treatment outcomes in adolescents concurrently receiving cognitive-behavioral therapy (CBT) for substance use disorders (SUD). Method: This was a…

Efficacy of a Reading and Language Intervention for Children with Down Syndrome: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Burgoyne, Kelly; Duff, Fiona J.; Clarke, Paula J.; Buckley, Sue; Snowling, Margaret J.; Hulme, Charles

2012-01-01

Background: This study evaluates the effects of a language and literacy intervention for children with Down syndrome. Methods: Teaching assistants (TAs) were trained to deliver a reading and language intervention to children in individual daily 40-min sessions. We used a waiting list control design, in which half the sample received the…

Impact on Seniors of the Patient-Centered Medical Home: Evidence from a Pilot Study

ERIC Educational Resources Information Center

Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.

2012-01-01

Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…

An Alternative Method Used in Evaluating Agreement among Repeat Measurements by Two Raters in Education

ERIC Educational Resources Information Center

Erdogan, Semra; Orekici Temel, Gülhan; Selvi, Hüseyin; Ersöz Kaya, Irem

2017-01-01

Taking more than one measurement of the same variable also hosts the possibility of contamination from error sources, both singly and in combination as a result of interactions. Therefore, although the internal consistency of scores received from measurement tools is examined by itself, it is necessary to ensure interrater or intra-rater agreement…

AN EVALUATION OF HIGH SCHOOL MATHEMATICS PROGRAMMED TEXTS WHEN USED WITH DEAF STUDENTS.

ERIC Educational Resources Information Center

BORNSTEIN, HARRY

A COMPARISON WAS MADE OF THE RATE AND LEVEL OF ACHIEVEMENT OF 150 DEAF STUDENTS RESULTING FROM THE USE OF PROGRAMED TEXTS AS AGAINST THE USUAL LECTURE METHODS IN HIGH SCHOOL MATHEMATICS. EACH OF FOUR MATHEMATICS TEACHERS HAD TWO COMPARABLE CLASSES. THE CONTROL GROUP RECEIVED INFORMATION BY SIMULTANEOUS LECTURE AND THE EXPERIMENTAL GROUPS USED THE…

Mobile MyPlate: A Pilot Study Using Text Messaging to Provide Nutrition Education and Promote Better Dietary Choices in College Students

ERIC Educational Resources Information Center

Brown, Onikia N.; O'Connor, Lauren E.; Savaiano, Dennis

2014-01-01

Objective: To evaluate the acceptance and effectiveness of repetitive nutrition-related text messages on college students' nutrition knowledge and fruit and vegetable consumption. Participants: One hundred fifty undergraduate (18-24 years old) non-health major students with a texting mobile phone. Methods: The intervention group received biweekly…

Defining Strategic Methods with Which To Access Runaway Youth into a Runaway Program.

ERIC Educational Resources Information Center

Bray, Sheldon

Thousands of children run away from home or placements each year. The many programs for these children require evaluation to determine effectiveness; one runaway program for at-risk children is examined here. It was felt that if the runaway youth could receive some counseling, then it might help these children and families to solve some of their…

Teaching Healthful Food Choices to Elementary School Students and Their Parents: The Nutrition Detectives[TM] Program

ERIC Educational Resources Information Center

Katz, David L.; Katz, Catherine S.; Treu, Judith A.; Reynolds, Jesse; Njike, Valentine; Walker, Jennifer; Smith, Erica; Michael, Jennifer

2011-01-01

Background: The purpose of this study was to evaluate the effects of a nutrition education program designed to teach elementary school students and their parents, and to distinguish between more healthful and less healthful choices in diverse food categories. Methods: Three schools were assigned to receive the Nutrition Detectives[TM] program and…

Removal of nano- and micronized-copper from treated wood by chelating agents

Treesearch

S. Nami Kartal; Evren Terzi; Bessie Woodward; Carol A. Clausen; Stan T. Lebow

2013-01-01

Micronized and nano-copper (Cu)-based and arsenic and chromium-free systems have received much attention for wood protection in recent years. Because they have different fixation, and micro-distribution properties, such copper systems may be more or less subject to release using known remediation methods than soluble forms of Cu. This study evaluated Cu recovery from...

Neuroprotective Treatment of Laser-Induced Retinal Injuries

DTIC Science & Technology

2001-10-01

to evaluate the neuroprotective effect of dextromethorphan, memantine and brimonidine in our rat model of laser- induced retinal-lesions Methods: Argon...dextromethorphan, memantine or brimonidine. The control groups (18 rats for each compound) received the solvent at the same volume and schedule as...size and the magnitude of photoreceptor nuclei loss within the lesions. Conclusions: Systemic treatments with dextromethorphan, memantine or brimonidine

Methods in pharmacoepidemiology: a review of statistical analyses and data reporting in pediatric drug utilization studies.

PubMed

Sequi, Marco; Campi, Rita; Clavenna, Antonio; Bonati, Maurizio

2013-03-01

To evaluate the quality of data reporting and statistical methods performed in drug utilization studies in the pediatric population. Drug utilization studies evaluating all drug prescriptions to children and adolescents published between January 1994 and December 2011 were retrieved and analyzed. For each study, information on measures of exposure/consumption, the covariates considered, descriptive and inferential analyses, statistical tests, and methods of data reporting was extracted. An overall quality score was created for each study using a 12-item checklist that took into account the presence of outcome measures, covariates of measures, descriptive measures, statistical tests, and graphical representation. A total of 22 studies were reviewed and analyzed. Of these, 20 studies reported at least one descriptive measure. The mean was the most commonly used measure (18 studies), but only five of these also reported the standard deviation. Statistical analyses were performed in 12 studies, with the chi-square test being the most commonly performed test. Graphs were presented in 14 papers. Sixteen papers reported the number of drug prescriptions and/or packages, and ten reported the prevalence of the drug prescription. The mean quality score was 8 (median 9). Only seven of the 22 studies received a score of ≥10, while four studies received a score of <6. Our findings document that only a few of the studies reviewed applied statistical methods and reported data in a satisfactory manner. We therefore conclude that the methodology of drug utilization studies needs to be improved.

Vaccum drainage system application in the management of operation-related non-regional epidural hematoma

PubMed Central

2013-01-01

Background Epidural intracranial hematoma is one of the most common complications of surgeries for intracranial tumors. The non-regional epidural hematoma is related to severe fluctuation of the intracranial pressure during the operation. The traditional management of hematoma evacuation through craniotomy is time-consuming and may aggravate intracranial pressure imbalance, which causes further complications. We designed a method using vaccum epidural drainage system, and tried to evaluate advantage and the disadvantage of this new technique. Methods Seven patients of intracranial tumors were selected. All of the patients received tumor resection and intra-operative non-regional epidural hematoma was confirmed through intra-operative ultrasound or CT scan. The vaccum drainage system was applied. Another ten patients who received craniotomy for intra-operative non-regional epidural hematoma evacuation were selected as comparison. Regular tests, like serial CT scan, were performed afterward to evaluate the effectiveness and to help deciding when to remove the drainage system. Results The vaccum drainage method was effective in epidual hemotoma clearance and prevented recurrent epidural hemorrhage. The drainage systems were removed within 4 days. All of the patients recovered well. No complications related to the drainage system were observed. Conclusions Compared to the traditional craniotomy, the new method of epidural hemoatoma management using vaccum epidural drainage system proved to be as effective in hematoma clearance, and was less-invasive and easier to perform, with less complication, shorter hospitalization, less economic burden, and better prognosis. PMID:23842198

Effectiveness of a computer-based tutorial for teaching how to make a blood smear.

PubMed

Preast, Vanessa; Danielson, Jared; Bender, Holly; Bousson, Maury

2007-09-01

Computer-aided instruction (CAI) was developed to teach veterinary students how to make blood smears. This instruction was intended to replace the traditional instructional method in order to promote efficient use of faculty resources while maintaining learning outcomes and student satisfaction. The purpose of this study was to evaluate the effect of a computer-aided blood smear tutorial on 1) instructor's teaching time, 2) students' ability to make blood smears, and 3) students' ability to recognize smear quality. Three laboratory sessions for senior veterinary students were taught using traditional methods (control group) and 4 sessions were taught using the CAI tutorial (experimental group). Students in the control group received a short demonstration and lecture by the instructor at the beginning of the laboratory and then practiced making blood smears. Students in the experimental group received their instruction through the self-paced, multimedia tutorial on a laptop computer and then practiced making blood smears. Data was collected from observation, interview, survey questionnaires, and smear evaluation by students and experts using a scoring rubric. Students using the CAI made better smears and were better able to recognize smear quality. The average time the instructor spent in the room was not significantly different between groups, but the quality of the instructor time was improved with the experimental instruction. The tutorial implementation effectively provided students and instructors with a teaching and learning experience superior to the traditional method of instruction. Using CAI is a viable method of teaching students to make blood smears.

Protocol for the mixed-methods process and context evaluation of the TB & Tobacco randomised controlled trial in Bangladesh and Pakistan: a hybrid effectiveness–implementation study

PubMed Central

Nohavova, Iveta; Dogar, Omara; Kralikova, Eva; Pankova, Alexandra; Zvolska, Kamila; Huque, Rumana; Fatima, Razia; Noor, Maryam; Elsey, Helen; Sheikh, Aziz; Siddiqi, Kamran; Kotz, Daniel

2018-01-01

Introduction Tuberculosis (TB) remains a significant public health problem in South Asia. Tobacco use increases the risks of TB infection and TB progression. The TB& Tobacco placebo-controlled randomised trial aims to (1) assess the effectiveness of the tobacco cessation medication cytisine versus placebo when combined with behavioural support and (2) implement tobacco cessation medication and behavioural support as part of general TB care in Bangladesh and Pakistan. This paper summarises the process and context evaluation protocol embedded in the effectiveness–implementation hybrid design. Methods and analysis We are conducting a mixed-methods process and context evaluation informed by an intervention logic model that draws on the UK Medical Research Council’s Process Evaluation Guidance. Our approach includes quantitative and qualitative data collection on context, recruitment, reach, dose delivered, dose received and fidelity. Quantitative data include patient characteristics, reach of recruitment among eligible patients, routine trial data on dose delivered and dose received, and a COM-B (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) questionnaire filled in by participating health workers. Qualitative data include semistructured interviews with TB health workers and patients, and with policy-makers at district and central levels in each country. Interviews will be analysed using the framework approach. The behavioural intervention delivery is audio recorded and assessed using a predefined fidelity coding index based on behavioural change technique taxonomy. Ethics and dissemination The study complies with the guidelines of the Declaration of Helsinki. Ethics approval for the study and process evaluation was granted by the University of Leeds (qualitative components), University of York (trial data and fidelity assessment), Bangladesh Medical Research Council and Bangladesh Drug Administration (trial data and qualitative components) and Pakistan Medical Research Council (trial data and qualitative components). Results of this research will be disseminated through reports to stakeholders and peer-reviewed publications and conference presentations. Trial registration number ISRCTN43811467; Pre-results. PMID:29602847

Implementation of an ergonomics intervention in a Swedish flight baggage handling company—A process evaluation

PubMed Central

Mathiassen, Svend Erik; Larsson, Johan; Kwak, Lydia

2018-01-01

Objective To conduct a process evaluation of the implementation of an ergonomics training program aimed at increasing the use of loading assist devices in flight baggage handling. Methods Feasibility related to the process items recruitment, reach, context, dose delivered (training time and content); dose received (participants’ engagement); satisfaction with training; intermediate outcomes (skills, confidence and behaviors); and barriers and facilitators of the training intervention were assessed by qualitative and quantitative methods. Results Implementation proved successful regarding dose delivered, dose received and satisfaction. Confidence among participants in the training program in using and talking about devices, observed use of devices among colleagues, and internal feedback on work behavior increased significantly (p<0.01). Main facilitators were self-efficacy, motivation, and perceived utility of training among the trainees. Barriers included lack of peer support, opportunities to observe and practice behaviors, and follow-up activities; as well as staff reduction and job insecurity. Conclusions In identifying important barriers and facilitators for a successful outcome, this study can help supporting the effectiveness of future interventions. Our results suggest that barriers caused by organizational changes may likely be alleviated by recruiting motivated trainees and securing strong organizational support for the implementation. PMID:29513671

The Study of Influence of Different Methods of Local Treatment on Wound Healing in Patients with Diabetic Foot Ulcers.

PubMed

Zaitseva, E L; Tokmakova, A Y; Shestakova, M V; Galstyan, G R; Doronina, L P

To evaluate the influence of different methods of local treatment on tissue repair in patients with diabetic foot ulcers. We evaluated such clinical characteristics as wound size and local perfusion after using negative pressure wound therapy (NPWT), local collagen, and standard care in patients with diabetic foot ulcers. We observed 63 patients with neuropathic and neuroischemic forms of diabetic foot (without critical ischemia) after surgical debridement. After that 21 patients received NPWT, 21 local collagen treatment and 21 ― standard care. After using NPWT wound area and depth decreased in 19,8% and 42,8% (p<0.05), in group of collagen dressings in 26,4 and 30,4% (p<0.05). In control group those parameters were 17,0 и 16.6% respectively (p<0.05). There was found the significant increase of local perfusion according to oxygen monitoring in group of NPWT (p<0.05). The received data showed that the intensity of lower limb tissue repair processes increases more significant after using NPWT and collagen dressings in comparison to standard care which is found according to wound size and tissue perfusion alterations.

Teaching cross-cultural communication skills online: a multi-method evaluation.

PubMed

Lee, Amy L; Mader, Emily M; Morley, Christopher P

2015-04-01

Cultural competency education is an important and required part of undergraduate medical education. The objective of this study was to evaluate whether an online cross-cultural communication module could increase student use of cross-cultural communication questions that assess the patient's definition of the problem, the way the problem affects their life, their concerns about the problem, and what the treatment should be (PACT). We used multi-method assessment of students assigned to family medicine clerkship blocks that were randomized to receive online cultural competency and PACT training added to their standard curriculum or to a control group receiving the standard curriculum only. Outcomes included comparison, via analysis of variance, of number of PACT questions used during an observed Standardized Patient Exercise, end-of-year OSCE scores, and qualitative analysis of student narratives. Students (n=119) who participated in the online module (n=60) demonstrated increased use of cross-cultural communication PACT questions compared to the control group (n=59) and generally had positive themes emerge from their reflective writing. The module had the biggest impact on students who later went on to match in high communication specialties. Online teaching of cross-cultural communication skills can be effective at changing medical student behavior.

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.

Nutritional evaluation of patients receiving dialysis for the management of protein-energy wasting: what is old and what is new?

PubMed

Riella, Miguel C

2013-05-01

Advances in the nutritional support of hospitalized patients in the early 1970s led to the recognition that tools were needed to evaluate the nutritional status of patients. The observation that malnutrition in patients receiving dialysis was associated with increased morbidity and mortality prompted many expert groups to develop nutritional scoring systems to be applied in these patients. Given the diverse and confusing terminologies that emerged from these publications, the International Society of Renal Nutritional and Metabolism convened an expert panel to recommend a new nomenclature and preferred methods to evaluate the nutritional status of patients with chronic kidney disease (CKD). The new and inclusive term protein-energy wasting (PEW) refers to a systematically defined condition based on certain criteria and reflects malnutrition and wasting caused not only by inadequate nutrient intake but also by depletion resulting from the inflammatory and noninflammatory conditions that prevail in this population. Serial assessment of nutritional status for detection and management of PEW is recommended using old and new scoring tools, including the Subjective Global Assessment (SGA), malnutrition inflammation score (MIS), Geriatric Nutritional Risk Index (GNRI), and PEW definition criteria. These tools, which are reliable methods and predictors of outcomes, are reviewed in this article. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Supporting underserved patients with their medicines: a study protocol for a patient/professional coproduced education intervention for community pharmacy staff to improve the provision and delivery of Medicine Use Reviews (MURs)

PubMed Central

Latif, Asam; Pollock, Kristian; Anderson, Claire; Waring, Justin; Solomon, Josie; Chen, Li-Chia; Anderson, Emma; Gulzar, Sulma; Abbasi, Nasa; Wharrad, Heather

2016-01-01

Introduction Community pharmacy increasingly features in global strategies to modernise the delivery of primary healthcare. Medicine Use Reviews (MURs) form part of the English Government's medicines management strategy to improve adherence and reduce medicine waste. MURs provide space for patient–pharmacist dialogue to discuss the well-known problems patients experience with medicine taking. However, ‘underserved’ communities (eg, black and minority ethnic communities, people with mental illness), who may benefit the most, may not receive this support. This study aims to develop, implement and evaluate an e-learning education intervention which is coproduced between patients from underserved communities and pharmacy teams to improve MUR provision. Methods and analysis This mixed-methods evaluative study will involve a 2-stage design. Stage 1 involves coproduction of an e-learning resource through mixed patient–professional development (n=2) and review (n=2) workshops, alongside informative semistructured interviews with patients (n=10) and pharmacy staff (n=10). Stage 2 involves the implementation and evaluation of the intervention with community pharmacy staff within all community pharmacies within the Nottinghamshire geographical area (n=237). Online questionnaires will be completed at baseline and postintervention (3 months) to assess changes in engagement with underserved communities and changes in self-reported attitudes and behaviour. To triangulate findings, 10 pharmacies will record at baseline and postintervention, details of actual numbers of MURs performed and the proportion that are from underserved communities. Descriptive and inferential statistics will be used to analyse the data. The evaluation will also include a thematic analysis of one-to-one interviews with pharmacy teams to explore the impact on clinical practice (n=20). Interviews with patients belonging to underserved communities, and who received an MUR, will also be conducted (n=20). Ethics and dissemination The study has received ethical approval from the NHS Research Ethics Committee (East Midlands–Derby) and governance clearance through the NHS Health Research Authority. Following the evaluation, the educational intervention will be freely accessible online. PMID:27940633

Technology for return of planetary samples

NASA Technical Reports Server (NTRS)

1975-01-01

The problem of returning a Mars sample to Earth was considered. The model ecosystem concept was advanced as the most reliable, sensitive method for assessing the biohazard from the Mars sample before it is permitted on Earth. Two approaches to ecosystem development were studied. In the first approach, the Mars sample would be introduced into the ecosystem and exposed to conditions which are as similar to the Martian environment as the constitutent terrestrial organisms can tolerate. In the second approach, the Mars sample would be tested to determine its effects on important terrestrial cellular functions. In addition, efforts were directed toward establishing design considerations for a Mars Planetary Receiving Laboratory. The problems encountered with the Lunar Receiving Laboratory were evaluated in this context. A questionnaire was developed to obtain information regarding important experiments to be conducted in the Planetary Receiving Laboratory.

Optimizing area under the ROC curve using semi-supervised learning

PubMed Central

Wang, Shijun; Li, Diana; Petrick, Nicholas; Sahiner, Berkman; Linguraru, Marius George; Summers, Ronald M.

2014-01-01

Receiver operating characteristic (ROC) analysis is a standard methodology to evaluate the performance of a binary classification system. The area under the ROC curve (AUC) is a performance metric that summarizes how well a classifier separates two classes. Traditional AUC optimization techniques are supervised learning methods that utilize only labeled data (i.e., the true class is known for all data) to train the classifiers. In this work, inspired by semi-supervised and transductive learning, we propose two new AUC optimization algorithms hereby referred to as semi-supervised learning receiver operating characteristic (SSLROC) algorithms, which utilize unlabeled test samples in classifier training to maximize AUC. Unlabeled samples are incorporated into the AUC optimization process, and their ranking relationships to labeled positive and negative training samples are considered as optimization constraints. The introduced test samples will cause the learned decision boundary in a multidimensional feature space to adapt not only to the distribution of labeled training data, but also to the distribution of unlabeled test data. We formulate the semi-supervised AUC optimization problem as a semi-definite programming problem based on the margin maximization theory. The proposed methods SSLROC1 (1-norm) and SSLROC2 (2-norm) were evaluated using 34 (determined by power analysis) randomly selected datasets from the University of California, Irvine machine learning repository. Wilcoxon signed rank tests showed that the proposed methods achieved significant improvement compared with state-of-the-art methods. The proposed methods were also applied to a CT colonography dataset for colonic polyp classification and showed promising results.1 PMID:25395692

Optimizing area under the ROC curve using semi-supervised learning.

PubMed

Wang, Shijun; Li, Diana; Petrick, Nicholas; Sahiner, Berkman; Linguraru, Marius George; Summers, Ronald M

2015-01-01

Receiver operating characteristic (ROC) analysis is a standard methodology to evaluate the performance of a binary classification system. The area under the ROC curve (AUC) is a performance metric that summarizes how well a classifier separates two classes. Traditional AUC optimization techniques are supervised learning methods that utilize only labeled data (i.e., the true class is known for all data) to train the classifiers. In this work, inspired by semi-supervised and transductive learning, we propose two new AUC optimization algorithms hereby referred to as semi-supervised learning receiver operating characteristic (SSLROC) algorithms, which utilize unlabeled test samples in classifier training to maximize AUC. Unlabeled samples are incorporated into the AUC optimization process, and their ranking relationships to labeled positive and negative training samples are considered as optimization constraints. The introduced test samples will cause the learned decision boundary in a multidimensional feature space to adapt not only to the distribution of labeled training data, but also to the distribution of unlabeled test data. We formulate the semi-supervised AUC optimization problem as a semi-definite programming problem based on the margin maximization theory. The proposed methods SSLROC1 (1-norm) and SSLROC2 (2-norm) were evaluated using 34 (determined by power analysis) randomly selected datasets from the University of California, Irvine machine learning repository. Wilcoxon signed rank tests showed that the proposed methods achieved significant improvement compared with state-of-the-art methods. The proposed methods were also applied to a CT colonography dataset for colonic polyp classification and showed promising results.

A systematic and comprehensive approach to teaching and evaluating interpersonal skills.

PubMed

Grayson, M; Nugent, C; Oken, S L

1977-11-01

This study addressed one problem with current methods for teaching and evaluating interpersonal skills: the failure to include a wide range of behaviors reported in the literature as contributing to patient dissatisfaction and noncompliance. To address this concern, the authors developed a comprehensive interpersonal skills training program and a pretest-posttest evaluation. The tests were administered to two student groups one of which received the interpersonal skills instruction. The student group exposed to the training exhibited a significant positive change from pretest to posttest. Additionally the change for this group was significantly greater than the change for the group not exposed to interpersonal skills instruction.

Apparatus for monitoring high temperature ultrasonic characterization

DOEpatents

Lanagan, M.T.; Kupperman, D.S.; Yaconi, G.A.

1998-03-24

A method and an apparatus for nondestructive detecting and evaluating changes in the microstructural properties of a material by employing one or more magnetostrictive transducers linked to the material by means of one or more sonic signal conductors. The magnetostrictive transducer or transducers are connected to a pulser/receiver which in turn is connected to an oscilloscope. The oscilloscope is connected to a computer which employs an algorithm to evaluate changes in the velocity of a signal transmitted to the material sample as function of time and temperature. 6 figs.

Simulation in an Undergraduate Nursing Pharmacology Course: A Pilot Study.

PubMed

Tinnon, Elizabeth; Newton, Rebecca

This study examined the effectiveness of simulation as a method of teaching pharmacological concepts to nursing students; perceptions of satisfaction with simulation as a teaching strategy were also evaluated. Second-semester juniors participated in three simulations and completed the National League for Nursing Student Satisfaction and Self-Confidence in Learning Questionnaire and the Student Evaluation of Educational Quality Survey; a control group received traditional lectures. A unit exam on anticoagulant therapy content was administered to measure effectiveness. Findings support that simulation is as effective as traditional lecture for an undergraduate pharmacology course.

Evaluation of the Predictive Validity of Thermography in Identifying Extravasation With Intravenous Chemotherapy Infusions.

PubMed

Matsui, Yuko; Murayama, Ryoko; Tanabe, Hidenori; Oe, Makoto; Motoo, Yoshiharu; Wagatsuma, Takanori; Michibuchi, Michiko; Kinoshita, Sachiko; Sakai, Keiko; Konya, Chizuko; Sugama, Junko; Sanada, Hiromi

Early detection of extravasation is important, but conventional methods of detection lack objectivity and reliability. This study evaluated the predictive validity of thermography for identifying extravasation during intravenous antineoplastic therapy. Of 257 patients who received chemotherapy through peripheral veins, extravasation was identified in 26. Thermography was performed every 15 to 30 minutes during the infusions. Sensitivity, specificity, positive predictive value, and negative predictive value using thermography were 84.6%, 94.8%, 64.7%, and 98.2%, respectively. This study showed that thermography offers an accurate prediction of extravasation.

Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial

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

Haffty, Bruce G.; Vicini, Frank A.; Beitsch, Peter

2008-12-01

Purpose: To evaluate cosmetic outcome and radiation recall in the American Society of Breast Surgeons registry trial, as a function of the interval between accelerated partial breast irradiation (APBI) and initiation of chemotherapy (CTX). Methods and Materials: A total of 1440 patients at 97 institutions participated in this trial. After lumpectomy for early-stage breast cancer, patients received APBI (34 Gy in 10 fractions) with MammoSite RTS brachytherapy. A total of 148 patients received CTX within 90 days of APBI. Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good or fair/poor. Results: Chemotherapy was initiated at a meanmore » of 3.9 weeks after the final MammoSite procedure and was administered {<=}3 weeks after APBI in 54 patients (36%) and >3 weeks after APBI in 94 patients (64%). The early and delayed groups were well balanced with respect to multiple factors that may impact on cosmetic outcome. There was a superior cosmetic outcome in those receiving chemotherapy >3 weeks after APBI (excellent/good in 72.2% at {<=}3 weeks vs. excellent/good in 93.8% at >3 weeks; p = 0.01). Radiation recall in those receiving CTX at {<=}3 weeks was 9 of 50 (18%), compared with 6 of 81(7.4%) in those receiving chemotherapy at >3 weeks (p = 0.09). Conclusion: The majority of patients receiving CTX after APBI have excellent/good cosmetic outcomes, with a low rate of radiation recall. Chemotherapy initiated >3 weeks after the final MammoSite procedure seems to be associated with a better cosmetic outcome and lower rate of radiation recall. An excellent/good cosmetic outcome in patients receiving CTX after 3 weeks was similar to the cosmetic outcome of the overall patient population who did not receive CTX.« less

Optimization of MLS receivers for multipath environments

NASA Technical Reports Server (NTRS)

Mcalpine, G. A.; Highfill, J. H., III

1979-01-01

The angle tracking problems in microwave landing system receivers along with a receiver design capable of optimal performance in the multipath environments found in air terminal areas were studied. Included were various theoretical and evaluative studies like: (1) signal model development; (2) derivation of optimal receiver structures; and (3) development and use of computer simulations for receiver algorithm evaluation. The development of an experimental receiver for flight testing is presented. An overview of the work and summary of principal results and conclusions are reported.

Teen worker safety training: methods used, lessons taught, and time spent.

PubMed

Zierold, Kristina M

2015-05-01

Safety training is strongly endorsed as one way to prevent teens from performing dangerous tasks at work. The objective of this mixed methods study was to characterize the safety training that teenagers receive on the job. From 2010 through 2012, focus groups and a cross-sectional survey were conducted with working teens. The top methods of safety training reported were safety videos (42 percent) and safety lectures (25 percent). The top lessons reported by teens were "how to do my job" and "ways to spot hazards." Males, who were more likely to do dangerous tasks, received less safety training than females. Although most teens are getting safety training, it is inadequate. Lessons addressing safety behaviors are missing, training methods used are minimal, and the time spent is insignificant. More research is needed to understand what training methods and lessons should be used, and the appropriate safety training length for effectively preventing injury in working teens. In addition, more research evaluating the impact of high-quality safety training compared to poor safety training is needed to determine the best training programs for teens. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Validity and reliability of a method for assessment of cervical vertebral maturation.

PubMed

Zhao, Xiao-Guang; Lin, Jiuxiang; Jiang, Jiu-Hui; Wang, Qingzhu; Ng, Sut Hong

2012-03-01

To evaluate the validity and reliability of the cervical vertebral maturation (CVM) method with a longitudinal sample. Eighty-six cephalograms from 18 subjects (5 males and 13 females) were selected from the longitudinal database. Total mandibular length was measured on each film; an increased rate served as the gold standard in examination of the validity of the CVM method. Eleven orthodontists, after receiving intensive training in the CVM method, evaluated all films twice. Kendall's W and the weighted kappa statistic were employed. Kendall's W values were higher than 0.8 at both times, indicating strong interobserver reproducibility, but interobserver agreement was documented twice at less than 50%. A wide range of intraobserver agreement was noted (40.7%-79.1%), and substantial intraobserver reproducibility was proved by kappa values (0.53-0.86). With regard to validity, moderate agreement was reported between the gold standard and observer staging at the initial time (kappa values 0.44-0.61). However, agreement seemed to be unacceptable for clinical use, especially in cervical stage 3 (26.8%). Even though the validity and reliability of the CVM method proved statistically acceptable, we suggest that many other growth indicators should be taken into consideration in evaluating adolescent skeletal maturation.

Monitor-based evaluation of pollutant load from urban stormwater runoff in Beijing.

PubMed

Liu, Y; Che, W; Li, J

2005-01-01

As a major pollutant source to urban receiving waters, the non-point source pollution from urban runoff needs to be well studied and effectively controlled. Based on monitoring data from urban runoff pollutant sources, this article describes a systematic estimation of total pollutant loads from the urban areas of Beijing. A numerical model was developed to quantify main pollutant loads of urban runoff in Beijing. A sub-procedure is involved in this method, in which the flush process influences both the quantity and quality of stormwater runoff. A statistics-based method was applied in computing the annual pollutant load as an output of the runoff. The proportions of pollutant from point-source and non-point sources were compared. This provides a scientific basis for proper environmental input assessment of urban stormwater pollution to receiving waters, improvement of infrastructure performance, implementation of urban stormwater management, and utilization of stormwater.

Leak Rate Performance of Silicone Elastomer O-Rings Contaminated with JSC-1A Lunar Regolith Simulant

NASA Technical Reports Server (NTRS)

Oravec, Heather Ann; Daniels, Christopher C.

2014-01-01

Contamination of spacecraft components with planetary and foreign object debris is a growing concern. Face seals separating the spacecraft cabin from the debris filled environment are particularly susceptible; if the seal becomes contaminated there is potential for decreased performance, mission failure, or catastrophe. In this study, silicone elastomer O-rings were contaminated with JSC- 1A lunar regolith and their leak rate performance was evaluated. The leak rate values of contaminated O-rings at four levels of seal compression were compared to those of as-received, uncontaminated, O-rings. The results showed a drastic increase in leak rate after contamination. JSC-1A contaminated O-rings lead to immeasurably high leak rate values for all levels of compression except complete closure. Additionally, a mechanical method of simulant removal was examined. In general, this method returned the leak rate to as-received values.

Picture book support for preparing children ahead of and during day surgery.

PubMed

Nilsson, Elisabeth; Svensson, Gunnar; Frisman, Gunilla Hollman

2016-10-07

Aim To develop and evaluate the use of a specific picture book aiming to prepare children for anaesthesia and surgery. Methods An intervention comparing two different information methods before ear, nose and throat day surgery was performed. The intervention involved using a specific information sheet and a specific picture book. Parents (n=104) of children aged 2-12 years completed open-ended questions that were analysed with qualitative content analysis. They were divided into two groups: one group received routine information and one received routine information and the intervention. Findings The picture sheet and picture book were valuable aids to prepare small children for anaesthesia and surgery by explaining the procedures that would take place. The parents expressed that knowledge of the procedures made them and the child feel secure. Conclusion Peri-operative information through pictures supports children and their parents during day surgery and may be helpful in future healthcare visits.

Nonlinear bias analysis and correction of microwave temperature sounder observations for FY-3C meteorological satellite

NASA Astrophysics Data System (ADS)

Hu, Taiyang; Lv, Rongchuan; Jin, Xu; Li, Hao; Chen, Wenxin

2018-01-01

The nonlinear bias analysis and correction of receiving channels in Chinese FY-3C meteorological satellite Microwave Temperature Sounder (MWTS) is a key technology of data assimilation for satellite radiance data. The thermal-vacuum chamber calibration data acquired from the MWTS can be analyzed to evaluate the instrument performance, including radiometric temperature sensitivity, channel nonlinearity and calibration accuracy. Especially, the nonlinearity parameters due to imperfect square-law detectors will be calculated from calibration data and further used to correct the nonlinear bias contributions of microwave receiving channels. Based upon the operational principles and thermalvacuum chamber calibration procedures of MWTS, this paper mainly focuses on the nonlinear bias analysis and correction methods for improving the calibration accuracy of the important instrument onboard FY-3C meteorological satellite, from the perspective of theoretical and experimental studies. Furthermore, a series of original results are presented to demonstrate the feasibility and significance of the methods.

[Ultrasound duplex scanning of head and neck vessels with the aim of preoperational preparation of the patients with inherent microtia of the III degree].

PubMed

Chkadua, T Z; Kuz'mina, I V; Ramazanova, Iu I

2010-01-01

For surgical treatment of patients with inherent microtia of the III degree we use one stage method of otoplasty with silicone implant and parietotemporal fascial flap. In order to receive most full picture of the status of superficial temporal artery and its branches the additional diagnostic study is necessary. Method of ultrasound duplex scanning let to study any vessel in real time regimen under monitor screen control. Received by us results of ultrasound duplex scanning of superficial temporal artery branches in patients with inherent microtia of the III degree let us to conclude about the status of the vessel wall, to determine diameter and vessel occlusion, to evaluate and measure blood flow parameters. It is diagnostically necessary criteria for answering the question about flap vitality and in such a way let to avoid possible complications.

Comparison of GPS receiver DCB estimation methods using a GPS network

NASA Astrophysics Data System (ADS)

Choi, Byung-Kyu; Park, Jong-Uk; Min Roh, Kyoung; Lee, Sang-Jeong

2013-07-01

Two approaches for receiver differential code biases (DCB) estimation using the GPS data obtained from the Korean GPS network (KGN) in South Korea are suggested: the relative and single (absolute) methods. The relative method uses a GPS network, while the single method determines DCBs from a single station only. Their performance was assessed by comparing the receiver DCB values obtained from the relative method with those estimated by the single method. The daily averaged receiver DCBs obtained from the two different approaches showed good agreement for 7 days. The root mean square (RMS) value of those differences is 0.83 nanoseconds (ns). The standard deviation of the receiver DCBs estimated by the relative method was smaller than that of the single method. From these results, it is clear that the relative method can obtain more stable receiver DCBs compared with the single method over a short-term period. Additionally, the comparison between the receiver DCBs obtained by the Korea Astronomy and Space Science Institute (KASI) and those of the IGS Global Ionosphere Maps (GIM) showed a good agreement at 0.3 ns. As the accuracy of DCB values significantly affects the accuracy of ionospheric total electron content (TEC), more studies are needed to ensure the reliability and stability of the estimated receiver DCBs.

A process evaluation of a social cognitive theory-based childhood obesity prevention intervention: the Comics for Health program.

PubMed

Branscum, Paul; Sharma, Manoj; Wang, Lihshing Leigh; Wilson, Bradley; Rojas-Guyler, Liliana

2013-03-01

Process evaluations are an often overlooked yet essential component of health promotion interventions. This study reports the results of a comprehensive process evaluation for the "Comics for Health" program, a childhood obesity prevention intervention implemented at 12 after-school programs. Qualitative and quantitative process data were collected using surveys, field notes, and open-item questionnaires, which assessed program fidelity, dose delivered, dose received, reach, recruitment, and context. Triangulation of methods was also employed to better understand how the program was implemented and received by the facilitator, staff members, and children in the program. Results indicated that program implementation had an almost perfect rate of fidelity with most lessons recording 100% tasks completed. Lessons were implemented in their intended order and lasted approximately 30 minutes as planned. After-school staff members reported that the program was well received by children, and this program should be replicated in the future. Attendance records showed that a majority of the children attended each lesson on the initial day of delivery (70.4%) and informal make-up lessons were implemented to compensate for the other children. Finally, several known sources of contamination were found such as past and concurrent exposure to similar health promotion interventions, which could potentially influence study outcomes. These findings will be used to help explain the results of this intervention and make recommendations for future intervention efforts.

Contrast-enhanced ultrasound evaluation of pancreatic cancer xenografts in nude mice after irradiation with sub-threshold focused ultrasound for tumor ablation

PubMed Central

Wang, Rui; Guo, Qian; Chen, Yi Ni; Hu, Bing; Jiang, Li Xin

2017-01-01

We evaluated the efficacy of contrast-enhanced ultrasound for assessing tumors after irradiation with sub-threshold focused ultrasound (FUS) ablation in pancreatic cancer xenografts in nude mice. Thirty tumor-bearing nude mice were divided into three groups: Group A received sham irradiation, Group B received a moderate-acoustic energy dose (sub-threshold), and Group C received a high-acoustic energy dose. In Group B, B-mode ultrasound (US), color Doppler US, and dynamic contrast-enhanced ultrasound (DCE-US) studies were conducted before and after irradiation. After irradiation, tumor growth was inhibited in Group B, and the tumors shrank in Group C. In Group A, the tumor sizes were unchanged. In Group B, contrast-enhanced ultrasound (CEUS) images showed a rapid rush of contrast agent into and out of tumors before irradiation. After irradiation, CEUS revealed contrast agent perfusion only at the tumor periphery and irregular, un-perfused volumes of contrast agent within the tumors. DCE-US perfusion parameters, including peak intensity (PI) and area under the curve (AUC), had decreased 24 hours after irradiation. PI and AUC were increased 48 hours and 2weeks after irradiation. Time to peak (TP) and sharpness were increased 24 hours after irradiation. TP decreased at 48 hours and 2 weeks after irradiation. CEUS is thus an effective method for early evaluation after irradiation with sub-threshold FUS. PMID:28402267

NOAA's Undergraduate Scholarship Program Outcomes and Opportunities

NASA Astrophysics Data System (ADS)

Kaplan, M.; Jabanoski, K.; Christenson, T.

2017-12-01

NOAA supports about 115 - 150 undergraduates per year through the Ernest F. Hollings Scholarship and the Educational Partnership Program Undergraduate Scholarship. These programs provide tuition support and paid summer internships at NOAA to exceptional students majoring in the geosciences. Multiple methods were used to evaluate program outcomes and track the career trajectories, including mining LinkedIn data and conducting evaluation surveys of recipients as well as students who applied but did not receive the award. Results show more than 75% of scholars continued on to graduate school, primarily in a NOAA mission fields. This compared to only 56% of nonrecipients. More than 60% of alumni had at least one professional record, with the most alumni working in private industry, followed by nongovernmental organizations and federal, state and local government. The evaluation identified 77 other scholarship programs applied to by NOAA scholarship recipients. The most commonly reported program was the NSF Research Experiences for Undergraduates (REU) for which 20% of scholars applied and 46% of applications were successful. Other common scholarships included the Goldwater Scholarship (received by 5% of NOAA scholars) and the Udall Scholarship (received by 4% of scholars). In the most recent class of 118 undergraduate scholars, 24% reported having another research experience by the time they arrived for orientation at the end of their sophomore year. These results suggest coordination across scholarship opportunities may be useful to engage and retain students in geoscience fields.

Effectiveness of Cognitive-Behavioral Therapy in Decreasing Suicidal Ideation and Hopelessness of the Adolescents with Previous Suicidal Attempts

PubMed Central

Alavi, Ali; Sharifi, Bahare; Ghanizadeh, Ahmad; Dehbozorgi, Gholamreza

2013-01-01

Objective To evaluate the effectiveness of a Cognitive-Behavioral therapy (CBT) for suicide prevention in decreasing suicidal ideation and hopelessness in a sample of depressed 12 to 18 year-old adolescents who had at least one previous suicidal attempt. Methods In a clinical trial, 30 depressed adolescents who attempted suicide in the recent 3 months were selected using simple sampling method and divided randomly into intervention and wait-list control groups. Both groups received psychiatric interventions as routine. The intervention group received a 12 session (once a week) of CBT program according to the package developed by Stanley et al, including psychoeducational interventions and individual and family skills training modules. All of the patients were evaluated by Scale for Suicidal Ideation, Beck's hopelessness Inventory, and Beck's Depression Inventory before the intervention and after 12 weeks. Findings There were significant differences between the two groups regarding the scores of the above mentioned scales after 12 weeks. Fifty-four to 77 percent decreases in the mean scores of the used scales were observed in the invention group. There were no significant changes in the scores of the control wait-list group. The differences between pre- and post-intervention scores in the intervention group were significant. Conclusion CBT is an effective method in reducing suicidal ideation and hopelessness in the depressed adolescents with previous suicidal attempts. PMID:24427502

Two controlled trials to increase participant retention in a randomized controlled trial of mobile phone-based smoking cessation support in the United Kingdom.

PubMed

Severi, Ettore; Free, Caroline; Knight, Rosemary; Robertson, Steven; Edwards, Philip; Hoile, Elizabeth

2011-10-01

Loss to follow-up of trial participants represents a threat to research validity. To date, interventions designed to increase participants' awareness of benefits to society of completing follow-up, and the impact of a telephone call from a senior female clinician and researcher requesting follow-up have not been evaluated robustly. Trial 1 aimed to evaluate the effect on trial follow-up of written information regarding the benefits of participation to society. Trial 2 aimed to evaluate the effect on trial follow-up of a telephone call from a senior female clinician and researcher. Two single-blind randomized controlled trials were nested within a larger trial, Txt2stop. In Trial 1, participants were allocated using minimization to receive a refrigerator magnet and a text message emphasizing the benefits to society of completing follow-up, or to a control group receiving a simple reminder regarding follow-up. In Trial 2, participants were randomly allocated to receive a telephone call from a senior female clinician and researcher, or to a control group receiving standard Txt2stop follow-up procedures. Trial 1: 33.5% (327 of 976) of the intervention group and 33.8% (329 of 974) of the control group returned the questionnaire within 26 weeks of randomization, risk ratio (RR) 0.99; 95% confidence interval (CI) 0.88-1.12. In all, 83.3% (813 of 976) of the intervention group and 82.2% (801 of/974) of the control group sent back the questionnaire within 30 weeks of randomization, RR 1.01; 95% CI 0.97, 1.05. Trial 2: 31% (20 of 65) of the intervention group and 32% (20 of 62) of the control group completed trial follow-up, RR 0.93; 95%CI 0.44, 1.98. In presence of other methods to increase follow-up neither experimental method (refrigerator magnet and text message emphasizing participation's benefits to society nor a telephone call from study's principal investigator) increased participant follow-up in the Txt2stop trial.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study

PubMed Central

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-01-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. PMID:25533447

Formative assessment based on an audit and feedback improves nuchal translucency ultrasound image quality.

PubMed

Chalouhi, Gihad E; Salomon, Laurent J; Fontanges, Marianne; Althuser, Marc; Haddad, Georges; Scemama, Olivier; Chabot, Jean-Michel; Duyme, Michel; Fries, Nicolas

2013-09-01

The purpose of this work was to study the impact of an audit and feedback on the quality of routine first-trimester nuchal transparency ultrasound images. Eighty-eight sonographers were each sent 2 different series of 30 consecutive nuchal translucency images at a mean interval of 3 months to a dedicated, protected server for remote double-blind independent analysis based on the new Collège Français d'Echographie Foetale/Centre National de la Recherche Scientifique image-scoring method (https://www.cfef.org/evaluation/ISMCFEFCNRS.pdf). The sonographers were classified as low (score below the median) or high (score above the median) scorers for each series. Before their second evaluation, 73 of the 88 sonographers received a feedback report on their first series of images, whereas the other 15 participants received no feedback. The baseline characteristics of the participants who did and did not receive feedback were comparable. Participants who received feedback increased their average score significantly, from a mean ± SD of 11.1 ± 1.3 to 13.4 ± 1.4 among low scorers (P < .00001) and from 15.1 ± 1.2 to 16.0 ± 1.4 among high scorers (P < .001), whereas no significant change was seen among participants who received no feedback (low scorers, 10.9 ± 1.5 to 12.1 ± 2.0; P = .11; high scorers, 14.7 ± 1.3 to 14.6 ± 1.3; P = .99). The proportion of satisfactory images increased by 48% among low scorers who received feedback. Formative assessment based on a moderately intensive audit and feedback is feasible and effective for improving the quality of routine first-trimester nuchal transparency ultrasound images.

Factors associated with use of pre-operative chemoradiation therapy for rectal cancer in the Cancer Care Outcomes Research and Surveillance Consortium

PubMed Central

Charlton, Mary E.; Lin, Chi; Jiang, Dingfeng; Stitzenberg, Karyn B.; Halfdanarson, Thorvardur R.; Pendergast, Jane F.; Chrischilles, Elizabeth A.; Wallace, Robert B.

2012-01-01

Purpose Pre-operative (pre-op) chemoradiation therapy (CRT) improves local control and reduces toxicity more than post-operative (post-op) CRT for the treatment of stages II/III rectal cancer, but studies suggest many patients still receive post-op CRT. We examined patient beliefs, and clinical and provider characteristics associated with receipt of recommended therapy. Methods We identified stage II/III rectal cancer patients who had primary site resection and CRT among subjects in the Cancer Care Outcomes Research and Surveillance Consortium, a population- and health system-based prospective cohort of newly diagnosed colorectal cancer patients from 2003 to 2005. Patient surveys and abstracted medical records were used to construct variables and determine sequence of CRT and surgery. Logistic regression was used to model the association between predictors and receipt of pre-op CRT. Results Of the 201 patients, 66% received pre-op and 34% received post-op CRT. Those visiting a medical oncologist and/or radiation oncologist prior to a surgeon had a 96% (95% CI, 92% to 100%) predicted probability of receiving pre-op CRT, compared to 48% (95% CI, 41% to 55%) for those visiting a surgeon first. Among those visiting a surgeon first, documentation of recommended staging procedures was associated with receiving pre-op CRT. Conclusion Sequence of provider visits and documentation of recommended staging procedures were important predictors of receiving pre-op CRT. Initial multidisciplinary evaluation led to better adherence to CRT guidelines. Further evaluation of provider characteristics, referral patterns and related health system processes should be undertaken to inform targeted interventions to reduce variation from recommended care. PMID:22992624

Parents’ Concerns as they Relate to Their Child’s Development and Later Diagnosis of Autism Spectrum Disorder

PubMed Central

Richards, Megan; Mossey, Jana; Robins, Diana L.

2016-01-01

Objective Data from a toddler screening study were used to examine: 1) categories of concerns regarding the development of their child reported by parents prior to diagnostic evaluation, 2) congruence of parent concerns with their child’s later diagnosis, 3) the extent to which parent concern(s) were associated with the therapies their child received and types of specialists consulted, and 4) the association between the number of parental concern categories and clinical measures. Methods Toddlers who screened positive for autism spectrum disorder (ASD) during well-child check-ups received a diagnostic evaluation and parents completed a history questionnaire (n=532; 274 ASD, 258 non-ASD). Parents’ concerns about their child’s development, therapy received, and specialists consulted were coded into discrete categories. Results Most parents (>90%) reported concerns about their child’s development. The most common concern in both the ASD and non-ASD groups was speech/communication (78.6%). Significant differences were found between diagnostic groups in the speech/communication, restricted/repetitive behaviors, social, behavioral, and medical concern categories. Parent concerns were associated with therapies received and specialists consulted. The number of concern categories was positively associated with several ASD scores. Conclusions The developmental concerns expressed by parents of undiagnosed toddlers were highly consistent with the diagnosis the child later received. Based in part on their areas of concern, parents made contact with the appropriate professionals and their children received some therapy prior to diagnosis. Finally, parents who reported concerns across different areas endorsed more symptoms during screening. Results emphasize the need for providers to elicit and take seriously parent concerns during the referral and diagnostic processes. PMID:27541581

Improving antimicrobial use among health workers in first-level facilities: results from the multi-country evaluation of the Integrated Management of Childhood Illness strategy.

PubMed Central

Gouws, Eleanor; Bryce, Jennifer; Habicht, Jean-Pierre; Amaral, João; Pariyo, George; Schellenberg, Joanna Armstrong; Fontaine, Olivier

2004-01-01

OBJECTIVE: The objective of this study was to assess the effect of Integrated Management of Childhood Illness (IMCI) case management training on the use of antimicrobial drugs among health-care workers treating young children at first-level facilities. Antimicrobial drugs are an essential child-survival intervention. Ensuring that children younger than five who need these drugs receive them promptly and correctly can save their lives. Prescribing these drugs only when necessary and ensuring that those who receive them complete the full course can slow the development of antimicrobial resistance. METHODS: Data collected through observation-based surveys in randomly selected first-level health facilities in Brazil, Uganda and the United Republic of Tanzania were statistically analysed. The surveys were carried out as part of the multi-country evaluation of IMCI effectiveness, cost and impact (MCE). FINDINGS: Results from three MCE sites show that children receiving care from health workers trained in IMCI are significantly more likely to receive correct prescriptions for antimicrobial drugs than those receiving care from workers not trained in IMCI.They are also more likely to receive the first dose of the drug before leaving the health facility, to have their caregiver advised how to administer the drug, and to have caregivers who are able to describe correctly how to give the drug at home as they leave the health facility. CONCLUSIONS: IMCI case management training is an effective intervention to improve the rational use of antimicrobial drugs for sick children visiting first-level health facilities in low-income and middle-income countries. PMID:15508195

A Randomized Trial of a Hepatitis Care Coordination Model in Methadone Maintenance Treatment

PubMed Central

Delucchi, Kevin L.; McKnight, Courtney; Hettema, Jennifer; Khalili, Mandana; Min, Albert; Jordan, Ashly E.; Pepper, Nicole; Hall, Jessica; Hengl, Nicholas S.; Young, Christopher; Shopshire, Michael S.; Manuel, Jennifer K.; Coffin, Lara; Hammer, Hali; Shapiro, Bradley; Seewald, Randy M.; Bodenheimer, Henry C.; Sorensen, James L.; Des Jarlais, Don C.; Perlman, David C.

2013-01-01

Objectives. We evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients. Methods. We conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2008 through June 2011. We randomized participants to a control arm (n = 245) and an intervention arm (n = 244), which included on-site screening, motivational-enhanced education and counseling, on-site vaccination, and case management services. Results. Compared with the control group, intervention group participants were significantly more likely (odds ratio [OR] = 41.8; 95% confidence interval [CI] = 19.4, 90.0) to receive their first vaccine dose within 30 days and to receive an HCV evaluation within 6 months (OR = 4.10; 95% CI = 2.35, 7.17). A combined intervention adherence outcome that measured adherence to HAV–HBV vaccination, HCV evaluation, or both strongly favored the intervention group (OR = 8.70; 95% CI = 5.56, 13.61). Conclusions. Hepatitis care coordination was efficacious in increasing adherence to HAV–HBV vaccination and HCV clinical evaluation among methadone patients. PMID:23947319

Improving contraceptive choice: fidelity of implementation and the gap between effectiveness and efficacy.

PubMed

Garbers, Samantha; Flandrick, Kathleen; Bermudez, Dayana; Meserve, Allison; Chiasson, Mary Ann

2014-11-01

Interventions to reduce unintended pregnancy through improved contraceptive use are a public health priority. A comprehensive process evaluation of a contraceptive assessment module intervention with demonstrated efficacy was undertaken. The 12-month process evaluation goal was to describe the extent to which the intervention was implemented as intended over time, and to identify programmatic adjustments to improve implementation fidelity. Quantitative and qualitative methods included staff surveys, electronic health record data, usage monitoring, and observations. Fidelity of implementation was low overall (<10% of eligible patients completed the entire module [dose received]). Although a midcourse correction making the module available in clinical areas led to increased dose delivered (23% vs. 30%, chi-square test p = .006), dose received did not increase significantly after this adjustment. Contextual factors including competing organizational and staff priorities and staff buy-in limited the level of implementation and precluded adoption of some strategies such as adjusting patient flow. Using a process evaluation framework enabled the research team to identify and address complexities inherent in effectiveness studies and facilitated the alignment of program and context. © 2014 Society for Public Health Education.

Seismic evaluation of vulnerability for SAMA educational buildings in Tehran

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

Amini, Omid Nassiri; Amiri, Javad Vaseghi

2008-07-08

Earthquake is a destructive phenomenon that trembles different parts of the earth yearly and causes many destructions. Iran is one of the (high seismicity) quack- prone parts of the world that has received a lot of pecuniary damages and life losses each year, schools are of the most important places to be protected during such crisis.There was no special surveillance on designing and building of school's building in Tehran till the late 70's, and as Tehran is on faults, instability of such buildings may cause irrecoverable pecuniary damages and especially life losses, therefore preventing this phenomenon is in an urgentmore » need.For this purpose, some of the schools built during 67-78 mostly with Steel braced frame structures have been selected, first, by evaluating the selected Samples, gathering information and Visual Survey, the prepared questionnaires were filled out. With the use of ARIA and SABA (Venezuela) Methods, new modified combined method for qualified evaluations was found and used.Then, for quantified evaluation, with the use of computer 3D models and nonlinear statically analysis methods, a number of selected buildings of qualified evaluation, were reevaluated and finally with nonlinear dynamic analysis method the real behavior of structures on the earthquakes is studied.The results of qualified and quantified evaluations were compared and a proper Pattern for seismic evaluation of Educational buildings was presented. Otherwise the results can be a guidance for the person in charge of retrofitting or if necessary rebuilding the schools.« less

Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets

PubMed Central

Cardoso, Mauricio de Almeida; Saraiva, Patrícia Pinto; Maltagliati, Liliana Ávila; Rhoden, Fernando Kleinübing; Costa, Carla Cristina Alvarenga; Normando, David; Capelozza, Leopoldino

2015-01-01

OBJECTIVE: The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets. METHODS: Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), two-way ANOVA followed by Tukey's test was used to assess CAL at each site of each tooth. Significance level was set at 5%. RESULTS: No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems. CONCLUSION: No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored. PMID:25992985

Evaluation of Rhenium Joining Methods

NASA Technical Reports Server (NTRS)

Reed, Brian D.; Morren, Sybil H.

1995-01-01

Coupons of rhenium-to-Cl03 flat plate joints, formed by explosive and diffusion bonding, were evaluated in a series of shear tests. Shear testing was conducted on as-received, thermally-cycled (100 cycles, from 21 to 1100 C), and thermally-aged (3 and 6 hrs at 1100 C) joint coupons. Shear tests were also conducted on joint coupons with rhenium and/or Cl03 electron beam welded tabs to simulate the joint's incorporation into a structure. Ultimate shear strength was used as a figure of merit to assess the effects of the thermal treatment and the electron beam welding of tabs on the joint coupons. All of the coupons survived thermal testing intact and without any visible degradation. Two different lots of as-received, explosively-bonded joint coupons had ultimate shear strengths of 281 and 310 MPa and 162 and 223 MPa, respectively. As-received, diffusion-bonded coupons had ultimate shear strengths of 199 and 348 MPa. For the most part, the thermally-treated and rhenium weld tab coupons had shear strengths slightly reduced or within the range of the as-received values. Coupons with Cl03 weld tabs experienced a significant reduction in shear strength. The degradation of strength appeared to be the result of a poor heat sink provided during the electron beam welding. The Cl03 base material could not dissipate heat as effectively as rhenium, leading to the formation of a brittle rhenium-niobium intermetallic.

A brief simulation intervention increasing basic science and clinical knowledge.

PubMed

Sheakley, Maria L; Gilbert, Gregory E; Leighton, Kim; Hall, Maureen; Callender, Diana; Pederson, David

2016-01-01

Background The United States Medical Licensing Examination (USMLE) is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. Purpose To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. Methods This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (n l =515) and the intervention group received lecture plus a simulation exercise (n l+s =1,066). Assessment included summative exam questions (n=4) that were scored as pass/fail (≥75%). USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Results Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003). Discussion Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

Evaluation of oral maropitant as an antiemetic in cats receiving morphine and dexmedetomidine.

PubMed

Martin-Flores, Manuel; Sakai, Daniel M; Mastrocco, Alicia; Learn, McKenzie M; Campoy, Luis; Kirch, Pati J; Boesch, Jordyn M; Gleed, Robin D

2016-11-01

Objectives The aim of the study was to evaluate the antiemetic effects of maropitant, after oral administration, in cats receiving morphine and dexmedetomidine. Methods This prospective, blinded, randomized controlled trial involved 98 healthy female domestic shorthair cats. Cats were randomly assigned to receive maropitant PO 8 mg total (group M) administered 18 h prior to sedation with intramuscular dexmedetomidine 20 µg/kg and morphine 0.1 mg/kg, or no antiemetic treatment (group C). The occurrence of signs of nausea (sialorrhea and lip-licking), retching and emesis during the 30 mins following administration of dexmedetomidine and morphine was measured for each group. Results Two cats were excluded from the investigation. Cats in group M (n = 46) received an average of 2.5 mg/kg of maropitant PO. Compared with group C (n = 50), cats in group M had lower incidences of emesis (M: 4% vs C: 40%), retching (M: 8% vs C: 40%) and lip-licking (M: 30% vs C: 52%) (all P <0.05). The incidence of sialorrhea was not different between groups (M: 21% vs C: 22%). Conclusions and relevance Maropitant 8 mg total PO was effective in reducing morphine and dexmedetomidine-induced emesis by 10-fold, when administered as early as 18 h in advance to healthy cats. Maropitant PO could be useful for administration the evening prior to a scheduled procedure requiring sedation/anesthesia to decrease the incidence of emesis.

Assessment of the Effectiveness of Protected Areas Management in Iran: Case Study in Khojir National Park

NASA Astrophysics Data System (ADS)

Kolahi, Mahdi; Sakai, Tetsuro; Moriya, Kazuyuki; Makhdoum, Majid F.; Koyama, Lina

2013-08-01

The requirement to assess the management effectiveness (ME) in protected areas (PAs) is increasing around the world to help improve management and accountability. An evaluation of ME for Khojir National Park (KNP), one of the Iran's oldest PAs, was conducted using a multi-method approach that consisted of structured interviews, open interviews, and site visits. This was the first ME evaluation in Iran. The structured interview was based on the management effectiveness tracking tool methodology. KNP received an average score of 43 %, which is lower than the global average, illustrating that its general management was in the low-intermediate level. The indices of legal status, resource inventory, planning for land and water use, regulations, and objectives received the highest average scores, whereas education and awareness, community co-management, regular work plan, boundary demarcation, visitor facilities, budget sources, staff training, protection systems, and management plan received the lowest ones. The management system of KNP was generally established, but many problems of the management still need to be resolved. To improve ME, some countermeasures should be taken, such as increasing funding, strengthening capacity building, planning, and adaptive management, and implementing community participation.

Optic neuritis occurring with anti‐tumour necrosis factor α therapy

PubMed Central

Simsek, Ismail; Erdem, Hakan; Pay, Salih; Sobaci, Gungor; Dinc, Ayhan

2007-01-01

Objective Various demyelinating disorders have been reported in association with anti‐tumour necrosis factor α (TNFα) agents. The objective of this study was to review the occurrence, clinical features and outcome of optic neuritis (ON) during treatment with anti‐TNFα agents. Methods A PubMed search was conducted to identify literature addressing the potential association between anti‐TNFα agents and ON, following our experience with a patient having rheumatoid arthritis in whom ON developed while being treated with infliximab. Results 15 patients including the case presented here with ON in whom the symptoms developed following TNFα antagonist therapy were evaluated. Eight of these patients had received infliximab, five had received etanercept and two patients had received adalimumab. Among them, nine patients experienced complete resolution, and two patients had partial resolution, while four patients continued to have symptoms. Discussion Patients being treated with a TNFα antagonist should be closely monitored for the development of ophthalmological or neurological signs and symptoms. Furthermore, consideration should be given to avoiding such therapies in patients with a history of demyelinating disease. If clinical evaluation leads to the diagnosis of ON, discontinuation of the medication and institution of steroid treatment should be a priority. PMID:17456525

A Summary of Evaluations for Learning and Attention Problems at a University Training Clinic

ERIC Educational Resources Information Center

Wierzbicki, Michael; Tyson, Clare M.

2007-01-01

Over a five year period, a university clinic performed psychological evaluations of 102 adults (including 85 college students) who reported that they were experiencing learning or attention problems. Of 92 persons who completed the evaluation, 40 (43.5%) received no diagnosis, 7 (7.6%) received the diagnosis of ADHD, 29 (31.5%) received the…

High temperature solar thermal receiver

NASA Technical Reports Server (NTRS)

1979-01-01

A design concept for a high temperature solar thermal receiver to operate at 3 atmospheres pressure and 2500 F outlet was developed. The performance and complexity of windowed matrix, tube-header, and extended surface receivers were evaluated. The windowed matrix receiver proved to offer substantial cost and performance benefits. An efficient and cost effective hardware design was evaluated for a receiver which can be readily interfaced to fuel and chemical processes or to heat engines for power generation.

BeiDou Inter-Satellite-Type Bias Evaluation and Calibration for Mixed Receiver Attitude Determination

PubMed Central

Nadarajah, Nandakumaran; Teunissen, Peter J. G.; Raziq, Noor

2013-01-01

The Chinese BeiDou system (BDS), having different types of satellites, is an important addition to the ever growing system of Global Navigation Satellite Systems (GNSS). It consists of Geostationary Earth Orbit (GEO) satellites, Inclined Geosynchronous Satellite Orbit (IGSO) satellites and Medium Earth Orbit (MEO) satellites. This paper investigates the receiver-dependent bias between these satellite types, for which we coined the name “inter-satellite-type bias” (ISTB), and its impact on mixed receiver attitude determination. Assuming different receiver types may have different delays/biases for different satellite types, we model the differential ISTBs among three BeiDou satellite types and investigate their existence and their impact on mixed receiver attitude determination. Our analyses using the real data sets from Curtin's GNSS array consisting of different types of BeiDou enabled receivers and series of zero-baseline experiments with BeiDou-enabled receivers reveal the existence of non-zero ISTBs between different BeiDou satellite types. We then analyse the impact of these biases on BeiDou-only attitude determination using the constrained (C-)LAMBDA method, which exploits the knowledge of baseline length. Results demonstrate that these biases could seriously affect the integer ambiguity resolution for attitude determination using mixed receiver types and that a priori correction of these biases will dramatically improve the success rate. PMID:23881141

Polysaccharide-Rich Fraction of Noni Fruit (Morinda citrifolia L.) as Doxorubicin Co-Chemotherapy: Evaluation of Catalase, Macrophages, and TCD8+ Lymphocytes

PubMed Central

Sasmito, Ediati; Hertiani, Triana; Novlita Renggani, Tiya; Jaya Laksana, Brata

2015-01-01

Noni fruit (Morinda citrifolia L.) has been acknowledged for its cytotoxic and immunostimulatory activity. Our previous results on the immunomodulatory effect of a noni juice polysaccharide-rich fraction encouraged this research to evaluate the potency of the polysaccharide-rich fraction as co-chemotherapy with doxorubicin (DOX) administration. Macrophage activity (MA) was evaluated with the latex bead method. The phagocytic index (PI) was measured as the number of latex beads ingested by 100 macrophages, while the phagocytosis ratio (PR) was indicated by the percentage of macrophages that ingested three or more latex beads. The CEC was evaluated by using a commercial assay kit, while CD8+ T lymphocyte proliferation was evaluated using a flowcytometry method following in vivo administration. Thirty male Wistar rats were divided into five groups (n = 6 each). The control group received DOX via i.p. at a concentration of 4.67 mg/kg BW on days 1 and 4; four treatment groups received PF p.o. at a concentration of 25; 50; 100; 200 mg/kg BW daily, respectively, and additionally DOX i.p. 4.67 mg/kg BW (days 1 and 4) for 7 days. The phagocytic activity was not affected significantly by PF administration compared to the Dox control, but PF administration at a dose of 25 and 50 mg/kg BW has been proven to increase TCD8+ cell proliferation in combination with DOX. The catalase concentration, on the other hand, significantly decreased following PF administration at a dose of 100 mg/kg BW. The results suggest that the polysaccharide-rich fraction of noni juice might induce immunomodulatory effects via TCD8+ activation, have antioxidant activity, and thus might be a potential candidate to be used as an adjuvant to DOX chemotherapy. PMID:26839832

Polysaccharide-Rich Fraction of Noni Fruit (Morinda citrifolia L.) as Doxorubicin Co-Chemotherapy: Evaluation of Catalase, Macrophages, and TCD8+ Lymphocytes.

PubMed

Sasmito, Ediati; Hertiani, Triana; Novlita Renggani, Tiya; Jaya Laksana, Brata

2015-01-01

Noni fruit (Morinda citrifolia L.) has been acknowledged for its cytotoxic and immunostimulatory activity. Our previous results on the immunomodulatory effect of a noni juice polysaccharide-rich fraction encouraged this research to evaluate the potency of the polysaccharide-rich fraction as co-chemotherapy with doxorubicin (DOX) administration. Macrophage activity (MA) was evaluated with the latex bead method. The phagocytic index (PI) was measured as the number of latex beads ingested by 100 macrophages, while the phagocytosis ratio (PR) was indicated by the percentage of macrophages that ingested three or more latex beads. The CEC was evaluated by using a commercial assay kit, while CD8+ T lymphocyte proliferation was evaluated using a flowcytometry method following in vivo administration. Thirty male Wistar rats were divided into five groups (n = 6 each). The control group received DOX via i.p. at a concentration of 4.67 mg/kg BW on days 1 and 4; four treatment groups received PF p.o. at a concentration of 25; 50; 100; 200 mg/kg BW daily, respectively, and additionally DOX i.p. 4.67 mg/kg BW (days 1 and 4) for 7 days. The phagocytic activity was not affected significantly by PF administration compared to the Dox control, but PF administration at a dose of 25 and 50 mg/kg BW has been proven to increase TCD8+ cell proliferation in combination with DOX. The catalase concentration, on the other hand, significantly decreased following PF administration at a dose of 100 mg/kg BW. The results suggest that the polysaccharide-rich fraction of noni juice might induce immunomodulatory effects via TCD8+ activation, have antioxidant activity, and thus might be a potential candidate to be used as an adjuvant to DOX chemotherapy.

SLIMMER: a randomised controlled trial of diabetes prevention in Dutch primary health care: design and methods for process, effect, and economic evaluation

PubMed Central

2014-01-01

Background Implementation of interventions in real-life settings requires a comprehensive evaluation approach. The aim of this article is to describe the evaluation design of the SLIMMER diabetes prevention intervention in a Dutch real-life setting. Methods/Design The SLIMMER study is a randomised, controlled intervention study including subjects aged 40 through 70 years with impaired fasting glucose or high risk of diabetes. The 10-month SLIMMER intervention involves a dietary and physical activity intervention, including case management and a maintenance programme. The control group receives usual health care and written information about a healthy lifestyle. A logic model of change is composed to link intervention activities with intervention outcomes in a logical order. Primary outcome is fasting insulin. Measurements are performed at baseline and after 12 and 18 months and cover quality of life, cardio-metabolic risk factors (e.g. glucose tolerance, serum lipids, body fatness, and blood pressure), eating and physical activity behaviour, and behavioural determinants. A process evaluation gives insight in how the intervention was delivered and received by participants and health care professionals. The economic evaluation consists of a cost-effectiveness analysis and a cost-utility analysis. Costs are assessed from both a societal and health care perspective. Discussion This study is expected to provide insight in the effectiveness, including its cost-effectiveness, and delivery of the SLIMMER diabetes prevention intervention conducted in Dutch primary health care. Results of this study provide valuable information for primary health care professionals, researchers, and policy makers. Trial registration The SLIMMER study is registered with ClinicalTrials.gov (NCT02094911) since March 19, 2014. PMID:24928217

Midterm Stability Evaluation of Wide-area Power System by using Synchronized Phasor Measurements

NASA Astrophysics Data System (ADS)

Ota, Yutaka; Ukai, Hiroyuki; Nakamura, Koichi; Fujita, Hideki

In recent years, the PMU (Phasor Measurement Unit) receives a great deal of attention as a synchronized measurement system of power systems. Synchronized phasor angles obtained by the PMU provide the effective information for evaluating the stability of a bulk power system. The aspect of instability phenomena during midterm tends to be more complicated, and the stability analysis using the synchronized phasor measurements is significant in order to keep a complicated power system stable. This paper proposes a midterm stability evaluation method of the wide-area power system by using the synchronized phasor measurements. By clustering and aggregating the power system to some coherent groups, the step-out is effectively predicted on the basis of the two-machine equivalent power system model. The midterm stability of a longitudinal power system model of Japanese 60Hz systems constructed by the PSA, which is a hybrid-type power system simulator, is practically evaluated using the proposed method.

A Synthesis Of Knowledge About Caregiver Decision Making Finds Gaps In Support For Those Who Care For Aging Loved Ones.

PubMed

Garvelink, Mirjam M; Ngangue, Patrice A G; Adekpedjou, Rheda; Diouf, Ndeye T; Goh, Larissa; Blair, Louisa; Légaré, France

2016-04-01

We conducted a mixed-methods knowledge synthesis to assess the effectiveness of interventions to improve caregivers' involvement in decision making with seniors, and to describe caregivers' experiences of decision making in the absence of interventions. We analyzed forty-nine qualitative, fourteen quantitative, and three mixed-methods studies. The qualitative studies indicated that caregivers had unmet needs for information, discussions of values and needs, and decision support, which led to negative sentiments after decision making. Our results indicate that there have been insufficient quantitative evaluations of interventions to involve caregivers in decision making with seniors and that the evaluations that do exist found few clinically significant effects. Elements of usual care that received positive evaluations were the availability of a decision coach and a supportive decision-making environment. Additional rigorously evaluated interventions are needed to help caregivers be more involved in decision making with seniors. Project HOPE—The People-to-People Health Foundation, Inc.

Application of Advanced Nondestructive Evaluation Techniques for Cylindrical Composite Test Samples

NASA Technical Reports Server (NTRS)

Martin, Richard E.; Roth, Donald J.; Salem, Jonathan A.

2013-01-01

Two nondestructive methods were applied to composite cylinder samples pressurized to failure in order to determine manufacturing quality and monitor damage progression under load. A unique computed tomography (CT) image processing methodology developed at NASA Glenn Research was used to assess the condition of the as-received samples while acoustic emission (AE) monitoring was used to identify both the extent and location of damage within the samples up to failure. Results show the effectiveness of both of these methods in identifying potentially critical fabrication issues and their resulting impact on performance.

Ocean tides from Seasat-A

NASA Technical Reports Server (NTRS)

Hendershott, M. C.; Munk, W. H.; Zetler, B. D.

1974-01-01

Two procedures for the evaluation of global tides from SEASAT-A altimetry data are elaborated: an empirical method leading to the response functions for a grid of about 500 points from which the tide can be predicted for any point in the oceans, and a dynamic method which consists of iteratively modifying the parameters in a numerical solution to Laplace tide equations. It is assumed that the shape of the received altimeter signal can be interpreted for sea state and that orbit calculations are available so that absolute sea levels can be obtained.

Day-case anaesthesia for termination of pregnancy. Evaluation of a total intravenous anaesthetic technique.

PubMed

Ogg, T W; Jennings, R A; Morrison, C G

1983-11-01

An investigation was undertaken to assess the use of a total intravenous anaesthetic technique of fentanyl and methohexitone for outpatient vaginal termination of pregnancy. When compared with a technique of fentanyl, methohexitone, nitrous oxide and trichloroethylene the total intravenous method caused swifter recovery, minimal side-effects and no cardiovascular depression. However, both anaesthetic techniques produced significant postoperative reduction of memory for new facts when compared with a control group receiving no general anaesthesia. There is a need to continue the search for anaesthetic methods appropriate for day cases.

Clinical Evaluation of Hyaluronic Acid Sponge with Zinc versus Placebo for Scar Reduction after Breast Surgery

PubMed Central

Mahedia, Monali; Shah, Nilay

2016-01-01

Background: Scar formation is a major source of dissatisfaction among patients and surgeons. Individually, hyaluronan, or hyaluronic acid (HA), and zinc have been shown to reduce scarring. The authors evaluated the safety and efficacy of an HA sponge with zinc compared with placebo when applied to bilateral breast surgery scars; specifically, they evaluated whether the use of this product modulates inflammation and immediate scarring in treated patients after bilateral breast surgery. Methods: This double-blind, randomized, prospective study was approved by the local institutional review board. Bilateral breast surgery patients with right and left incision lines were randomly assigned to receive HA sponge with zinc or placebo within 2 to 4 days after their procedure. Participants were followed up at 6 weeks, 12 weeks, and 1 year and evaluated at 12 weeks. Three blinded evaluators reviewed photographs of the incision lines and assessed the scars using a visual analog scale, new scale, and a patient satisfaction survey. Results: Nineteen bilateral breast surgery patients were enrolled in the study. Statistical analysis was performed on 14 patients who completed the follow-up. The mean visual analog scale score was lower for the side receiving the HA sponge with zinc (2.6) than for the side receiving placebo (3.0), indicating a better outcome (t test; P = 0.08). The HA sponge with zinc was found to have significant positive findings on a patient satisfaction survey (P = 0.01). Conclusions: This is a preliminary study that shows zinc hyaluronan was associated with high patient satisfaction in achieving a better scar after bilateral breast surgery, irrespective of skin color. It seems to be safe and effective for early scars. PMID:27536470

The Safety Course Design and Operations of Composite Overwrapped Pressure Vessels (COPV)

NASA Technical Reports Server (NTRS)

Saulsberry, Regor; Prosser, William

2015-01-01

Following a Commercial Launch Vehicle On-Pad COPV (Composite Overwrapped Pressure Vessels) failure, a request was received by the NESC (NASA Engineering and Safety Center) June 14, 2014. An assessment was approved July 10, 2014, to develop and assess the capability of scanning eddy current (EC) nondestructive evaluation (NDE) methods for mapping thickness and inspection for flaws. Current methods could not identify thickness reduction from necking and critical flaw detection was not possible with conventional dye penetrant (PT) methods, so sensitive EC scanning techniques were needed. Developmental methods existed, but had not been fully developed, nor had the requisite capability assessment (i.e., a POD (Probability of Detection) study) been performed.

Evaluation of a Mobile Phone–Based Intervention to Increase Parents’ Knowledge About the Measles-Mumps-Rubella Vaccination and Their Psychological Empowerment: Mixed-Method Approach

PubMed Central

Galimberti, Elisa; Fiordelli, Maddalena; Schulz, Peter Johannes

2018-01-01

Background There is mixed evidence on the effectiveness of vaccination-related interventions. A major limitation of most intervention studies is that they do not apply randomized controlled trials (RCTs), the method that, over the last 2 decades, has increasingly been considered as the only method to provide proof of the effectiveness of an intervention and, consequently, as the most important instrument in deciding whether to adopt an intervention or not. This study, however, holds that methods other than RCTs also can produce meaningful results. Objective The aim of this study was to evaluate 2 mobile phone–based interventions aimed at increasing parents’ knowledge of the measles-mumps-rubella (MMR) vaccination (through elements of gamification) and their psychological empowerment (through the use of narratives), respectively. The 2 interventions were part of an RCT. Methods We conducted 2 studies with the RCT participants: a Web-based survey aimed at assessing their rating of the tool regarding a number of qualities such as usability and usefulness (N=140), and qualitative telephonic interviews to explore participants’ experiences with the app (N=60). Results The results of the survey showed that participants receiving the knowledge intervention (alone or together with the empowerment intervention) liked the app significantly better compared with the group that only received the empowerment intervention (F2,137=15.335; P<.001). Parents who were exposed to the empowerment intervention complained that they did not receive useful information but were only invited to make an informed, autonomous MMR vaccination decision. Conclusions The results suggest that efforts to empower patients should always be accompanied by the provision of factual information. Using a narrative format that promotes parents’ identification can be an appropriate strategy, but it should be employed together with the presentation of more points of views and notions regarding, for instance, the risks and benefits of the vaccination at the same time. Trial Registration International Standard Randomized Controlled Trial Number 30768813; http://www.isrctn.com/ ISRCTN30768813 (Archived by WebCite at http://www.webcitation.org/6xOQSJ3w8) PMID:29514772

Neuroprotective Treatment of Laser-Induced Retinal Injuries.

DTIC Science & Technology

1999-10-01

evaluate the neuroprotective effect of dextromethorphan , which is FDA approved and clinically used drug, in our rat model of laser-induced retinal...lesions. Methods: Argon laser retinal lesions were inflicted in the eyes of 36 pigmented rats. The treated group received dextromethorphan 50 mg/kg...size and the magnitude of photoreceptor nuclei loss within the lesions. Conclusions: Dextromethorphan treatment is not effective in ameliorating the

Incentivizing Children's Fruit and Vegetable Consumption: Results of a United States Pilot Study of the "Food Dudes" Program

ERIC Educational Resources Information Center

Wengreen, Heidi J.; Madden, Gregory J.; Aguilar, Sheryl S.; Smits, Rochelle R.; Jones, Brooke A.

2013-01-01

Objective: Preliminary evaluation in the United States (US) of a school-based fruit and vegetable (F/V) intervention, known as the "Food Dudes" (FD) program, developed in the United Kingdom. Methods: Over 16 days (Phase 1), elementary-school children (n = 253) watched short videos featuring heroic peers (the FD) eating F/V and received a…

Development of Grammatical Accuracy in English-Speaking Children with Cochlear Implants: A Longitudinal Study

ERIC Educational Resources Information Center

Guo, Ling-Yu; Spencer, Linda J.

2017-01-01

Purpose: We sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span. Method: Ten children who received CIs before age 30 months participated in this study at 3, 4, and 5 years postimplantation. For the purpose of comparison, 10 children each at ages 3, 4, and 5 years…

A SURVEY OF METHODS FOR SETTING MINIMUM INSTREAM FLOW STANDARDS IN THE CARIBBEAN BASIN.

Treesearch

F. N. SCATENA

2004-01-01

To evaluate the current status of instream flow practices in streams that drain into the Caribbean Basin, a voluntary survey of practising water resource managers was conducted. Responses were received from 70% of the potential continental countries, 100% of the islands in the Greater Antilles, and 56% of all the Caribbean island nations. Respondents identified ‘...

The Effects of a Goal Setting Intervention on Aerobic Fitness in Middle School Students

ERIC Educational Resources Information Center

McDonald, Samantha M.; Trost, Stewart G.

2015-01-01

Purpose: This study evaluated the effects of a goal setting intervention on aerobic fitness (AF) in 6 to 8 grade students. Method: Students at the intervention school received a lesson on SMART goal setting. Students in the comparison school served as a measurement-only group. AF was assessed via the PACER multi-stage shuttle run test pre and post…

Cochlear Implant in the Second Year of Life: Lexical and Grammatical Outcomes

ERIC Educational Resources Information Center

Caselli, Maria Cristina; Rinaldi, Pasquale; Varuzza, Cristiana; Giuliani, Anna; Burdo, Sandro

2012-01-01

Purpose: The authors studied the effect of the cochlear implant (CI) on language comprehension and production in deaf children who had received a CI in the 2nd year of life. Method: The authors evaluated lexical and morphosyntactic skills in comprehension and production in 17 Italian children who are deaf (M = 54 months of age) with a CI and in 2…

[Thin layer agar represents a cost-effective alternative for the rapid diagnosis of multi-drug resistant tuberculosis].

PubMed

Hernández-Sarmiento, José M; Martínez-Negrete, Milton A; Castrillón-Velilla, Diana M; Mejía-Espinosa, Sergio A; Mejía-Mesa, Gloria I; Zapata-Fernández, Elsa M; Rojas-Jiménez, Sara; Marín-Castro, Andrés E; Robledo-Restrepo, Jaime A

2014-01-01

Using cost-benefit analysis for comparing the thin-layer agar culture method to the standard multiple proportion method used in diagnosing multidrug-resistant tuberculosis (MDR TB). A cost-benefit evaluation of two diagnostic tests was made at the Corporación para Investigaciones Biológicas (CIB) in Medellín, Colombia. 100 patients were evaluated; 10.8% rifampicin resistance and 14.3% isoniazid resistance were found. A computer-based decision tree model was used for cost-effectiveness analysis (Treeage Pro); the thin-layer agar culture method was most cost-effective, having 100% sensitivity, specificity and predictive values for detecting rifampicin and isoniazid resistance. The multiple proportion method value was calculated as being US$ 71 having an average 49 day report time compared to US$ 18 and 14 days for the thin-layer agar culture method. New technologies have been developed for diagnosing tuberculosis which are apparently faster and more effective; their operating characteristics must be evaluated as must their effectiveness in terms of cost-benefit. The present study established that using thin-layer agar culture was cheaper, equally effective and could provide results more quickly than the traditional method. This implies that a patient could receive MDR TB treatment more quickly.

A Specialized Multi-Transmit Head Coil for High Resolution fMRI of the Human Visual Cortex at 7T

PubMed Central

Sengupta, Shubharthi; Roebroeck, Alard; Kemper, Valentin G.; Poser, Benedikt A.; Zimmermann, Jan; Goebel, Rainer; Adriany, Gregor

2016-01-01

Purpose To design, construct and validate radiofrequency (RF) transmit and receive phased array coils for high-resolution visual cortex imaging at 7 Tesla. Methods A 4 channel transmit and 16 channel receive array was constructed on a conformal polycarbonate former. Transmit field efficiency and homogeneity were simulated and validated, along with the Specific Absorption Rate, using B1+ mapping techniques and electromagnetic simulations. Receiver signal-to-noise ratio (SNR), temporal SNR (tSNR) across EPI time series, g-factors for accelerated imaging and noise correlations were evaluated and compared with a commercial 32 channel whole head coil. The performance of the coil was further evaluated with human subjects through functional MRI (fMRI) studies at standard and submillimeter resolutions of upto 0.8mm isotropic. Results The transmit and receive sections were characterized using bench tests and showed good interelement decoupling, preamplifier decoupling and sample loading. SNR for the 16 channel coil was ∼ 1.5 times that of the commercial coil in the human occipital lobe, and showed better g-factor values for accelerated imaging. fMRI tests conducted showed better response to Blood Oxygen Level Dependent (BOLD) activation, at resolutions of 1.2mm and 0.8mm isotropic. Conclusion The 4 channel phased array transmit coil provides homogeneous excitation across the visual cortex, which, in combination with the dual row 16 channel receive array, makes for a valuable research tool for high resolution anatomical and functional imaging of the visual cortex at 7T. PMID:27911950

Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial.

PubMed Central

Fu, Dongbo; Fu, Hua; McGowan, Patrick; Shen, Yi-e; Zhu, Lizhen; Yang, Huiqin; Mao, Jianguo; Zhu, Shitai; Ding, Yongming; Wei, Zhihua

2003-01-01

OBJECTIVE: To evaluate the effectiveness of the Shanghai Chronic Disease Self-Management Program (CDSMP). METHODS: A randomized controlled trial with six-month follow-up compared patients who received treatment with those who did not receive treatment (waiting-list controls) in five urban communities in Shanghai, China. Participants in the treatment group received education from a lay-led CDSMP course and one copy of a help book immediately; those in the control group received the same education and book six months later. FINDINGS: In total, 954 volunteer patients with a medical record that confirmed a diagnosis of hypertension, heart disease, chronic lung disease, arthritis, stroke, or diabetes who lived in communities were assigned randomly to treatment (n = 526) and control (n = 428) groups. Overall, 430 (81.7%) and 349 (81.5%) patients in the treatment and control groups completed the six-month study. Patients who received treatment had significant improvements in weekly minutes of aerobic exercise, practice of cognitive symptom management, self-efficacy to manage own symptoms, and self-efficacy to manage own disease in general compared with controls. They also had significant improvements in eight indices of health status and, on average, fewer hospitalizations. CONCLUSION: When implemented in Shanghai, the CDSMP was acceptable culturally to Chinese patients. The programme improved participants' health behaviour, self-efficacy, and health status and reduced the number of hospitalizations six months after the course. The locally based delivery model was integrated into the routine of community government organizations and community health services. Chinese lay leaders taught the CDSMP courses as successfully as professionals. PMID:12764513

A hybrid method for transient wave propagation in a multilayered solid

NASA Astrophysics Data System (ADS)

Tian, Jiayong; Xie, Zhoumin

2009-08-01

We present a hybrid method for the evaluation of transient elastic-wave propagation in a multilayered solid, integrating reverberation matrix method with the theory of generalized rays. Adopting reverberation matrix formulation, Laplace-Fourier domain solutions of elastic waves in the multilayered solid are expanded into the sum of a series of generalized-ray group integrals. Each generalized-ray group integral containing Kth power of reverberation matrix R represents the set of K-times reflections and refractions of source waves arriving at receivers in the multilayered solid, which was computed by fast inverse Laplace transform (FILT) and fast Fourier transform (FFT) algorithms. However, the calculation burden and low precision of FILT-FFT algorithm limit the application of reverberation matrix method. In this paper, we expand each of generalized-ray group integrals into the sum of a series of generalized-ray integrals, each of which is accurately evaluated by Cagniard-De Hoop method in the theory of generalized ray. The numerical examples demonstrate that the proposed method makes it possible to calculate the early-time transient response in the complex multilayered-solid configuration efficiently.

Mesoscale mapping of available solar energy at the earth's surface by use of satellites

NASA Technical Reports Server (NTRS)

Hiser, H. W.; Senn, H. V.

1980-01-01

A method is presented for use of cloud images in the visual spectrum from the SMS/GOES geostationary satellites to determine the hourly distribution of sunshine on the mesoscale. Cloud coverage and density as a function of time of day and season are evaluated through the use of digital data processing techniques. Seasonal geographic distributions of cloud cover/sunshine are converted to joules of solar radiation received at the earth's surface through relationships developed from long-term measurements of these two parameters at six widely distributed stations. The technique can be used to generate maps showing the geographic distribution of total solar radiation on the mesoscale which is received at the earth's surface.

30 CFR 77.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2011 CFR

2011-07-01

... receiving power from ungrounded alternating current power systems. 77.701-1 Section 77.701-1 Mineral...-1 Approved methods of grounding of equipment receiving power from ungrounded alternating current... receiving power from ungrounded alternating current power systems, the following methods of grounding will...

30 CFR 77.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2010 CFR

2010-07-01

... receiving power from ungrounded alternating current power systems. 77.701-1 Section 77.701-1 Mineral...-1 Approved methods of grounding of equipment receiving power from ungrounded alternating current... receiving power from ungrounded alternating current power systems, the following methods of grounding will...

Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

PubMed Central

Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

2016-01-01

Background The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. Objective This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. Methods A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Results Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. Conclusions There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic and cross-disciplinary nature of the field. There is a need to develop and deliver methods of understanding users’ psychological experiences while using an intervention. PMID:27363519

Assessing potential effects of highway runoff on receiving-water quality at selected sites in Oregon with the Stochastic Empirical Loading and Dilution Model (SELDM)

USGS Publications Warehouse

Risley, John C.; Granato, Gregory E.

2014-01-01

6. An analysis of the use of grab sampling and nonstochastic upstream modeling methods was done to evaluate the potential effects on modeling outcomes. Additional analyses using surrogate water-quality datasets for the upstream basin and highway catchment were provided for six Oregon study sites to illustrate the risk-based information that SELDM will produce. These analyses show that the potential effects of highway runoff on receiving-water quality downstream of the outfall depends on the ratio of drainage areas (dilution), the quality of the receiving water upstream of the highway, and the concentration of the criteria of the constituent of interest. These analyses also show that the probability of exceeding a water-quality criterion may depend on the input statistics used, thus careful selection of representative values is important.

Iterative Frequency Domain Decision Feedback Equalization and Decoding for Underwater Acoustic Communications

NASA Astrophysics Data System (ADS)

Zhao, Liang; Ge, Jian-Hua

2012-12-01

Single-carrier (SC) transmission with frequency-domain equalization (FDE) is today recognized as an attractive alternative to orthogonal frequency-division multiplexing (OFDM) for communication application with the inter-symbol interference (ISI) caused by multi-path propagation, especially in shallow water channel. In this paper, we investigate an iterative receiver based on minimum mean square error (MMSE) decision feedback equalizer (DFE) with symbol rate and fractional rate samplings in the frequency domain (FD) and serially concatenated trellis coded modulation (SCTCM) decoder. Based on sound speed profiles (SSP) measured in the lake and finite-element ray tracking (Bellhop) method, the shallow water channel is constructed to evaluate the performance of the proposed iterative receiver. Performance results show that the proposed iterative receiver can significantly improve the performance and obtain better data transmission than FD linear and adaptive decision feedback equalizers, especially in adopting fractional rate sampling.

The Effect of Radiation on Complication Rates and Patient Satisfaction in Breast Reconstruction using Temporary Tissue Expanders and Permanent Implants.

PubMed

Anker, Christopher J; Hymas, Richard V; Ahluwalia, Ravinder; Kokeny, Kristine E; Avizonis, Vilija; Boucher, Kenneth M; Neumayer, Leigh A; Agarwal, Jayant P

2015-01-01

The optimal method of reconstruction following mastectomy for breast cancer patients receiving radiation therapy (RT) is controversial. This study evaluated patient satisfaction and complication rates among patients who received implant-based breast reconstruction. The specific treatment algorithm analyzed included patients receiving mastectomy and immediate temporary tissue expander (TE), followed by placement of a permanent breast implant (PI). If indicated, RT was delivered to the fully expanded TE. Records of 218 consecutive patients with 222 invasive (85%) or in situ (15%) breast lesions from the Salt Lake City region treated between 1998 and 2009 were retrospectively reviewed, 28% of whom received RT. Median RT dose was 50.4 Gy, and 41% received a scar boost at a median dose of 10 Gy. Kaplan-Meier analyses were performed to evaluate the cumulative incidence of surgical complications, including permanent PI removal. Risk factors associated with surgical events were analyzed. To evaluate cosmetic results and patient satisfaction, an anonymous survey was administered. Mean follow-up was 44 months (range 6-144). Actuarial 5-year PI removal rates for non-RT and RT patients were 4% and 22%, respectively. On multivariate analysis (MVA), the only factor associated with PI removal was RT (p = 0.009). Surveys were returned describing the outcomes of 149 breasts. For the non-RT and RT groups, those who rated their breast appearance as good or better were 63% versus 62%, respectively. Under 1/3 of each group was dissatisfied with their reconstruction. RT did not significantly affect patient satisfaction scores, but on MVA RT was the only factor associated with increased PI removal. This reconstruction technique may be considered an acceptable option even if RT is needed, but the increased complication risk with RT must be recognized. © 2015 Wiley Periodicals, Inc.

Improving patient information leaflets: developing and applying an evaluative model of patient-centredness for text.

PubMed

Fage-Butler, Antoinette

2013-01-01

The purpose of this paper is to present an evaluative model of patient-centredness for text and to illustrate how this can be applied to patient information leaflets (PILs) that accompany medication in the European Union. Patients have criticized PILs for sidelining their experiences, knowledge and affective needs, and denying their individuality. The health communication paradigm of patient-centredness provides valuable purchase on these issues, taking its starting point in the dignity and integrity of the patient as a person. Employing this evaluative model involves two stages. First, a Foucauldian Discourse Analysis is performed of sender and receiver and of the main discourses in PILs. These aspects are then evaluated using the perspectives of patient-centredness theory relating to the medical practitioner, patient and content. The evaluative model is illustrated via a PIL for medication for depression and panic attacks. Evaluation reveals a preponderance of biomedical statements, with a cluster of patient-centred statements primarily relating to the construction of the patient. The paper contributes a new method and evaluative approach to PIL and qualitative health research, as well as outlining a method that facilitates the investigation of interdiscursivity, a recent focus of critical genre analysis.

IMPROVEMENT IN SURVIVAL ASSOCIATED WITH ADULT-TO-ADULT LIVING DONOR LIVER TRANSPLANTATION1,2

PubMed Central

Berg, Carl L.; Gillespie, Brenda W.; Merion, Robert M.; Brown, Robert S.; Abecassis, Michael M.; Trotter, James F.; Fisher, Robert A.; Freise, Chris E.; Ghobrial, R. Mark; Shaked, Abraham; Fair, Jeffrey H.; Everhart, James E.

2009-01-01

Background and Aims More than 2000 adult-to-adult living donor liver transplants (LDLT) have been performed in the U.S., yet the potential benefit to liver transplant candidates of undergoing LDLT compared to waiting for deceased donor liver transplant (DDLT) is unknown. The aim of this study was to determine if there is a survival benefit of adult LDLT Methods Adults with chronic liver disease who had a potential living donor evaluated from 1/98 to 2/03 at nine university-based hospitals were analyzed. Starting at the time of a potential donor’s evaluation, we compared mortality after LDLT to mortality among those who remained on the waitlist or received DDLT. Median follow-up was 4.4 years. Comparisons were made by hazard ratios (HR) adjusted for LDLT candidate characteristics at the time of donor evaluation. Results Among 807 potential living donor recipients, 389 received LDLT, 249 received DDLT, 99 died without transplant, and 70 were awaiting transplant at last follow-up. Receipt of LDLT was associated with an adjusted mortality HR of 0.56 (95% confidence interval [CI] 0.42–0.74; P<0.001) relative to candidates who did not receive LDLT. As centers gained greater experience (> 20 LDLT), LDLT benefit was magnified, with a mortality HR of 0.35 (CI 0.23–0.53; P<0.001). Conclusions Adult LDLT was associated with lower mortality than the alternative of waiting for DDLT. This reduction in mortality was magnified as centers gained experience with living donor liver transplantation. This reduction in transplant candidate mortality must be balanced against the risks undertaken by the living donors themselves. PMID:18054553

Primary care patients’ expectations regarding medical appointments and their experiences during a visit: does age matter?

PubMed Central

Jaworski, Mariusz; Rzadkiewicz, Marta; Adamus, Miroslawa; Chylinska, Joanna; Lazarewicz, Magdalena; Haugan, Gørill; Lillefjell, Monica; Espnes, Geir Arild; Wlodarczyk, Dorota

2017-01-01

Introduction There is evidence that meeting patients’ expectations toward health care correlates with involvement in the treatment they receive. The most important patient expectations concern certain types of information: explanation of disease and treatment, health promotion, and improvement in quality of life. Other demands include proper rapport and emotional support. The aim of this paper was to examine different patient groups over the age of 50 years and their expectations toward medical visits, evaluated before a visit and after the visit. Patients and methods The study group consisted of 4,921 primary health-care patients. The patients received self-administered questionnaires that they filled in before and after the appointment with the doctor. Interviews with patients were conducted individually by specially trained interviewers. The PRACTA Patient Expectations Scale was used to measure the appointment-related expectations of the patients. Results We observed differences related to age in patients’ expectations before medical visits regarding the following factors: disease explanation, treatment explanation, quality of life, rapport, and emotional support. The same differences were not observed on health promotion. Evaluation of patients’ appointment-related experiences after the visit showed that there were significant differences between the age-groups regarding all types of expectations included in the study. Differences between previsit and postvisit measurements were statistically significant in all age-groups. Patients who received less than they expected from doctors outnumbered those who received what they expected or more in all the groups. Conclusion Patients’ expectations toward medical visits are conditioned by age. Therefore, doctors should pay more attention to requirements related to age in their effort to identify and satisfy expectations. This is particularly important in light of the discrepancy between previsit expectations and the actual experiences of patients evaluated after the visit. PMID:28761335

Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation

PubMed Central

Sung, Lillian; Robinson, Paula; Treister, Nathaniel; Baggott, Tina; Gibson, Paul; Tissing, Wim; Wiernikowski, John; Brinklow, Jennifer; Dupuis, L Lee

2017-01-01

Purpose To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children (0–18 years) receiving treatment for cancer or undergoing haematopoietic stem cell transplantation (HSCT). Methods The Mucositis Prevention Guideline Development Group was interdisciplinary and included internationally recognised experts in paediatric mucositis. For the evidence review, we included randomised controlled trials (RCTs) conducted in either children or adults evaluating the following interventions selected according to prespecified criteria: cryotherapy, low level light therapy (LLLT) and keratinocyte growth factor (KGF). We also examined RCTs of any intervention conducted in children. For all systematic reviews, we synthesised the occurrence of severe oral mucositis. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to describe quality of evidence and strength of recommendations. Results We suggest cryotherapy or LLLT may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. We also suggest KGF may be offered to children receiving HSCT conditioning with regimens associated with a high rate of severe mucositis. However, KGF use merits caution as there is a lack of efficacy and toxicity data in children, and a lack of long-term follow-up data in paediatric cancers. No other interventions were recommended for oral mucositis prevention in children. Conclusions All three specific interventions evaluated in this clinical practice guideline were associated with a weak recommendation for use. There may be important organisational and cost barriers to the adoption of LLLT and KGF. Considerations for implementation and key research gaps are highlighted. PMID:25818385

Evaluation of the Veterans Health Administration's Specialty Care Transformational Initiatives to Promote Patient-Centered Delivery of Specialty Care: A Mixed-Methods Approach.

PubMed

Williams, Katherine M; Kirsh, Susan; Aron, David; Au, David; Helfrich, Christian; Lambert-Kerzner, Anne; Lowery, Julie; Battaglia, Catherine; Graham, Glenn D; Doukas, Michael; Jain, Rajiv; Ho, P Michael

2017-07-01

Veteran's Affairs Office of Specialty Care (OSC) launched four national initiatives (Electronic-Consults [e-Consults], Specialty Care Access Networks-Extension for Community Healthcare Outcomes [SCAN-ECHO], Mini-Residencies, and Specialty Care Neighborhood) to improve specialty care delivery and funded a center to evaluate the initiatives. The evaluation, guided by two implementation frameworks, provides formative (administrator/provider interviews and surveys) and summative data (quantitative data on patterns of use) about the initiatives to OSC. Evaluation of initiative implementation is assessed through CFIR (Consolidated Framework for Implementation Research)-grounded qualitative interviews to identify barriers/facilitators. Depending on high or low implementation, factors such as receiving workload credit, protected time, existing workflow/systems compatibility, leadership engagement, and access to information/resources were considered implementation barriers or facilitators. Findings were shared with OSC and used to further refine implementation at additional sites. Evaluation of other initiatives is ongoing. The mixed-methods approach has provided timely information to OSC about initiative effect and impacted OSC policies on implementation at additional sites.

Dietary olive oil induces cannabinoid CB2 receptor expression in adipose tissue of ApcMin/+ transgenic mice

PubMed Central

Notarnicola, Maria; Tutino, Valeria; Tafaro, Angela; Bianco, Giusy; Guglielmi, Emilia; Caruso, Maria Gabriella

2016-01-01

BACKGROUND: Cannabinoid- 2 (CB2) receptor is known for its anti-obesity effects silencing the activated immune cells that are key drivers of metabolic syndrome and inflammation. Nutritional interventions in experimental models of carcinogenesis have been demonstrated to modulate tissue inflammation state and proliferation. OBJECTIVE: Aim of this study was to test, in ApcMin/+ mice, whether a diet enriched with olive oil, omega- 3 and omega-6- PUFAs affects the adipose tissue inflammation status. METHODS: Four groups of animal were studied: ST group, receiving a standard diet; OO group, receiving the standard diet in which soybean oil (source of fats) was replaced with olive oil; OM-3 group, receiving the standard diet in which soybean oil was replaced with salmon oil; OM-6 group, receiving the standard diet in which soybean oil was replaced with oenothera oil. Gene and protein expression, in adipose tissue, were evaluated by RT-PCR and Western Blotting, respectively. Enzymatic activities were assayed by fluorescent and radiometric method, where appropriated. RESULTS: The diet enriched with olive oil significantly induced CB2 receptor expression and it was able to control inflammatory and proliferative activity of mice adipose tissue. CONCLUSIONS: The present findings open opportunities for developing novel nutritional strategies considering olive oil a key ingredient of a healthy dietary pattern. PMID:28035344

Epidermal Growth Factor Receptor Is Related to Poor Survival in Glioblastomas: Single-Institution Experience

PubMed Central

Choi, Youngmin; Lee, Hyung-Sik; Hur, Won-Joo; Sung, Ki-Han; Kim, Ki-Uk; Choi, Sun-Seob; Kim, Su-Jin; Kim, Dae-Cheol

2013-01-01

Purpose There are conflicting results surrounding the prognostic significance of epidermal growth factor receptor (EGFR) status in glioblastoma (GBM) patients. Accordingly, we attempted to assess the influence of EGFR expression on the survival of GBM patients receiving postoperative radiotherapy. Materials and Methods Thirty three GBM patients who had received surgery and postoperative radiotherapy at our institute, between March 1997 and February 2006, were included. The evaluation of EGFR expression with immunohistochemistry was available for 30 patients. Kaplan-Meier survival analysis and Cox regression were used for statistical analysis. Results EGFR was expressed in 23 patients (76.7%), and not expressed in seven (23.3%). Survival in EGFR expressing GBM patients was significantly less than that in non-expressing patients (median survival: 12.5 versus 17.5 months, p=0.013). Patients who received more than 60 Gy showed improved survival over those who received up to 60 Gy (median survival: 17.0 versus 9.0 months, p=0.000). Negative EGFR expression and a higher radiation dose were significantly correlated with improved survival on multivariate analysis. Survival rates showed no differences according to age, sex, and surgical extent. Conclusion The expression of EGFR demonstrated a significantly deleterious effect on the survival of GBM patients. Therefore, approaches targeting EGFR should be considered in potential treatment methods for GBM patients, in addition to current management strategies. PMID:23225805

The Study of External Dose Rate and Retained Body Activity of Patients Receiving 131I Therapy for Differentiated Thyroid Carcinoma

PubMed Central

Zhang, Haiying; Jiao, Ling; Cui, Songye; Wang, Liang; Tan, Jian; Zhang, Guizhi; He, Yajing; Ruan, Shuzhou; Fan, Saijun; Zhang, Wenyi

2014-01-01

Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving 131I therapy. Seventy patients were stratified into two groups: the ablation group (A) and the follow-up group (FU). The patients’ external dose rate was measured, and simultaneously, their retained body radiation activity was monitored at various time points. The equations of the external dose rate and the retained body activity, described as a function of hours post administration, were fitted. Additionally, the release time for patients was calculated. The reduction in activity in the group receiving a second or subsequent treatment was more rapid than the group receiving only the initial treatment. Most important, an expeditious method was established to indirectly evaluate the retained body activity of patients by measuring the external dose rate with a portable radiation survey meter. By this method, the calculated external dose rate limits are 19.2, 8.85, 5.08 and 2.32 μSv·h−1 at 1, 1.5, 2 and 3 m, respectively, according to a patient’s released threshold level of retained body activity <400 MBq. This study is beneficial for radiation safety decision-making. PMID:25337944

Using a binaural biomimetic array to identify bottom objects ensonified by echolocating dolphins

USGS Publications Warehouse

Heiweg, D.A.; Moore, P.W.; Martin, S.W.; Dankiewicz, L.A.

2006-01-01

The development of a unique dolphin biomimetic sonar produced data that were used to study signal processing methods for object identification. Echoes from four metallic objects proud on the bottom, and a substrate-only condition, were generated by bottlenose dolphins trained to ensonify the targets in very shallow water. Using the two-element ('binaural') receive array, object echo spectra were collected and submitted for identification to four neural network architectures. Identification accuracy was evaluated over two receive array configurations, and five signal processing schemes. The four neural networks included backpropagation, learning vector quantization, genetic learning and probabilistic network architectures. The processing schemes included four methods that capitalized on the binaural data, plus a monaural benchmark process. All the schemes resulted in above-chance identification accuracy when applied to learning vector quantization and backpropagation. Beam-forming or concatenation of spectra from both receive elements outperformed the monaural benchmark, with higher sensitivity and lower bias. Ultimately, best object identification performance was achieved by the learning vector quantization network supplied with beam-formed data. The advantages of multi-element signal processing for object identification are clearly demonstrated in this development of a first-ever dolphin biomimetic sonar. ?? 2006 IOP Publishing Ltd.

Assessment of the use of latissimus dorsi restoration during modified radical mastectomy in breast cancer patients.

PubMed

Yang, Chao; Wang, Xinle; Zhang, Geng; Yang, Liu; Guo, Xuan; Wang, Xue; Song, Zhenchuan

2017-12-01

The incision area of modified radical mastectomy in breast cancer patients is associated with subcutaneous effusion and skin flap necrosis as the most common complications. The aim of the present study was to assess the effect of latissimus dorsi restoration during modified radical mastectomy in breast cancer patients by evaluating 365 cases. Among these cases, 185 received modified radical mastectomy combined with intraoperative latissimus dorsi restoration, while 180 received modified radical mastectomy alone. The flap tension, drainage fluid amount and extubation time were compared between the two methods. The flap tension in patients who received modified radical mastectomy combined with intraoperative latissimus dorsi restoration was significantly lower and the blood supply was better. After surgery, the drainage fluid amount was also significantly lower in these patients compared with the control group. Furthermore, the mean time to drainage tube removal was significantly shorter in these patients and the postoperative cosmetic outcome was superior. Thus, it was concluded that modified radical mastectomy combined with intraoperative latissimus dorsi restoration in breast cancer patients was associated with reduced drainage fluid effusion, shorter hospitalization time and decreased flap tension. Overall, this method appears to be potentially suitable for extensive application in the clinical setting.

A comparison of methods to evaluate gray scale response of tomosynthesis systems using a software breast phantom

NASA Astrophysics Data System (ADS)

Sousa, Maria A. Z.; Bakic, Predrag R.; Schiabel, Homero; Maidment, Andrew D. A.

2017-03-01

Digital breast tomosynthesis (DBT) has been shown to be an effective imaging tool for breast cancer diagnosis as it provides three-dimensional images of the breast with minimal tissue overlap. The quality of the reconstructed image depends on many factors that can be assessed using uniform or realistic phantoms. In this paper, we created four models of phantoms using an anthropomorphic software breast phantom and compared four methods to evaluate the gray scale response in terms of the contrast, noise and detectability of adipose and glandular tissues binarized according to phantom ground truth. For each method, circular regions of interest (ROIs) were selected with various sizes, quantity and positions inside a square area in the phantom. We also estimated the percent density of the simulated breast and the capability of distinguishing both tissues by receiver operating characteristic (ROC) analysis. Results shows a sensitivity of the methods to the ROI size, placement and to the slices considered.

[The effect of social support on women's perception of global stress and health status].

PubMed

Sprusińska, E; Makowska, Z

1992-01-01

Social support is considered to be an essential factor in the perception of global stress, as it reduces the impact of the stressors (and thereby protects against excessive stress), a well as reduces the detrimental effects of stress. The purpose of the study was to determine the level of social support received by women in two essential areas: family life and occupational work, and to estimate the relationships between the support level and stress perception by women and the condition of their health (estimated with the use of the Goldberg General Health Questionnaire). The APGAR questionnaire designed by G. Smilkstein was used to estimate the support. This was the first instance of the application of the method in a Polish study--with prior written consent of the author of the method. The study involved 98 women in four occupational groups (physicians, nurses, spinning machine operators, and employees of financial department of an industrial plant). The results of the study indicate that the situation of the women in respect of the received social support differs, to a statistically significant degree depending on the occupational group to which they belong. The evaluations of the support are also, significant correlated with the evaluations of global stress in the whole population test--higher results with respect to the support are correlated with the lower degree of stress. The support from the family shows higher degree of correlation with the level of the perceived stress than the support received at the place of employment.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosing periprosthetic joint infection: has the era of the biomarker arrived?

PubMed

Deirmengian, Carl; Kardos, Keith; Kilmartin, Patrick; Cameron, Alexander; Schiller, Kevin; Parvizi, Javad

2014-11-01

The diagnosis of periprosthetic joint infection (PJI) remains a serious clinical challenge. There is a pressing need for improved diagnostic testing methods; biomarkers offer one potentially promising approach. We evaluated the diagnostic characteristics of 16 promising synovial fluid biomarkers for the diagnosis of PJI. Synovial fluid was collected from 95 patients meeting the inclusion criteria of this prospective diagnostic study. All patients were being evaluated for a revision hip or knee arthroplasty, including patients with systemic inflammatory disease and those already receiving antibiotic treatment. The Musculoskeletal Infection Society (MSIS) definition was used to classify 29 PJIs and 66 aseptic joints. Synovial fluid samples were tested by immunoassay for 16 biomarkers optimized for use in synovial fluid. Sensitivity, specificity, and receiver operating characteristic curve analysis were performed to assess for diagnostic performance. Five biomarkers, including human α-defensin 1-3, neutrophil elastase 2, bactericidal/permeability-increasing protein, neutrophil gelatinase-associated lipocalin, and lactoferrin, correctly predicted the MSIS classification of all patients in this study, with 100% sensitivity and specificity for the diagnosis of PJI. An additional eight biomarkers demonstrated excellent diagnostic strength, with an area under the curve of greater than 0.9. Synovial fluid biomarkers exhibit a high accuracy in diagnosing PJI, even when including patients with systemic inflammatory disease and those receiving antibiotic treatment. Considering that these biomarkers match the results of the more complex MSIS definition of PJI, we believe that synovial fluid biomarkers can be a valuable addition to the methods utilized for the diagnosis of infection. Level II, diagnostic study. See Instructions for Authors for a complete description of levels of evidence.

Quantifying the quality of medical x-ray images: An evaluation based on normal anatomy for lumbar spine and chest radiography

NASA Astrophysics Data System (ADS)

Tingberg, Anders Martin

Optimisation in diagnostic radiology requires accurate methods for determination of patient absorbed dose and clinical image quality. Simple methods for evaluation of clinical image quality are at present scarce and this project aims at developing such methods. Two methods are used and further developed; fulfillment of image criteria (IC) and visual grading analysis (VGA). Clinical image quality descriptors are defined based on these two methods: image criteria score (ICS) and visual grading analysis score (VGAS), respectively. For both methods the basis is the Image Criteria of the ``European Guidelines on Quality Criteria for Diagnostic Radiographic Images''. Both methods have proved to be useful for evaluation of clinical image quality. The two methods complement each other: IC is an absolute method, which means that the quality of images of different patients and produced with different radiographic techniques can be compared with each other. The separating power of IC is, however, weaker than that of VGA. VGA is the best method for comparing images produced with different radiographic techniques and has strong separating power, but the results are relative, since the quality of an image is compared to the quality of a reference image. The usefulness of the two methods has been verified by comparing the results from both of them with results from a generally accepted method for evaluation of clinical image quality, receiver operating characteristics (ROC). The results of the comparison between the two methods based on visibility of anatomical structures and the method based on detection of pathological structures (free-response forced error) indicate that the former two methods can be used for evaluation of clinical image quality as efficiently as the method based on ROC. More studies are, however, needed for us to be able to draw a general conclusion, including studies of other organs, using other radiographic techniques, etc. The results of the experimental evaluation of clinical image quality are compared with physical quantities calculated with a theoretical model based on a voxel phantom, and correlations are found. The results demonstrate that the computer model can be a useful toot in planning further experimental studies.

The effect of a whole-body vibration therapy on the sitting balance of subacute stroke patients: a randomized controlled trial.

PubMed

Lee, Jong Hwa; Kim, Sang Beom; Lee, Kyeong Woo; Lee, Sook Joung; Park, Hyuntae; Kim, Dong Won

2017-09-01

The use of a whole-body vibration (WBV) therapy has recently been applied and investigated as a rehabilitation method for subacute stroke patients. To evaluate the effects of a WBV therapy on recovery of balance in subacute stroke patients who were unable to gain sitting balance. The conventional rehabilitation group (CG) received conventional physical therapy, including sitting balance training by a physical therapist, for 30 min a one session, for twice a day for five days a week for two weeks. The whole-body vibration group (VG) received one session of conventional physical therapy, and received WBV therapy instead of conventional physical therapy for 30 min a day for five days a week for two weeks. There were 15 patients in the CG and 15 patients in the VG who completed the two-week therapy. After the two-week therapy, both groups showed functional improvement. Patients in the VG improved functional ambulation categories, Berg balance scale, trunk impairment scale scores. But, no statistically significant correlations between the therapeutic methods and outcomes were observed in either group. Our results suggest that WBV therapy led to improvement of the recovery in balance recovery for subacute stroke patients. Because the WBV therapy was as effective as conventional physical therapy, we can consider a WBV therapy as a clinical method to improve the sitting balance of subacute stoke patients.

A mixed-method evaluation of the feasibility and acceptability of a telehealth-based parent-mediated intervention for children with autism spectrum disorder.

PubMed

Pickard, Katherine E; Wainer, Allison L; Bailey, Kathryn M; Ingersoll, Brooke R

2016-10-01

Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online. This study used mixed-methods analysis to create a more thorough understanding of parent experiences likely to influence the adoption and implementation of the program in community settings. Specific research questions included (1) What are parents' perceptions of the online program? (2) How does ImPACT Online compare to other services that parents are accessing for their children? And (3) Do parents' experience in, and perceptions of, the program differ based on whether they received a therapist-assisted version of the program? Results from 28 parents of a child with autism spectrum disorder indicate that parents saw improvements in their child's social communication skills and their own competence during the course of the program, regardless of whether they received therapist assistance. However, qualitative interviews indicate that parents who received therapist assistance were more likely endorse the acceptability and observability of the program. These findings support the potential for Internet-based service delivery to more efficiently disseminate evidence-based parent training interventions for autism spectrum disorder. © The Author(s) 2016.

Combined spinal-epidural anesthesia and non-pharmacological methods of pain relief during normal childbirth and maternal satisfaction: a randomized clinical trial.

PubMed

Orange, Flavia Augusta de; Passini, Renato; Melo, Adriana S O; Katz, Leila; Coutinho, Isabela Cristina; Amorim, Melania M R

2012-01-01

The objective of this study was to compare maternal satisfaction with childbirth according to whether or not combined spinal-epidural anesthesia (CSE) of pain relief was used during labor. A randomized, open clinical trial was performed with 70 pregnant women, 35 of whom received CSE anesthesia while 35 received only non-pharmacological forms of pain relief during labor. The variables evaluated were visual analogue scale (VAS) pain score, maternal satisfaction with the technique of pain relief used during childbirth and with delivery, the patient's intention to request the same technique in a subsequent delivery, and loss of control during delivery. VAS pain score decreased significantly in patients receiving CSE during vaginal delivery. Furthermore, maternal satisfaction with the technique of pain relief and with delivery was higher in the CSE group, and around 97% of the patients would repeat the same technique at future deliveries compared to 82.4% of the women in the group using only non-pharmacological methods. With respect to the women's impressions of their control during delivery, approximately half the women in both groups felt that they had lost control at some point during the process. The use of CSE was associated with a significant reduction in VAS pain scores during delivery and with greater maternal satisfaction with the pain relief method and with the childbirth process.

Development of LLNA:DAE: a new local lymph node assay that includes the elicitation phase, discriminates borderline-positive chemicals, and is useful for cross-sensitization testing.

PubMed

Yamashita, Kunihiko; Shinoda, Shinsuke; Hagiwara, Saori; Itagaki, Hiroshi

2014-02-01

We developed a new local lymph node assay (LLNA) that includes the elicitation phase termed LLNA:DAE for discrimination of borderline-positive chemicals as classified by the LLNA modified by Daicel based on ATP content (LLNA:DA) and for cross-sensitization testing. Although the LLNA:DA method could help identify skin sensitizers, some skin irritants classified as non-sensitizers by the LLNA were classified as borderline positive. In addition, the evaluation for the cross-sensitization potential between chemicals was impossible. In the LLNA:DAE procedure, test group of mice received four applications of chemicals on the dorsum of the right ear for induction and one application on the dorsum of the left ear for elicitation. Control group of mice received one chemical application on the dorsum of the left ear. We evaluated the sensitizing potential by comparing the weights of the lymph nodes from the left ears between the two groups. The results of using the LLNA:DAE method to examine 24 chemicals, which contained borderline-positive chemicals, were consistent with those from the LLNA method, except for nickel chloride (NiCl2). Two chemical pairs, 2,4-dinitrochlorobenzene (DNCB) with 2,4-dinitrofluorobenzene (DNFB) and hydroquinone (HQ) with p-benzoquinone (p-BQ), showed clear cross-sensitization with each other, while another chemical pair, DNFB with hexylcinnamic aldehyde (HCA) did not. Taken together, our results suggest that the LLNA:DAE method is useful for discriminating borderline-positive chemicals and for determining chemical cross-sensitization.

Methodology for the evaluation of the Stephanie Alexander Kitchen Garden program.

PubMed

Gibbs, L; Staiger, P K; Townsend, M; Macfarlane, S; Gold, L; Block, K; Johnson, B; Kulas, J; Waters, E

2013-04-01

Community and school cooking and gardening programs have recently increased internationally. However, despite promising indications, there is limited evidence of their effectiveness. This paper presents the evaluation framework and methods negotiated and developed to meet the information needs of all stakeholders for the Stephanie Alexander Kitchen Garden (SAKG) program, a combined cooking and gardening program implemented in selectively funded primary schools across Australia. The evaluation used multiple aligned theoretical frameworks and models, including a public health ecological approach, principles of effective health promotion and models of experiential learning. The evaluation is a non-randomised comparison of six schools receiving the program (intervention) and six comparison schools (all government-funded primary schools) in urban and rural areas of Victoria, Australia. A mixed-methods approach was used, relying on qualitative measures to understand changes in school cultures and the experiential impacts on children, families, teachers, parents and volunteers, and quantitative measures at baseline and 1 year follow up to provide supporting information regarding patterns of change. The evaluation study design addressed the limitations of many existing evaluation studies of cooking or garden programs. The multistrand approach to the mixed methodology maintained the rigour of the respective methods and provided an opportunity to explore complexity in the findings. Limited sensitivity of some of the quantitative measures was identified, as well as the potential for bias in the coding of the open-ended questions. The SAKG evaluation methodology will address the need for appropriate evaluation approaches for school-based kitchen garden programs. It demonstrates the feasibility of a meaningful, comprehensive evaluation of school-based programs and also demonstrates the central role qualitative methods can have in a mixed-method evaluation. So what? This paper contributes to debate about appropriate evaluation approaches to meet the information needs of all stakeholders and will support the sharing of measures and potential comparisons between program outcomes for comparable population groups and settings.

The importance of considering competing treatment affecting prognosis in the evaluation of therapy in trials: the example of renal transplantation in hemodialysis trials.

PubMed

Hazelbag, C Marijn; Peters, Sanne A E; Blankestijn, Peter J; Bots, Michiel L; Canaud, Bernard; Davenport, Andrew; Grooteman, Muriel P C; Kircelli, Fatih; Locatelli, Francesco; Maduell, Francisco; Morena, Marion; Nubé, Menso J; Ok, Ercan; Torres, Ferran; Hoes, Arno W; Groenwold, Rolf H H

2017-04-01

During the follow-up in a randomized controlled trial (RCT), participants may receive additional (non-randomly allocated) treatment that affects the outcome. Typically such additional treatment is not taken into account in evaluation of the results. Two pivotal trials of the effects of hemodiafiltration (HDF) versus hemodialysis (HD) on mortality in patients with end-stage renal disease reported differing results. We set out to evaluate to what extent methods to take other treatments (i.e. renal transplantation) into account may explain the difference in findings between RCTs. This is illustrated using a clinical example of two RCTs estimating the effect of HDF versus HD on mortality. Using individual patient data from the Estudio de Supervivencia de Hemodiafiltración On-Line (ESHOL; n  =  902) and The Dutch CONvective TRAnsport STudy (CONTRAST; n  = 714) trials, five methods for estimating the effect of HDF versus HD on all-cause mortality were compared: intention-to-treat (ITT) analysis (i.e. not taking renal transplantation into account), per protocol exclusion (PP excl ; exclusion of patients who receive transplantation), PP cens (censoring patients at the time of transplantation), transplantation-adjusted (TA) analysis and an extension of the TA analysis (TA ext ) with additional adjustment for variables related to both the risk of receiving a transplant and the risk of an outcome (transplantation-outcome confounders). Cox proportional hazards models were applied. Unadjusted ITT analysis of all-cause mortality led to differing results between CONTRAST and ESHOL: hazard ratio (HR) 0.95 (95% CI 0.75-1.20) and HR 0.76 (95% CI 0.59-0.97), respectively; difference between 5 and 24% risk reductions. Similar differences between the two trials were observed for the other unadjusted analytical methods (PP cens, PP excl , TA) The HRs of HDF versus HD treatment became more similar after adding transplantation as a time-varying covariate and including transplantation-outcome confounders: HR 0.89 (95% CI 0.69-1.13) in CONTRAST and HR 0.80 (95% CI 0.62-1.02) in ESHOL. The apparent differences in estimated treatment effects between two dialysis trials were to a large extent attributable to differences in applied methodology for taking renal transplantation into account in their final analyses. Our results exemplify the necessity of careful consideration of the treatment effect of interest when estimating the therapeutic effect in RCTs in which participants may receive additional treatments. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

A framework for telepsychiatric training and e-health: Competency-based education, evaluation and implications.

PubMed

Hilty, Donald M; Crawford, Allison; Teshima, John; Chan, Steven; Sunderji, Nadiya; Yellowlees, Peter M; Kramer, Greg; O'neill, Patrick; Fore, Chris; Luo, John; Li, Su-Ting

2015-01-01

Telepsychiatry (TP; video; synchronous) is effective, well received and a standard way to practice. Best practices in TP education, but not its desired outcomes, have been published. This paper proposes competencies for trainees and clinicians, with TP situated within the broader landscape of e-mental health (e-MH) care. TP competencies are organized using the US Accreditation Council of Graduate Medical Education framework, with input from the CanMEDS framework. Teaching and assessment methods are aligned with target competencies, learning contexts, and evaluation options. Case examples help to apply concepts to clinical and institutional contexts. Competencies can be identified, measured and evaluated. Novice or advanced beginner, competent/proficient, and expert levels were outlined. Andragogical (i.e. pedagogical) methods are used in clinical care, seminar, and other educational contexts. Cross-sectional and longitudinal evaluation using quantitative and qualitative measures promotes skills development via iterative feedback from patients, trainees, and faculty staff. TP and e-MH care significantly overlap, such that institutional leaders may use a common approach for change management and an e-platform to prioritize resources. TP training and assessment methods need to be implemented and evaluated. Institutional approaches to patient care, education, faculty development, and funding also need to be studied.

Internal Stress Monitoring of In-Service Structural Steel Members with Ultrasonic Method

PubMed Central

Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying

2016-01-01

Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members. PMID:28773347

Internal Stress Monitoring of In-Service Structural Steel Members with Ultrasonic Method.

PubMed

Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying

2016-03-23

Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members.

Evaluation of the Predictive Validity of Thermography in Identifying Extravasation With Intravenous Chemotherapy Infusions

PubMed Central

Murayama, Ryoko; Tanabe, Hidenori; Oe, Makoto; Motoo, Yoshiharu; Wagatsuma, Takanori; Michibuchi, Michiko; Kinoshita, Sachiko; Sakai, Keiko; Konya, Chizuko; Sugama, Junko; Sanada, Hiromi

2017-01-01

Early detection of extravasation is important, but conventional methods of detection lack objectivity and reliability. This study evaluated the predictive validity of thermography for identifying extravasation during intravenous antineoplastic therapy. Of 257 patients who received chemotherapy through peripheral veins, extravasation was identified in 26. Thermography was performed every 15 to 30 minutes during the infusions. Sensitivity, specificity, positive predictive value, and negative predictive value using thermography were 84.6%, 94.8%, 64.7%, and 98.2%, respectively. This study showed that thermography offers an accurate prediction of extravasation. PMID:29112585

An Innovative Method to Involve Community Health Workers as Partners in Evaluation Research

PubMed Central

Issel, L. Michele; Townsell, Stephanie J.; Chapple-McGruder, Theresa; Handler, Arden

2011-01-01

Objectives. We developed a process through which community outreach workers, whose role is not typically that of a trained researcher, could actively participate in collection of qualitative evaluation data. Methods. Outreach workers for a community-based intervention project received training in qualitative research methodology and certification in research ethics. They used a Voice over Internet Protocol phone-in system to provide narrative reports about challenges faced by women they encountered in their outreach activities as well as their own experiences as outreach workers. Results. Qualitative data contributed by outreach workers provided insights not otherwise available to the evaluation team, including details about the complex lives of underserved women at risk for poor pregnancy outcomes and the challenges and rewards of the outreach worker role. Conclusions. Lay health workers can be a valuable asset as part of a research team. Training in research ethics and methods can be tailored to their educational level and preferences, and their insights provide important information and perspectives that may not be accessible via other data collection methods. Challenges encountered in the dual roles of researcher and lay health worker can be addressed in training. PMID:22021290

The development of an advanced generic solar dynamic heat receiver thermal model

NASA Technical Reports Server (NTRS)

Wu, Y. C.; Roschke, E. J.; Kohout, L.

1988-01-01

An advanced generic solar dynamic heat receiver thermal model under development which can analyze both orbital transient and orbital average conditions is discussed. This model can be used to study advanced receiver concepts, evaluate receiver concepts under development, analyze receiver thermal characteristics under various operational conditions, and evaluate solar dynamic system thermal performances in various orbit conditions. The model and the basic considerations that led to its creation are described, and results based on a set of baseline orbit, configuration, and operational conditions are presented to demonstrate the working of the receiver model.

Evaluation of pollutant loads from stormwater BMPs to receiving water using load frequency curves with uncertainty analysis.

PubMed

Park, Daeryong; Roesner, Larry A

2012-12-15

This study examined pollutant loads released to receiving water from a typical urban watershed in the Los Angeles (LA) Basin of California by applying a best management practice (BMP) performance model that includes uncertainty. This BMP performance model uses the k-C model and incorporates uncertainty analysis and the first-order second-moment (FOSM) method to assess the effectiveness of BMPs for removing stormwater pollutants. Uncertainties were considered for the influent event mean concentration (EMC) and the aerial removal rate constant of the k-C model. The storage treatment overflow and runoff model (STORM) was used to simulate the flow volume from watershed, the bypass flow volume and the flow volume that passes through the BMP. Detention basins and total suspended solids (TSS) were chosen as representatives of stormwater BMP and pollutant, respectively. This paper applies load frequency curves (LFCs), which replace the exceedance percentage with an exceedance frequency as an alternative to load duration curves (LDCs), to evaluate the effectiveness of BMPs. An evaluation method based on uncertainty analysis is suggested because it applies a water quality standard exceedance based on frequency and magnitude. As a result, the incorporation of uncertainty in the estimates of pollutant loads can assist stormwater managers in determining the degree of total daily maximum load (TMDL) compliance that could be expected from a given BMP in a watershed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Evaluations and Comparisons of Treatment Effects Based on Best Combinations of Biomarkers with Applications to Biomedical Studies

PubMed Central

Chen, Xiwei; Yu, Jihnhee

2014-01-01

Abstract Many clinical and biomedical studies evaluate treatment effects based on multiple biomarkers that commonly consist of pre- and post-treatment measurements. Some biomarkers can show significant positive treatment effects, while other biomarkers can reflect no effects or even negative effects of the treatments, giving rise to a necessity to develop methodologies that may correctly and efficiently evaluate the treatment effects based on multiple biomarkers as a whole. In the setting of pre- and post-treatment measurements of multiple biomarkers, we propose to apply a receiver operating characteristic (ROC) curve methodology based on the best combination of biomarkers maximizing the area under the receiver operating characteristic curve (AUC)-type criterion among all possible linear combinations. In the particular case with independent pre- and post-treatment measurements, we show that the proposed method represents the well-known Su and Liu's (1993) result. Further, proceeding from derived best combinations of biomarkers' measurements, we propose an efficient technique via likelihood ratio tests to compare treatment effects. We show an extensive Monte Carlo study that confirms the superiority of the proposed test in comparison with treatment effects based on multiple biomarkers in a paired data setting. For practical applications, the proposed method is illustrated with a randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients as well as a treatment study for children with attention deficit-hyperactivity disorder and severe mood dysregulation. PMID:25019920

An innovative method to involve community health workers as partners in evaluation research.

PubMed

Peacock, Nadine; Issel, L Michele; Townsell, Stephanie J; Chapple-McGruder, Theresa; Handler, Arden

2011-12-01

We developed a process through which community outreach workers, whose role is not typically that of a trained researcher, could actively participate in collection of qualitative evaluation data. Outreach workers for a community-based intervention project received training in qualitative research methodology and certification in research ethics. They used a Voice over Internet Protocol phone-in system to provide narrative reports about challenges faced by women they encountered in their outreach activities as well as their own experiences as outreach workers. Qualitative data contributed by outreach workers provided insights not otherwise available to the evaluation team, including details about the complex lives of underserved women at risk for poor pregnancy outcomes and the challenges and rewards of the outreach worker role. Lay health workers can be a valuable asset as part of a research team. Training in research ethics and methods can be tailored to their educational level and preferences, and their insights provide important information and perspectives that may not be accessible via other data collection methods. Challenges encountered in the dual roles of researcher and lay health worker can be addressed in training.

Improving Passive Time Reversal Underwater Acoustic Communications Using Subarray Processing.

PubMed

He, Chengbing; Jing, Lianyou; Xi, Rui; Li, Qinyuan; Zhang, Qunfei

2017-04-24

Multichannel receivers are usually employed in high-rate underwater acoustic communication to achieve spatial diversity. In the context of multichannel underwater acoustic communications, passive time reversal (TR) combined with a single-channel adaptive decision feedback equalizer (TR-DFE) is a low-complexity solution to achieve both spatial and temporal focusing. In this paper, we present a novel receiver structure to combine passive time reversal with a low-order multichannel adaptive decision feedback equalizer (TR-MC-DFE) to improve the performance of the conventional TR-DFE. First, the proposed method divides the whole received array into several subarrays. Second, we conduct passive time reversal processing in each subarray. Third, the multiple subarray outputs are equalized with a low-order multichannel DFE. We also investigated different channel estimation methods, including least squares (LS), orthogonal matching pursuit (OMP), and improved proportionate normalized least mean squares (IPNLMS). The bit error rate (BER) and output signal-to-noise ratio (SNR) performances of the receiver algorithms are evaluated using simulation and real data collected in a lake experiment. The source-receiver range is 7.4 km, and the data rate with quadrature phase shift keying (QPSK) signal is 8 kbits/s. The uncoded BER of the single input multiple output (SIMO) systems varies between 1 × 10 - 1 and 2 × 10 - 2 for the conventional TR-DFE, and between 1 × 10 - 2 and 1 × 10 - 3 for the proposed TR-MC-DFE when eight hydrophones are utilized. Compared to conventional TR-DFE, the average output SNR of the experimental data is enhanced by 3 dB.

Improving Passive Time Reversal Underwater Acoustic Communications Using Subarray Processing

PubMed Central

He, Chengbing; Jing, Lianyou; Xi, Rui; Li, Qinyuan; Zhang, Qunfei

2017-01-01

Multichannel receivers are usually employed in high-rate underwater acoustic communication to achieve spatial diversity. In the context of multichannel underwater acoustic communications, passive time reversal (TR) combined with a single-channel adaptive decision feedback equalizer (TR-DFE) is a low-complexity solution to achieve both spatial and temporal focusing. In this paper, we present a novel receiver structure to combine passive time reversal with a low-order multichannel adaptive decision feedback equalizer (TR-MC-DFE) to improve the performance of the conventional TR-DFE. First, the proposed method divides the whole received array into several subarrays. Second, we conduct passive time reversal processing in each subarray. Third, the multiple subarray outputs are equalized with a low-order multichannel DFE. We also investigated different channel estimation methods, including least squares (LS), orthogonal matching pursuit (OMP), and improved proportionate normalized least mean squares (IPNLMS). The bit error rate (BER) and output signal-to-noise ratio (SNR) performances of the receiver algorithms are evaluated using simulation and real data collected in a lake experiment. The source-receiver range is 7.4 km, and the data rate with quadrature phase shift keying (QPSK) signal is 8 kbits/s. The uncoded BER of the single input multiple output (SIMO) systems varies between 1×10−1 and 2×10−2 for the conventional TR-DFE, and between 1×10−2 and 1×10−3 for the proposed TR-MC-DFE when eight hydrophones are utilized. Compared to conventional TR-DFE, the average output SNR of the experimental data is enhanced by 3 dB. PMID:28441763

Cold air analgesia as pain reduction during photodynamic therapy of actinic keratoses.

PubMed

Stangeland, K Z; Kroon, S

2012-07-01

Photodynamic therapy (PDT) is an effective treatment for actinic keratoses and non-melanoma skin cancer. The main side effect of PDT is pain during the illumination. To assess the effect of cold air as pain relief during MAL-PDT for field cancerization on different body areas. A prospective, open, intra-individual right-left comparison study was performed in 43 patients with MAL-PDT as field cancerization. One area received cold air analgesia while the other did not. Pain was evaluated by numeric rating scale (NRS) during the illumination. The patients' received a questionnaire and recorded pain and postinflammatory symptoms on a visual analogue scale (VAS). We found a statistical significant difference in overall pain score at 3 and 9 minutes. The area receiving cold air during illumination had a mean NRS of 5.1 while the opposite side, not receiving cold air, had NRS of 6.1. At 9 minutes the side receiving cold air had mean NRS of 5.0, and the side without had 5.7. The pain difference on the chest was the most pronounced with a NRS of 5.2 without air and 3.5 with cold air. There was a significant difference in erythema immediately after, 1 h and 24 h after illumination. Small, open, not blinded study. The difference in pain was small. Cold air is an effective method for moderate pain relief. It is an easy, noninvasive method that can be used on all body parts. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

Advanced solar receivers for space power

NASA Technical Reports Server (NTRS)

Strumpf, H. J.; Coombs, M. G.; Lacy, D. E.

1988-01-01

A study has been conducted to generate and evaluate advanced solar heat receiver concepts suitable for orbital application with Brayton and Stirling engine cycles in the 7-kW size range. The generated receiver designs have thermal storage capability and, when implemented, will be lighter, smaller, and/or more efficient than baseline systems such as the configuration used for the Brayton solar receiver under development by Garrett AiResearch for the NASA Space Station. In addition to the baseline designs, four other receiver concepts were designed and evaluated with respect to Brayton and Stirling engines. These concepts include a higher temperature version of the baseline receiver, a packed bed receiver, a plate-fin receiver, and a heat pipe receiver. The thermal storage for all designs is provided by the melting and freezing of a salt.

Comparison of automated volumetry of the hippocampus using NeuroQuant® and visual assessment of the medial temporal lobe in Alzheimer's disease.

PubMed

Persson, Karin; Barca, Maria Lage; Cavallin, Lena; Brækhus, Anne; Knapskog, Anne-Brita; Selbæk, Geir; Engedal, Knut

2017-01-01

Background Different clinically feasible methods for evaluation of medial temporal lobe atrophy exists and are useful in diagnostic work-up of Alzheimer's disease (AD). Purpose To compare the diagnostic properties of two clinically available magnetic resonance imaging (MRI)-based methods-an automated volumetric software, NeuroQuant® (NQ) (evaluation of hippocampus volume) and the Scheltens scale (visual evaluation of medial temporal lobe atrophy [MTA])-in patients with AD dementia, and subjective and mild cognitive impairment (non-dementia). Material and Methods MRIs from 56 patients (31 AD, 25 non-dementia) were assessed with both methods. Correlations between the methods were calculated and receiver operating curve (ROC) analyses that yield area under the curve (AUC) statistics were conducted. Results High correlations were found between the two MRI assessments for the total hippocampal volume measured with NQ and mean MTA score (-0.753, P < 0.001), for the right (-0.767, P < 0.001), and for the left (-0.675, P < 0.001) sides. The NQ total measure yielded somewhat higher AUC (0.88, "good") compared to the MTA mean measure (0.80, "good") in the comparison of patients with AD and non-dementia, but the accuracy was in favor of the MTA scale. Conclusion The two methods correlated highly and both methods reached equally "good" power.

Tumor Volume Estimation and Quasi-Continuous Administration for Most Effective Bevacizumab Therapy

PubMed Central

Sápi, Johanna; Kovács, Levente; Drexler, Dániel András; Kocsis, Pál; Gajári, Dávid; Sápi, Zoltán

2015-01-01

Background Bevacizumab is an exogenous inhibitor which inhibits the biological activity of human VEGF. Several studies have investigated the effectiveness of bevacizumab therapy according to different cancer types but these days there is an intense debate on its utility. We have investigated different methods to find the best tumor volume estimation since it creates the possibility for precise and effective drug administration with a much lower dose than in the protocol. Materials and Methods We have examined C38 mouse colon adenocarcinoma and HT-29 human colorectal adenocarcinoma. In both cases, three groups were compared in the experiments. The first group did not receive therapy, the second group received one 200 μg bevacizumab dose for a treatment period (protocol-based therapy), and the third group received 1.1 μg bevacizumab every day (quasi-continuous therapy). Tumor volume measurement was performed by digital caliper and small animal MRI. The mathematical relationship between MRI-measured tumor volume and mass was investigated to estimate accurate tumor volume using caliper-measured data. A two-dimensional mathematical model was applied for tumor volume evaluation, and tumor- and therapy-specific constants were calculated for the three different groups. The effectiveness of bevacizumab administration was examined by statistical analysis. Results In the case of C38 adenocarcinoma, protocol-based treatment did not result in significantly smaller tumor volume compared to the no treatment group; however, there was a significant difference between untreated mice and mice who received quasi-continuous therapy (p = 0.002). In the case of HT-29 adenocarcinoma, the daily treatment with one-twelfth total dose resulted in significantly smaller tumors than the protocol-based treatment (p = 0.038). When the tumor has a symmetrical, solid closed shape (typically without treatment), volume can be evaluated accurately from caliper-measured data with the applied two-dimensional mathematical model. Conclusion Our results provide a theoretical background for a much more effective bevacizumab treatment using optimized administration. PMID:26540189

Smartphone app uses loyalty point incentives and push notifications to encourage influenza vaccine uptake.

PubMed

Dale, Leila Pfaeffli; White, Lauren; Mitchell, Marc; Faulkner, Guy

2018-04-23

Carrot Rewards is a free, incentive-based, smartphone health app available in participating provinces in Canada. One feature of Carrot was designed to incentivize influenza vaccine education messages and encourage vaccine uptake for users in the province of British Columbia. This study aimed to evaluate the uptake of the Carrot Flu Campaign educational quiz and to determine if mobile "push" notifications, plus loyalty point incentives, resulted in users visiting a sponsored pharmacy to discuss and receive the influenza vaccine. The Carrot Flu Campaign delivered an in-app quiz, educating users on the importance of the influenza vaccine. Push notifications were then sent to users when they came within 200 m of a sponsored pharmacy. Those who visited the pharmacy collected bonus points and completed a follow up quiz tracking influenza vaccine behaviour. A sub-sample of users completed the Flu Campaign between their baseline and follow up Health Risk Assessment (HRA), a survey which asked about influenza vaccine uptake behaviour. Descriptive statistics were summarized. A total of 38.1% (30,538/80,228) registered Carrot users completed the Flu Campaign quiz. Of those in participating cities (n = 21,469), 41% clicked on the map to show the nearest sponsored pharmacy and 78% enabled their smartphone's "locations" feature, allowing them to receive the push notifications. A small number of users spoke to a pharmacist (n = 96) and less than half reported receiving the influenza vaccine (38/96; 39.6%). From the HRA sub-sample (n = 3693), approximately 5% more users reported receiving the influenza vaccine during the 2017 influenza season compared to the previous year. Carrot Rewards used a novel delivery method to educate the general population and showed geolocation could be used to facilitate influenza vaccine uptake. Future iterations could tailor content to target those most at risk and should consider more robust evaluation methods to determine the app's effectiveness. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Strathclyde Evaluation of Children's Active Travel (SE-CAT): study rationale and methods.

PubMed

McMinn, David; Rowe, David A; Murtagh, Shemane; Nelson, Norah M

2011-12-30

The school commute is a prime opportunity to increase children's physical activity levels. However, active commuting has decreased over the past 40 years. Strategies that increase walking to school are therefore needed. Travelling Green (TG) is a school-based active travel resource aimed at increasing children's walking to school. The resource consists of a curriculum-based program of lessons and goal setting activities. A previous study found that children who received the TG intervention increased self-reported distance travelled to school by active modes and reduced the distance travelled by inactive modes. This study was limited by self-reported outcome measures, a small sample, and no follow-up measures. A more robust evaluation of TG is required to address these limitations. This paper describes the rationale and methods for such an evaluation of Travelling Green, and describes the piloting of various active commuting measures in primary school children. Measures of active commuting were piloted in a sample of 26 children (aged 8-9 years) over one school week. These measures were subsequently used in an 18-month quasi-experimental design to evaluate the effect of TG on commuting behaviour. Participants were 166 children (60% male) aged 8-9 years from 5 primary schools. Two schools (n = 79 children) received TG in September/October 2009. Three schools (n = 87 children) acted as a comparison group, and subsequently received TG at a later date. Physical activity was measured using Actigraph GT1M accelerometers. Personal and environmental determinants of active commuting were measured via parent and child questionnaires, as were factors related to the Theory of Planned Behaviour and the construct of habit. Measures were taken pre- and post-intervention and at 5 and 12 months follow-up. The piloted protocol was practical and feasible and piloted measures were reliable and valid. All study data, including 5 and 12 month follow-up, have been collected and processed. Data analysis is ongoing. Results will indicate whether TG successfully increases active commuting in a sample of Scottish school children and will inform future efforts in school active travel promotion.

Evaluation of the effects of the North Carolina Improved Pregnancy Outcome Project: implications for state-level decision-making.

PubMed Central

Peoples, M D; Grimson, R C; Daughtry, G L

1984-01-01

This study was designed to assess the effects of the North Carolina Improved Pregnancy Outcome (IPO) Project on use of prenatal care and incidence of low birthweight among its primarily Black registrants . Weighted least squares and stratified analysis procedures were used to scrutinize vital statistics data for subpopulation effects. IPO services were received by 51.7 per cent of Black women in the counties served by the project. For all Black registrants , the risk of receiving less than adequate prenatal care was 55.1 per cent of that of the comparison group. For Black teenage registrants , the risk was even less: 37.2 per cent of that of the comparison group. Nevertheless, no corresponding effects on the incidence of low birthweight could be detected. The evaluation methods used in this study can be applied to programs for mothers and infants in other locales to generate useful and practical information for state-level decision-making. PMID:6721010

Evaluation of US Veterans Nutrition Education for Diabetes Prevention.

PubMed

Erickson, Megan; Braun, Katie; List, Riesa; Utech, Anne; Moore, Carolyn; White, Donna L; Garcia, Jose M

2016-09-01

Evaluate the effectiveness of nutrition education interventions for diabetes prevention. Retrospective cohort design. Tertiary-care US Veterans' Hospital, July 2007 to July 2012, using pre-existing database. Prediabetic, adult veterans (n = 372), mostly men (94.4%, n = 351). Visits with existing nutrition education classes were collected. diabetes status; predictors: visits/encounters, age, body mass index, weight change, and hemoglobin A1c. Cox proportional hazards method, χ(2) test, and logistic regression. In this sample, prediabetic veterans who received nutrition education were less likely to develop diabetes when compared with prediabetic veterans who did not receive nutrition education (hazard ratio, 0.71; 95% confidence interval, 0.55-0.92; P < .01). This difference remained significant after adjusting for body mass index and weight change. Nutrition education was significantly associated with preventing the progression from prediabetes to diabetes in US Veterans participating in a nutrition education intervention at the Michael E. DeBakey Veterans Affairs Medical Center. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.

Evaluation of safety profile of black shilajit after 91 days repeated administration in rats

PubMed Central

Velmurugan, C; Vivek, B; Wilson, E; Bharathi, T; Sundaram, T

2012-01-01

Objective To evaluate the safety of shilajit by 91 days repeated administration in different dose levels in rats. Methods In this study the albino rats were divided into four groups. Group I received vehicle and group II, III and IV received 500, 2 500 and 5 000 mg/kg of shilajit, respectively. Finally animals were sacrificed and subjected to histopathology and iron was estimated by flame atomic absorption spectroscopy and graphite furnace. Results The result showed that there were no significant changes in iron level of treated groups when compared with control except liver (5 000 mg/kg) and histological slides of all organs revealed normal except negligible changes in liver and intestine with the highest dose of shilajit. The weight of all organs was normal when compared with control. Conclusions The result suggests that black shilajit, an Ayurvedic formulation, is safe for long term use as a dietary supplement for a number of disorders like iron deficiency anaemia. PMID:23569899

A New Paradigm for NDE (Non Destructive Evaluation)

DTIC Science & Technology

2013-12-06

determining specific physical properties of the armor which are correlated with armor structural health. A pair of Lead Zirconate Titanate ( PZT ...this is commonly called the “pitch and catch” method. The armor plate vibrates when it is excited by a mechanical vibration from the PZT actuator...transducer, and this vibration is transmitted through the plate and induces an electrical signal in the PZT receiver transducer by virtue of the

Forest fire risk assessment-an integrated approach based on multicriteria evaluation.

PubMed

Goleiji, Elham; Hosseini, Seyed Mohsen; Khorasani, Nematollah; Monavari, Seyed Masoud

2017-11-06

The present study deals with application of the weighted linear combination method for zoning of forest fire risk in Dohezar and Sehezar region of Mazandaran province in northern Iran. In this study, the effective criteria for fires were identified by the Delphi method, and these included ecological and socioeconomic parameters. In this regard, the first step comprised of digital layers; the required data were provided from databases, related centers, and field data collected in the region. Then, the map of criteria was digitized in a geographic information system, and all criteria and indexes were normalized by fuzzy logic. After that, the geographic information system (GIS 10.3) was integrated with the Weighted Linear Combination and the Analytical Network Process, to produce zonation of the forest fire risk map in the Dohezar and Sehezar region. In order to analyze accuracy of the evaluation, the results obtained from the study were compared to records of former fire incidents in the region. This was done using the Kappa coefficient test and a receiver operating characteristic curve. The model showing estimations for forest fire risk explained that the prepared map had accuracy of 90% determined by the Kappa coefficient test and the value of 0.924 by receiver operating characteristic. These results showed that the prepared map had high accuracy and efficacy.

Application of fractal and grey level co-occurrence matrix analysis in evaluation of brain corpus callosum and cingulum architecture.

PubMed

Pantic, Igor; Dacic, Sanja; Brkic, Predrag; Lavrnja, Irena; Pantic, Senka; Jovanovic, Tomislav; Pekovic, Sanja

2014-10-01

This aim of this study was to assess the discriminatory value of fractal and grey level co-occurrence matrix (GLCM) analysis methods in standard microscopy analysis of two histologically similar brain white mass regions that have different nerve fiber orientation. A total of 160 digital micrographs of thionine-stained rat brain white mass were acquired using a Pro-MicroScan DEM-200 instrument. Eighty micrographs from the anterior corpus callosum and eighty from the anterior cingulum areas of the brain were analyzed. The micrographs were evaluated using the National Institutes of Health ImageJ software and its plugins. For each micrograph, seven parameters were calculated: angular second moment, inverse difference moment, GLCM contrast, GLCM correlation, GLCM variance, fractal dimension, and lacunarity. Using the Receiver operating characteristic analysis, the highest discriminatory value was determined for inverse difference moment (IDM) (area under the receiver operating characteristic (ROC) curve equaled 0.925, and for the criterion IDM≤0.610 the sensitivity and specificity were 82.5 and 87.5%, respectively). Most of the other parameters also showed good sensitivity and specificity. The results indicate that GLCM and fractal analysis methods, when applied together in brain histology analysis, are highly capable of discriminating white mass structures that have different axonal orientation.

A case-cohort study with propensity score matching to evaluate the effects of mannitol on venous thromboembolism.

PubMed

Fletcher, Jeffrey J; Kade, Allison M; Sheehan, Kyle M; Wilson, Thomas J

2014-08-01

Mannitol has been shown to damage endothelial cells and activate coagulation pathways leading to intravascular thrombosis. Dehydration and hemagglutination have also been associated with mannitol use, although the risk of clinically evident venous thromboembolism (VTE) disease is not well-defined. The aim of this study was to compare the risk of VTE in critically ill neurological patients who received mannitol compared to only hypertonic saline. A case-cohort study design with propensity score matching was used to evaluate the risk of VTE among patients who received mannitol compared to those who received hypertonic saline alone. The odds of thrombosis were evaluated by the Cochran-Mantel-Haenszel method and conditional logistic regression was used to adjust for year of treatment. Ninety-one of 330 patients (27.6%; 95% confidence interval [CI] 23-33%) developed a VTE; however, the yearly proportion remained unchanged over the 8 year study period. Cumulative use of mannitol declined and use of hypertonic saline increased significantly. The odds of thrombosis for those exposed to mannitol compared to hypertonic saline alone was 1.11 (95% CI 0.65-1.73; p=0.75). This remained insignificant after adjusting for year of injury. In conclusion, despite a significant change in the pattern of osmotic therapy used at our institution, the proportion of patients with VTE remained unchanged. We found no evidence that mannitol use was associated with VTE compared to hypertonic saline alone. Copyright © 2014. Published by Elsevier Ltd.

Evaluating the visibility of presentation slides

NASA Astrophysics Data System (ADS)

Sugawara, Genki; Umezu, Nobuyuki

2017-03-01

Presentations using slide software such as PowerPoint are widely performed in offices and schools. The improvement of presentation skills among ordinary people is required because these days such an opportunity of giving presentation is becoming so common. One of the key factors for making successful presentation is the visibility of the slides, as well as the contents themselves. We propose an algorithm to numerically evaluate the visibility of presentation slides. Our method receives a presentation as a set of images and eliminates the background from the slides to extract characters and figures. This algorithm then evaluates the visibility according to the number and size of characters, their colors, and figure layouts. The slide evaluation criteria are based on the series of experiments with 20 participants to parameterize typical values for visual elements in slides. The algorithm is implemented on an iMac and takes 0.5 sec. to evaluate a slide image. The evaluation score is given as a value between 0 and 100 and the users can improve their slide pages with lower scores. Our future work includes a series of experiments with various presentations and extending our method to publish as a web-based rating service for learning presentation skills.

Promoting Sun Safety Among US Postal Service Letter Carriers: Impact of a 2-Year Intervention

PubMed Central

Mayer, Joni A.; Slymen, Donald J.; Clapp, Elizabeth J.; Pichon, Latrice C.; Eckhardt, Laura; Eichenfield, Lawrence F.; Elder, John P.; Sallis, James F.; Weinstock, Martin A.; Achter, April; Balderrama, Cynthia; Galindo, Gabriel R.; Oh, Sam S.

2007-01-01

Objectives. We examined whether US Postal Service letter carriers who received a sun safety intervention would wear wide-brim hats and sunscreen significantly more often than those who did not receive the intervention. Methods. We used a 2-group randomized design with 2662 evaluation cohort participants from 70 US postal stations. Evaluations were conducted at baseline, 3 months, 1 year, and 2 years. Questionnaire items assessed occupational use of sun-screen and wide-brim hats. The 2-year sun safety intervention included the provision of wide-brim hats, accessible sunscreen, reminders, and 6 educational sessions. Results. At the 3-month follow-up evaluations, the odds ratio (OR) for regular sun-screen use was 2.8 times higher among the intervention group than among the control group (95% confidence interval [CI]=2.2, 3.5); at the 2-year follow-up evaluations, the rate was still significantly higher (OR=2.0; 95% CI=1.6, 2.6). Intervention group participants also had significantly higher rates of hat use, with the differences remaining consistent across all follow-ups (OR=2.9; 95% CI=2.3, 3.6). Conclusions. The intervention should be disseminated to postal stations nationwide and possibly to other occupational groups that work outdoors. PMID:17267715

Evaluating Disparities in Inpatient Surgical Cancer Care Among American Indian/Alaska Native Patients

PubMed Central

Simianu, Vlad V.; Morris, Arden M.; Varghese, Thomas K.; Porter, Michael P.; Henderson, Jeffrey A.; Buchwald, Dedra S.; Flum, David R.; Javid, Sara H.

2016-01-01

Background American Indian/Alaska Native (AI/AN) patients with cancer have the lowest survival rates of all racial and ethnic groups, possibly because they are less likely to receive “best practice” surgical care than patients of other races. Methods Prospective cohort study comparing adherence to generic and cancer-specific guidelines on processes of surgical care between AI/AN and non-Hispanic white (NHW) patients in Washington State (2010–2014). Results 156 AI/AN and 6,030 NHW patients underwent operations for 10 different cancers, and had similar mean adherence to generic surgical guidelines (91.5% vs 91.9%, p=0.57). AI/AN patients with breast cancer less frequently received preoperative diagnostic core-needle biopsy (81% versus 94%, p=0.004). AI/AN patients also less frequently received care adherent to prostate cancer-specific guidelines (74% versus 92%,p=0.001). Conclusions While AI/ANs undergoing cancer operations in Washington receive similar overall best practice surgical cancer care to NHW patients, there remain important, modifiable disparities that may contribute to their lower survival. PMID:26846176

Thyroid cancer post radioactive iodine treatment for hyperthyroidism - case series and review of the literature.

PubMed

Al Eyadeh, Abdallah A; Al-Sarihin, Khaldon; Etewi, Suzan; Al-Omari, Ahmed; Al-Asa'd, Rania Atallah; Haddad, Fares Halim

2017-01-01

To assess the rate of thyroid cancer and mortality rate in a cohort of patients who received RAI¹³¹ treatment for hyperthyroidism and to report the index cases' characteristics and management MATERIAL AND METHODS: A cohort of 264 patients who received RAI¹³¹ treatment for different causes of thyrotoxicosis were followed up over a period of 18 years (1996-2014) by physical exam, radiological evaluation and serial thyroid function tests. During the follow up period, three cases of thyroid cancer were identified. The prevalence of thyroid cancer was 1.136% of cases who received RAI¹³¹. The relative risk was 378.79 (95% CI: 76.8 < RR < 1868.23). The P value was < 0.0000004 and the SMR is 1.99/1000. The prevalence of thyroid cancer was 1.136% in the cohort of patients treated with RAI¹³¹. Despite the fact that no direct cause-effect relationship between RAI and thyroid cancer could be established, these cases highlights the importance of life-long surveillance of patients who receive RAI¹³¹.

Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

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

Casimiro de Deus Cardoso, Cejana; Giordani, Adelmo Jose; Borri Wolosker, Angela Maria

Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptomsmore » of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.« less

Safety and efficacy of two ocular anesthetic methods for phacoemulsification: topical anesthesia and viscoanesthesia (VisThesia).

PubMed

Perone, J M; Popovici, A; Ouled-Moussa, R; Herasymyuk, O; Reynders, S

2007-01-01

VisThesia is a new ophthalmic viscosurgical device (OVD) which has 1% lidocaine combined with 1.5% sodium hyaluronate. This is a prospective evaluation of the safety and efficacy of VisThesia used in association with phacoemulsification. A total of 114 eyes were divided into two groups. Fifty-nine eyes were treated with tetracaine + oxybuprocaine topical anesthesia and DuoVisc OVD and 55 eyes were treated with VisThesia, for use as both topical anesthetic and OVD. Endothelial cell counts were measured at 30 days postoperatively and compared to preoperative baseline values. Pain and discomfort was subjectively evaluated by patients using a visual analog pain scale (0-10). All surgeries were uneventful with no intraoperative or immediate postoperative complications. Patients receiving topical anesthesia had a mean pain score of 1.1+/-6.8 compared to a mean score of 1.3+/-4.6 for patients receiving VisThesia (p=0.59). Postoperatively, endothelial cell loss at 1 month was greater for patients receiving VisThesia (20.32%+/-43.75) than for those receiving the topical anesthetic (8.8%+/-59.6; p<0.0001). The results from the visual analog pain scale were comparable between groups, showing that VisThesia provides similar pain relief to topical anesthesia. Specular microscopy performed at 30 days postoperatively showed a significantly greater loss of endothelial cells with the use of VisThesia, suggesting that the 1% lidocaine concentration used in VisThesia may be toxic to corneal endothelial cells.

Curcumin-loaded chitosan-alginate-STPP nanoparticles ameliorate memory deficits and reduce glial activation in pentylenetetrazol-induced kindling model of epilepsy.

PubMed

Hashemian, Mona; Anissian, Diana; Ghasemi-Kasman, Maryam; Akbari, Atefeh; Khalili-Fomeshi, Mohsen; Ghasemi, Shahram; Ahmadi, Fatemeh; Moghadamnia, Ali Akbar; Ebrahimpour, Anahita

2017-10-03

Despite several beneficial effects of curcumin, its medical application has been hampered due to low water solubility. To improve the aqueous solubility of curcumin, it has been loaded on chitosan (CS)-alginate (ALG) - sodium tripolyphosphate (STPP) nanoparticles (NPs). Then, the effect of curcumin NPs on memory improvement and glial activation was investigated in pentylenetetrazol (PTZ)-induced kindling model. Male NMRI mice have received the daily injection of curcumin NPs at dose of 12.5 or 25mg/kg. All interventions were injected intraperitoneally (i.p), 10days before PTZ administration and the injections were continued until 1h before each PTZ injection. Spatial learning and memory was evaluated using Morris water maze test after the 7th PTZ injection. Animals have received 10 injections of PTZ and then, brain tissues were removed for histological evaluation. Nissl staining was used to determine the level of cell death in hippocampus and immunostaining method was performed against NeuN and GFAP/Iba1 for assessment of neuronal density and glial activation respectively. Behavioral results showed that curcumin NPs exhibit anticonvulsant activity and prevent cognitive impairment in fully kindled animals. The level of cell death and glial activation reduced in animals which have received curcumin NPs compared to those received free curcumin. To conclude, these findings suggest that curcumin NPs effectively ameliorate memory impairment and attenuate the level of activated glial cells in a mice model of chronic epilepsy. Copyright © 2017. Published by Elsevier Inc.

Solar disinfection of water for diarrhoeal prevention in southern India

PubMed Central

Rose, A; Roy, S; Abraham, V; Holmgren, G; George, K; Balraj, V; Abraham, S; Muliyil, J; Joseph, A; Kang, G

2006-01-01

Aims To evaluate the efficacy and acceptability of solar irradiation in the prevention of diarrhoeal morbidity in children under 5 years of age, in an urban slum in Vellore, Tamil Nadu. Methods A total of 100 children were assigned to receive drinking water that had been subjected to solar disinfection in polyethylene terephthalate bottles. One hundred age and sex matched controls were also selected. Both groups were followed by weekly home visits for a period of six months for any diarrhoeal morbidity. At the end of the follow up period, the acceptability of the intervention was assessed by interviews, questionnaires, and focus group discussions. Results There was significant reduction in the incidence, duration, and severity of diarrhoea in children receiving solar disinfected water, despite 86% of the children drinking water other than that treated by the intervention. The incidence of diarrhoea in the intervention group was 1.7 per child‐year, and among controls 2.7 per child‐year, with an incidence rate ratio of 0.64 (95% CI −0.48 to 0.86). The risk of diarrhoea was reduced by 40% by using solar disinfection. In qualitative evaluation of acceptability, most women felt that solar disinfection was a feasible and sustainable method of disinfecting water. Conclusions Solar disinfection of water is an inexpensive, effective, and acceptable method of increasing water safety in a resource limited environment, and can significantly decrease diarrhoeal morbidity in children. PMID:16403847

Structural analysis of a reflux pool-boiler solar receiver

NASA Astrophysics Data System (ADS)

Hoffman, E. L.; Stone, C. M.

1991-06-01

Coupled thermal-structural finite element calculations of a reflux pool-boiler solar receiver were performed to characterize the operating stresses and to address issues affecting the service life of the receiver. Analyses performed using shell elements provided information for receiver material selection and design optimization. Calculations based on linear elastic fracture mechanics principles were performed using continuum elements to assess the vulnerability of a seam-weld to fatigue crack growth. All calculations were performed using ABAQUS, a general purpose finite element code, and elements specifically formulated for coupled thermal-structural analysis. Two materials were evaluated: 316L SS and Haynes 230 alloys. The receiver response was simulated for a combination of structural and thermal loads that represent the startup and operating conditions of the receiver. For both materials, maximum stresses in the receiver developed shortly after startup due to uneven temperature distribution across the receiver surface. The largest effective stress was near yield in the 316L SS receiver and below 39 percent of yield in the Haynes 230 receiver. The calculations demonstrated that stress reductions of over 25 percent could be obtained by reducing the aft dome thickness to one closer to the absorber. The fatigue calculations demonstrated that the stress distribution near the seam-weld notch depends primarily on the structural load created by internal pressurization of the receiver rather than the thermal, indicating that the thermal loads can be neglected when assessing the stress intensity near the seam-weld notch. The stress intensity factor, computed using the J-integral method and crack opening-displacement field equations, was significantly below the fatigue threshold for most steels. The calculations indicated that the weld notch was always loaded in compression, a condition which is not conducive to fatigue crack growth.

Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms

PubMed Central

Moseholm, Ellen; Rydahl-Hansen, Susan; Lindhardt, Bjarne Ørskov

2016-01-01

Aim Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio-demographic and medical factors associated with HRQoL at the time of diagnosis. Methods This was a prospective, multicenter survey study that included patients who were referred for a diagnostic evaluation due to non-specific cancer symptoms. Participants completed the EORTC-QLQ-C30 quality of life scale before and after completing the diagnostic evaluation. The baseline and follow-up EORTC-QLQ-C30 scores were compared with reference populations. The impact of socio-demographic and medical factors on HRQoL at follow-up was explored by bootstrapped multivariate linear regression. Results A total of 838 patients participated in the study; 680 (81%) also completed follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of follow-up. Patients presented initially with a high burden of symptoms, less role and emotional functioning and a lower global health/QoL. Most domains improved after diagnosis and no clinically important difference between baseline and follow-up scores was found. Patients reported effects on HRQoL both at baseline and at follow-up compared with the Danish reference population and had similar scores as a cancer reference population. Co-morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis. Conclusions Patients with non-specific symptoms reported an affected HRQoL while undergoing a diagnostic evaluation for possible cancer. Morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis. PMID:26840866

Recommendations for a mixed methods approach to evaluating the patient-centered medical home.

PubMed

Goldman, Roberta E; Parker, Donna R; Brown, Joanna; Walker, Judith; Eaton, Charles B; Borkan, Jeffrey M

2015-03-01

There is a strong push in the United States to evaluate whether the patient-centered medical home (PCMH) model produces desired results. The explanatory and contextually based questions of how and why PCMH succeeds in different practice settings are often neglected. We report the development of a comprehensive, mixed qualitative-quantitative evaluation set for researchers, policy makers, and clinician groups. To develop an evaluation set, the Brown Primary Care Transformation Initiative convened a multidisciplinary group of PCMH experts, reviewed the PCMH literature and evaluation strategies, developed key domains for evaluation, and selected or created methods and measures for inclusion. The measures and methods in the evaluation set (survey instruments, PCMH meta-measures, patient outcomes, quality measures, qualitative interviews, participant observation, and process evaluation) are meant to be used together. PCMH evaluation must be sufficiently comprehensive to assess and explain both the context of transformation in different primary care practices and the experiences of diverse stakeholders. In addition to commonly assessed patient outcomes, quality, and cost, it is critical to include PCMH components integral to practice culture transformation: patient and family centeredness, authentic patient activation, mutual trust among practice employees and patients, and transparency, joy, and collaboration in delivering and receiving care in a changing environment. This evaluation set offers a comprehensive methodology to enable understanding of how PCMH transformation occurs in different practice settings. This approach can foster insights about how transformation affects critical outcomes to achieve meaningful, patient-centered, high-quality, and cost-effective sustainable change among diverse primary care practices. © 2015 Annals of Family Medicine, Inc.

Relationship between Counseling Students' Childhood Memories and Current Negative Self-Evaluations When Receiving Corrective Feedback

ERIC Educational Resources Information Center

Stroud, Daniel; Olguin, David; Marley, Scott

2016-01-01

This article entails a study focused on the relationship between counseling students' negative childhood memories of receiving corrective feedback and current negative self-evaluations when receiving similar feedback in counselor education programs. Participants (N = 186) completed the Corrective Feedback Instrument-Revised (CFI-R; Hulse-Killacky…

Comparative study of receiver-side ghost wavefield attenuation on different marine acquisition configurations

NASA Astrophysics Data System (ADS)

Zhang, Hao; Liu, Qiancheng; Li, Hongyuan; Zhang, Yi

2018-04-01

In marine seismic exploration, the ghost energies (down-going waves), which arise from the reflection at the surface, are often treated as unwanted signals for data processing. The ghost wave fields interfere with the desired primary signals, leads to frequency notches and attenuation of low frequencies, which in turn downgrade the resolution of the recorded seismic data. There are two main categories of methods to solve the ghost or the so-called notch problem: the non-conventional acquisition configuration-based technique and a deghosting algorithm-based solution. The variable-depth streamer (VDS) acquisition solution is one of the most representative methods in the first category, which has become a popular solution for marine seismic acquisition to obtain broad data bandwidth. However, this approach is not as economic as the conventional constant depth streamer (CDS) acquisition, due to the precise control of the towing streamer. In addition, there are large quantities of conventionally-towed legacy data stored in the data library. Applying receiver deghosting to the CDS data thus becomes a more economical method. In theory, both types of data after deghosting should have the same bandwidth and S/N ratio, but in reality they are different. In this paper, we conduct a comparative study and evaluation to apply receiver deghosting to a set of real 2D marine data including both types of acquisition (CDS and VDS) corresponding to the same geology. The deghosting algorithm we employed is a self-sustained, inversion-based approach operated in the τ-p domain. This evaluation can help us to understand two questions: whether the VDS acquisition has more broadband characteristics compared to conventional CDS acquisition after deghosting, and whether we can achieve the identical or similar data quality (e.g., S/N ratio) through the proper deghosting algorithm for both types of data. The comparative results are illustrated and discussed.

Guide to the evaluation of human exposure to noise from large wind turbines

NASA Technical Reports Server (NTRS)

Stephens, D. G.; Shepherd, K. P.; Hubbard, H. H.; Grosveld, F.

1982-01-01

Guidance for evaluating human exposure to wind turbine noise is provided and includes consideration of the source characteristics, the propagation to the receiver location, and the exposure of the receiver to the noise. The criteria for evaluation of human exposure are based on comparisons of the noise at the receiver location with the human perception thresholds for wind turbine noise and noise-induced building vibrations in the presence of background noise.

Changes in tear volume and ocular symptoms of patients receiving oral anticancer drug S-1.

PubMed

Kuriki, Reiko; Hata, Tsuyoshi; Nakayama, Kinuyo; Ito, Yuichi; Misawa, Kazunari; Ito, Seiji; Tatematsu, Michiko; Kaneda, Norio

2018-01-01

Most eye disorders are not fatal but may deteriorate the quality of life of a patient. The eye disorder that is most frequently reported in the cancer chemotherapy is associated with the combination of tegafur/gimeracil/potassium oxonate (S-1). However, preventive methods or treatment methods for the eye disorder have not yet been established. This study aimed to determine changes in tear volume and subjective ocular symptoms during the treatment period in patients receiving S-1 monotherapy for early detection of adverse effects in the eye and establishment of its treatment methods. This study included eleven patients receiving S-1 monotherapy as a postoperative adjuvant chemotherapy for gastric cancer. Six subjective ocular symptoms including watering eyes were evaluated and changes in tear volume measured by the Schirmer's test in patients receiving S-1 during the treatment period. In the present study, the patients were divided into "no watering eyes" (patients not experienced watering eyes) group and "watering eyes" (patients experienced watering eyes even once) group. Six out of eleven patients developed watering eyes after receiving S-1 monotherapy. Among these, the earliest onset occurred on the 2nd week after oral administration. Watering eyes and eye discharge were highly related in patients having a trouble in daily life due to the decreased QOL. Changes in tear volume in the "watering eyes" group significantly increased compared to the "no watering eyes" group during the treatment period, especially when the patients had no subjective symptom of the increased tear volume. It is essential to prevent eye disorders including watering eyes as an adverse effect of S-1 administration. The present study recommends that the tear volume should be periodically measured using Schirmer's test, and the patient should be interviewed regarding the subjective ocular symptoms for the early detection of watering eyes caused by S-1 administration. If the tear volume can not be measured periodically, medical staffs should pay attention to the patient with eye discharge.

[Modern research progress of traditional Chinese medicine based on integrative pharmacology].

PubMed

Wang, Ping; Tang, Shi-Huan; Su, Jin; Zhang, Jia-Qi; Cui, Ru-Yi; Xu, Hai-Yu; Yang, Hong-Jun

2018-04-01

Integrative pharmacology (IP) is a discipline that studies the interaction, integration and principle of action of multiple components with the body, emphasizing the integrations of multi-level and multi-link, such as "whole and part", " in vivo and in vitro ", " in vivo process and activity evaluation". After four years of development and practice, the theory and method of IP has received extensive attention and application.In order to better promote the development of IP, this paper systematically reviews the concepts, research contents, research methods and application fields about IP. Copyright© by the Chinese Pharmaceutical Association.

Optical air data systems and methods

NASA Technical Reports Server (NTRS)

Spaeth, Lisa G. (Inventor); O'Brien, Martin (Inventor); Tang, Shoou-yu (Inventor); Acott, Phillip E. (Inventor); Caldwell, Loren M. (Inventor)

2011-01-01

Systems and methods for sensing air includes at least one, and in some embodiments three, transceivers for projecting the laser energy as laser radiation to the air. The transceivers are scanned or aligned along several different axes. Each transceiver receives laser energy as it is backscattered from the air. A computer processes signals from the transceivers to distinguish molecular scattered laser radiation from aerosol scattered laser radiation and determines air temperatures, wind speeds, and wind directions based on the scattered laser radiation. Applications of the system to wind power site evaluation, wind turbine control, traffic safety, general meteorological monitoring and airport safety are presented.

Stereotactic Radiosurgery and Fractionated Stereotactic Radiation Therapy for the Treatment of Uveal Melanoma

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

Yazici, Gozde; Kiratli, Hayyam; Ozyigit, Gokhan

Purpose: To evaluate treatment results of stereotactic radiosurgery or fractionated stereotactic radiation therapy (SRS/FSRT) for uveal melanoma. Methods and Materials: We retrospectively evaluated 181 patients with 182 uveal melanomas receiving SRS/FSRT between 2007 and 2013. Treatment was administered with CyberKnife. Results: According to Collaborative Ocular Melanoma Study criteria, tumor size was small in 1%, medium in 49.5%, and large in 49.5% of the patients. Seventy-one tumors received <45 Gy, and 111 received ≥45 Gy. Median follow-up time was 24 months. Complete and partial response was observed in 8 and 104 eyes, respectively. The rate of 5-year overall survival was 98%, disease-free survival 57%,more » local recurrence-free survival 73%, distant metastasis-free survival 69%, and enucleation-free survival 73%. There was a significant correlation between tumor size and disease-free survival, SRS/FSRT dose and enucleation-free survival; and both were prognostic for local recurrence-free survival. Enucleation was performed in 41 eyes owing to progression in 26 and complications in 11. Conclusions: The radiation therapy dose is of great importance for local control and eye retention; the best treatment outcome was achieved using ≥45 Gy in 3 fractions.« less

Nurses' Evaluation of Their Use and Mastery in Health Assessment Skills: Selected Iran's Hospitals

PubMed Central

Adib-Hajbaghery, Mohsen; Safa, Azade

2013-01-01

Background: Health assessment skills are of the most important skills which nurses require. The more precise assessment, the better results would be obtained and the quality of patient care would be improved. However, in Iran, few studies have investigated nurses’ assessment skills. Objectives: This study was aimed to assessnurses' evaluation of the learned skills of health assessment and their use. Materials and Methods: This cross-sectional study was conducted on 200 nurses in Isfahan province hospitals. Data was collected by a questionnaire including demographic data and 120 health assessment skills. Nurses scored their frequency of using and proficiency in skills. Statistical analysis was conducted by ANOVA, Tukey test and independent sample T-tests. Results: The highest level of using and proficiency in skills was related to taking history. Nurses received 87.25% of score in this field. The lowest level of application was in assessment of the urogenital system so that nurses received 16.37% of score in this area. Also the lowest proficiency was in assessment of the nervous system and nurses received 34.58% of score in this area. Conclusions: The level of nurses' proficiency in the health assessment skills was not satisfactory. Modifying the curriculum and cooperating of nurse managers and nursing schools can help to improve the situation. PMID:25414875

Dual-Polarization Observations of Slowly Varying Solar Emissions from a Mobile X-Band Radar

PubMed Central

Gabella, Marco; Leuenberger, Andreas

2017-01-01

The radio noise that comes from the Sun has been reported in literature as a reference signal to check the quality of dual-polarization weather radar receivers for the S-band and C-band. In most cases, the focus was on relative calibration: horizontal and vertical polarizations were evaluated versus the reference signal mainly in terms of standard deviation of the difference. This means that the investigated radar receivers were able to reproduce the slowly varying component of the microwave signal emitted by the Sun. A novel method, aimed at the absolute calibration of dual-polarization receivers, has recently been presented and applied for the C-band. This method requires the antenna beam axis to be pointed towards the center of the Sun for less than a minute. Standard deviations of the difference as low as 0.1 dB have been found for the Swiss radars. As far as the absolute calibration is concerned, the average differences were of the order of −0.6 dB (after noise subtraction). The method has been implemented on a mobile, X-band radar, and this paper presents the successful results that were obtained during the 2016 field campaign in Payerne (Switzerland). Despite a relatively poor Sun-to-Noise ratio, the “small” (~0.4 dB) amplitude of the slowly varying emission was captured and reproduced; the standard deviation of the difference between the radar and the reference was ~0.2 dB. The absolute calibration of the vertical and horizontal receivers was satisfactory. After the noise subtraction and atmospheric correction a, the mean difference was close to 0 dB. PMID:28531164

Dual-Polarization Observations of Slowly Varying Solar Emissions from a Mobile X-Band Radar.

PubMed

Gabella, Marco; Leuenberger, Andreas

2017-05-22

The radio noise that comes from the Sun has been reported in literature as a reference signal to check the quality of dual-polarization weather radar receivers for the S-band and C-band. In most cases, the focus was on relative calibration: horizontal and vertical polarizations were evaluated versus the reference signal mainly in terms of standard deviation of the difference. This means that the investigated radar receivers were able to reproduce the slowly varying component of the microwave signal emitted by the Sun. A novel method, aimed at the absolute calibration of dual-polarization receivers, has recently been presented and applied for the C-band. This method requires the antenna beam axis to be pointed towards the center of the Sun for less than a minute. Standard deviations of the difference as low as 0.1 dB have been found for the Swiss radars. As far as the absolute calibration is concerned, the average differences were of the order of -0.6 dB (after noise subtraction). The method has been implemented on a mobile, X-band radar, and this paper presents the successful results that were obtained during the 2016 field campaign in Payerne (Switzerland). Despite a relatively poor Sun-to-Noise ratio, the "small" (~0.4 dB) amplitude of the slowly varying emission was captured and reproduced; the standard deviation of the difference between the radar and the reference was ~0.2 dB. The absolute calibration of the vertical and horizontal receivers was satisfactory. After the noise subtraction and atmospheric correction a, the mean difference was close to 0 dB.

Contraceptive Provision in the VA Healthcare System to Women Who Report Military Sexual Trauma

PubMed Central

Mattocks, Kristin; Schwarz, Eleanor Bimla; Borrero, Sonya; Skanderson, Melissa; Zephyrin, Laurie; Brandt, Cynthia; Haskell, Sally

2014-01-01

Abstract Background: Women Veterans who suffered military sexual trauma (MST) may be at high risk for unintended pregnancy and benefit from contraceptive services. The objective of this study is to compare documented provision of contraceptives to women Veterans using the Department of Veterans Affairs (VA) health system who report or deny MST. Methods: This retrospective cohort study included women Veterans aged 18–45 years who served in Operation Enduring or Iraqi Freedom and had at least one visit to a VA medical center between 2002 and 2010. Data were obtained from VA administrative and clinical databases. Chi-squared tests and logistic regression were conducted to evaluate the association between MST, ascertained by routine clinical screening, and first documented receipt of hormonal or long-acting contraception. Results: Of 68,466 women Veterans, 13% reported, 59% denied and 28% had missing data for the MST screen. Among the entire study cohort, 30% of women had documented receipt of a contraceptive method. Women reporting MST were significantly more likely than those denying MST to receive a method of contraception (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.07–1.18) including an intrauterine device (odds ratio [OR] 1.29, 95% CI 1.17–1.41) or contraceptive injection (OR 1.17, 95% CI 1.05–1.29). Women who were younger, unmarried, seen at a women's health clinic, or who had more than one visit were more likely to receive contraception. Conclusions: A minority of women Veterans of reproductive age receive contraceptive services from the VA. Women Veterans who report MST, and particularly those who seek care at VA women's health clinics, are more likely to receive contraception. PMID:24787680

Implementing collaborative care for depression treatment in primary care: A cluster randomized evaluation of a quality improvement practice redesign

PubMed Central

2011-01-01

Background Meta-analyses show collaborative care models (CCMs) with nurse care management are effective for improving primary care for depression. This study aimed to develop CCM approaches that could be sustained and spread within Veterans Affairs (VA). Evidence-based quality improvement (EBQI) uses QI approaches within a research/clinical partnership to redesign care. The study used EBQI methods for CCM redesign, tested the effectiveness of the locally adapted model as implemented, and assessed the contextual factors shaping intervention effectiveness. Methods The study intervention is EBQI as applied to CCM implementation. The study uses a cluster randomized design as a formative evaluation tool to test and improve the effectiveness of the redesign process, with seven intervention and three non-intervention VA primary care practices in five different states. The primary study outcome is patient antidepressant use. The context evaluation is descriptive and uses subgroup analysis. The primary context evaluation measure is naturalistic primary care clinician (PCC) predilection to adopt CCM. For the randomized evaluation, trained telephone research interviewers enrolled consecutive primary care patients with major depression in the evaluation, referred enrolled patients in intervention practices to the implemented CCM, and re-surveyed at seven months. Results Interviewers enrolled 288 CCM site and 258 non-CCM site patients. Enrolled intervention site patients were more likely to receive appropriate antidepressant care (66% versus 43%, p = 0.01), but showed no significant difference in symptom improvement compared to usual care. In terms of context, only 40% of enrolled patients received complete care management per protocol. PCC predilection to adopt CCM had substantial effects on patient participation, with patients belonging to early adopter clinicians completing adequate care manager follow-up significantly more often than patients of clinicians with low predilection to adopt CCM (74% versus 48%%, p = 0.003). Conclusions Depression CCM designed and implemented by primary care practices using EBQI improved antidepressant initiation. Combining QI methods with a randomized evaluation proved challenging, but enabled new insights into the process of translating research-based CCM into practice. Future research on the effects of PCC attitudes and skills on CCM results, as well as on enhancing the link between improved antidepressant use and symptom outcomes, is needed. Trial Registration ClinicalTrials.gov: NCT00105820 PMID:22032247

The Relationship between Electronic Goal Reminders and Subsequent Drug Use and Treatment Initiation in a Criminal Justice Setting

PubMed Central

Spohr, Stephanie A.; Taxman, Faye S.; Walters, Scott T.

2015-01-01

Introduction Opportunities to influence behavior through the use of electronic reminders has not been examined in a criminal justice population. The purpose of this study was to assess probationer preferences for short-term goals from a web-based program and evaluate the role of voluntary electronic reminders (e.g., text messaging, email) in achieving early treatment and probation tasks. Methods We used data from drug-involved offenders (n=76) participating in a clinical trial of a 2-session motivational computer program. As part of the program, participants could choose to receive text or email reminders about their probation and treatment goals for the next month. Poisson regression models were utilized to evaluate goal and reminder selection in relation to the days of substance use and treatment attendance at two-month follow-up. Results The most common goals were related to probation and treatment tasks, relationships, and cognitive reappraisals. Forty-five percent of probationers elected to receive electronic goal reminders at Session 1 with a slight increase at Session two (49%). Probationers who opted to receive electronic goal reminders at Session one selected significantly more goals on average (M = 4.4, SD = 2.1) than probationers who did not want reminders (M = 3.4, SD = 1.8), (t = 2.41, p = .019). Reminder selection and total number of goals selected predicted days of substance use and treatment attendance at a two-month follow-up. Probationers who opted not to receive electronic reminders and those who only chose to receive reminders at one visit had more days of substance use compared to those who chose to receive reminders at both visits, 1.66 and 2.31 times respectively. Probationers who chose not to receive electronic reminders attended 56% fewer days of treatment compared to those who chose to receive reminders at both visits. Conclusions People’s choice of short-term goals and reminders can provide advance notification of the likelihood of substance use and treatment initiation. Probation systems might use such information to triage at-risk probationers to a higher level of service, before problems have emerged. PMID:26217929

SU-E-J-206: Adaptive Radiotherapy for Gynecological Malignancies with MRIGuided Cobolt-60 Radiotherapy

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

Lamb, J; Kamrava, M; Agazaryan, N

Purpose: Even in the IMRT era, bowel toxicity and bone marrow irradiation remain concerns with pelvic irradiation. We examine the potential gain from an adaptive radiotherapy workflow for post-operative gynecological patients treated to pelvic targets including lymph nodes using MRI-guided Co-60 radiation therapy. Methods: An adaptive workflow was developed with the intent of minimizing time overhead of adaptive planning. A pilot study was performed using retrospectively analyzed images from one patient’s treatment. The patient’s treated plan was created using conventional PTV margins. Adaptive treatment was simulated on the patient’s first three fractions. The daily PTV was created by removing non-targetmore » tissue, including bone, muscle and bowel, from the initial PTV based on the daily MRI. The number of beams, beam angles, and optimization parameters were kept constant, and the plan was re-optimized. Normal tissue contours were not adjusted for the re-optimization, but were adjusted for evaluation of plan quality. Plan quality was evaluated based on PTV coverage and normal tissue DVH points per treatment protocol. Bowel was contoured as the entire bowel bag per protocol at our institution. Pelvic bone marrow was contoured per RTOG protocol 1203. Results: For the clinically treated plan, the volume of bowel receiving 45 Gy was 380 cc, 53% of the rectum received 30 Gy, 35% of the bladder received 45 Gy, and 28% of the pelvic bone marrow received 40 Gy. For the adaptive plans, the volume of bowel receiving 45 Gy was 175–201 cc, 55–62% of the rectum received 30 Gy, 21– 27% of the bladder received 45 Gy, and 13–17% of the pelvic bone marrow received 40 Gy. Conclusion: Adaptive planning led to a large reduction of bowel and bone marrow dose in this pilot study. Further study of on-line adaptive techniques for the radiotherapy of pelvic lymph nodes is warranted. Dr. Low is a member of the scientific advisory board of ViewRay, Inc.« less

Primary mediastinal large B-cell lymphoma: Clinical features, prognostic factors and survival with RCHOP in Arab patients in the PET scan era

PubMed Central

Al Shemmari, Salem; Sankaranarayanan, Sreedharan P.; Krishnan, Yamini

2014-01-01

Objective: PMBCL is a distinct type of nonhodgkins lymphoma with specific clinicopathological features. To clarify clinical features, treatment alternatives and outcomes, we evaluated 28 Arab patients treated with chemotherapy or radiotherapy between 2006 and 2011. Patients and Methods: PMBCL lymphoma patients identified according to WHO classification and treated at KCCC between 2006 and 2011 were included in this study. Demographic and clinical data are presented as means or medians. Overall survival was estimated using the Kaplan-Meier method. Survival rates were compared using the log-rank test. A P < 0.05 was considered significant. Results: The median age of the patients was 31 years and the male to female ratio was 2:1. Majority of the patients (75%) presented with stage I/II disease. Most had features of local extension like pleural effusion (18%) and SVCO (39%). Only 11% of the patients had bone marrow involvement at presentation. 96% of the patients required biopsy from the mediastinal mass either by image guided core biopsy (75%) or by surgical biopsy. Most patients were treated by RCHOP and involved field radiotherapy. Patients with positive PET scan after RCHOP chemotherapy received salvage chemotherapy and BEAM autologous marrow transplant. The five year OS for the entire group was 85% while the PFS was 73%. Patients who had PET scan for response evaluation had better OS [P = 0.013] and PFS [P = 0.039] when compared with those patients who received only radiotherapy based on CT scan evaluation. Conclusion: PMBCL is a specific lymphoma entity seen in the young with good survival. The role of PET scan for response evaluation and the type of consolidation therapy needs to be further clarified PMID:25125808

Evaluation of the Diode laser (810nm, 980 nm) on color change of teeth after external bleaching

PubMed Central

Kiomars, Nazanin; Azarpour, Pouneh; Mirzaei, Mansooreh; Hashemi kamangar, Sedighe Sadat; Kharazifard, Mohammad Javad

2016-01-01

Subject and aim: The aim of this study was to evaluate the efficiency of diode laser-activated bleaching systems for color change of teeth. Materials & Methods: 40 premolars with intact enamel surfaces were selected for five external bleaching protocols (n=8). Two different wavelengths of diode laser (810 and 980 nm) with two different hydrogen peroxide concentrations (30% and 46%) were selected for laser bleaching. Group 1 received bleaching (Heydent- Germany) with a 810 nm diode laser; Group 2 received bleaching (Heydent- Germany) with a 980 nm diode laser; Group 3 received bleaching (laser white*20- Biolase) with a 810 nm diode laser; Group 4 received bleaching (laser white*20- Biolase) with a 980 nm diode laser, with an output power of 1.5 W, in continuous wave (cw) mode for each irradiation. Group 5 as control group received 40% hydrogen peroxide (Opalescence Boost, Ultradent-USA) with no light activation. The color of teeth was scored at baseline and 1 week after bleaching with spectrophotometer. Color change data on the CIEL*a*b* system were analyzed statistically by the one-way ANOVA and Tukey's HSD test. Results: All the bleaching techniques resulted in shade change. According to ΔE values, all techniques were effective to bleach the teeth (ΔE ≥ 3). Statistically significant differences were detected among bleaching protocols (p=0.06). Regarding shade change values expressed as ΔL*, Δa*, Δb*, ΔE*, laser bleached groups were no statistically different with each other (p>0.05). Conclusion: Bleaching with different wavelengths of diode laser resulted in the same results. PMID:28765671

Management of Chemoradiation-Induced Mucositis in Head and Neck Cancers With Oral Glutamine

PubMed Central

Panda, Niharika; Dash, Manoj Kumar; Mohanty, Sumita; Samantaray, Sagarika

2016-01-01

Purpose Head and neck cancers are the third most common cancers worldwide. Oral mucositis is the most common toxicity seen in patients who receive chemoradiation to treat head and neck cancer. The aim of this study was to evaluate the efficacy and safety of oral glutamine supplementation in these patients. Materials and Methods From December 2013 to December 2014, we randomly assigned to two arms 162 patients who had squamous cell carcinoma of the head and neck. Patients in arm A were given oral glutamine once per day, whereas those in arm B served as negative control subjects. All patients received radiotherapy given as 70 Gy in 35 fractions over 7 weeks with an injection of cisplatin once per week. Patients were assessed once per week to evaluate for the onset and severity of mucositis, pain, use of analgesics, and for Ryle tube feeding. Results We observed that 53.1% of patients developed mucositis toward the fifth week in the glutamine arm compared with 55.5% of patients in the control arm at the third week. None in the glutamine arm compared with 92.35% of patients in the control arm developed G3 mucositis. Rates of adverse events like pain, dysphagia, nausea, edema, and cough, as well as use of analgesics and Ryle tube feeding, were significantly lower in the glutamine arm than in the control arm. Conclusion This study highlights that the onset as well as the severity of mucositis in patients receiving glutamine was significantly delayed. None of the patients receiving glutamine developed G3 mucositis. Hence, the findings emphasize the use of oral glutamine supplementation as a feasible and affordable treatment option for mucositis in patients with head and neck cancers who are receiving chemoradiation. PMID:28717702

Evaluation of the Diode laser (810nm, 980 nm) on color change of teeth after external bleaching.

PubMed

Kiomars, Nazanin; Azarpour, Pouneh; Mirzaei, Mansooreh; Hashemi Kamangar, Sedighe Sadat; Kharazifard, Mohammad Javad; Chiniforush, Nasim

2016-12-30

Subject and aim: The aim of this study was to evaluate the efficiency of diode laser-activated bleaching systems for color change of teeth. Materials & Methods: 40 premolars with intact enamel surfaces were selected for five external bleaching protocols (n=8). Two different wavelengths of diode laser (810 and 980 nm) with two different hydrogen peroxide concentrations (30% and 46%) were selected for laser bleaching. Group 1 received bleaching (Heydent- Germany) with a 810 nm diode laser; Group 2 received bleaching (Heydent- Germany) with a 980 nm diode laser; Group 3 received bleaching (laser white*20- Biolase) with a 810 nm diode laser; Group 4 received bleaching (laser white*20- Biolase) with a 980 nm diode laser, with an output power of 1.5 W, in continuous wave (cw) mode for each irradiation. Group 5 as control group received 40% hydrogen peroxide (Opalescence Boost, Ultradent-USA) with no light activation. The color of teeth was scored at baseline and 1 week after bleaching with spectrophotometer. Color change data on the CIEL*a*b* system were analyzed statistically by the one-way ANOVA and Tukey's HSD test. Results: All the bleaching techniques resulted in shade change. According to ΔE values, all techniques were effective to bleach the teeth (ΔE ≥ 3). Statistically significant differences were detected among bleaching protocols (p=0.06). Regarding shade change values expressed as ΔL*, Δa*, Δb*, ΔE*, laser bleached groups were no statistically different with each other (p>0.05). Conclusion: Bleaching with different wavelengths of diode laser resulted in the same results.

A high throughput architecture for a low complexity soft-output demapping algorithm

NASA Astrophysics Data System (ADS)

Ali, I.; Wasenmüller, U.; Wehn, N.

2015-11-01

Iterative channel decoders such as Turbo-Code and LDPC decoders show exceptional performance and therefore they are a part of many wireless communication receivers nowadays. These decoders require a soft input, i.e., the logarithmic likelihood ratio (LLR) of the received bits with a typical quantization of 4 to 6 bits. For computing the LLR values from a received complex symbol, a soft demapper is employed in the receiver. The implementation cost of traditional soft-output demapping methods is relatively large in high order modulation systems, and therefore low complexity demapping algorithms are indispensable in low power receivers. In the presence of multiple wireless communication standards where each standard defines multiple modulation schemes, there is a need to have an efficient demapper architecture covering all the flexibility requirements of these standards. Another challenge associated with hardware implementation of the demapper is to achieve a very high throughput in double iterative systems, for instance, MIMO and Code-Aided Synchronization. In this paper, we present a comprehensive communication and hardware performance evaluation of low complexity soft-output demapping algorithms to select the best algorithm for implementation. The main goal of this work is to design a high throughput, flexible, and area efficient architecture. We describe architectures to execute the investigated algorithms. We implement these architectures on a FPGA device to evaluate their hardware performance. The work has resulted in a hardware architecture based on the figured out best low complexity algorithm delivering a high throughput of 166 Msymbols/second for Gray mapped 16-QAM modulation on Virtex-5. This efficient architecture occupies only 127 slice registers, 248 slice LUTs and 2 DSP48Es.

Job Offers to Individuals With Severe Mental Illness After Participation in Virtual Reality Job Interview Training.

PubMed

Smith, Matthew J; Fleming, Michael F; Wright, Michael A; Jordan, Neil; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D

2015-11-01

Individuals with severe mental illness have low employment rates, and the job interview presents a critical barrier for them to obtain competitive employment. Prior randomized controlled trials (RCTs) indicated that virtual reality job interview training (VR-JIT) improved job interviewing skills among trainees. This study assessed whether VR-JIT participation was associated with greater odds of receiving job offers in the six-months after completion of training. To assess the efficacy of VR-JIT, trainees (N=39) in the method and a comparison group (N=12) completed a brief survey approximately six months after participating in the RCTs. Primary vocational outcome measures included receiving a job offer and number of weeks searching for employment. A larger proportion of trainees than comparison participants received a job offer (51% versus 25%, respectively). Trainees were more likely to receive a job offer than comparison participants (odds ratio=9.64, p=.02) after analyses accounted for cognition, recency of last job, and diagnosis. Trainees had greater odds of receiving a job offer for each completed VR-JIT trial (odds ratio=1.41, p=.04), and a greater number of completed VR-JIT trials predicted fewer weeks of searching for employment (β=-.74, p=.02). Results provide preliminary support that VR-JIT is a promising intervention associated with enhanced vocational outcomes among individuals with severe mental illness. Given that participants had minimal access to standardized vocational services, future research could evaluate the effectiveness of VR-JIT among individuals with and without access to standardized vocational services as well as evaluate strategies to implement VR-JIT within a large community mental health service provider.

Spectrophotometric analysis of the effectiveness of a novel in-office laser-assisted tooth bleaching method using Er,Cr:YSGG laser.

PubMed

Dionysopoulos, Dimitrios; Strakas, Dimitrios; Tolidis, Kosmas; Tsitrou, Effrosyni; Koumpia, Effimia; Koliniotou-Koumpia, Eugenia

2017-11-01

The purpose of this in vitro study was to compare the effectiveness of a novel Er,Cr:YSGG laser-assisted in-office tooth bleaching method with a conventional method by spectrophotometric analysis of the tooth color change. Furthermore, the influence of the application time of the bleaching gel on the effectiveness of the methods and the maintenance of the results 7 days and 1 month after the treatments were also evaluated. Twenty-four bovine incisors were stained and randomly distributed into four groups. Group 1 specimens received an in-office bleaching treatment with 35% H 2 O 2 for 2 × 15 min. Group 2 specimens received the same treatment but with extended application time (2 × 20 min). In Group 3, the same in-office bleaching procedure (2 × 15 min) was carried out as that in Group 1, using Er,Cr:YSGG laser irradiation for 2 × 15 s on each specimen to catalyze the reaction of H 2 O 2 breakdown. Group 4 specimens received the same bleaching treatment as Group 3 but with extended application time (2 × 20 min). Er,Cr:YSGG laser-assisted tooth bleaching treatment is more effective than the conventional treatment regarding color change of the teeth. Application time of the bleaching agent may influence the effectiveness of the methods. The color change of the tested treatments decreases after 7 days and 1 month. The clinical relevance of this study is that this novel laser-assisted bleaching treatment may be more advantageous in color change and application time compared to the conventional bleaching treatment.

Patency of cavopulmonary connection studied by single phase electron beam computed tomography.

PubMed

Choi, Byoung Wook; Park, Young Hwan; Lee, Jong Kyun; Kim, Dong Joon; Kim, Min Jung; Choe, Kyu Ok

2003-10-01

The shunt patency and anatomic alteration of central PA after cavopulmonary connection was assessed by one phase electron-beam computed tomography (EBCT) METHODS: Thirteen patients that received a bi-directional cavo-pulmonary shunt (BCPS, n = 7) or total cavo-pulmonary connection (TCPC, n = 6) were included. The patency of the shunt and the anatomy of intra-pericardial PA were evaluated by EBCT, and compared by angiography and echocardiography. EBCT accurately evaluated shunt patency and the anatomy of the intra-pericardial PA, except for the incorrect diagnosis of SVC-PA shunt patency and peripheral pulmonary stenosis in two TCPC patients. Both of these patients had bilateral SVC and received either bilateral BCPS or ligation of the left SVC respectively. The baffle between the IVC and PA was partly opacified through a fenestration of the baffle, but was not opacified in two patients without fenestration. EBCT accurately evaluated shunt patency and the anatomy of central PA, however, the accuracy was limited in two cases with bilateral SVC. The opacification of the intra-atrial baffle was insufficient in TCPC cases. Multi-phase CT angiography may overcome this limitation in this patient subset.

Development of a consensus method for culture of Clostridium difficile from meat and its use in a survey of U.S. retail meats.

PubMed

Limbago, Brandi; Thompson, Angela D; Greene, Sharon A; MacCannell, Duncan; MacGowan, Charles E; Jolbitado, Beverly; Hardin, Henrietta D; Estes, Stephanie R; Weese, J Scott; Songer, J Glenn; Gould, L Hannah

2012-12-01

Three previously described methods for culture of Clostridium difficile from meats were evaluated by microbiologists with experience in C. difficile culture and identification. A consensus protocol using BHI broth enrichment followed by ethanol shock and plating to selective and non-selective media was selected for use, and all participating laboratories received hands-on training in the use of this method prior to study initiation. Retail meat products (N = 1755) were cultured for C. difficile over 12 months during 2010-2011 at 9 U.S. FoodNet sites. No C. difficile was recovered, although other clostridia were isolated. Published by Elsevier Ltd.

Development of a consensus method for culture of Clostridium difficile from meat and its use in a survey of U.S. retail meats

PubMed Central

Limbago, Brandi; Thompson, Angela D.; Greene, Sharon A.; MacCannell, Duncan; MacGowan, Charles E.; Jolbitado, Beverly; Hardin, Henrietta D.; Estes, Stephanie R.; Weese, J. Scott; Songer, J. Glenn; Gould, L. Hannah

2017-01-01

Three previously described methods for culture of Clostridium difficile from meats were evaluated by microbiologists with experience in C. difficile culture and identification. A consensus protocol using BHI broth enrichment followed by ethanol shock and plating to selective and non-selective media was selected for use, and all participating laboratories received hands-on training in the use of this method prior to study initiation. Retail meat products (N = 1755) were cultured for C. difficile over 12 months during 2010-2011 at 9 U.S. FoodNet sites. No C. difficile was recovered, although other clostridia were isolated. PMID:22986214

Assessment of patients for treatment with tinnitus retraining therapy.

PubMed

Henry, James A; Jastreboff, Margaret M; Jastreboff, Pawel J; Schechter, Martin A; Fausti, Stephen A

2002-01-01

Clinical management for patients complaining of severe tinnitus has improved dramatically in the last 25 years. During that period of time, various methods of treatment have been introduced and are being used with varying degrees of success. One method that has received considerable attention is tinnitus retraining therapy (TRT). This method is being practiced by hundreds of clinicians worldwide, and retrospective clinical data indicate that TRT has been effective for the majority of patients. This article provides a guide for clinicians to evaluate their patients for treatment with TRT. Included in this guide is the expanded version of the TRT initial interview and specific instructions for the clinician administering the interview.

Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study

PubMed Central

Haguma, Priscilla; Ochom, Emmanuel; Ayakaka, Irene; Mugabe, Frank; Miller, Cecily; Vittinghoff, Eric; Davis, J. Lucian; Handley, Margaret A.; Cattamanchi, Adithya

2015-01-01

Background Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda. Methods We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC): performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks’ duration. Results The performance feedback evaluation included 1,446 adults; 838 (58%) were evaluated during the pre-intervention period and 608 (42%) during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47%) were evaluated during the pre-intervention period and 1,043 (53%) during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10% to +18%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. Conclusions Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries. PMID:26172948

Motor outcome differences between two groups of children with spastic diplegia who received different intensities of early onset physiotherapy followed for 5 years.

PubMed

Kanda, Toyoko; Pidcock, Frank S; Hayakawa, Katumi; Yamori, Yuriko; Shikata, Yuko

2004-03-01

The objective of this study is to determine the clinical effectiveness of early onset long-term intensive physiotherapy on motor development in children with spastic diplegic cerebral palsy (CP). The study was a non-randomized cohort study with 62 months (mean) follow-up. The participants were ten infants who were first examined before 3 months of age corrected for prematurity. All had a gestational age of less than 33 weeks and a birth weight of less than 2000 g. Brain magnetic resonance imaging revealed periventricular white matter injury in nine subjects and moderate grade bilateral porencephaly in one. Five completed a full course of training of 52 months (mean), two did not receive therapy, and three received an insufficient course of therapy. The study was conducted at the Regional Center for Children with Disabilities including outpatient clinics and a school for children with special needs. The Vojta Method was used, which is an extensive family oriented physiotherapy program which uses isometric strengthening of muscles with tactile stimulation. Subjects were evaluated for the highest motor developmental level at the outcome evaluation 59 months (mean) after initiation of therapy. Four of the five who completed training could either stand still for 5 s or walk at the time of the outcome evaluation 52 months after the beginning of the therapy program. None of the five subjects with no training or insufficient training could accomplish this task when evaluated 64 months following therapy initiation. This was a statistically significant difference (P = 0.0278). A consistently applied physiotherapy program resulted in better motor outcomes in this group of children at risk for developing spastic diplegic CP.

Overlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs

PubMed Central

Goldman, Eliot; Offord, David; Costello, Elizabeth J.; Friedman, Robert; Huff, Barbara; Crowe, Maura; Amsel, Lawrence; Bennett, Kathryn; Bird, Hector; Conger, Rand; Fisher, Prudence; Hoagwood, Kimberly; Kessler, Ronald C.; Roberts, Robert

2011-01-01

OBJECTIVE: The US Surgeon General has called for new approaches to close the mental health services gap for the large proportion of US children with significant mental health needs who have not received evaluation or services within the previous 6 to 12 months. In response, investigators sought to develop brief, easily understood, scientifically derived “warning signs” to help parents, teachers, and the lay public to more easily recognize children with unmet mental health needs and bring these children to health care providers' attention for evaluation and possible services. METHOD: Analyses of epidemiologic data sets from >6000 children and parents were conducted to (1) determine the frequency of common but severely impairing symptom profiles, (2) examine symptom profile frequencies according to age and gender, (3) evaluate positive predictive values of symptom profiles relative to Diagnostic and Statistical Manual of Mental Disorders diagnoses, and (4) examine whether children with 1 or more symptom profiles receive mental health services. RESULTS: Symptom-profile frequencies ranged from 0.5% to 2.0%, and 8% of the children had 1 or more symptom profile. Profiles generated moderate-to-high positive predictive values (52.7%–75.4%) for impairing psychiatric diagnoses, but fewer than 25% of children with 1 or more profiles had received services in the previous 6 months. CONCLUSIONS: Scientifically robust symptom profiles that reflect severe but largely untreated mental health problems were identified. Used as “action signs,” these profiles might help increase public awareness about children's mental health needs, facilitate communication and referral for specific children in need of evaluation, and narrow the child mental health services gap. PMID:22025589

Single-Fraction Intraoperative Radiotherapy for Breast Cancer: Early Cosmetic Results

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

Beal, Kathryn; McCormick, Beryl; Zelefsky, Michael J.

2007-09-01

Purpose: To evaluate the cosmetic outcome of patients treated with wide local excision and intraoperative radiotherapy for early-stage breast cancer. Methods and Materials: A total of 50 women were treated on a pilot study to evaluate the feasibility of intraoperative radiotherapy at wide local excision. The eligibility criteria included age >60, tumor size {<=}2.0 cm, clinically negative lymph nodes, and biopsy-established diagnosis. After wide local excision, a custom breast applicator was placed in the excision cavity, and a dose of 20 Gy was prescribed to a depth of 1 cm. After 18 patients were treated, the dose was constrained laterallymore » to 18 Gy. The cosmetic outcome was evaluated by photographs at baseline and at 6 and 12 months postoperatively. Four examiners graded the photographs for symmetry, edema, discoloration, contour, and scarring. The grades were evaluated in relationship to the volume of irradiated tissue, tumor location, and dose at the lateral aspects of the cavity. Results: The median volume of tissue receiving 100% of the prescription dose was 47 cm{sup 3} (range, 20-97 cm{sup 3}). Patients with {<=}47 cm{sup 3} of treated tissue had better cosmetic outcomes than did the women who had >47 cm{sup 3} of treated tissue. Women who had received 18 Gy at the lateral aspects of their cavities had better cosmetic outcomes than did women who had received 20 Gy at the lateral aspects. When comparing the 6- and 12-month results, the scores remained stable for 63%, improved for 17%, and worsened for 20%. Conclusion: Intraoperative radiotherapy appears feasible for selected patients. A favorable cosmetic outcome appears to be related to a smaller treatment volume. The cosmetic outcome is acceptable, although additional follow-up is necessary.« less

An Overview of Virtual Acoustic Simulation of Aircraft Flyover Noise

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.

2013-01-01

Methods for testing human subject response to aircraft flyover noise have greatly advanced in recent years as a result of advances in simulation technology. Capabilities have been developed which now allow subjects to be immersed both visually and aurally in a three-dimensional, virtual environment. While suitable for displaying recorded aircraft noise, the true potential is found when synthesizing aircraft flyover noise because it allows the flexibility and freedom to study sounds from aircraft not yet flown. A virtual acoustic simulation method is described which is built upon prediction-based source noise synthesis, engineering-based propagation modeling, and empirically-based receiver modeling. This source-path-receiver paradigm allows complete control over all aspects of flyover auralization. With this capability, it is now possible to assess human response to flyover noise by systematically evaluating source noise reductions within the context of a system level simulation. Examples of auralized flyover noise and movie clips representative of an immersive aircraft flyover environment are made in the presentation.

Fifteen-second skin icing using a frozen gel pack is effective for reducing goserelin injection pain.

PubMed

Naya, Yoshio; Hagiwara, Nobuhisa; Takeuchi, Ichiro; Mori, Masaru; Inagaki, Akinori; Nakanouchi, Tsuneyuki; Mikami, Kazuya

2014-01-01

The efficacy of skin icing to reduce the pain of goserelin injection has been reported. We investigated the optimal icing time with a frozen gel pack and its effectiveness. Abdominal skin temperatures of 49 healthy volunteers were measured after application of the frozen gel pack for 10, 15 and 30 s, and it was decided that a 15-second icing was adequate. For 55 consecutive patients who received goserelin (10.8 mg) injection, pain was evaluated employing a visual analog scale (VAS). The first injection was administered routinely. A second injection was administered after skin icing in 27 of 55 patients who wanted to try icing. At the time of the third injection, all patient decided whether they were to receive icing or the routine method. After icing, VAS scores decreased in 20 of 27 patients. At the third injection, 18 patients requested icing. When a patient complains of injection pain, the icing method should be considered for pain reduction. 2014 S. Karger AG, Basel.

On the more accurate channel model and positioning based on time-of-arrival for visible light localization

NASA Astrophysics Data System (ADS)

Amini, Changeez; Taherpour, Abbas; Khattab, Tamer; Gazor, Saeed

2017-01-01

This paper presents an improved propagation channel model for the visible light in indoor environments. We employ this model to derive an enhanced positioning algorithm using on the relation between the time-of-arrivals (TOAs) and the distances for two cases either by assuming known or unknown transmitter and receiver vertical distances. We propose two estimators, namely the maximum likelihood estimator and an estimator by employing the method of moments. To have an evaluation basis for these methods, we calculate the Cramer-Rao lower bound (CRLB) for the performance of the estimations. We show that the proposed model and estimations result in a superior performance in positioning when the transmitter and receiver are perfectly synchronized in comparison to the existing state-of-the-art counterparts. Moreover, the corresponding CRLB of the proposed model represents almost about 20 dB reduction in the localization error bound in comparison with the previous model for some practical scenarios.

Accurate Phylogenetic Tree Reconstruction from Quartets: A Heuristic Approach

PubMed Central

Reaz, Rezwana; Bayzid, Md. Shamsuzzoha; Rahman, M. Sohel

2014-01-01

Supertree methods construct trees on a set of taxa (species) combining many smaller trees on the overlapping subsets of the entire set of taxa. A ‘quartet’ is an unrooted tree over taxa, hence the quartet-based supertree methods combine many -taxon unrooted trees into a single and coherent tree over the complete set of taxa. Quartet-based phylogeny reconstruction methods have been receiving considerable attentions in the recent years. An accurate and efficient quartet-based method might be competitive with the current best phylogenetic tree reconstruction methods (such as maximum likelihood or Bayesian MCMC analyses), without being as computationally intensive. In this paper, we present a novel and highly accurate quartet-based phylogenetic tree reconstruction method. We performed an extensive experimental study to evaluate the accuracy and scalability of our approach on both simulated and biological datasets. PMID:25117474

TH-EF-BRA-03: Assessment of Data-Driven Respiratory Motion-Compensation Methods for 4D-CBCT Image Registration and Reconstruction Using Clinical Datasets

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

Riblett, MJ; Weiss, E; Hugo, GD

Purpose: To evaluate the performance of a 4D-CBCT registration and reconstruction method that corrects for respiratory motion and enhances image quality under clinically relevant conditions. Methods: Building on previous work, which tested feasibility of a motion-compensation workflow using image datasets superior to clinical acquisitions, this study assesses workflow performance under clinical conditions in terms of image quality improvement. Evaluated workflows utilized a combination of groupwise deformable image registration (DIR) and image reconstruction. Four-dimensional cone beam CT (4D-CBCT) FDK reconstructions were registered to either mean or respiratory phase reference frame images to model respiratory motion. The resulting 4D transformation was usedmore » to deform projection data during the FDK backprojection operation to create a motion-compensated reconstruction. To simulate clinically realistic conditions, superior quality projection datasets were sampled using a phase-binned striding method. Tissue interface sharpness (TIS) was defined as the slope of a sigmoid curve fit to the lung-diaphragm boundary or to the carina tissue-airway boundary when no diaphragm was discernable. Image quality improvement was assessed in 19 clinical cases by evaluating mitigation of view-aliasing artifacts, tissue interface sharpness recovery, and noise reduction. Results: For clinical datasets, evaluated average TIS recovery relative to base 4D-CBCT reconstructions was observed to be 87% using fixed-frame registration alone; 87% using fixed-frame with motion-compensated reconstruction; 92% using mean-frame registration alone; and 90% using mean-frame with motion-compensated reconstruction. Soft tissue noise was reduced on average by 43% and 44% for the fixed-frame registration and registration with motion-compensation methods, respectively, and by 40% and 42% for the corresponding mean-frame methods. Considerable reductions in view aliasing artifacts were observed for each method. Conclusion: Data-driven groupwise registration and motion-compensated reconstruction have the potential to improve the quality of 4D-CBCT images acquired under clinical conditions. For clinical image datasets, the addition of motion compensation after groupwise registration visibly reduced artifact impact. This work was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA166119. Hugo and Weiss hold a research agreement with Philips Healthcare and license agreement with Varian Medical Systems. Weiss receives royalties from UpToDate. Christensen receives funds from Roger Koch to support research.« less

Spread Spectrum Receiver Electromagnetic Interference (EMI) Test Guide

NASA Technical Reports Server (NTRS)

Wheeler, Mark L.

1998-01-01

This program consisted of: (1) a study to define appropriate EMI test guidelines and test methods for direct sequence (DS) spread spectrum receivers; and (2) preparation of a written test guide to document the recommended test methods. The scope of this test guide includes: (1) a discussion of generic DS receiver performance characteristics; (2) a summary of S-band TDRSS receiver operation; (3) a discussion of DS receiver EMI susceptibility mechanisms and characteristics; (4) a summary of military standard test guidelines; (5) recommended test approach and methods; and (6) general conclusions and recommendations for future studies in the area of spread spectrum receiver testing.

Biogenic carbon in combustible waste: waste composition, variability and measurement uncertainty.

PubMed

Larsen, Anna W; Fuglsang, Karsten; Pedersen, Niels H; Fellner, Johann; Rechberger, Helmut; Astrup, Thomas

2013-10-01

Obtaining accurate data for the contents of biogenic and fossil carbon in thermally-treated waste is essential for determination of the environmental profile of waste technologies. Relations between the variability of waste chemistry and the biogenic and fossil carbon emissions are not well described in the literature. This study addressed the variability of biogenic and fossil carbon in combustible waste received at a municipal solid waste incinerator. Two approaches were compared: (1) radiocarbon dating ((14)C analysis) of carbon dioxide sampled from the flue gas, and (2) mass and energy balance calculations using the balance method. The ability of the two approaches to accurately describe short-term day-to-day variations in carbon emissions, and to which extent these short-term variations could be explained by controlled changes in waste input composition, was evaluated. Finally, the measurement uncertainties related to the two approaches were determined. Two flue gas sampling campaigns at a full-scale waste incinerator were included: one during normal operation and one with controlled waste input. Estimation of carbon contents in the main waste types received was included. Both the (14)C method and the balance method represented promising methods able to provide good quality data for the ratio between biogenic and fossil carbon in waste. The relative uncertainty in the individual experiments was 7-10% (95% confidence interval) for the (14)C method and slightly lower for the balance method.

Turboprop and rotary-wing aircraft flight parameter estimation using both narrow-band and broadband passive acoustic signal-processing methods.

PubMed

Ferguson, B G; Lo, K W

2000-10-01

Flight parameter estimation methods for an airborne acoustic source can be divided into two categories, depending on whether the narrow-band lines or the broadband component of the received signal spectrum is processed to estimate the flight parameters. This paper provides a common framework for the formulation and test of two flight parameter estimation methods: one narrow band, the other broadband. The performances of the two methods are evaluated by applying them to the same acoustic data set, which is recorded by a planar array of passive acoustic sensors during multiple transits of a turboprop fixed-wing aircraft and two types of rotary-wing aircraft. The narrow-band method, which is based on a kinematic model that assumes the source travels in a straight line at constant speed and altitude, requires time-frequency analysis of the acoustic signal received by a single sensor during each aircraft transit. The broadband method is based on the same kinematic model, but requires observing the temporal variation of the differential time of arrival of the acoustic signal at each pair of sensors that comprises the planar array. Generalized cross correlation of each pair of sensor outputs using a cross-spectral phase transform prefilter provides instantaneous estimates of the differential times of arrival of the signal as the acoustic wavefront traverses the array.

Emlen funnel experiments revisited: methods update for studying compass orientation in songbirds.

PubMed

Bianco, Giuseppe; Ilieva, Mihaela; Veibäck, Clas; Öfjäll, Kristoffer; Gadomska, Alicja; Hendeby, Gustaf; Felsberg, Michael; Gustafsson, Fredrik; Åkesson, Susanne

2016-10-01

Migratory songbirds carry an inherited capacity to migrate several thousand kilometers each year crossing continental landmasses and barriers between distant breeding sites and wintering areas. How individual songbirds manage with extreme precision to find their way is still largely unknown. The functional characteristics of biological compasses used by songbird migrants has mainly been investigated by recording the birds directed migratory activity in circular cages, so-called Emlen funnels. This method is 50 years old and has not received major updates over the past decades. The aim of this work was to compare the results from newly developed digital methods with the established manual methods to evaluate songbird migratory activity and orientation in circular cages.We performed orientation experiments using the European robin ( Erithacus rubecula ) using modified Emlen funnels equipped with thermal paper and simultaneously recorded the songbird movements from above. We evaluated and compared the results obtained with five different methods. Two methods have been commonly used in songbirds' orientation experiments; the other three methods were developed for this study and were based either on evaluation of the thermal paper using automated image analysis, or on the analysis of videos recorded during the experiment.The methods used to evaluate scratches produced by the claws of birds on the thermal papers presented some differences compared with the video analyses. These differences were caused mainly by differences in scatter, as any movement of the bird along the sloping walls of the funnel was recorded on the thermal paper, whereas video evaluations allowed us to detect single takeoff attempts by the birds and to consider only this behavior in the orientation analyses. Using computer vision, we were also able to identify and separately evaluate different behaviors that were impossible to record by the thermal paper.The traditional Emlen funnel is still the most used method to investigate compass orientation in songbirds under controlled conditions. However, new numerical image analysis techniques provide a much higher level of detail of songbirds' migratory behavior and will provide an increasing number of possibilities to evaluate and quantify specific behaviors as new algorithms will be developed.

Nuclear medicine and quantitative imaging research (instrumentation and quantitative methods of evaluation)

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

Beck, R.N.; Cooper, M.D.

1990-09-01

This report summarizes goals and accomplishments of the research program supported under DOE Grant No. FG02-86ER60418 entitled Instrumentation and Quantitative Methods of Evaluation, with R. Beck, P. I. and M. Cooper, Co-P.I. during the period January 15, 1990 through September 1, 1990. This program addresses the problems involving the basic science and technology underlying the physical and conceptual tools of radioactive tracer methodology as they relate to the measurement of structural and functional parameters of physiologic importance in health and disease. The principal tool is quantitative radionuclide imaging. The overall objective of this program is to further the development andmore » transfer of radiotracer methodology from basic theory to routine clinical practice in order that individual patients and society as a whole will receive the maximum net benefit from the new knowledge gained. The focus of the research is on the development of new instruments and radiopharmaceuticals, and the evaluation of these through the phase of clinical feasibility. 7 figs.« less

3-D Characterization of Seismic Properties at the Smart Weapons Test Range, YPG

DTIC Science & Technology

2001-10-01

confidence limits around each interpolated value. Ground truth was accomplished through cross-hole seismic measurements and borehole logs. Surface wave... seismic method, as well as estimating the optimal orientation and spacing of the seismic array . A variety of sources and receivers was evaluated...location within the array is partially related to at least two seismic lines. Either through good fortune or foresight by the designers of the SWTR site

The Shock and Vibration Digest. Volume 15, Number 10

DTIC Science & Technology

1983-10-01

tendency to increase. The SMDE spectrum guarantees that the simply supported beam model provides a APLICATIONS OF SRS IN DESIGN conservative design for...Effects on Boron-Aluminum Composites," "The Charpy Impact Test as a Method for --- Masters Thesis (Mar 1974). Evaluating Impact Resistance of Composite...peon rings in responsq to the Impacts received Ph.D. Thesis , Georgia Inst. of Tech., 462 pp (1982) . - from the tool hammer and the workplace. A

Prevalence of Analgesic Prescriptions among Patients with Cancer in Japan: An Analysis of Health Insurance Claims Data

PubMed Central

Higashi, Takahiro; Yoshimoto, Tetsusuke; Matoba, Motohiro

2012-01-01

Objectives: To promote effective management of cancer pain as a nationwide health policy, it is necessary to monitor the performance of health care providers in managing pain in their patients. To plan a system that monitors the performance of pain management, the exact methods of measurement, including the range of target patients, and estimate the resources must be defined. Performance in pain management can be evaluated either in all patients with cancer or restricted to patients with cancer who are already taking analgesics. Restricting the target patient group to patients on analgesics may be more efficient but the extent of that efficiency remains uncertain. Methods: Using insurance claims from eight employer-sponsored insurance companies, we analyzed data from patients (N = 2858) who had received anti-cancer treatment (ie, surgery, chemotherapy, and radiation therapy) for the five major cancers in Japan (ie, breast, colorectal, liver, lung, and stomach cancers). Results: Overall, 22.9% of patients received some kind of analgesic prescription in the course of a month. Lung cancer patients were more likely to be prescribed analgesic prescriptions (any analgesics 34.8%; opioids 18.2%) than patients with the other four cancers. The observed percentage of patients who received analgesic prescriptions over the study period (ie, January 2005 to November 2009) decreased. Conclusion: If we limit the target patient group to patients with cancer already on analgesics, we can reduce the number of persons to be contacted by about three-fourths, compared to assessing pain in all patients with cancer. Although we do not wish to ignore the problem of undetected pain among patients with cancer, beginning our systematic evaluation with patients with cancer already on analgesics may be a realistic option. PMID:23121757

Efficacy of Parenting Education Compared to the Standard Method in Improvement of Reading and Writing Disabilities in Children

PubMed Central

Karahmadi, Mojgan; Shakibayee, Fereshteh; Amirian, Hushang; Bagherian-Sararoudi, Reza; Maracy, Mohammad Reza

2014-01-01

Objective: The present study aimed to evaluate the effect of parenting education on improvement of reading and writing disabilities in children. Methods: A randomized controlled trial was done on primary school students with reading and writing disabilities and their mothers. The subjects were divided into three groups with 26 members in each group. The first group (mothers’ education group) received 6 one-hour new educational sessions. The second group (standard group) received 12-15 standard educational sessions for learning disability, and the third group (control group) which consisted of students with learning disability did not receive any treatments. Research instruments included reading and writing tests, and demographic questionnaire. The three groups were evaluated via pretest and posttests at baseline and after one and three months of educational interventions. Data were analyzed using the chi-square, t-test, and repeated measures multivariate analysis of variance (MANOVA). Results: The mean reading speed had the most progression in the mothers' education group. Comparison among reading speed, reading accuracy, and spelling scores has been statistically significant (F 2, 6 = 90.64;p < 0.001) but the mean of these scores has been insignificant among the three groups (F 2, 67 = 0.583;p > 0.05). The mean reading accuracy, mostly increased after 3-month interventions in the mothers group. The control group had the lowest mean reading accuracy scores. Conclusion: Parenting education in mothers had a positive effect on the treatment of children with reading and writing disabilities. Declaration of interest: None. Clinical Trial Registration-URL: http://www.irct.ir. Unique identifier: IRCT201101205653N1. PMID:24995030

The effect of financial incentives on top of behavioral support on quit rates in tobacco smoking employees: study protocol of a cluster-randomized trial.

PubMed

van den Brand, F A; Nagelhout, G E; Winkens, B; Evers, S M A A; Kotz, D; Chavannes, N H; van Schayck, C P

2016-10-06

Stimulating successful tobacco cessation among employees has multiple benefits. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. Despite the evidence for these benefits of tobacco cessation, a successful method to stimulate employees to quit tobacco is lacking. The aim of this study is to evaluate whether adding a financial incentive to behavioral support (compared with no additional incentive) is effective and cost-effective in increasing abstinence rates in tobacco smoking employees participating in a smoking cessation group training. In this cluster-randomized trial employees in the intervention and control group both participate in a smoking cessation group training consisting of seven weekly counseling sessions of ninety minutes each. In addition to the training, employees in the intervention group receive a voucher as an incentive for being abstinent from smoking at the end of the training (€50), after three months (€50), after six months (€50), and after one year (€200). The control group does not receive any incentive. The primary outcome is carbon monoxide validated 12-month continuous abstinence from smoking (Russel's standard). Additionally, an economic evaluation is performed from a societal and an employer perspective. The present paper describes the methods and design of this cluster-randomized trial in detail. We hypothesize that the financial incentive for abstinence in the form of vouchers increases abstinence rates over and above the group training. The results of this study can provide important recommendations for enhancement of employee tobacco cessation. Dutch Trial Register: NTR5657 . First received 27-01-2016.

Using programme theory to assess the feasibility of delivering micronutrient Sprinkles through a food-assisted maternal and child health and nutrition programme in rural Haiti.

PubMed

Loechl, Cornelia U; Menon, Purnima; Arimond, Mary; Ruel, Marie T; Pelto, Gretel; Habicht, Jean-Pierre; Michaud, Lesly

2009-01-01

This paper uses programme theory to assess, in the context of an effectiveness evaluation, the feasibility and acceptability of distributing micronutrient Sprinkles through a food-assisted maternal and child health and nutrition programme in rural Haiti. We laid out the steps related to programme delivery and household utilization of Sprinkles and used qualitative and quantitative methods to gather data on these steps. Methods included structured observations, checks of beneficiary ration cards, exit interviews, focus group discussions (FGD), individual interviews and survey data from the effectiveness evaluation. Results are as follows: (1) information on use of Sprinkles was provided before mothers first received them, as planned; (2) Sprinkles were re-packaged and distributed as planned and in the appropriate amount; (3) almost all mothers (96%) received two monthly rations of Sprinkles and received timely information on their use; (4) mothers understood instructions about use of Sprinkles and acceptance was high, and no selling of the product was reported or observed; and (5) mothers reported using Sprinkles as instructed, every day (63% in survey; 86% at exit interviews), and for the child only (99%). FGD with staff highlighted the acceptance of the intervention, with a reported 'modest' increase in workload. Within this well-established programme, it proved feasible to distribute Sprinkles and to ensure appropriate use by beneficiary mothers. Existing programme venues were suitable for distributing Sprinkles and educating mothers about their use. Use of programme theory helped to assess feasibility and acceptability of the Sprinkles intervention and provided useful information for programme replication or scale-up.

Interdisciplinary team-based care for patients with chronic pain on long-term opioid treatment in primary care (PPACT) – Protocol for a pragmatic cluster randomized trial

PubMed Central

DeBar, Lynn; Benes, Lindsay; Bonifay, Allison; Deyo, Richard A.; Elder, Charles R.; Keefe, Francis J.; Leo, Michael C.; McMullen, Carmit; Mayhew, Meghan; Owen-Smith, Ashli; Smith, David H.; Trinacty, Connie M.; Vollmer, William M.

2018-01-01

Background Chronic pain is one of the most common, disabling, and expensive public health problems in the United States. Interdisciplinary pain management treatments that employ behavioral approaches have been successful in helping patients with chronic pain reduce symptoms and regain functioning. However, most patients lack access to such treatments. We are conducting a pragmatic clinical trial to test the hypothesis that patients who receive an interdisciplinary biopsychosocial intervention, the Pain Program for Active Coping and Training (PPACT), at their primary care clinic will have a greater reduction in pain impact in the year following than patients receiving usual care. Methods/design This is an effectiveness-implementation hybrid pragmatic clinical trial in which we randomize clusters of primary care providers and their patients with chronic pain who are on long-term opioid therapy to 1) receive an interdisciplinary behavioral intervention in conjunction with their current health care or 2) continue with current health care services. Our primary outcome is pain impact (a composite of pain intensity and pain-related interference) measured using the PEG, a validated three-item assessment. Secondary outcomes include pain-related disability, patient satisfaction, opioids dispensed and health care utilization. An economic evaluation assesses the resources and costs necessary to deliver the intervention and its cost-effectiveness compared with usual care. A formative evaluation employs mixed methods to understand the context for implementation in the participating health care systems. Discussion This trial will inform the feasibility of implementing interdisciplinary behavioral approaches to pain management in the primary care setting, potentially providing a more effective, safer, and more satisfactory alternative to opioid-based chronic pain treatment. Clinical Trials Registration Number: NCT02113592 PMID:29522897

Telephone Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Non-inferiority Trial

PubMed Central

Turner, Cynthia M.; Mataix-Cols, David; Lovell, Karina; Krebs, Georgina; Lang, Katie; Byford, Sarah; Heyman, Isobel

2014-01-01

Objective Many adolescents with obsessive-compulsive disorder (OCD) do not have access to evidence-based treatment. A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy (TCBT) for adolescents with OCD compared to standard clinic-based, face-to-face CBT. Method Seventy-two adolescents, aged 11 through 18 years with primary OCD, and their parents were randomized to receive specialist TCBT or CBT. The intervention provided differed only in the method of treatment delivery. All participants received up to 14 sessions of CBT, incorporating exposure with response prevention (E/RP), provided by experienced therapists. The primary outcome measure was the Children’s Yale–Brown Obsessive-Compulsive Scale (CY-BOCS). Blind assessor ratings were obtained at midtreatment, posttreatment, 3-month, 6-month, and 12-month follow-up. Results Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment, 3-month, and 6-month follow-up. At 12-month follow-up, there were no significant between-group differences on the CY-BOCS, but the confidence intervals exceeded the non-inferiority threshold. All secondary measures confirmed non-inferiority at all assessment points. Improvements made during treatment were maintained through to 12-month follow-up. Participants in each condition reported high levels of satisfaction with the intervention received. Conclusion TCBT is an effective treatment and is not inferior to standard clinic-based CBT, at least in the midterm. This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD. Clinical trial registration information–Evaluation of telephone-administered cognitive-behaviour therapy (CBT) for young people with obsessive-compulsive disorder (OCD); http://www.controlled-trials.com; ISRCTN27070832. PMID:25457928

Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell's palsy: a comparative study.

PubMed

Huang, Bin; Zhou, Zhang-ling; Wang, Li-li; Zuo, Cong; Lu, Yan; Chen, Yong

2014-07-01

There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell's palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell's palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell's palsy. The facial nerve function of 68 patients with Bell's palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to find the relationship between electrical response and therapeutic effects or prognosis. Checking consistency between electrical response grading and House-Brackmann scale: Kappa value 0.028 (P = 0.578). Correlation analysis: the two methods were correlated with the prognosis, and electrical response grading (rER = 0.789) was better than the House-Brackmann scale (rHB = 0.423). Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.

Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice

PubMed Central

Yen, Chu-Yu; Tseng, Gow-Lieng

2018-01-01

Abstract Rationale: Penetrating astigmatic keratotomy (penetrating AK) is a well-known method to correct corneal astigmatism but rarely be performed nowadays. This article reevaluated the clinical effectiveness and confounding factors of penetrating AK. Patient concerns: Penetrating AK has been introduced to serve as one alternative operation for astigmatism correction, and is thought to have the potential advantage of being more affordable and easy to perform. The purpose of our study is to evaluate the effectiveness and confounding factors of penetrating AK. Diagnoses: The chart of 95 patients with corneal astigmatism (range: 0.75–3.25 diopters [D]) who received penetrating AK from January 2014 to December 2016 was collected. The corneal astigmatism were measured by an autokeratometer (Topcon KR8100PA topographer-autorefractor), and repeated with manual keratometer in low reproducibility cases. Interventions: All patients received penetrating AK by an experienced ophthalmologist (Dr. Gow-Lieng Tseng, MD, PHD) in the operation room. Among which, 66 patients received penetrating AK with phacoemulsification simultaneously (group A), whereas 29 patients received penetrating AK at least 3 months after phacoemulsification (group B). After excluding the patients combined with other procedures or lost followed up, 79 patients are remaining for analysis. The outcome was evaluated by net correction, the difference between preoperative corneal astigmatism (PCA) and residual corneal astigmatism (RCA). Two sample t tests and Pearson test were used for effectiveness evaluation. For confounding factors, multivariate linear regression was used for statistical analysis. Outcomes: The mean preoperative and postoperative refractive cylinders were 1.97 ± 0.77 and 1.08 ± 0.64 D, respectively, in group A and 2.62 ± 1.05 and 1.51 ± 0.89 D in group B. There were no statistically significant differences in net correction between these two groups (0.9 ± 0.66 vs. 1.1 ± 0.69, P = .214). Higher PCA were associated with higher net correction in both group A (P = .002) and group B (P = .019). Compound myopic astigmatism caused less net correction than others only in group A (P = 0.031). Lessons: Penetrating AK is an accessible, affordable, and effective way to correct corneal astigmatism. The results of this procedure are comparable to modern methods in patients with low to moderate corneal astigmatism. PMID:29369200

New method of scoliosis assessment: preliminary results using computerized photogrammetry.

PubMed

Aroeira, Rozilene Maria Cota; Leal, Jefferson Soares; de Melo Pertence, Antônio Eustáquio

2011-09-01

A new method for nonradiographic evaluation of scoliosis was independently compared with the Cobb radiographic method, for the quantification of scoliotic curvature. To develop a protocol for computerized photogrammetry, as a nonradiographic method, for the quantification of scoliosis, and to mathematically relate this proposed method with the Cobb radiographic method. Repeated exposure to radiation of children can be harmful to their health. Nevertheless, no nonradiographic method until now proposed has gained popularity as a routine method for evaluation, mainly due to a low correspondence to the Cobb radiographic method. Patients undergoing standing posteroanterior full-length spine radiographs, who were willing to participate in this study, were submitted to dorsal digital photography in the orthostatic position with special surface markers over the spinous process, specifically the vertebrae C7 to L5. The radiographic and photographic images were sent separately for independent analysis to two examiners, trained in quantification of scoliosis for the types of images received. The scoliosis curvature angles obtained through computerized photogrammetry (the new method) were compared to those obtained through the Cobb radiographic method. Sixteen individuals were evaluated (14 female and 2 male). All presented idiopathic scoliosis, and were between 21.4 ± 6.1 years of age; 52.9 ± 5.8 kg in weight; 1.63 ± 0.05 m in height, with a body mass index of 19.8 ± 0.2. There was no statistically significant difference between the scoliosis angle measurements obtained in the comparative analysis of both methods, and a mathematical relationship was formulated between both methods. The preliminary results presented demonstrate equivalence between the two methods. More studies are needed to firmly assess the potential of this new method as a coadjuvant tool in the routine following of scoliosis treatment.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.

PubMed

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-03-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Text Messaging (SMS) Helping Cancer Care in Patients Undergoing Chemotherapy Treatment: a Pilot Study.

PubMed

Rico, Timóteo Matthies; Dos Santos Machado, Karina; Fernandes, Vanessa Pellegrini; Madruga, Samanta Winck; Noguez, Patrícia Tuerlinckx; Barcelos, Camila Rose Guadalupe; Santin, Mateus Madail; Petrarca, Cristiane Rios; Dumith, Samuel Carvalho

2017-10-09

Cancer treatment is an extremely stressful life experience that is accompanied by a range of psychological, social, physical, and practical difficulties. Cancer patients need to receive information that helps them to better understand the disease, assists them in decision-making, and helps them deal with treatment. Patients are interested in receiving such information. The degree of satisfaction with the information received has been associated with positive health outcomes, specifically regarding quality of life, severity of side effects, and psychological well-being. This study investigates a method of guiding cancer patients, in relation to outpatient chemotherapy treatment, using SMS (short message service) text messaging. A smartphone application called cHEmotHErApp was developed, and its primary function is to send out SMS text messages with guidance for self-care and emotional support for oncology patients undergoing chemotherapy. Thus, the main objective of this study is to evaluate the acceptance and perception of patients of the receipt of these SMS messages, as well as to evaluate the possible benefits reported by the participants. Adult patients diagnosed with cancer, who started the first outpatient chemotherapy treatment scheme between August and November 2016 at the School Hospital (HE) of the Federal University of Pelotas (UFPel), were invited to participate in this pilot study. In total, 14 cancer patients were adherent to this study. Each of these patients received a daily text message on their cell phone with some guidance on encouraging self-care and emotional support. Patients reported that, because of the SMS text messages they received, they felt more confident in their treatment, felt more supported and encouraged, and that the text messages facilitated self-care. In addition, patients reported that the SMS text messages they received helped them to take better care of themselves and to continue further treatment.

An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina.

PubMed Central

Buescher, P A; Roth, M S; Williams, D; Goforth, C M

1991-01-01

BACKGROUND. Care coordination is an important component of the enhanced prenatal care services provided under the recent expansions of the Medicaid program. The effect of maternity care coordination services on birth outcomes in North Carolina was assessed by comparing women on Medicaid who did and did not receive these services. METHODS. Health program data files, including Medicaid claims paid for maternity care coordination, were linked to 1988 and 1989 live birth certificates. Simple comparisons of percentages and rates were supplemented by a logistic regression analysis. RESULTS. Among women on Medicaid who did not receive maternity care coordination services, the low birth weight rate was 21% higher, the very low birth weight rate was 62% higher, and the infant mortality rate was 23% higher than among women on Medicaid who did receive such services. It was estimated that, for each $1.00 spent on maternity care coordination, Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among the women who did receive maternity care coordination, those receiving it for 3 or more months had better outcomes than those receiving it for less than 3 months. CONCLUSIONS: These results suggest that maternity care coordination can be effective in reducing low birth weight, infant mortality, and newborn medical care costs among babies born to women in poverty. PMID:1746659

Who receives a medical evaluation for infertility in the United States?

PubMed

Farland, Leslie V; Collier, Ai-Ris Y; Correia, Katharine F; Grodstein, Francine; Chavarro, Jorge E; Rich-Edwards, Janet; Missmer, Stacey A

2016-05-01

To investigate characteristics of receiving a medical evaluation for infertility among infertile women. Prospective cohort. Academic institution. A total of 7,422 women who reported incident infertility between 1989 and 2009 in the Nurses' Health Study II. None. Report of receiving a medical evaluation for infertility. Approximately 65% of women who reported infertility had a medical evaluation for infertility. Infertile women who were parous (relative risk [RR] = 0.81, 95% confidence interval [CI] 0.78-0.84), older, current smokers (RR = 0.89, 95% CI 0.83-0.96), or who had a higher body mass index (BMI) were less likely to report receiving a medical infertility evaluation. Infertile women who exercised frequently, took multivitamins (RR = 1.03, 95% CI 1.00-1.07), lived in states with comprehensive insurance coverage (RR = 1.09, 95% CI 1.00-1.19), had a high household income, or who had a recent physical examination (RR = 1.15, 95% CI 1.06-1.24) were more likely to report receiving a medical infertility evaluation. These findings highlight demographic, lifestyle, and access barriers to receiving medical infertility care. Historically, the discussion of barriers to infertility care has centered on financial access, geographic access, and socioeconomic status. Our findings build off literature by supporting previously reported associations and showcasing the importance of demographic and lifestyle factors in accessing care. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Who receives a medical evaluation for infertility in the United States?

PubMed Central

Farland, Leslie V; Collier, Ai-ris Y; Correia, Katharine F; Grodstein, Francine; Chavarro, Jorge E; Rich-Edwards, Janet; Missmer, Stacey A

2015-01-01

Objective To investigate characteristics of receiving a medical evaluation for infertility among infertile women Design Prospective Cohort Setting Academic Institution Patients Seven thousand four-hundred and twenty two women who reported incident infertility between 1989 and 2009 in the Nurses’ Health Study II. Intervention None Main Outcome Measures Report of receiving a medical evaluation for infertility Results Approximately 65% of women who reported infertility had a medical evaluation for infertility. Infertile women who were parous (RR:0.81, CI:0.78, 0.84), older (P-value, test for linear trend:<0.001), current smokers (RR:0.89, CI:0.83, 0.96), or who had a higher body mass index (BMI)(P-value: 0.01) were less likely to report receiving a medical infertility evaluation. Infertile women who exercised frequently (P-value: 0.04), took multivitamins (RR: 1.03, CI:1.00, 1.07), lived in states with comprehensive insurance coverage (RR:1.09, CI:1.00, 1.19), had a high household income (P-value: 0.05), or who had a recent physical exam (RR:1.15, CI:1.06, 1.24) were more likely to report receiving a medical infertility evaluation. Conclusions These findings highlight demographic, lifestyle, and access barriers to receiving medical infertility care. Historically, the discussion of barriers to infertility care has centered on financial access, geographic access, and socioeconomic status. Our findings build off previous literature by supporting previously reported associations and showcasing the importance of demographic and lifestyle factors in accessing care. PMID:26785253

Apertured averaged scintillation of fully and partially coherent Gaussian, annular Gaussian, flat toped and dark hollow beams

NASA Astrophysics Data System (ADS)

Eyyuboğlu, Halil T.

2015-03-01

Apertured averaged scintillation requires the evaluation of rather complicated irradiance covariance function. Here we develop a much simpler numerical method based on our earlier introduced semi-analytic approach. Using this method, we calculate aperture averaged scintillation of fully and partially coherent Gaussian, annular Gaussian flat topped and dark hollow beams. For comparison, the principles of equal source beam power and normalizing the aperture averaged scintillation with respect to received power are applied. Our results indicate that for fully coherent beams, upon adjusting the aperture sizes to capture 10 and 20% of the equal source power, Gaussian beam needs the largest aperture opening, yielding the lowest aperture average scintillation, whilst the opposite occurs for annular Gaussian and dark hollow beams. When assessed on the basis of received power normalized aperture averaged scintillation, fixed propagation distance and aperture size, annular Gaussian and dark hollow beams seem to have the lowest scintillation. Just like the case of point-like scintillation, partially coherent beams will offer less aperture averaged scintillation in comparison to fully coherent beams. But this performance improvement relies on larger aperture openings. Upon normalizing the aperture averaged scintillation with respect to received power, fully coherent beams become more advantageous than partially coherent ones.

Vibration anesthesia for the reduction of pain with facial dermal filler injections.

PubMed

Mally, Pooja; Czyz, Craig N; Chan, Norman J; Wulc, Allan E

2014-04-01

Vibration anesthesia is an effective pain-reduction technique for facial cosmetic injections. The analgesic effect of this method was tested in this study during facial dermal filler injections. The study aimed to evaluate the safety and efficacy of vibration anesthesia for these facial injections. This prospective study analyzed 41 patients who received dermal filler injections to the nasolabial folds, tear troughs, cheeks, and other facial sites. The injections were administered in a randomly assigned split-face design. One side of the patient's face received vibration together with dermal filler injections, whereas the other side received dermal filler injections alone. The patients completed a posttreatment questionnaire pertaining to injection pain, adverse effects, and preference for vibration with future dermal filler injections. The patients experienced both clinically and statistically significant pain reduction when a vibration stimulus was co-administered with the dermal filler injections. No adverse events were reported. The majority of the patients (95 %) reported a preference for vibration anesthesia with subsequent dermal filler injections. Vibration is a safe and effective method of achieving anesthesia during facial dermal filler injections. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Spoofing Detection Using GNSS/INS/Odometer Coupling for Vehicular Navigation

PubMed Central

Broumandan, Ali; Lachapelle, Gérard

2018-01-01

Location information is one of the most vital information required to achieve intelligent and context-aware capability for various applications such as driverless cars. However, related security and privacy threats are a major holdback. With increasing focus on using Global Navigation Satellite Systems (GNSS) for autonomous navigation and related applications, it is important to provide robust navigation solutions, yet signal spoofing for illegal or covert transportation and misleading receiver timing is increasing and now frequent. Hence, detection and mitigation of spoofing attacks has become an important topic. Several contributions on spoofing detection have been made, focusing on different layers of a GNSS receiver. This paper focuses on spoofing detection utilizing self-contained sensors, namely inertial measurement units (IMUs) and vehicle odometer outputs. A spoofing detection approach based on a consistency check between GNSS and IMU/odometer mechanization is proposed. To detect a spoofing attack, the method analyses GNSS and IMU/odometer measurements independently during a pre-selected observation window and cross checks the solutions provided by GNSS and inertial navigation solution (INS)/odometer mechanization. The performance of the proposed method is verified in real vehicular environments. Mean spoofing detection time and detection performance in terms of receiver operation characteristics (ROC) in sub-urban and dense urban environments are evaluated. PMID:29695064

Spoofing Detection Using GNSS/INS/Odometer Coupling for Vehicular Navigation.

PubMed

Broumandan, Ali; Lachapelle, Gérard

2018-04-24

Location information is one of the most vital information required to achieve intelligent and context-aware capability for various applications such as driverless cars. However, related security and privacy threats are a major holdback. With increasing focus on using Global Navigation Satellite Systems (GNSS) for autonomous navigation and related applications, it is important to provide robust navigation solutions, yet signal spoofing for illegal or covert transportation and misleading receiver timing is increasing and now frequent. Hence, detection and mitigation of spoofing attacks has become an important topic. Several contributions on spoofing detection have been made, focusing on different layers of a GNSS receiver. This paper focuses on spoofing detection utilizing self-contained sensors, namely inertial measurement units (IMUs) and vehicle odometer outputs. A spoofing detection approach based on a consistency check between GNSS and IMU/odometer mechanization is proposed. To detect a spoofing attack, the method analyses GNSS and IMU/odometer measurements independently during a pre-selected observation window and cross checks the solutions provided by GNSS and inertial navigation solution (INS)/odometer mechanization. The performance of the proposed method is verified in real vehicular environments. Mean spoofing detection time and detection performance in terms of receiver operation characteristics (ROC) in sub-urban and dense urban environments are evaluated.

Assessment of the use of latissimus dorsi restoration during modified radical mastectomy in breast cancer patients

PubMed Central

Yang, Chao; Wang, Xinle; Zhang, Geng; Yang, Liu; Guo, Xuan; Wang, Xue; Song, Zhenchuan

2017-01-01

The incision area of modified radical mastectomy in breast cancer patients is associated with subcutaneous effusion and skin flap necrosis as the most common complications. The aim of the present study was to assess the effect of latissimus dorsi restoration during modified radical mastectomy in breast cancer patients by evaluating 365 cases. Among these cases, 185 received modified radical mastectomy combined with intraoperative latissimus dorsi restoration, while 180 received modified radical mastectomy alone. The flap tension, drainage fluid amount and extubation time were compared between the two methods. The flap tension in patients who received modified radical mastectomy combined with intraoperative latissimus dorsi restoration was significantly lower and the blood supply was better. After surgery, the drainage fluid amount was also significantly lower in these patients compared with the control group. Furthermore, the mean time to drainage tube removal was significantly shorter in these patients and the postoperative cosmetic outcome was superior. Thus, it was concluded that modified radical mastectomy combined with intraoperative latissimus dorsi restoration in breast cancer patients was associated with reduced drainage fluid effusion, shorter hospitalization time and decreased flap tension. Overall, this method appears to be potentially suitable for extensive application in the clinical setting. PMID:29285380

Pharmacokinetics of terbinafine in little brown myotis (Myotis lucifugus) infected with Pseudogymnoascus destructans.

PubMed

Court, Michael H; Robbins, Alison H; Whitford, Anne M; Beck, Erika V; Tseng, Flo S; Reeder, DeeAnn M

2017-01-01

OBJECTIVE To determine the pharmacokinetics of terbinafine in little brown myotis (Myotis lucifugus) infected with Pseudogymnoascus destructans. ANIMALS 123 bats from a P destructans-infected hibernation site in Virginia. PROCEDURES 3 bats were euthanized and necropsied to confirm the presence of P destructans within the population. The remaining 120 bats were systematically assigned to 6 groups (20 bats/group). Bats in each of 3 groups received 6, 20, or 60 mg of terbinafine/kg, SC, once daily for 10 days. Bats in another group received 200 mg of terbinafine/kg, SC, once daily for 5 days. Bats in 1 group received the terbinafine vehicle solution (0.1 mL/kg, SC, once daily for 10 days). Bats in the remaining group did not receive any treatment. Following the treatment period (days 1 through 10), bats were housed in a hibernation chamber and monitored daily until euthanasia on day 42, 75, or 109. Tissue specimens were collected from all bats as soon as possible after death or euthanasia to determine terbinafine concentration. Within each group and tissue type, terbinafine concentration data were pooled, and pharmacokinetic parameters were calculated by noncompartmental methods. RESULTS Adverse neurologic effects and a high mortality rate before day 10 were observed in bats that received the highest terbinafine dose (200 mg/kg) but not those that received lower doses. Presumed therapeutic terbinafine concentrations (≥ 2 μg/g) were maintained in skin and wing for at least 30 and 6 days in bats that received the 60 and 20 mg/kg doses, respectively, but were not achieved in most bats that received the 6 mg/kg dose. Tissue terminal half-life ranged from 14 to 22 days. Terbinafine concentration in hair was positively correlated with that in skin and wing. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated terbinafine doses > 6 but < 200 mg/kg should be further evaluated for the treatment of P destructans-infected bats. Collection of serial hair specimens may represent a noninvasive method for monitoring terbinafine concentration in treated bats.

Anti-hypertensive treatment prolongs tPA door-to-treatment time: Secondary analysis of the INSTINCT trial.

PubMed Central

Skolarus, Lesli E.; Scott, Phillip A.; Burke, James F.; Adelman, Eric E.; Frederiksen, Shirley M.; Kade, Allison M.; Kalbfleisch, Jack D.; Ford, Andria L.; Meurer, William J.

2012-01-01

Background/Purpose Identifying modifiable tPA treatment delays may improve stroke outcomes. We hypothesized that pre-thrombolytic anti-hypertensive treatment (AHT) may prolong door-to-treatment time (DTT). Methods Analysis of consecutive tPA-treated patients at 24 randomly selected community hospitals in the INSTINCT trial between 2007-2010. DTTs among stroke patients who received pre-thrombolytic AHT were compared to those that did not receive pre-thrombolytic AHT. We then calculated a propensity score for the probability of receiving pre-thrombolytic AHT using logistic regression with demographics, stroke risk factors, home medications, stroke severity (NIHSS), onset-to-door time, admission glucose, pretreatment blood pressure, EMS transport and location at time of stroke as independent variables. A paired t-test was performed to compare the DTTs between the propensity matched groups. Results Of 534 tPA treated stroke patients analyzed, 95 received pre-thrombolytic AHT. In the unmatched cohort, patients who received pre-thrombolytic AHT had a longer DTT (mean increase 9 minutes; 95% confidence interval (CI) 2-16 minutes) than patients who did not. After propensity matching, patients who received pre-thrombolytic AHT had a longer DTT (mean increase 10.4 minutes, 95% CI 1.9 - 18.8) than patients who did not receive pre-thrombolytic AHT. Conclusion Pre-thrombolytic AHT is associated with modest delays in DTT. This represents a potential target for quality improvement initiatives. Further research evaluating optimum pre-thrombolytic hypertension management is warranted. PMID:23033348

Internet cigarette vendor compliance with credit card payment and shipping bans.

PubMed

Williams, Rebecca S; Ribisl, Kurt M

2014-02-01

Most Internet cigarette sales have violated taxation and youth access laws, leading to landmark 2005 agreements with credit card companies, PayPal, and private shippers (United Parcel Service, Federal Express, DHL) to cease participation in these transactions. Despite their promise at the time, loopholes allowed for check payment and U.S. Postal Service (USPS) shipping. This study assessed actual vendor compliance with the payment and shipping bans using a purchase survey. In late 2007 and early 2008, an adult buyer attempted to order cigarettes from the 97 most popular Internet cigarette vendors (ICVs) using banned payment and shipping methods. When banned payment or shipping methods were unavailable, purchases were attempted with alternate methods (e.g., checks, e-checks, USPS). Twenty-seven of 100 orders were placed with (banned) credit cards; 23 were successfully received. Seventy-one orders were placed with checks (60 successfully received). Four orders were delivered using banned shippers; 79 of 83 successfully received orders were delivered by the USPS. About a quarter of ICVs violated the payment ban, others adapted by accepting checks. Most vendors complied with the shipping ban, perhaps because USPS was an easy substitute shipping option. Better enforcement of the bans is needed; the 2009 Prevent All Cigarette Trafficking Act closed the USPS loophole by making cigarettes nonmailable material; evaluation of enforcement efforts and adaptations by vendors are needed. These sorts of bans are a promising approach to controlling the sale of restricted goods online.

Cement bond evaluation method in horizontal wells using segmented bond tool

NASA Astrophysics Data System (ADS)

Song, Ruolong; He, Li

2018-06-01

Most of the existing cement evaluation technologies suffer from tool eccentralization due to gravity in highly deviated wells and horizontal wells. This paper proposes a correction method to lessen the effects of tool eccentralization on evaluation results of cement bond using segmented bond tool, which has an omnidirectional sonic transmitter and eight segmented receivers evenly arranged around the tool 2 ft from the transmitter. Using 3-D finite difference parallel numerical simulation method, we investigate the logging responses of centred and eccentred segmented bond tool in a variety of bond conditions. From the numerical results, we find that the tool eccentricity and channel azimuth can be estimated from measured sector amplitude. The average of the sector amplitude when the tool is eccentred can be corrected to the one when the tool is centred. Then the corrected amplitude will be used to calculate the channel size. The proposed method is applied to both synthetic and field data. For synthetic data, it turns out that this method can estimate the tool eccentricity with small error and the bond map is improved after correction. For field data, the tool eccentricity has a good agreement with the measured well deviation angle. Though this method still suffers from the low accuracy of calculating channel azimuth, the credibility of corrected bond map is improved especially in horizontal wells. It gives us a choice to evaluate the bond condition for horizontal wells using existing logging tool. The numerical results in this paper can provide aids for understanding measurements of segmented tool in both vertical and horizontal wells.

Rationale, design and methods for process evaluation in the HEALTHY study.

PubMed

Schneider, M; Hall, W J; Hernandez, A E; Hindes, K; Montez, G; Pham, T; Rosen, L; Sleigh, A; Thompson, D; Volpe, S L; Zeveloff, A; Steckler, A

2009-08-01

The HEALTHY study was a multi-site randomized trial designed to determine whether a 3-year school-based intervention targeting nutrition and physical activity behaviors could effectively reduce risk factors associated with type 2 diabetes in middle school children. Pilot and formative studies were conducted to inform the development of the intervention components and the process evaluation methods for the main trial. During the main trial, both qualitative and quantitative assessments monitored the fidelity of the intervention and motivated modifications to improve intervention delivery. Structured observations of physical education classes, total school food environments, classroom-based educational modules, and communications and promotional campaigns provided verification that the intervention was delivered as intended. Interviews and focus groups yielded a multidimensional assessment of how the intervention was delivered and received, as well as identifying the barriers to and facilitators of the intervention across and within participating schools. Interim summaries of process evaluation data were presented to the study group as a means of ensuring standardization and quality of the intervention across the seven participating centers. Process evaluation methods and procedures documented the fidelity with which the HEALTHY study was implemented across 21 intervention schools and identified ways in which the intervention delivery might be enhanced throughout the study.

‘Health and happiness is more important than weight’: a qualitative investigation of the views of parents receiving written feedback on their child's weight as part of the National Child Measurement Programme

PubMed Central

Syrad, H; Falconer, C; Cooke, L; Saxena, S; Kessel, A S; Viner, R; Kinra, S; Wardle, J; Croker, H

2015-01-01

Background The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback. Methods Fifty-two parents of overweight and obese children aged 4–5 years and 10–11 years enrolled in the NCMP programme in England in 2010–2011 participated in qualitative, semi-structured interviews about their perceptions of their child's weight and health risk after receiving weight feedback. Interviews were audio tape recorded and were conducted either by telephone (n = 9) or in the respondents’ homes (n = 41). Interviews were transcribed verbatim and analysed using interpretative thematic analysis. Results Parents who received NCMP written feedback informing them that their child was overweight disregarded the results because they viewed ‘health and happiness as being more important than weight’. The feedback was viewed as less credible because it did not consider the individual child's lifestyle. ‘Broad definitions of healthy’ were described that did not include weight, such as reference to the child having good emotional and physical health and a healthy diet. Parents attributed weight to ‘inherited/acquired factors’ such as genetics or puppy fat, or did not regard their child's ‘appearance’ as reflecting being overweight. ‘Cultural influence’ also meant that being overweight was not viewed negatively by some non-white parents. Conclusions After receiving written weight feedback, parents use methods other than actual weight when evaluating their child's weight status and health risks. Parents’ conceptions of health and weight should be considered when communicating with parents, with the aim of bridging the gap between parental recognition of being overweight and subsequent behaviour change. PMID:26295077

Short-term overlap lamivudine treatment with adefovir dipivoxil in patients with lamivudine-resistant chronic hepatitis B

PubMed Central

Nam, Soon Woo; Bae, Si Hyun; Lee, Seung Woo; Kim, Yeon Soo; Kang, Sang Bum; Choi, Jong Young; Cho, Se Hyun; Yoon, Seung Kew; Han, Joon-Yeol; Yang, Jin Mo; Lee, Young Suk

2008-01-01

AIM: To evaluate the efficacy of short-term overlap lamivudine therapy with adefovir in patients with lamivudine-resistant and naïve chronic hepatitis B, we compared patients receiving overlap therapy with those receiving adefovir alone. METHODS: Eighty patients who had received lamivudine treatment for various periods and had a lamivudine-resistant liver function abnormality were enrolled. Forty of these patients received adefovir treatment combined with lamivudine treatment for ≥ 2 mo, while the other 40 received adefovir alone. We assessed the levels of hepatitis B virus (HBV) DNA at 0, 12 and 48 wk and serum alanine aminotransferase (ALT) levels after 0, 12, 24 and 48 wk of adefovir treatment in each group. RESULTS: We found serum ALT became normalized in 72 (87.5%) of the 80 patients, and HBV DNA decreased by ≥ 2 log10 copies/mL in 60 (75%) of the 80 patients at the end of a 48-wk treatment. HBV DNA levels were not significantly different between the groups. The improvements in serum ALT were also not significantly different between the two groups. CONCLUSION: These findings suggest short-term overlap lamivudine treatment results in no better virological and biological outcomes than non-overlap adefovir monotherapy. PMID:18350610

Administration of Intravenous Inf liximab for Prevention of Peritoneal Adhesions Formation in Rats.

PubMed

Nikeghbalian, Saman; Vafaei, Homeira; Moradian, Farid; Kazemi, Kourosh; Tanideh, Nader; Shayan, Leila; Nikeghbalian, Zahra

2015-07-01

To investigate the effects of intravenous infliximab in preventing the formation of peritoneal adhesions in an animal model of rat. This was an experimental study being performed in animal laboratory of Shiraz University of Medical Sciences during 2012. Sixty albino rats were randomly assigned in to three groups by Random Design Method. The first group received single infliximab injection (n=20), the second one received double infliximab injection (n=20) and the third received nothing (n=20), after receiving intra-peritoneal injection of talc for induction of peritoneal adhesions. All the animals were sacrificed after 6 weeks and the peritoneal adhesions were evaluated according to Nair classification. We observed that the mean adhesion grade was lower in those who received double dose of infliximib when compared to single dose and controls. However the difference did not reach a significant value (p=0.178). The grade of peritoneal adhesion was also comparable between the three study groups (p=0.103). The mean number of 1st WBC count was also comparable between three study groups (p=0.382). We observed that 2nd WBC count was also comparable between two study groups (p=0.317). Administration of intravenous infliximab after intraabdominal surgicalprocedures would not prevent the formation of peritoneal adhesions in animal model of albino rat.

Integration of Monte-Carlo ray tracing with a stochastic optimisation method: application to the design of solar receiver geometry.

PubMed

Asselineau, Charles-Alexis; Zapata, Jose; Pye, John

2015-06-01

A stochastic optimisation method adapted to illumination and radiative heat transfer problems involving Monte-Carlo ray-tracing is presented. A solar receiver shape optimisation case study illustrates the advantages of the method and its potential: efficient receivers are identified using a moderate computational cost.

Operational adaptability evaluation index system of pumped storage in UHV receiving-end grids

NASA Astrophysics Data System (ADS)

Yuan, Bo; Zong, Jin; Feng, Junshu

2017-01-01

Pumped storage is an effective solution to deal with the emergency reserve shortage, renewable energy accommodating and peak-shaving problems in ultra-high voltage (UHV) transmission receiving-end grids. However, governments and public opinion in China tend to evaluate the operational effectiveness of pumped storage using annual utilization hour, which may result in unreasonable and unnecessary dispatch of pumped storage. This paper built an operational adaptability evaluation index system for pumped storage in UHV-receiving end grids from three aspects: security insurance, peak-shaving and renewable energy accommodating, which can provide a comprehensive and objective way to evaluate the operational performance of a pumped storage station.

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

Methods for assessing fracture risk prediction models: experience with FRAX in a large integrated health care delivery system.

PubMed

Pressman, Alice R; Lo, Joan C; Chandra, Malini; Ettinger, Bruce

2011-01-01

Area under the receiver operating characteristics (AUROC) curve is often used to evaluate risk models. However, reclassification tests provide an alternative assessment of model performance. We performed both evaluations on results from FRAX (World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK), a fracture risk tool, using Kaiser Permanente Northern California women older than 50yr with bone mineral density (BMD) measured during 1997-2003. We compared FRAX performance with and without BMD in the model. Among 94,489 women with mean follow-up of 6.6yr, 1579 (1.7%) sustained a hip fracture. Overall, AUROCs were 0.83 and 0.84 for FRAX without and with BMD, suggesting that BMD did not contribute to model performance. AUROC decreased with increasing age, and BMD contributed significantly to higher AUROC among those aged 70yr and older. Using an 81% sensitivity threshold (optimum level from receiver operating characteristic curve, corresponding to 1.2% cutoff), 35% of those categorized above were reassigned below when BMD was added. In contrast, only 10% of those categorized below were reassigned to the higher risk category when BMD was added. The net reclassification improvement was 5.5% (p<0.01). Two versions of this risk tool have similar AUROCs, but alternative assessments indicate that addition of BMD improves performance. Multiple methods should be used to evaluate risk tool performance with less reliance on AUROC alone. Copyright © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Implementing the Patient-Centered Medical Home: Observation and Description of the National Demonstration Project

PubMed Central

Stewart, Elizabeth E.; Nutting, Paul A.; Crabtree, Benjamin F.; Stange, Kurt C.; Miller, William L.; Jaén, Carlos Roberto

2010-01-01

PURPOSE We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. METHODS An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). RESULTS The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. CONCLUSIONS The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning. PMID:20530392

Referral and Diagnosis of Developmental Auditory Processing Disorder in a Large, United States Hospital-Based Audiology Service.

PubMed

Moore, David R; Sieswerda, Stephanie L; Grainger, Maureen M; Bowling, Alexandra; Smith, Nicholette; Perdew, Audrey; Eichert, Susan; Alston, Sandra; Hilbert, Lisa W; Summers, Lynn; Lin, Li; Hunter, Lisa L

2018-05-01

Children referred to audiology services with otherwise unexplained academic, listening, attention, language, or other difficulties are often found to be audiometrically normal. Some of these children receive further evaluation for auditory processing disorder (APD), a controversial construct that assumes neural processing problems within the central auditory nervous system. This study focuses on the evaluation of APD and how it relates to diagnosis in one large pediatric audiology facility. To analyze electronic records of children receiving a central auditory processing evaluation (CAPE) at Cincinnati Children's Hospital, with a broad goal of understanding current practice in APD diagnosis and the test information which impacts that practice. A descriptive, cross-sectional analysis of APD test outcomes in relation to final audiologist diagnosis for 1,113 children aged 5-19 yr receiving a CAPE between 2009 and 2014. Children had a generally high level of performance on the tests used, resulting in marked ceiling effects on about half the tests. Audiologists developed the diagnostic category "Weakness" because of the large number of referred children who clearly had problems, but who did not fulfill the AAA/ASHA criteria for diagnosis of a "Disorder." A "right-ear advantage" was found in all tests for which each ear was tested, irrespective of whether the tests were delivered monaurally or dichotically. However, neither the side nor size of the ear advantage predicted the ultimate diagnosis well. Cooccurrence of CAPE with other learning problems was nearly universal, but neither the number nor the pattern of cooccurring problems was a predictor of APD diagnosis. The diagnostic patterns of individual audiologists were quite consistent. The number of annual assessments decreased dramatically during the study period. A simple diagnosis of APD based on current guidelines is neither realistic, given the current tests used, nor appropriate, as judged by the audiologists providing the service. Methods used to test for APD must recognize that any form of hearing assessment probes both sensory and cognitive processing. Testing must embrace modern methods, including digital test delivery, adaptive testing, referral to normative data, appropriate testing for young children, validated screening questionnaires, and relevant objective (physiological) methods, as appropriate. Audiologists need to collaborate with other specialists to understand more fully the behaviors displayed by children presenting with listening difficulties. To achieve progress, it is essential for clinicians and researchers to work together. As new understanding and methods become available, it will be necessary to sort out together what works and what doesn't work in the clinic, both from a theoretical and a practical perspective. American Academy of Audiology.

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.

The Therapeutic Relationship in Cognitive-Behavioral Therapy and Pharmacotherapy for Anxious Youth

PubMed Central

Cummings, Colleen M.; Caporino, Nicole E.; Settipani, Cara A.; Read, Kendra L.; Compton, Scott N.; March, John; Sherrill, Joel; Piacentini, John; McCracken, James; Walkup, John; Ginsburg, Golda; Albano, Anne Marie; Rynn, Moira; Birmaher, Boris; Sakolsky, Dara; Gosch, Elizabeth; Keeton, Courtney; Kendall, Philip C.

2014-01-01

Objective Examine the therapeutic relationship with cognitive-behavioral therapists and with pharmacotherapists for youth from the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008). The therapeutic relationship was examined in relation to treatment outcomes. Method Participants were 488 youth (ages 7-17; 50% male) randomized to cognitive-behavioral therapy (CBT; Coping cat), pharmacotherapy (SRT; sertraline), their combination, or pill placebo. Participants met DSM-IV criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. The therapeutic relationship was assessed by youth-report at weeks 6 and 12 of treatment using the Child's Perception of Therapeutic Relationship scale. Outcome measures (Pediatric Anxiety Rating Scale; Clinical Global Impressions Scales) were completed by Independent Evaluators blind to condition. Results For youth who received CBT only, a stronger therapeutic relationship predicted positive treatment outcome. In contrast, the therapeutic relationship did not predict outcome for youth receiving sertraline, combined treatment, or placebo. Conclusions A therapeutic relationship may be important for anxious youth who receive CBT alone. PMID:23750468

Advanced Stirling receiver development program, phase 1

NASA Technical Reports Server (NTRS)

Lurio, Charles A.

1990-01-01

Critical technology experiments were designed and developed to evaluate the Stirling cavity heat pipe receiver for a space solar power system. Theoretical criteria were applied to the design of a module for containing energy storage phase change material while avoiding thermal ratcheting. Zero-g drop tower tests, without phase change, were conducted to affirm that the bubble location required to avoid ratcheting could be achieved without the use of container materials that are wetted by the phase change material. A full scale module was fabricated, but not tested. A fabrication method was successfully developed for the sodium evaporator dome, with a sintered screen wick, to be used as the focal point for the receiver. Crushing of the screen during hydroforming was substantially reduced over the results of other researchers by using wax impregnation. Superheating of the sodium in the wick under average flux conditions is expected to be under 10K. A 2000K furnace which will simulate solar flux conditions for testing the evaporator dome was successfully built and tested.

An exact noniterative linear method for locating sources based on measuring receiver arrival times.

PubMed

Militello, C; Buenafuente, S R

2007-06-01

In this paper an exact, linear solution to the source localization problem based on the time of arrival at the receivers is presented. The method is unique in that the source's position can be obtained by solving a system of linear equations, three for a plane and four for a volume. This simplification means adding an additional receiver to the minimum mathematically required (3+1 in two dimensions and 4+1 in three dimensions). The equations are easily worked out for any receiver configuration and their geometrical interpretation is straightforward. Unlike other methods, the system of reference used to describe the receivers' positions is completely arbitrary. The relationship between this method and previously published ones is discussed, showing how the present, more general, method overcomes nonlinearity and unknown dependency issues.

Automatic localization of bifurcations and vessel crossings in digital fundus photographs using location regression

NASA Astrophysics Data System (ADS)

Niemeijer, Meindert; Dumitrescu, Alina V.; van Ginneken, Bram; Abrámoff, Michael D.

2011-03-01

Parameters extracted from the vasculature on the retina are correlated with various conditions such as diabetic retinopathy and cardiovascular diseases such as stroke. Segmentation of the vasculature on the retina has been a topic that has received much attention in the literature over the past decade. Analysis of the segmentation result, however, has only received limited attention with most works describing methods to accurately measure the width of the vessels. Analyzing the connectedness of the vascular network is an important step towards the characterization of the complete vascular tree. The retinal vascular tree, from an image interpretation point of view, originates at the optic disc and spreads out over the retina. The tree bifurcates and the vessels also cross each other. The points where this happens form the key to determining the connectedness of the complete tree. We present a supervised method to detect the bifurcations and crossing points of the vasculature of the retina. The method uses features extracted from the vasculature as well as the image in a location regression approach to find those locations of the segmented vascular tree where the bifurcation or crossing occurs (from here, POI, points of interest). We evaluate the method on the publicly available DRIVE database in which an ophthalmologist has marked the POI.

A software engineering approach to expert system design and verification

NASA Technical Reports Server (NTRS)

Bochsler, Daniel C.; Goodwin, Mary Ann

1988-01-01

Software engineering design and verification methods for developing expert systems are not yet well defined. Integration of expert system technology into software production environments will require effective software engineering methodologies to support the entire life cycle of expert systems. The software engineering methods used to design and verify an expert system, RENEX, is discussed. RENEX demonstrates autonomous rendezvous and proximity operations, including replanning trajectory events and subsystem fault detection, onboard a space vehicle during flight. The RENEX designers utilized a number of software engineering methodologies to deal with the complex problems inherent in this system. An overview is presented of the methods utilized. Details of the verification process receive special emphasis. The benefits and weaknesses of the methods for supporting the development life cycle of expert systems are evaluated, and recommendations are made based on the overall experiences with the methods.

Using LDPC Code Constraints to Aid Recovery of Symbol Timing

NASA Technical Reports Server (NTRS)

Jones, Christopher; Villasnor, John; Lee, Dong-U; Vales, Esteban

2008-01-01

A method of utilizing information available in the constraints imposed by a low-density parity-check (LDPC) code has been proposed as a means of aiding the recovery of symbol timing in the reception of a binary-phase-shift-keying (BPSK) signal representing such a code in the presence of noise, timing error, and/or Doppler shift between the transmitter and the receiver. This method and the receiver architecture in which it would be implemented belong to a class of timing-recovery methods and corresponding receiver architectures characterized as pilotless in that they do not require transmission and reception of pilot signals. Acquisition and tracking of a signal of the type described above have traditionally been performed upstream of, and independently of, decoding and have typically involved utilization of a phase-locked loop (PLL). However, the LDPC decoding process, which is iterative, provides information that can be fed back to the timing-recovery receiver circuits to improve performance significantly over that attainable in the absence of such feedback. Prior methods of coupling LDPC decoding with timing recovery had focused on the use of output code words produced as the iterations progress. In contrast, in the present method, one exploits the information available from the metrics computed for the constraint nodes of an LDPC code during the decoding process. In addition, the method involves the use of a waveform model that captures, better than do the waveform models of the prior methods, distortions introduced by receiver timing errors and transmitter/ receiver motions. An LDPC code is commonly represented by use of a bipartite graph containing two sets of nodes. In the graph corresponding to an (n,k) code, the n variable nodes correspond to the code word symbols and the n-k constraint nodes represent the constraints that the code places on the variable nodes in order for them to form a valid code word. The decoding procedure involves iterative computation of values associated with these nodes. A constraint node represents a parity-check equation using a set of variable nodes as inputs. A valid decoded code word is obtained if all parity-check equations are satisfied. After each iteration, the metrics associated with each constraint node can be evaluated to determine the status of the associated parity check. Heretofore, normally, these metrics would be utilized only within the LDPC decoding process to assess whether or not variable nodes had converged to a codeword. In the present method, it is recognized that these metrics can be used to determine accuracy of the timing estimates used in acquiring the sampled data that constitute the input to the LDPC decoder. In fact, the number of constraints that are satisfied exhibits a peak near the optimal timing estimate. Coarse timing estimation (or first-stage estimation as described below) is found via a parametric search for this peak. The present method calls for a two-stage receiver architecture illustrated in the figure. The first stage would correct large time delays and frequency offsets; the second stage would track random walks and correct residual time and frequency offsets. In the first stage, constraint-node feedback from the LDPC decoder would be employed in a search algorithm in which the searches would be performed in successively narrower windows to find the correct time delay and/or frequency offset. The second stage would include a conventional first-order PLL with a decision-aided timing-error detector that would utilize, as its decision aid, decoded symbols from the LDPC decoder. The method has been tested by means of computational simulations in cases involving various timing and frequency errors. The results of the simulations ined in the ideal case of perfect timing in the receiver.

Callers’ attitudes and experiences of UK breastfeeding helpline support

PubMed Central

2013-01-01

Background Breastfeeding peer support, is considered to be a key intervention for increasing breastfeeding duration rates. Whilst a number of national organisations provide telephone based breastfeeding peer support, to date there have been no published evaluations into callers’ experiences and attitudes of this support. In this study we report on the descriptive and qualitative insights provided by 908 callers as part of an evaluation of UK-based breastfeeding helpline(s). Methods A structured telephone interview, incorporating Likert scale responses and open-ended questions was undertaken with 908 callers over May to August, 2011 to explore callers’ experiences of the help and support received via the breastfeeding helpline(s). Results Overall satisfaction with the helpline was high, with the vast majority of callers’ recalling positive experiences of the help and support received. Thematic analysis was undertaken on all qualitative and descriptive data recorded during the evaluation, contextualised within the main areas addressed within the interview schedule in terms of ‘contact with the helplines’; ‘experiences of the helpline service’, ‘perceived effectiveness of support provision’ and ‘impact on caller wellbeing’. Conclusion Callers valued the opportunity for accessible, targeted, non-judgmental and convenient support. Whilst the telephone support did not necessarily influence women’s breastfeeding decisions, the support they received left them feeling reassured, confident and more determined to continue breastfeeding. We recommend extending the helpline service to ensure support can be accessed when needed, and ongoing training and support for volunteers. Further advertising and promotion of the service within wider demographic groups is warranted. PMID:23628104

Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal

PubMed Central

Joshi, Amit; Tandon, Nidhi; Noronha, Vanita; Dhumal, Sachin; Patil, Vijay; Arya, Supreeta; Juvekar, Shashikant; Agarwal, Jaiprakash; DCruz, Anil; Pai, Prathmesh; Prabhash, Kumar

2015-01-01

Background: Carcinoma of external auditory canal (EAC) is a very rare malignancy with surgical resection as the main modality of treatment. The outcomes with nonsurgical modalities are very dismal. We present a retrospective analysis of 4 patients evaluating the role of neoadjuvant chemotherapy in technically unresectable cancers. Materials and Methods: This is a retrospective analysis of 4 patients from our institute from 2010 to 2014 with carcinoma EAC who were deemed unfit for surgery due to extensive disease involving occipital bone with soft tissue infiltration (n = 2), temporal dura (n = 1), left temporal lobe, and extensive soft tissue involvement (n = 1). All these patients received neoadjuvant chemotherapy with docetaxel, cisplatin and 5 fluorouracil (n = 3) and paclitaxel and cisplatin (n = 1). Results: Response evaluation showed a partial response (PR) in 3 and stable disease (SD) in 1 patient by Response Evaluation Criteria in Solid Tumors criteria. All 3 patients who received 3 drug chemotherapy had PR while 1 patient who received 2 drug chemotherapy had SD. Two of these patients underwent surgery, and other 2 underwent definitive chemoradiation. One of 3 patients who achieved PR underwent surgical resection; the other 2 remained unresectable in view of the persistent intradural extension and infratemporal fossa involvement. One patient who had SD could undergo surgery in view of clearance of infraatemporal fossa. Recent follow-up shows that 3 out of these 4 patients are alive. Conclusion: This indicates that there may be a role of induction chemotherapy in converting potentially unresectable tumors to resectable disease that could produce better outcomes in carcinoma EAC. PMID:26855526

Three or Four Fractions of 4-5 Gy per Week in Postoperative High-Dose-Rate Brachytherapy for Endometrial Carcinoma

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

Rovirosa, Angeles, E-mail: rovirosa@clinic.ub.es; Ascaso, Carlos; Sanchez-Reyes, Alberto

2011-10-01

Purpose: To evaluate the results of high-dose-rate brachytherapy (HDRBT) using a schedule of three or four fractions per week, when possible, in 89 patients on local control and toxicity in postoperative treatment of endometrial carcinoma. The effect of the overall HDRBT treatment time (OTT) on toxicity was also evaluated. Patients and Methods: Federation Internationale de Gynecologie Obstetrique Stage: 24 IB, 45 IC, 4 IIA, 6 IIB, 4 IIIA, 2 IIIB, and 4 IIIC. Radiotherapy: Group 1-67 of 89 patients received external beam irradiation (EBI; 44-50 Gy) plus HDRBT (3 fractions of 4-6 Gy); Group 2-22 of 89 patients received HDRBTmore » alone (6 fractions of 4-5 Gy). OTT: Group 1-HDRBT was completed in a median of 5 days in 32 patients and in >5 days in 35; Group 2-HDRBT was completed in <15 days in 11 patients and in {>=}16 days in 11. Toxicity was evaluated using Radiation Therapy Oncology Group scores and the bioequivalent dose (BED) study was performed in vaginal mucosa surface. Statistics included Student's t test, chi-square test, and receiving operator curves. Results: With a mean follow-up of 31 months (range, 6-70), 1 of 89 patients had vaginal relapse. Early toxicity appeared in 8 of 89 (9%) patients and was resolved. Late toxicity appeared in 13/89 (14%): vaginal nine Grade 1, three Grade 2, one Grade 4; bladder two Grade 2; rectal three Grade 1, one Grade 2. No differences were found in relation to OTT in Groups 1 and 2. Mean BED was 88.48 Gy in Group 1 and 165.28 Gy in Group 2. Cases with Grade 2 late vaginal toxicity received >75 Gy after EBI and >165 Gy in Group 2. Conclusions: Three fractions of 4-5 Gy in 3-5 days after EBI or 6 fractions in <15 days in patients receiving HDRBT alone was a safe treatment in relation to toxicity and local control. Vaginal surface BED less than 75 Gy after EBI and less than 160 Gy in HDRBT alone may be safe to avoid G2 toxicity.« less

Comparison of the efficacies of patching and penalization therapies for the treatment of amblyopia patients

PubMed Central

Cabi, Cemalettin; Sayman Muslubas, Isil Bahar; Aydin Oral, Ayse Yesim; Dastan, Metin

2014-01-01

AIM To compare the efficacies of patching and penalization therapies for the treatment of amblyopia patients. METHODS The records of 64 eyes of 50 patients 7 to 16y of age who had presented to our clinics with a diagnosis of amblyopia, were evaluated retrospectively. Forty eyes of 26 patients who had received patching therapy and 24 eyes of 24 patients who had received penalization therapy included in this study. The latencies and amplitudes of visual evoked potential (VEP) records and best corrected visual acuities (BCVA) of these two groups were compared before and six months after the treatment. RESULTS In both patching and the penalization groups, the visual acuities increased significantly following the treatments (P<0.05). The latency measurements of the P100 wave obtained at 1.0°, 15 arc min. Patterns of both groups significantly decreased following the 6-months-treatment. However, the amplitude measurements increased (P<0.05). CONCLUSION The patching and the penalization methods, which are the main methods used in the treatment of amblyopia, were also effective over the age of 7y, which has been accepted as the critical age for the treatment of amblyopia. PMID:24967195