Pay modernisation and healthcare governance.

PubMed

Benton, David C

Policies interact and have direct and indirect consequences resulting in both short-term and longer-term effects on the working lives of professionals, the care they offer and the education needed by future generations of staff. This article explores how pay modernisation could result in benefits and risks for corporate, clinical and staff governance. It is argued that if pay modernisation as a major enabler of service redesign is to succeed then far greater understanding of how various policies interact and their potential consequences is required.

Lessons We Can Learn from Other Countries. IAB Labour Market Research Topics No. 44.

ERIC Educational Resources Information Center

Walwei, Ulrich; Werner, Heinz; Konig, Ingeborg

This document contains three papers from an international conference on "ways and means for more employment." The first paper, "Employment Policy Comparisons and Policy Advice" (Ulrich Walwei), covers the German labor market in the second half of the 1990s and requirements for longer-term employment success through coping with…

The challenge to keep global warming below 2 °C

NASA Astrophysics Data System (ADS)

Peters, Glen P.; Andrew, Robbie M.; Boden, Tom; Canadell, Josep G.; Ciais, Philippe; Le Quéré, Corinne; Marland, Gregg; Raupach, Michael R.; Wilson, Charlie

2013-01-01

The latest carbon dioxide emissions continue to track the high end of emission scenarios, making it even less likely global warming will stay below 2 °C. A shift to a 2 °C pathway requires immediate significant and sustained global mitigation, with a probable reliance on net negative emissions in the longer term.

The use and misuse of photosynthesis in the quest for novel methods to harness solar energy to make fuel.

PubMed

Cogdell, Richard J; Gardiner, Alastair T; Molina, Pedro I; Cronin, Leroy

2013-08-13

This short review will illustrate that photosynthesis can provide a real contribution towards our sustain- able, green fuel requirements in the future. However, it is argued that the focus on biofuels is misplaced and that, in the longer term, investment in artificial photosynthesis will prove much more beneficial.

The Foreign Language and Intercultural Competence Teacher: The Acquisition of a New Professional Identity

ERIC Educational Resources Information Center

Sercu, Lies

2006-01-01

It has now become commonplace to state that foreign language learning should be viewed in an intercultural perspective. The main objective of foreign language education is no longer defined strictly in terms of the acquisition of communicative competence. Teachers are now required to teach intercultural communicative competence. The aim of the…

Phased Array Feeds

NASA Astrophysics Data System (ADS)

Fisher, J. Richard; Bradley, Richard F.; Brisken, Walter F.; Cotton, William D.; Emerson, Darrel T.; Kerr, Anthony R.; Lacasse, Richard J.; Morgan, Matthew A.; Napier, Peter J.; Norrod, Roger D.; Payne, John M.; Pospieszalski, Marian W.; Symmes, Arthur; Thompson, A. Richard; Webber, John C.

2009-03-01

This white paper offers cautionary observations about the planning and development of new, large radio astronomy instruments. Complexity is a strong cost driver so every effort should be made to assign differing science requirements to different instruments and probably different sites. The appeal of shared resources is generally not realized in practice and can often be counterproductive. Instrument optimization is much more difficult with longer lists of requirements, and the development process is longer and less efficient. More complex instruments are necessarily further behind the technology state of the art because of longer development times. Including technology R&D in the construction phase of projects is a growing trend that leads to higher risks, cost overruns, schedule delays, and project de-scoping. There are no technology breakthroughs just over the horizon that will suddenly bring down the cost of collecting area. Advances come largely through careful attention to detail in the adoption of new technology provided by industry and the commercial market. Radio astronomy instrumentation has a very bright future, but a vigorous long-term R&D program not tied directly to specific projects needs to be restored, fostered, and preserved.

Large Instrument Development for Radio Astronomy

NASA Astrophysics Data System (ADS)

Fisher, J. Richard; Warnick, Karl F.; Jeffs, Brian D.; Norrod, Roger D.; Lockman, Felix J.; Cordes, James M.; Giovanelli, Riccardo

2009-03-01

This white paper offers cautionary observations about the planning and development of new, large radio astronomy instruments. Complexity is a strong cost driver so every effort should be made to assign differing science requirements to different instruments and probably different sites. The appeal of shared resources is generally not realized in practice and can often be counterproductive. Instrument optimization is much more difficult with longer lists of requirements, and the development process is longer and less efficient. More complex instruments are necessarily further behind the technology state of the art because of longer development times. Including technology R&D in the construction phase of projects is a growing trend that leads to higher risks, cost overruns, schedule delays, and project de-scoping. There are no technology breakthroughs just over the horizon that will suddenly bring down the cost of collecting area. Advances come largely through careful attention to detail in the adoption of new technology provided by industry and the commercial market. Radio astronomy instrumentation has a very bright future, but a vigorous long-term R&D program not tied directly to specific projects needs to be restored, fostered, and preserved.

Improvement in Parenteral Nutrition-Associated Cholestasis With the Use of Omegaven in an Infant With Short Bowel Syndrome.

PubMed

Strang, Brian J; Reddix, Bruce A; Wolk, Robert A

2016-10-01

Parenteral nutrition-associated cholestasis (PNAC) and liver disease have been associated with soybean oil-based intravenous fat emulsions (IVFEs). The benefit of fish oil-based IVFEs in the reversal of parenteral nutrition (PN)-associated liver damage includes allowing for longer PN duration without immediate need for bowel or liver transplantation. The present case involves an infant born with short bowel syndrome (SBS) requiring long-term PN with development of PNAC and subsequent administration of a fish oil-based IVFE. An infant born with SBS was initiated on PN and enteral feeds. After failed enteral progression, bowel lengthening by serial transverse enteroplasty (STEP) resulted in postoperative ileus with delayed enteral feeding for 4 weeks. The administration of long-term PN led to development of PNAC, resulting in initiation of a fish oil-based IVFE. After 4 months, the cholestasis had resolved. Despite the STEP, at 16 months, the child required bowel tapering due to inability to advance enteral feeding. Fish oil-based IVFE was effectively used to reverse PNAC in a child with SBS. Despite early STEP, the patient was not able to tolerate enteral feedings and required bowel tapering. This case illustrates that early surgical intervention did not allow for improved feed tolerance. This resulted in a significant period without enteral nutrition, leading to development of cholestasis. The use of fish oil-based IVFE may permit a longer duration of PN administration without the development of cholestasis or liver disease, allowing for longer time for bowel adaptation prior to the need for surgical intervention. © 2016 American Society for Parenteral and Enteral Nutrition.

A prospective study of the severity of early respiratory distress in late preterms compared to term infants.

PubMed

Kitsommart, Ratchada; Phatihattakorn, Chayawat; Pornladnun, Pornpat; Paes, Bosco

2016-01-01

To compare the severity of early respiratory distress in late preterm (LPT) versus term infants. A prospective cohort study was conducted in a tertiary care neonatal unit in Thailand. Levels of respiratory support, duration of intubation, and short term morbidities were compared between LPT and term infants. Two-hundred nineteen LPT and 564 term infants were included over a period of 2 years (2009-2011). 106 (48.4%) LPTs versus 58 (10.3%) term infants received non-invasive ventilation or intubation [p < 0.001; OR (95% CI) 8.2 (5.6, 12.0)]. The intubation rate was 24.7% in LPTs versus 7.3% in term infants [p < 0.001; OR (95% CI) 4.18 (2.7, 6.5)]. The duration of intubation was longer in LPT infants (median 5.0 versus 2.0 days. p = 0.03). There was a non-significant trend towards a higher mortality rate in the LPT group [p = 0.14; OR (95% CI) 3.9 (0.7, 23.5)]. This is one of three published prospective studies on the topic. The study design lends more robust credence to the results previously identified only in retrospective and systematic reviews. LPT infants are more likely to require positive-pressure ventilation support and incur a longer duration of intubation. A trend towards greater mortality is prevalent compared to term infants.

Promoting Critical Reflection: An Evaluation of the Longer-Term Impact of a Substantial Faculty Development Program

ERIC Educational Resources Information Center

Calkins, Susanna; Harris, Muveddet

2017-01-01

For many faculty, critical reflection on teaching and learning requires space and time that is not readily available. For fifteen years, we have run a substantial year-long faculty development program designed to help participants: (1) reflect critically on their teaching and their students' learning; and (2) develop a project related to their…

76 FR 9329 - Efficiency Initiative Effort To Reduce Non-Value-Added Costs Imposed on Industry by Department of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

..., backed by specific, credible, convincing data. DoD's goal is to develop a fact-based program to reform... changes that can only be made over the longer term or require additional follow-up data before they are... data that it needs along with information about some additional areas of non-value- added cost...

Evidence for early disease-modifying drugs in rheumatoid arthritis

PubMed Central

Scott, David L

2004-01-01

Some research evidence supports early aggressive treatment of rheumatoid arthritis (RA) using combination therapy with two or more disease modifying anti-rheumatic drugs (DMARDs) plus steroids, or even DMARDs plus an anti-TNF. By contrast, conservatively delayed DMARD monotherapy, given after non-steroidal anti-inflammatory drugs have failed, has been criticised. However, recent long-term studies highlight the complexities in evaluating whether to abandon pyramidal treatment in favour of early DMARDs. Although patients given early DMARD therapy show short-term benefits, longer-term results show no prolonged clinical advantages from early DMARDs. By 5 years patients receiving early DMARDs had similar disease activity and comparable health assessment questionnaire scores to patients who received DMARDs later in their disease course. X-ray progression was persistent and virtually identical in both groups. These negative findings do not invalidate the case for early DMARD therapy, as it is gives sustained reductions in disease activity in the early years of treatment without excessive risks from adverse effects. However, early DMARDs alone do not adequately control RA in the longer term. This may require starting with very aggressive therapy or treating patients more aggressively after early DMARD therapy has been initiated. PMID:14979927

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

Lotfi, S., E-mail: shamim.lotfi@kcl.ac.uk; Clough, R. E.; Ali, T.

Hybrid repair constitutes supra-aortic debranching before thoracic endovascular aortic repair (TEVAR). It offers improved short-term outcome compared with open surgery; however, longer-term studies are required to assess patient outcomes and patency of the extra-anatomic bypass grafts. A prospectively maintained database of 380 elective and urgent patients who had undergone TEVAR (1997-2011) was analyzed retrospectively. Fifty-one patients (34 males; 17 females) underwent hybrid repair. Median age was 71 (range, 18-90) years with mean follow-up of 15 (range, 0-61) months. Perioperative complications included death: 10 % (5/51), stroke: 12 % (6/51), paraplegia: 6 % (3/51), endoleak: 16 % (8/51), rupture: 4 %more » (2/51), upper-limb ischemia: 2 % (1/51), bypass graft occlusion: 4 % (2/51), and cardiopulmonary complications in 14 % (7/51). Three patients (6 %) required emergency intervention for retrograde dissection: (2 aortic root repairs; 2 innominate stents). Early reintervention was performed for type 1 endoleak in two patients (2 proximal cuff extensions). One patient underwent innominate stenting and revision of their bypass for symptomatic restenosis. At 48 months, survival was 73 %. Endoleak was detected in three (6 %) patients (type 1 = 2; type 2 = 1) requiring debranching with proximal stent graft (n = 2) and proximal extension cuff (n = 1). One patient had a fatal rupture of a mycotic aneurysm and two arch aneurysms expanded. No bypass graft occluded after the perioperative period. Hybrid operations to treat aortic arch disease can be performed with results comparable to open surgery. The longer-term outcomes demonstrate low rates of reintervention and high rates of graft patency.« less

Mapping patterns of change in emotion-focused psychotherapy: Implications for theory, research, practice, and training.

PubMed

Watson, Jeanne C

2018-05-01

An important objective in humanistic-experiential psychotherapies and particularly emotion-focused psychotherapy (EFT) is to map patterns of change. Effective mapping of the processes and pathways of change requires that in-session processes be linked to in-session resolutions, immediate post-session changes, intermediate outcome, final therapy outcome, and longer-term change. This is a challenging and long-term endeavour. Fine-grained descriptions of in-session processes that lead to resolution of specific interpersonal and intrapersonal issues linked with longer-term outcomes are the foundation of EFT, the process-experiential approach. In this paper, evidence in support of EFT as a treatment approach will be reviewed along with research on two mechanisms of change, viewed as central to EFT, clients' emotional processing and the therapeutic relationship conditions. The implications for psychotherapy research are discussed. Given the methodological constraints, there is a need for more innovative methodologies and strategies to investigate specific psychotherapy processes within and across different approaches to map patterns and mechanisms of change to enhance theory, research, practice, and training.

Elaborative rehearsal of nontemporal information interferes with temporal processing of durations in the range of seconds but not milliseconds.

PubMed

Rammsayer, Thomas; Ulrich, Rolf

2011-05-01

The distinct timing hypothesis suggests a sensory mechanism for processing of durations in the range of milliseconds and a cognitively controlled mechanism for processing of longer durations. To test this hypothesis, we employed a dual-task approach to investigate the effects of maintenance and elaborative rehearsal on temporal processing of brief and long durations. Unlike mere maintenance rehearsal, elaborative rehearsal as a secondary task involved transfer of information from working to long-term memory and elaboration of information to enhance storage in long-term memory. Duration discrimination of brief intervals was not affected by a secondary cognitive task that required either maintenance or elaborative rehearsal. Concurrent elaborative rehearsal, however, impaired discrimination of longer durations as compared to maintenance rehearsal and a control condition with no secondary task. These findings endorse the distinct timing hypothesis and are in line with the notion that executive functions, such as continuous memory updating and active transfer of information into long-term memory interfere with temporal processing of durations in the second, but not in the millisecond range. 2011 Elsevier B.V. All rights reserved.

Optimizing home dialysis: role of hemodiafiltration.

PubMed

Vilar, Enric; Farrington, Ken; Bates, Chris; Mumford, Carol; Greenwood, Roger

2011-01-01

Over the last 40 years the technical obstacles which prevented a convective contribution to diffusive dialysis have been overcome. Hemodiafiltration represents a natural evolution of intermittent extracorporeal blood purification and the technology is now available to offer this as standard treatment in-center. The first randomized control trial of dialysis dose (National Cooperative Dialysis Study) showed that for three times weekly dialysis a critical level of urea clearance was necessary to ensure complication-free survival, the effect being noticeable by 3 months. Following this, observational studies suggested that higher doses improved longer term outcome. In a second large randomized controlled study (HEMO), higher small molecule clearance did not further improve outcome, but high-flux membranes, which permitted enhanced clearance of middle molecules, appeared to confer survival benefit in patients who had already been on dialysis > 3.7 years. Recently, outcomes from the Membrane Permeability Outcome study confirmed a survival benefit of high-flux membranes in high-risk patients. These studies indicate that in the medium term survival is critically dependent on achieving a minimum level of small solute removal. However, longer term survival (measured in years or decades) not only requires better small solute clearance but also enhanced clearance of middle molecules, the toxicity of which manifest over longer time scales. The rationale for convective treatment is strongest, therefore in those patients who have the greatest potential for long-term survival. Patients who opt for self-care at home to allow frequent dialysis generally are constituents of this group. Hemodiafiltration is likely to become standard therapy in-center and in the home. Copyright © 2011 S. Karger AG, Basel.

Evaluation of actuator energy storage and power sources for spacecraft applications

NASA Technical Reports Server (NTRS)

Simon, William E.; Young, Fred M.

1993-01-01

The objective of this evaluation is to determine an optimum energy storage/power source combination for electrical actuation systems for existing (Solid Rocket Booster (SRB), Shuttle) and future (Advanced Launch System (ALS), Shuttle Derivative) vehicles. Characteristic of these applications is the requirement for high power pulses (50-200 kW) for short times (milliseconds to seconds), coupled with longer-term base or 'housekeeping' requirements (5-16 kW). Specific study parameters (e.g., weight, volume, etc.) as stated in the proposal and specified in the Statement of Work (SOW) are included.

Autonomous Rendezvous and Docking Conference, volume 2

NASA Technical Reports Server (NTRS)

1990-01-01

Autonomous Rendezvous and Docking (ARD) will be a requirement for future space programs. Clear examples include satellite servicing, repair, recovery, and reboost in the near term, and the longer range lunar and planetary exploration programs. ARD will permit more aggressive unmanned space activities, while providing a valuable operational capability for manned missions. The purpose of the conference is to identify the technologies required for an on-orbit demonstration of ARD, assess the maturity of those technologies, and provide the necessary insight for a quality assessment of programmatic management, technical, schedule, and cost risks.

A requirement for memory retrieval during and after long-term extinction learning

PubMed Central

Ouyang, Ming; Thomas, Steven A.

2005-01-01

Current learning theories are based on the idea that learning is driven by the difference between expectations and experience (the delta rule). In extinction, one learns that certain expectations no longer apply. Here, we test the potential validity of the delta rule by manipulating memory retrieval (and thus expectations) during extinction learning. Adrenergic signaling is critical for the time-limited retrieval (but not acquisition or consolidation) of contextual fear. Using genetic and pharmacologic approaches to manipulate adrenergic signaling, we find that long-term extinction requires memory retrieval but not conditioned responding. Identical manipulations of the adrenergic system that do not affect memory retrieval do not alter extinction. The results provide substantial support for the delta rule of learning theory. In addition, the timing over which extinction is sensitive to adrenergic manipulation suggests a model whereby memory retrieval occurs during, and several hours after, extinction learning to consolidate long-term extinction memory. PMID:15947076

Liquid lubrication in space

NASA Technical Reports Server (NTRS)

Zaretsky, Erwin V.

1990-01-01

The requirement for long-term, reliable operation of aerospace mechanisms has, with a few exceptions, pushed the state of the art in tribology. Space mission life requirements in the early 1960s were generally 6 months to a year. The proposed U.S. space station schedule to be launched in the 1990s must be continuously usable for 10 to 20 years. Liquid lubrication systems are generally used for mission life requirements longer than a year. Although most spacecraft or satellites have reached their required lifetimes without a lubrication-related failure, the application of liquid lubricants in the space environment presents unique challenges. The state of the art of liquid lubrication in space as well as the problems and their solutions are reviewed.

40 CFR 63.1952 - When am I no longer required to comply with the requirements of this subpart if I own or operate...

Code of Federal Regulations, 2011 CFR

2011-07-01

... with the requirements of this subpart if I own or operate a bioreactor? 63.1952 Section 63.1952... longer required to comply with the requirements of this subpart if I own or operate a bioreactor? If you own or operate a landfill that includes a bioreactor, you are no longer required to comply with the...

40 CFR 63.1952 - When am I no longer required to comply with the requirements of this subpart if I own or operate...

Code of Federal Regulations, 2010 CFR

2010-07-01

... with the requirements of this subpart if I own or operate a bioreactor? 63.1952 Section 63.1952... longer required to comply with the requirements of this subpart if I own or operate a bioreactor? If you own or operate a landfill that includes a bioreactor, you are no longer required to comply with the...

Developing principles of sustainability and stakeholder engagement for "gentle" remediation approaches: the European context.

PubMed

Cundy, A B; Bardos, R P; Church, A; Puschenreiter, M; Friesl-Hanl, W; Müller, I; Neu, S; Mench, M; Witters, N; Vangronsveld, J

2013-11-15

Gentle Remediation Options (GRO) are risk management strategies or techniques for contaminated sites that result in no gross reduction in soil functionality (or a net gain) as well as risk management. Intelligently applied GROs can provide: (a) rapid risk management via pathway control, through containment and stabilisation, coupled with a longer term removal or immobilisation/isolation of the contaminant source term; and (b) a range of additional economic (e.g. biomass generation), social (e.g. leisure and recreation) and environmental (e.g. CO2 sequestration) benefits. In order for these benefits to be optimised or indeed realised, effective stakeholder engagement is required. This paper reviews current sector practice in stakeholder engagement and its importance when implementing GRO and other remediation options. From this, knowledge gaps are identified, and strategies to promote more effective stakeholder engagement during GRO application are outlined. Further work is required on integrating stakeholder engagement strategies into decision support systems and tools for GRO (to raise the profile of the benefits of effective stakeholder engagement and participation, particularly with sector professionals), and developing criteria for the identification of different stakeholder profiles/categories. Demonstrator sites can make a significant contribution to stakeholder engagement via providing evidence on the effectiveness of GRO under varying site contexts and conditions. Effective and sustained engagement strategies however will be required to ensure that site risk is effectively managed over the longer-term, and that full potential benefits of GRO (e.g. CO2 sequestration, economic returns from biomass generation and "leverage" of marginal land, amenity and educational value, ecosystem services) are realised and communicated to stakeholders. Copyright © 2013 Elsevier Ltd. All rights reserved.

Use of outsourced nurses in long-term acute care hospitals: outcomes and leadership preferences.

PubMed

Alvarez, M Raymond; Kerr, Bernard J; Burtner, Joan; Ledlow, Gerald; Fulton, Larry V

2011-02-01

When staffing effectiveness is not maintained over time, the likelihood of negative outcomes increases. This challenge is particularly problematic in long-term acute care hospitals (LTACHs) where use of outsourced temporary nurses is common when providing safe, sufficient care to medically complex patients who require longer hospital stays than normally would occur. To assess this issue, the authors discuss the outcomes of their survey of LTACH chief nursing officers that demonstrated LTACH quality indicators and overall patient satisfaction were within nationally accepted benchmarks even with higher levels of outsourced nurses used in this post-acute care setting.

GEWEX America Prediction Project (GAPP) Science and Implementation Plan

NASA Technical Reports Server (NTRS)

2004-01-01

The purpose of this Science and Implementation Plan is to describe GAPP science objectives and the activities required to meet these objectives, both specifically for the near-term and more generally for the longer-term. The GEWEX Americas Prediction Project (GAPP) is part of the Global Energy and Water Cycle Experiment (GEWEX) initiative that is aimed at observing, understanding and modeling the hydrological cycle and energy fluxes at various time and spatial scales. The mission of GAPP is to demonstrate skill in predicting changes in water resources over intraseasonal-to-interannual time scales, as an integral part of the climate system.

Blonanserin: a review of its use in the management of schizophrenia.

PubMed

Deeks, Emma D; Keating, Gillian M

2010-01-01

Oral blonanserin (Lonasen) is an atypical antipsychotic agent indicated for use in patients with schizophrenia in Japan and Korea. It is effective in the treatment of patients with schizophrenia, providing short- and long-term efficacy against both the positive and negative symptoms of the disorder in several randomized and noncomparative trials. Notably, in two randomized, double-blind trials of 8 weeks' duration, blonanserin was noninferior to haloperidol or risperidone for primary endpoints, although it appeared to be better than haloperidol in improving negative symptoms. Blonanserin is generally well tolerated and appears to have an acceptable profile in terms of bodyweight gain. Potential tolerability benefits of the drug in short-term trials included fewer extrapyramidal symptoms than haloperidol and fewer reports of prolactin level increases or hyperprolactinaemia than risperidone. Nevertheless, extrapyramidal symptoms and hyperprolactinaemia were among the most common adverse reactions associated with blonanserin in noncomparative long-term studies. Further prospective and long-term comparative studies are required in order to definitively position blonanserin with respect to other antipsychotic agents. In the meantime, available clinical data suggest that blonanserin is an effective and generally well tolerated option for the short-term treatment of schizophrenia and for those requiring longer-term therapy.

Independent Assessment of the Afghan National Security Forces

DTIC Science & Technology

2014-01-01

increase the likelihood of ANSF success through 2018 , thereby improving the longer-term prospects for a negotiated political settlement to end the war. We...Afghanistan through 2018 ; con- ducted a troop-to-task analysis of ANSF force structure required to achieve these operational objectives; identified...the Taliban insurgency will become a greater threat to Afghanistan’s stability in the 2015– 2018 timeframe than it is now. The insurgency has been

Staff expectations and views of cognitive behaviour therapy (CBT) for adults with intellectual disabilities.

PubMed

Stenfert Kroese, Biza; Jahoda, Andrew; Pert, Carol; Trower, Peter; Dagnan, Dave; Selkirk, Mhairi

2014-03-01

The role of support workers and other professionals in the psychotherapeutic process has been commented upon but not as yet been systematically investigated. To explore their views and expectations of cognitive behaviour therapy (CBT) for adults with intellectual disabilities, eleven paid support workers and professionals were recruited and interviewed before the CBT sessions commenced for their service users and nine took part in the second interview that took place after nine sessions. Thematic Analysis of the interview transcripts indicates that staff members do not perceive CBT as a long-term solution for psychological problems have little knowledge of CBT and do not feel included in the process. Nevertheless, after nine sessions, most participants reported improved psychological well-being for their service users and expressed a wish for longer-term involvement of the therapist. The results suggest that for CBT to be effective in the longer term, the therapist is required to consider a wider systemic approach including staff training and supervision, staff and management consultancy and creating a delicate balance between confidentiality and sharing the psychological formulation with 'significant others' to ensure maintenance and generalisation of improved psychological well-being. © 2013 John Wiley & Sons Ltd.

Methods for assessing long-term mean pathogen count in drinking water and risk management implications.

PubMed

Englehardt, James D; Ashbolt, Nicholas J; Loewenstine, Chad; Gadzinski, Erik R; Ayenu-Prah, Albert Y

2012-06-01

Recently pathogen counts in drinking and source waters were shown theoretically to have the discrete Weibull (DW) or closely related discrete growth distribution (DGD). The result was demonstrated versus nine short-term and three simulated long-term water quality datasets. These distributions are highly skewed such that available datasets seldom represent the rare but important high-count events, making estimation of the long-term mean difficult. In the current work the methods, and data record length, required to assess long-term mean microbial count were evaluated by simulation of representative DW and DGD waterborne pathogen count distributions. Also, microbial count data were analyzed spectrally for correlation and cycles. In general, longer data records were required for more highly skewed distributions, conceptually associated with more highly treated water. In particular, 500-1,000 random samples were required for reliable assessment of the population mean ±10%, though 50-100 samples produced an estimate within one log (45%) below. A simple correlated first order model was shown to produce count series with 1/f signal, and such periodicity over many scales was shown in empirical microbial count data, for consideration in sampling. A tiered management strategy is recommended, including a plan for rapid response to unusual levels of routinely-monitored water quality indicators.

NASA's advanced space transportation system launch vehicles

NASA Technical Reports Server (NTRS)

Branscome, Darrell R.

1991-01-01

Some insight is provided into the advanced transportation planning and systems that will evolve to support long term mission requirements. The general requirements include: launch and lift capacity to low earth orbit (LEO); space based transfer systems for orbital operations between LEO and geosynchronous equatorial orbit (GEO), the Moon, and Mars; and Transfer vehicle systems for long duration deep space probes. These mission requirements are incorporated in the NASA Civil Needs Data Base. To accomplish these mission goals, adequate lift capacity to LEO must be available: to support science and application missions; to provide for construction of the Space Station Freedom; and to support resupply of personnel and supplies for its operations. Growth in lift capacity must be time phased to support an expanding mission model that includes Freedom Station, the Mission to Planet Earth, and an expanded robotic planetary program. The near term increase in cargo lift capacity associated with development of the Shuttle-C is addressed. The joint DOD/NASA Advanced Launch System studies are focused on a longer term new cargo capability that will significantly reduce costs of placing payloads in space.

Violation of eating expectancies does not reduce conditioned desires for chocolate.

PubMed

van den Akker, Karolien; van den Broek, Myrr; Havermans, Remco C; Jansen, Anita

2016-05-01

Although eating desires can be easily learned, their extinction appears more difficult. The present two-session study aimed to investigate the role of eating expectancies in the short and longer-term extinction of eating desires. In addition, the relationship between eating desires and conditioned evaluations was examined to test whether they might share a similar mechanism. It was hypothesized that the short-term extinction of eating desires would be more successful after the disconfirmation of eating expectancies (instructed extinction or IE), while resulting in worse longer-term extinction because omission of the food reward during extinction is not surprising. In contrast to the hypotheses, it was found that IE had no effect on the short-term and longer-term extinction of eating desires. Eating desires correlated with conditioned evaluations only to some extent. It is concluded that eating expectancies do not mediate the short-term extinction of conditioned eating desires. In addition, their longer-term extinction does not appear to be facilitated by a greater violation of eating expectancies. This suggests that it might not be necessary to focus on expectancy violation in cue exposure therapy to reduce eating desires. Copyright © 2016 Elsevier Ltd. All rights reserved.

Massed versus Spaced Practice in Vocology: Effect of a Short-Term Intensive Voice Training versus a Longer-Term Traditional Voice Training

ERIC Educational Resources Information Center

Meerschman, Iris; Van Lierde, Kristiane; Van Puyvelde, Caro; Bostyn, Astrid; Claeys, Sofie; D'haeseleer, Evelien

2018-01-01

Background: In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown. Aims: The aim of this study was to compare the effect of a short-term intensive voice training (IVT) with a longer-term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy…

Life after colectomy for fulminant Clostridium difficile colitis: a 7-year follow up study.

PubMed

Dallas, Kai B; Condren, Audree; Divino, Celia M

2014-04-01

The long-term prognosis of patients undergoing colectomy for fulminant Clostridium difficile colitis has not been well studied. The authors present 7-year survival trends in such patients. Patients were identified through a pathologic database. Medical records were reviewed and follow-up phone calls made to determine relevant patient history, longevity, and quality of life. The 61 patients identified had mean and median survival of 18.1 and 3.2 months, respectively, and 1-year, 2-year, 5-year, and 7-year mortality of 68.5%, 79.6%, 88.9%, and 90.7%, respectively. Previous C difficile infection, hypotension, requirement of vasopressors, mental status changes, elevated arterial lactate, decreased platelet counts, intubation, and longer duration on nonoperative therapy were associated with in-hospital mortality. There were no factors correlated with long-term survival. Patients who require colectomy for fulminant C difficile colitis have a poor prognosis with poor long-term survival and significant morbidity. Although there are several factors associated with in-hospital mortality, there were no factors correlated with long-term survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Quality of Life Changes Following Surgery for Hyperhidrosis.

PubMed

de Campos, José Ribas Milanez; da Fonseca, Hugo Veiga Sampaio; Wolosker, Nelson

2016-11-01

The best way to evaluate the impact of primary hyperhidrosis on quality of life (QL) is through specific questionnaires, avoiding generic models that do not appropriately evaluate individuals. QL improves significantly in the short term after sympathectomy. In the longer term, a sustained and stable improvement is seen, although there is a small decline in the numbers; after 5 and even at 10 years of follow-up it shows virtually the same numerical distribution. Compensatory hyperhidrosis is a major side effect and the main aggravating factor in postoperative QL, requiring attention to its management and prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

An environmental cost-benefit analysis of alternative green roofing strategies

NASA Astrophysics Data System (ADS)

Richardson, M.; William, R. K.; Goodwell, A. E.; Le, P. V.; Kumar, P.; Stillwell, A. S.

2016-12-01

Green roofs and cool roofs are alternative roofing strategies that mitigate urban heat island effects and improve building energy performance. Green roofs consist of soil and vegetation layers that provide runoff reduction, thermal insulation, and potential natural habitat, but can require regular maintenance. Cool roofs involve a reflective layer that reflects more sunlight than traditional roofing materials, but require additional insulation during winter months. This study evaluates several roofing strategies in terms of energy performance, urban heat island mitigation, water consumption, and economic cost. We use MLCan, a multi-layer canopy model, to simulate irrigated and non-irrigated green roof cases with shallow and deep soil depths during the spring and early summer of 2012, a drought period in central Illinois. Due to the dry conditions studied, periodic irrigation is implemented in the model to evaluate its effect on evapotranspiration. We simulate traditional and cool roof scenarios by altering surface albedo and omitting vegetation and soil layers. We find that both green roofs and cool roofs significantly reduce surface temperature compared to the traditional roof simulation. Cool roof temperatures always remain below air temperature and, similar to traditional roofs, require low maintenance. Green roofs remain close to air temperature and also provide thermal insulation, runoff reduction, and carbon uptake, but might require irrigation during dry periods. Due to the longer lifetime of a green roof compared to cool and traditional roofs, we find that green roofs realize the highest long term cost savings under simulated conditions. However, using longer-life traditional roof materials (which have a higher upfront cost) can help decrease this price differential, making cool roofs the most affordable option due to the higher maintenance costs associated with green roofs

Innovation in health economic modelling of service improvements for longer-term depression: demonstration in a local health community.

PubMed

Tosh, Jonathan; Kearns, Ben; Brennan, Alan; Parry, Glenys; Ricketts, Thomas; Saxon, David; Kilgarriff-Foster, Alexis; Thake, Anna; Chambers, Eleni; Hutten, Rebecca

2013-04-26

The purpose of the analysis was to develop a health economic model to estimate the costs and health benefits of alternative National Health Service (NHS) service configurations for people with longer-term depression. Modelling methods were used to develop a conceptual and health economic model of the current configuration of services in Sheffield, England for people with longer-term depression. Data and assumptions were synthesised to estimate cost per Quality Adjusted Life Years (QALYs). Three service changes were developed and resulted in increased QALYs at increased cost. Versus current care, the incremental cost-effectiveness ratio (ICER) for a self-referral service was £11,378 per QALY. The ICER was £2,227 per QALY for the dropout reduction service and £223 per QALY for an increase in non-therapy services. These results were robust when compared to current cost-effectiveness thresholds and accounting for uncertainty. Cost-effective service improvements for longer-term depression have been identified. Also identified were limitations of the current evidence for the long term impact of services.

Budget Issues: Accrual Budgeting Useful in Certain Areas but Does Not Provide Sufficient Information for Reporting on Our Nation’s Longer-Term Fiscal Challenge

DTIC Science & Technology

2007-12-01

Government Auditing Standards GDP gross domestic product IPSAS International Public Sector Accounting Standards OBEGAL Operating Balance...aligned with the international public sector accounting standards ( IPSAS ), but there were some deviations from IPSAS for constitutional reasons such...which is required under IPSAS . Besides developing the accounting standards to be used in the budget, a key challenge when switching to accrual

Solar photochemistry - twenty years of progress, what`s been accomplished, and where does it lead?

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

Blake, D M

1995-01-01

It has been more than 20 years since the first oil embargo. That event created an awareness of the need for alternative sources of energy and renewed interest in combining sunlight and chemistry to produce the chemicals and materials required by industry. This paper will review approaches that have been taken, progress that has been made, and give some projections for the near and longer term prospects for commercialization of solar photochemistry.

PCB remediation in schools: a review.

PubMed

Brown, Kathleen W; Minegishi, Taeko; Cummiskey, Cynthia Campisano; Fragala, Matt A; Hartman, Ross; MacIntosh, David L

2016-02-01

Growing awareness of polychlorinated biphenyls (PCBs) in legacy caulk and other construction materials of schools has created a need for information on best practices to control human exposures and comply with applicable regulations. A concise review of approaches and techniques for management of building-related PCBs is the focus of this paper. Engineering and administrative controls that block pathways of PCB transport, dilute concentrations of PCBs in indoor air or other exposure media, or establish uses of building space that mitigate exposure can be effective initial responses to identification of PCBs in a building. Mitigation measures also provide time for school officials to plan a longer-term remediation strategy and to secure the necessary resources. These longer-term strategies typically involve removal of caulk or other primary sources of PCBs as well as nearby masonry or other materials contaminated with PCBs by the primary sources. The costs of managing PCB-containing building materials from assessment through ultimate disposal can be substantial. Optimizing the efficacy and cost-effectiveness of remediation programs requires aligning a thorough understanding of sources and exposure pathways with the most appropriate mitigation and abatement methods.

Bringing influenza vaccines into the 21st century

PubMed Central

Settembre, Ethan C; Dormitzer, Philip R; Rappuoli, Rino

2014-01-01

The recent H7N9 influenza outbreak in China highlights the need for influenza vaccine production systems that are robust and can quickly generate substantial quantities of vaccines that target new strains for pandemic and seasonal immunization. Although the influenza vaccine system, a public-private partnership, has been effective in providing vaccines, there are areas for improvement. Technological advances such as mammalian cell culture production and synthetic vaccine seeds provide a means to increase the speed and accuracy of targeting new influenza strains with mass-produced vaccines by dispensing with the need for egg isolation, adaptation, and reassortment of vaccine viruses. New influenza potency assays that no longer require the time-consuming step of generating sheep antisera could further speed vaccine release. Adjuvants that increase the breadth of the elicited immune response and allow dose sparing provide an additional means to increase the number of available vaccine doses. Together these technologies can improve the influenza vaccination system in the near term. In the longer term, disruptive technologies, such as RNA-based flu vaccines and ‘universal’ flu vaccines, offer a promise of a dramatically improved influenza vaccine system. PMID:24378716

Bringing influenza vaccines into the 21st century.

PubMed

Settembre, Ethan C; Dormitzer, Philip R; Rappuoli, Rino

2014-01-01

The recent H7N9 influenza outbreak in China highlights the need for influenza vaccine production systems that are robust and can quickly generate substantial quantities of vaccines that target new strains for pandemic and seasonal immunization. Although the influenza vaccine system, a public-private partnership, has been effective in providing vaccines, there are areas for improvement. Technological advances such as mammalian cell culture production and synthetic vaccine seeds provide a means to increase the speed and accuracy of targeting new influenza strains with mass-produced vaccines by dispensing with the need for egg isolation, adaptation, and reassortment of vaccine viruses. New influenza potency assays that no longer require the time-consuming step of generating sheep antisera could further speed vaccine release. Adjuvants that increase the breadth of the elicited immune response and allow dose sparing provide an additional means to increase the number of available vaccine doses. Together these technologies can improve the influenza vaccination system in the near term. In the longer term, disruptive technologies, such as RNA-based flu vaccines and 'universal' flu vaccines, offer a promise of a dramatically improved influenza vaccine system.

Discharge and aftercare in chronic lung disease of the newborn.

PubMed

Primhak, R A

2003-04-01

This article deals with the discharge planning and continuing care of babies with chronic lung disease of the newborn (CLD), especially those with a continuing oxygen requirement, with some reference to longer term outcome. The pattern of CLD has changed since early descriptions, and the most useful definition for persisting morbidity in a baby with lung disease is a continuing oxygen requirement beyond 36 weeks post-menstrual age. Long-term oxygen therapy to maintain oxygen saturation at a mean of 95% or more and prevent levels below 90% is the cornerstone of management, and with adequate oxygen therapy the excess mortality previously reported in CLD can largely be avoided. Care must be given to the method of assessing oxygen saturation: overnight monitoring using appropriate recording devices is recommended. Exposure to respiratory viruses should be minimized where possible. Metabolic requirements are increased, but if efforts are made to maintain adequate energy input the long-term outlook for catch-up growth in height is good. Respiratory morbidity is increased in early life, but this improves in later childhood, along with lung function and exercise tolerance. Although respiratory symptoms should be treated as they arise, there is no evidence for long-term benefit from any pharmacological intervention in CLD.

Effect of drug-related cues on response inhibition through abstinence: A pilot study in male heroin abstainers.

PubMed

Su, Bobo; Yang, Ling; Wang, Grace Y; Wang, Sha; Li, Shaomei; Cao, Hua; Zhang, Yan

2017-11-01

Chronic heroin use can cause a deficit of inhibitory function, leading to a loss of control over drug use. Exposure to drug-related cues is considered as one of the contributing factors. However, it is unclear whether there are dynamic changes on the effect of drug-related cues on response inhibition following prolonged abstinence. The present study investigated the effect of drug-related cues on response inhibition in heroin abstainers at different abstinent phases. 26 shorter-term (2-6 months) and 26 longer-term (19-24 months) male heroin abstainers performed on a modified two-choice Oddball task, which included two conditions: in the cued condition, neutral pictures served as the background of standard stimuli (yellow frame) and heroin-related pictures served as the background of deviant stimuli (blue frame), reversed in the controlled conditions. Compared to longer-term abstainers, mean reaction time (RT) for drug deviants in shorter-term abstainers was significantly longer. Shorter-term abstainers also showed markedly slower response to neutral deviants relative to drug deviants, but this tendency was not observed in longer-term abstainers. Nevertheless, both groups had similar RT for standard stimuli regardless of their paired background pictures. Effect of drug-related cues on response inhibition remains at the early stage of abstinence; however, this effect may be reduced following a longer period of drug abstinence. Our findings highlight the importance of assessing and improving the ability of inhibiting drug-related cue reactivity during treatment.

Cognitive changes in people with temporal lobe epilepsy over a 13-year period.

PubMed

Mameniškienė, Rūta; Rimšienė, Justė; Puronaitė, Roma

2016-10-01

The aims of our study were to evaluate cognitive decline in people with temporal lobe epilepsy over a period of 13years and to determine what clinical and treatment characteristics may have been associated with these. Thirty-three individuals with temporal lobe epilepsy underwent the same neuropsychological assessment of verbal and nonverbal memory, attention, and executive functions using the same cognitive test battery as one used 13years ago. Long-term verbal and nonverbal memory was tested four weeks later. Results were compared with those carried out 13years earlier. There was no significant change in verbal and verbal-logical memory tests; however, nonverbal memory worsened significantly. Long-term verbal memory declined for 21.9% of participants, long-term verbal-logical memory for 34.4%, and long-term nonverbal memory for 56.3%. Worsening of working verbal and verbal-logical memory was associated with longer epilepsy duration and lower levels of patients' education; worsening of verbal delayed recall and long-term verbal-logical memory was associated with higher seizure frequency. Decline in long-term nonverbal memory had significant association with a longer duration of epilepsy. The worsening of reaction and attention inversely correlated with the symptoms of depression. Over a 13-year period, cognitive functions did not change significantly. Good seizure control and reduced symptoms of depression in this sample of people with temporal lobe epilepsy were associated with better cognitive functioning. The predictors of change of cognitive functions could be complex and require further study. Copyright © 2016 Elsevier Inc. All rights reserved.

Intermittent fasting and cardiovascular disease: current evidence and unresolved questions.

PubMed

Tinsley, Grant M; Horne, Benjamin D

2018-01-01

Intermittent fasting has produced a variety of beneficial health effects in animal models, although high-quality research in humans has been limited. This special report examines current evidences for intermittent fasting in humans, discusses issues that require further examination, and recommends new research that can improve the knowledge base in this emerging research area. While potentially useful for health improvement, intermittent fasting requires further study prior to widespread implementation for health purposes. Randomized, longer-term studies are needed to determine whether using intermittent fasting as a lifestyle rather than a diet is feasible and beneficial for the health of some members of the human population.

Workshop: Theory an Applications of Coupled Cell Networks

DTIC Science & Technology

2006-03-22

physical location and environment and the scientific inter- actions with the longer term participants in the PFD programme. Furthermore, the Institute...in generating a tangible air of excitement about the challenges posed by coupled cell systems, both in terms of the mathematical questions, and in the...longer term visitors interacted with the workshop participants, and by focusing on a slightly different collection of themes, the workshop participants

Outlining face processing skills of portrait artists: Perceptual experience with faces predicts performance.

PubMed

Devue, Christel; Barsics, Catherine

2016-10-01

Most humans seem to demonstrate astonishingly high levels of skill in face processing if one considers the sophisticated level of fine-tuned discrimination that face recognition requires. However, numerous studies now indicate that the ability to process faces is not as fundamental as once thought and that performance can range from despairingly poor to extraordinarily high across people. Here we studied people who are super specialists of faces, namely portrait artists, to examine how their specific visual experience with faces relates to a range of face processing skills (perceptual discrimination, short- and longer term recognition). Artists show better perceptual discrimination and, to some extent, recognition of newly learned faces than controls. They are also more accurate on other perceptual tasks (i.e., involving non-face stimuli or mental rotation). By contrast, artists do not display an advantage compared to controls on longer term face recognition (i.e., famous faces) nor on person recognition from other sensorial modalities (i.e., voices). Finally, the face inversion effect exists in artists and controls and is not modulated by artistic practice. Advantages in face processing for artists thus seem to closely mirror perceptual and visual short term memory skills involved in portraiture. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Requirement Generation for the SKYLON Launch System

NASA Astrophysics Data System (ADS)

Hempsell, M.

SKYLON is a reusable single stage to orbit spaceplane intended to lower the cost of reaching space. The project has a 25 year history stretching back to the British Aerospace HOTOL study and over the many configuration iterations the performance has been established using feasibility designs, with market studies being used to establish that the resulting system has utility. In preparation for the final concept study of the D1 configuration the market and other stakeholder's requirements have been prepared as an input rather than an output to the design process. These requirements have been established from both an analysis of the existing market - as a model for the entry into service requirements - and future studies of advanced applications - as a model for the longer term requirements. The final conclusions have been incorporated into a preliminary User Manual which is the basis of a requirements' validation exercise.

Thrombopoietin treatment of one graft in a double cord blood transplant provides early platelet recovery while contributing to long-term engraftment in NSG mice.

PubMed

van der Garde, Mark; van Hensbergen, Yvette; Brand, Anneke; Slot, Manon C; de Graaf-Dijkstra, Alice; Mulder, Arend; Watt, Suzanne M; Zwaginga, Jaap Jan

2015-01-01

Human cord blood (CB) hematopoietic stem cell (HSC) transplants demonstrate delayed early neutrophil and platelet recovery and delayed longer term immune reconstitution compared to bone marrow and mobilized peripheral blood transplants. Despite advances in enhancing early neutrophil engraftment, platelet recovery after CB transplantation is not significantly altered when compared to contemporaneous controls. Recent studies have identified a platelet-biased murine HSC subset, maintained by thrombopoietin (TPO), which has enhanced capacity for short- and long-term platelet reconstitution, can self-renew, and can give rise to myeloid- and lymphoid-biased HSCs. In previous studies, we have shown that transplantation of human CB CD34(+) cells precultured in TPO as a single graft accelerates early platelet recovery as well as yielding long-term repopulation in immune-deficient mice. In this study, using a double CB murine transplant model, we investigated whether TPO cultured human CB CD34(+) cells have a competitive advantage or disadvantage over untreated human CB CD34(+) cells in terms of (1) short-term and longer term platelet recovery and (2) longer term hematological recovery. Our studies demonstrate that the TPO treated graft shows accelerated early platelet recovery without impairing the platelet engraftment of untreated CD34(+) cells. Notably, this was followed by a dominant contribution to platelet production through the untreated CD34(+) cell graft over the intermediate to longer term. Furthermore, although the contribution of the TPO treated graft to long-term hematological engraftment was reduced, the TPO treated and untreated grafts both contributed significantly to long-term chimerism in vivo.

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0-5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review.

PubMed

Laws, Rachel; Campbell, Karen J; van der Pligt, Paige; Russell, Georgina; Ball, Kylie; Lynch, John; Crawford, David; Taylor, Rachael; Askew, Deborah; Denney-Wilson, Elizabeth

2014-08-01

Children from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families. Searches of major electronic databases identified articles published from 1993-2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity. Thirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m(2) to -0.54 kg/m(2) for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3-5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery. There is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required. PROSPERO Registration no: CRD42013006536.

Relative to open surgery, minimally-invasive renal and ureteral pediatric surgery offers no improvement in 30-day complications, yet requires longer operative time: Data from the National Surgical Quality Improvement Program Pediatrics.

PubMed

Colaco, Marc; Hester, Austin; Visser, William; Rasper, Alison; Terlecki, Ryan

2018-05-01

Performance of minimally-invasive surgery (MIS) is increasing relative to open surgery. We sought to compare the contemporary rates of short-term complications of open versus laparoscopic renal and ureteral surgery in pediatric patients. A retrospective cross-sectional analysis of the National Surgical Quality Improvement Program Pediatrics database was performed of all cases in 2014 identified using CPT procedure codes for nephrectomy, partial nephrectomy (PN), ureteroneocystostomy (UNC), and pyeloplasty, and reviewed for postoperative complications. Univariate analysis was performed to determine 30-day complications, with comparison between open and MIS approaches. Receiver operator curve (ROC) analysis was performed to determine differences in body surface area (BSA) and age for open versus MIS. Review identified 207 nephrectomies, 72 PN, 920 UNC, and 625 pyeloplasties. MIS was associated with older age and larger BSA except for cases of UNC. Apart from PN, operative durations were longer with MIS. However, only PN was associated with significantly longer length of hospital stay (LOS). There was no difference in incidence of all other 30-day complications. When evaluating BSA via ROC, the area under the curve (AUC) was found to be 0.730 and was significant. Children with a BSA greater than 0.408 m 2 were more likely to have MIS (sensitivity, 66.9%; specificity, 69.3%). Regarding age, the AUC was 0.732. Children older than 637.5 days were more likely to have MIS (sensitivity, 72.8%; specificity, 63.3%). Pediatric MIS is associated with longer operative time for nephrectomy, but shorter LOS following PN. Surgical approach was not associated with difference in short-term complications.

Investigation of Fat Metabolism during Antiobesity Interventions by Magnetic Resonance Imaging and Spectroscopy.

PubMed

Pola, Arunima; Sadananthan, Suresh Anand; Gopalan, Venkatesh; Tan, Min-Li Sandra; Keong, Terry Yew; Zhou, Zhihong; Ishino, Seigo; Nakano, Yoshihide; Watanabe, Masanori; Horiguchi, Takashi; Nishimoto, Tomoyuki; Zhu, Bin; Velan, S Sendhil

2014-01-01

The focus of current treatments for obesity is to reduce the body weight or visceral fat, which requires longer duration to show effect. In this study, we investigated the short-term changes in fat metabolism in liver, abdomen, and skeletal muscle during antiobesity interventions including Sibutra mine treatment and diet restriction in obese rats using magnetic resonance imaging, magnetic resonance spectroscopy, and blood chemistry. Sibutramine is an antiobesity drug that results in weight loss by increasing satiety and energy expenditure. The Sibutramine-treated rats showed reduction of liver fat and intramyocellular lipids on day 3. The triglycerides (TG) decreased on day 1 and 3 compared to baseline (day 0). The early response/nonresponse in different fat depots will permit optimization of treatment for better clinical outcome rather than staying with a drug for longer periods.

The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis.

PubMed

Stevens, Briony; Buettner, Petra; Watt, Kerrianne; Clough, Alan; Brimblecombe, Julie; Judd, Jenni

2015-10-01

The beneficial effect of balanced protein energy supplementation during pregnancy on subsequent child growth is unclear and may depend upon the mother entering pregnancy adequately nourished or undernourished. Systematic reviews to-date have included studies from high-, middle- and low-income countries. However, the effect of balanced protein energy supplementation should not be generalised. This review assesses the effect of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries on child growth. A systematic review of articles published in English (1970-2015) was conducted via MEDLINE, Scopus, the Cochrane Register and hand searching. Only peer-reviewed experimental studies analysing the effects of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries with measures of physical growth as the primary outcome were included. Two reviewers independently assessed full-text articles against inclusion criteria. Validity of eligible studies was ascertained using the Quality Assessment Tool for Quantitative Studies (EPHPP QAT). In total, seven studies met the inclusion criteria. All studies reported on birthweight, five on birth length, three on birth head circumference, and one on longer-term growth. Standardised mean differences were calculated using a random-effects meta-analysis. Balanced protein energy supplementation significantly improved birthweight (seven randomised controlled trials, n = 2367; d = 0.20, 95% confidence interval, 0.03-0.38, P = 0.02). No significant benefit was observed on birth length or birth head circumference. Impact of intervention could not be determined for longer-term physical growth due to limited evidence. Additional research is required in low- and middle-income countries to identify impacts on longer-term infant growth. © 2015 John Wiley & Sons Ltd.

Feasibility and acceptability of insecticide-treated plastic sheeting (ITPS) for vector control in Papua New Guinea

PubMed Central

2012-01-01

Background This study assessed the feasibility and acceptability of utilizing insecticide-treated plastic sheeting (ITPS) as a malaria control intervention in Papua New Guinea (PNG). Methods ZeroVector® ITPS was installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires were completed at the time of ITPS installation (n=40) and at four weeks post installation (n=40) with the household head. Similarly, group interviews with the male and/or female household heads were completed at installation (n=5) and four-week follow-up (n=4). Results ZeroVector® ITPS was successfully installed in a range of homes employing traditional and/or modern building materials in PNG. The ITPS installations remained intact over the course of the four-week trial period and were highly acceptable to both male and female household heads. No dissatisfaction with the ITPS product was reported at four-week follow-up; however, the installation process was time consuming, participants reported a reduction in mosquito net use following ITPS installation and many participants expressed concern about the longevity of ITPS over the longer term. Conclusion ZeroVector® ITPS installation is feasible and highly acceptable in a diverse range of PNG contexts and is likely to be favourably received as a vector control intervention if accessible en masse. A longer-term evaluation is required before firm policy or public health decisions can be made regarding the potential application of ITPS in the national malaria control programme. The positive study findings suggest a longer-term evaluation of this promising malaria control intervention warrants consideration. PMID:23046535

Feasibility and acceptability of insecticide-treated plastic sheeting (ITPS) for vector control in Papua New Guinea.

PubMed

Pulford, Justin; Tandrapah, Anthony; Atkinson, Jo-An; Kaupa, Brown; Russell, Tanya; Hetzel, Manuel W

2012-10-09

This study assessed the feasibility and acceptability of utilizing insecticide-treated plastic sheeting (ITPS) as a malaria control intervention in Papua New Guinea (PNG). ZeroVector® ITPS was installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires were completed at the time of ITPS installation (n=40) and at four weeks post installation (n=40) with the household head. Similarly, group interviews with the male and/or female household heads were completed at installation (n=5) and four-week follow-up (n=4). ZeroVector® ITPS was successfully installed in a range of homes employing traditional and/or modern building materials in PNG. The ITPS installations remained intact over the course of the four-week trial period and were highly acceptable to both male and female household heads. No dissatisfaction with the ITPS product was reported at four-week follow-up; however, the installation process was time consuming, participants reported a reduction in mosquito net use following ITPS installation and many participants expressed concern about the longevity of ITPS over the longer term. ZeroVector® ITPS installation is feasible and highly acceptable in a diverse range of PNG contexts and is likely to be favourably received as a vector control intervention if accessible en masse. A longer-term evaluation is required before firm policy or public health decisions can be made regarding the potential application of ITPS in the national malaria control programme. The positive study findings suggest a longer-term evaluation of this promising malaria control intervention warrants consideration.

Growth of Greenland ice sheet - Interpretation

NASA Technical Reports Server (NTRS)

Zwally, H. Jay

1989-01-01

An observed 0.23 m/year thickening of the Greenland ice sheet indicates a 25 percent to 45 percent excess ice accumulation over the amount required to balance the outward ice flow. The implied global sea-level depletion is 0.2 to 0.4 mm/year, depending on whether the thickening is only recent (5 to 10 years) or longer term (less than 100 years). If there is a similar imbalance in the northern 60 percent of the ice-sheet area, the depletion is 0.35 to 0.7 mm/year. Increasing ice thickness suggests that the precipitation is higher than the long-term average; higher precipitation may be a characteristic of warmer climates in polar regions.

CF6-6D engine performance deterioration

NASA Technical Reports Server (NTRS)

Wulf, R. H.; Kramer, W. H.; Pass, J. E.; Smith, J. J.

1980-01-01

Cruise cockpit recordings and test cell performance data in conjunction with hardware inspection data from airline overhaul shops were analyzed to define the extent and magnitude of performance deterioration of the General Electric CF6-6D model engine. These studies successfully isolated short-term deterioration from the longer term, and defined areas where a significant reduction in aircraft energy requirements for the 1980's can be realized. Unrestored losses which remain after engine refurbishment represent over 70% of the loss at engine shop visit. Sixty-three percent of the unrestored losses are cost-effective to restore which could reduce fuel consumed by CF6-6D engines in 1980 by 10.9 million gallons.

Catheter-based renal denervation for treatment of resistant hypertension

PubMed Central

Hatipoglu, Emine; Ferro, Albert

2013-01-01

Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy. PMID:24175081

Parental distress in response to childhood medical trauma: A mediation model.

PubMed

Currie, Roseanne; Anderson, Vicki A; McCarthy, Maria C; Burke, Kylie; Hearps, Stephen Jc; Muscara, Frank

2018-04-01

This study explored the relationship between individual and family-level risk in predicting longer-term parental distress following their child's unexpected diagnosis of serious illness. A mediation model was tested, whereby parents' pre-existing psychosocial risk predicts longer-term posttraumatic stress symptoms, indirectly through parents' acute stress response. One hundred and thirty-two parents of 104 children participated. Acute stress response partially mediated the relationship between psychosocial risk and posttraumatic stress symptoms, with a moderate indirect effect ( r 2 = .20, P M = .56, p < .001). Findings demonstrated that cumulative psychosocial risk factors predispose parents to acute stress and longer-term posttraumatic stress symptoms, highlighting the need for psychosocial screening in this population.

Lack of regulation of 11β-hydroxysteroid dehydrogenase type 1 during short-term manipulation of GH in patients with hypopituitarism

PubMed Central

Sigurjonsdottir, Helga A; Andrew, Ruth; Stimson, Roland H; Johannsson, Gudmundur; Walker, Brian R

2009-01-01

Objective Evidence from long-term clinical studies measuring urinary steroid ratios, and from in vitro studies, suggests that GH administered for longer than 2 months down-regulates 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), thereby reducing cortisol regeneration in liver and adipose tissue. We aimed to measure acute effects of GH on 11β-HSD1 in liver and adipose tissue in vivo, including using a stable isotope tracer. Design Observational studies of GH withdrawal and reintroduction in patients with hypopituitarism. Methods Twelve men with benign pituitary disease causing GH and ACTH deficiency on stable replacement therapy for >6 months were studied after GH withdrawal for 3 weeks, and after either placebo or GH injections were reintroduced for another 3 weeks. We measured cortisol kinetics during 9,11,12,12-2H4-cortisol (d4-cortisol) infusion, urinary cortisol/cortisone metabolite ratios, liver 11β-HSD1 by appearance of plasma cortisol after oral cortisone, and 11β-HSD1 mRNA levels in subcutaneous adipose biopsies. Results GH withdrawal and reintroduction had no effect on 9,12,12-[2H]3-cortisol (d3-cortisol) appearance, urinary cortisol/cortisone metabolite ratios, initial appearance of cortisol after oral cortisone, or adipose 11β-HSD1 mRNA. GH withdrawal increased plasma cortisol 30–180 min after oral cortisone, increased d4-cortisol clearance, and decreased relative excretion of 5α-reduced cortisol metabolites. Conclusions In this setting, GH did not regulate 11β-HSD1 rapidly in vivo in humans. Altered cortisol metabolism with longer term changes in GH may reflect indirect effects on 11β-HSD1. These data do not suggest that glucocorticoid replacement doses need to be increased immediately after introducing GH therapy to compensate for reduced 11β-HSD1 activity, although dose adjustment may be required in the longer term. PMID:19549748

A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems

PubMed Central

Taylor, Tatiana L; Killaspy, Helen; Wright, Christine; Turton, Penny; White, Sarah; Kallert, Thomas W; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kališová, Lucie; Onchev, Georgi; Dimitrov, Hristo; Mezzina, Roberto; Wolf, Kinou; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitri; Gonidakis, Fragiskos; Caldas-de-Almeida, José; Cardoso, Graça; King, Michael B

2009-01-01

Background A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to identify the key components of institutional care for people with longer term mental health problems and the effectiveness of these components. Methods We undertook a systematic review of the literature using comprehensive search terms in 11 electronic databases and identified 12,182 titles. We viewed 550 abstracts, reviewed 223 papers and included 110 of these. A "critical interpretative synthesis" of the evidence was used to identify domains of institutional care that are key to service users' recovery. Results We identified eight domains of institutional care that were key to service users' recovery: living conditions; interventions for schizophrenia; physical health; restraint and seclusion; staff training and support; therapeutic relationship; autonomy and service user involvement; and clinical governance. Evidence was strongest for specific interventions for the treatment of schizophrenia (family psychoeducation, cognitive behavioural therapy (CBT) and vocational rehabilitation). Conclusion Institutions should, ideally, be community based, operate a flexible regime, maintain a low density of residents and maximise residents' privacy. For service users with a diagnosis of schizophrenia, specific interventions (CBT, family interventions involving psychoeducation, and supported employment) should be provided through integrated programmes. Restraint and seclusion should be avoided wherever possible and staff should have adequate training in de-escalation techniques. Regular staff supervision should be provided and this should support service user involvement in decision making and positive therapeutic relationships between staff and service users. There should be clear lines of clinical governance that ensure adherence to evidence-based guidelines and attention should be paid to service users' physical health through regular screening. PMID:19735562

A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems.

PubMed

Taylor, Tatiana L; Killaspy, Helen; Wright, Christine; Turton, Penny; White, Sarah; Kallert, Thomas W; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisová, Lucie; Onchev, Georgi; Dimitrov, Hristo; Mezzina, Roberto; Wolf, Kinou; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitri; Gonidakis, Fragiskos; Caldas-de-Almeida, José; Cardoso, Graça; King, Michael B

2009-09-07

A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to identify the key components of institutional care for people with longer term mental health problems and the effectiveness of these components. We undertook a systematic review of the literature using comprehensive search terms in 11 electronic databases and identified 12,182 titles. We viewed 550 abstracts, reviewed 223 papers and included 110 of these. A "critical interpretative synthesis" of the evidence was used to identify domains of institutional care that are key to service users' recovery. We identified eight domains of institutional care that were key to service users' recovery: living conditions; interventions for schizophrenia; physical health; restraint and seclusion; staff training and support; therapeutic relationship; autonomy and service user involvement; and clinical governance. Evidence was strongest for specific interventions for the treatment of schizophrenia (family psychoeducation, cognitive behavioural therapy (CBT) and vocational rehabilitation). Institutions should, ideally, be community based, operate a flexible regime, maintain a low density of residents and maximise residents' privacy. For service users with a diagnosis of schizophrenia, specific interventions (CBT, family interventions involving psychoeducation, and supported employment) should be provided through integrated programmes. Restraint and seclusion should be avoided wherever possible and staff should have adequate training in de-escalation techniques. Regular staff supervision should be provided and this should support service user involvement in decision making and positive therapeutic relationships between staff and service users. There should be clear lines of clinical governance that ensure adherence to evidence-based guidelines and attention should be paid to service users' physical health through regular screening.

Health Care Costs of Spontaneous Aneurysmal Subarachnoid Hemorrhage for Rehabilitation, Home Care, and In-Hospital Treatment for the First Year.

PubMed

Ridwan, Sami; Urbach, Horst; Greschus, Susanne; von Hagen, Johanna; Esche, Jonas; Boström, Azize

2017-01-01

Given the young age of onset and high probability of long-term disability after subarachnoid hemorrhage (SAH), the financial impact is expected to be substantial. Our primary objective was to highlight subsequent treatment costs after the acute in-hospital stay, including rehabilitation and home care, compared with costs for ischemic stroke. The study included 101 patients (median age 52 years, 70 women) with aneurysmal SAH treated from July 2007 to April 2009. In-hospital costs were calculated using German diagnosis related groups. Rehabilitation costs depended on rehabilitation phase/grade and daily rate. Level of severity of care requirements determined the costs for home care. Of patients, 54% received coiling and 46% received clipping. The clipping group included more poor-grade patients than the coiling group (P = 0.039); 23 patients died. Of 78 surviving patients, 70 received rehabilitation treatment (68 in Germany). Mean rehabilitation costs were €16,030 per patient. Patients in the clipping group generated higher rehabilitation costs and longer treatment periods in rehabilitation facilities (P = 0.001 for costs [€20,290 vs. €11,771] and P = 0.011 for duration (54.4 days vs. 40.5 days). Of surviving patients, 32% needed home care, of whom 52% required constant care. Multivariate regression analysis identified longer intensive care unit stay and poor Hunt and Hess grade as independent predictors of higher costs. Aneurysmal SAH prevalently affects working individuals with long-term occupational disability necessitating long-term medical rehabilitation for most patients and subsequent nursing care in one third of survivors. Overall, SAH treatment generates far higher costs than reported for ischemic stroke. Copyright © 2016 Elsevier Inc. All rights reserved.

The longer term experiences of parent training: a qualitative analysis.

PubMed

Furlong, M; McGilloway, S

2015-09-01

Child conduct problems are a major public health priority. Group-based parenting programmes are popular in addressing such problems, but evidence for their longer-term effectiveness is limited. Moreover, process evaluations are rare and little is understood about the key facilitative and inhibitive factors associated with maintaining outcomes in the longer term. This study involved the use of qualitative methods as part of a larger process evaluation to explore the longer-term experiences of parents who participated in a randomized controlled trial (RCT) of the Incredible Years Parenting Programme (IYPP) in disadvantaged settings in Ireland. A series of one-to-one in-depth interviews was conducted with parents at 12- (n = 20) and 18-month follow-up (n = 8) and analysed using constructivist grounded theory. Most parents reported positive child behaviour despite several challenges, but a substantial subset reported periods of relapse in positive outcomes. A relapse in child behaviour was linked to relinquishing skills in stressful times, the negative influence of an unsupportive environment, and the perceived ineffectiveness of parenting skills. Resilience in implementing skills despite adversity, and the utilization of available social supports, were associated with the maintenance of positive outcomes. Strengthening resilience and social support capacities may be important factors in maintaining positive longer-term outcomes. Those who design, research and deliver parenting programmes might consider the possibility of including a relapse-prevention module and/or the provision of post-intervention supports for more vulnerable families. © 2014 John Wiley & Sons Ltd.

Evaluating the feasibility of biological waste processing for long term space missions.

PubMed

Garland, J L; Alazraki, M P; Atkinson, C F; Finger, B W

1998-01-01

Recycling waste products during orbital (e.g., International Space Station) and planetary missions (e.g., lunar base, Mars transit mission, Martian base) will reduce storage and resupply costs. Wastes streams on the space station will include human hygiene water, urine, faeces, and trash. Longer term missions will contain human waste and inedible plant material from plant growth systems used for atmospheric regeneration, food production, and water recycling. The feasibility of biological and physical-chemical waste recycling is being investigated as part of National Aeronautics and Space Administration's (NASA) Advanced Life Support (ALS) Program. In-vessel composting has lower manpower requirements, lower water and volume requirements, and greater potential for sanitization of human waste compared to alternative bioreactor designs such as continuously stirred tank reactors (CSTR). Residual solids from the process (i.e. compost) could be used a biological air filter, a plant nutrient source, and a carbon sink. Potential in-vessel composting designs for both near- and long-term space missions are presented and discussed with respect to the unique aspects of space-based systems.

Evaluating the feasibility of biological waste processing for long term space missions

NASA Technical Reports Server (NTRS)

Garland, J. L.; Alazraki, M. P.; Atkinson, C. F.; Finger, B. W.; Sager, J. C. (Principal Investigator)

1998-01-01

Recycling waste products during orbital (e.g., International Space Station) and planetary missions (e.g., lunar base, Mars transit mission, Martian base) will reduce storage and resupply costs. Wastes streams on the space station will include human hygiene water, urine, faeces, and trash. Longer term missions will contain human waste and inedible plant material from plant growth systems used for atmospheric regeneration, food production, and water recycling. The feasibility of biological and physical-chemical waste recycling is being investigated as part of National Aeronautics and Space Administration's (NASA) Advanced Life Support (ALS) Program. In-vessel composting has lower manpower requirements, lower water and volume requirements, and greater potential for sanitization of human waste compared to alternative bioreactor designs such as continuously stirred tank reactors (CSTR). Residual solids from the process (i.e. compost) could be used a biological air filter, a plant nutrient source, and a carbon sink. Potential in-vessel composting designs for both near- and long-term space missions are presented and discussed with respect to the unique aspects of space-based systems.

Dendritic sodium spikes are required for long-term potentiation at distal synapses on hippocampal pyramidal neurons

PubMed Central

Kim, Yujin; Hsu, Ching-Lung; Cembrowski, Mark S; Mensh, Brett D; Spruston, Nelson

2015-01-01

Dendritic integration of synaptic inputs mediates rapid neural computation as well as longer-lasting plasticity. Several channel types can mediate dendritically initiated spikes (dSpikes), which may impact information processing and storage across multiple timescales; however, the roles of different channels in the rapid vs long-term effects of dSpikes are unknown. We show here that dSpikes mediated by Nav channels (blocked by a low concentration of TTX) are required for long-term potentiation (LTP) in the distal apical dendrites of hippocampal pyramidal neurons. Furthermore, imaging, simulations, and buffering experiments all support a model whereby fast Nav channel-mediated dSpikes (Na-dSpikes) contribute to LTP induction by promoting large, transient, localized increases in intracellular calcium concentration near the calcium-conducting pores of NMDAR and L-type Cav channels. Thus, in addition to contributing to rapid neural processing, Na-dSpikes are likely to contribute to memory formation via their role in long-lasting synaptic plasticity. DOI: http://dx.doi.org/10.7554/eLife.06414.001 PMID:26247712

Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status.

PubMed

Shah, Meena; Simha, Vinaya; Garg, Abhimanyu

2006-11-01

The number of patients who undergo Roux-en-Y gastric bypass (RYGB) and gastric banding (GB) surgeries has increased dramatically over the past decade, yet the long-term impact of these surgeries on body weight, comorbidities, and nutritional status remains unclear, as do the mechanisms of weight regain. The articles were found via PubMed searches. To review the impact of bariatric surgery on weight maintenance and comorbidities, only articles with a postoperative follow-up of 3 yr or longer were included. The articles on nutritional status had a follow-up of 12 months or longer. RYGB and GB surgeries lead to substantial weight loss in individuals with morbid obesity. However, significant weight regain occurs over the long term, and according to the only well-designed prospective controlled study, the improvement in comorbidities associated with weight loss mitigates in the long term on weight regain. There is some evidence from a retrospective study that RYGB surgery is associated with a modest decrease in long-term mortality. These results remain to be substantiated by well-designed, long-term, randomized and prospective controlled studies. The mechanisms that lead to weight regain need to be further examined and may include increase in energy intake due to enlargement of stoma and adaptive changes in the levels of gut and adipocyte hormones such as ghrelin and leptin, which regulate energy intake; decrease in physical activity; changes in energy expenditure; and other factors. In addition to weight regain, RYGB surgery is associated with frequent incidence of iron, vitamin B12, folate, calcium, and vitamin D deficiency, which requires regular supplementation and monitoring.

Current Status and Future Potential of Transcatheter Interventions in Congenital Heart Disease.

PubMed

Kenny, Damien P; Hijazi, Ziyad M

2017-03-17

Percutaneous therapies for congenital heart disease have evolved rapidly in the past 3 decades. This has occurred despite limited investment from industry and support from regulatory bodies resulting in a lack of specific device development. Indeed, many devices remain off-label with a best-fit approach often required, spurning an innovative culture within the subspecialty, which had arguably laid the foundation for many of the current and evolving structural heart interventions. Challenges remain, not least encouraging device design focused on smaller infants and the inevitable consequences of somatic growth. Data collection tools are emerging but remain behind adult cardiology and cardiac surgery and leading to partial blindness as to the longer-term consequences of our interventions. Tail coating on the back of developments in other fields of adult intervention will soon fail to meet the expanding needs for more precise interventions and biological materials. Increasing collaboration with surgical colleagues will require development of dedicated equipment for hybrid interventions aimed at minimizing the longer-term consequences of scar to the heart. Therefore, great challenges remain to ensure that children and adults with congenital heart disease continue to benefit from an exponential growth in minimally invasive interventions and technology. This can only be achieved through a concerted collaborative approach from physicians, industry, academia, and regulatory bodies supporting great innovators to continue the philosophy of thinking beyond the limits that has been the foundation of our specialty for the past 50 years. © 2017 American Heart Association, Inc.

Coastal and Estuarine Mangrove Squeeze in the Mekong and Saigon Delta

NASA Astrophysics Data System (ADS)

Stive, M.

2016-02-01

Both in the Mekong and Saigon deltas coastal squeeze is a frequent and pregnant problem, which leads to amazingly alarmous coastal and estuarine erosion rates. From the landside the squeeze is due to encroaching dike relocations and agri- and aquacultures, from the sea side it is due to decreasing sediment sources and relative sea level rise. These multiple pressures at some locations, certainly away from the sediment sources (like Ca Mau) leads to unprecedentent erosion rates. Managed retreat may be a longer term solution, but this will require a new way of thinking. Sandy and silt nourishment strategies may be an innovative alternative, but will require underbuilding scientific and practical research.

Longer-term effects of selective thinning on microarthropod communities in a late-successional coniferous forest.

Treesearch

Robert W. Peck; Christine G. Niwa

2005-01-01

Microarthropod densities within late-successional coniferous forests thinned 16-41 yr before sampling were compared with adjacent unthinned stands to identify longer term effects of thinning on this community. Soil and forest floor layers were sampled separately on eight paired sites. Within the forest floor oribatid, mesostigmatid, and to a marginal extent,...

12-Month Follow-Up of Fluoxetine and Cognitive Behavioral Therapy for Binge Eating Disorder

ERIC Educational Resources Information Center

Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.

2012-01-01

Objective: The longer term efficacy of medication treatments for binge-eating disorder (BED) remains unknown. This study examined the longer term effects of fluoxetine and cognitive behavioral therapy (CBT) either with fluoxetine (CBT + fluoxetine) or with placebo (CBT + placebo) for BED through 12-month follow-up after completing treatments.…

Mutual Adaptation: Enhancing Longer-Term Sustainability of Cross-Cultural In-Service Teacher Training Initiatives in China

ERIC Educational Resources Information Center

Yan, Chunmei

2008-01-01

This paper reports on a study that examines decisive factors for longer-term sustainability of cross-cultural teacher training initiatives in China. It focuses on teacher trainees' perspectives of a Sino-British adult education English language teaching project based in Central China. Questionnaires and semi-structured interviews were employed to…

NICU management and outcomes of infants with trisomy 21 without major anomalies.

PubMed

McAndrew, Sarah; Acharya, Krishna; Nghiem-Rao, T Hang; Leuthner, Steven; Clark, Reese; Lagatta, Joanne

2018-05-25

To describe how trisomy 21 affects neonatal intensive care management and outcomes of full-term infants without congenital anomalies. Retrospective cohort of full-term infants without anomalies with and without trisomy 21 admitted to Pediatrix NICUs from 2005 to 2012. We compared diagnoses, management, length of stay, and discharge outcomes. In all, 4623 infants with trisomy 21 and 606 770 infants without trisomy 21 were identified. One-third of infants in the NICU with and without trisomy 21 were full term without major anomalies. Trisomy 21 infants had more respiratory distress, thrombocytopenia, feeding problems, and pulmonary hypertension. They received respiratory support for a longer period of time and had a longer length of stay. One-third of infants with trisomy 21 admitted to the NICU are full term without major anomalies. Common diagnoses and greater respiratory needs place infants with trisomy 21 at risk for longer length of stay.

Microbiological and abiotic processes in modelling longer-term marine corrosion of steel.

PubMed

Melchers, Robert E

2014-06-01

Longer term exposure of mild steel in natural (biotic) waters progresses as a bimodal function of time, both for corrosion mass loss and for pit depth. Recent test results, however, found this also for immersion in clean fresh, almost pure and triply distilled waters. This shows chlorides or microbiological activity is not essential for the electrochemical processes producing bimodal behaviour. It is proposed that the first mode is aerobic corrosion that eventually produces a non-homogeneous corroded surface and rust coverage sufficient to allow formation of anoxic niches. Within these, aggressive autocatalytic reduction then occurs under anoxic abiotic conditions, caused by sulfide species originating from the MnS inclusions typical in steels. This is consistent with Wranglen's model for abiotic anoxic crevice and pitting corrosion without external aggressive ions. In biotic conditions, metabolites from anaerobic bacterial activity within and near the anoxic niches provides additional (sulfide) species to contribute to the severity of corrosion. Limited observational evidence that supports this hypothesis is given but further investigation is required to determine all contributor(s) to the cathodic current for the electrochemical reaction. The results are important for estimating the contribution of microbiological corrosion in infrastructure applications. © 2013.

In situ treatment with activated carbon reduces bioaccumulation in aquatic food chains.

PubMed

Kupryianchyk, D; Rakowska, M I; Roessink, I; Reichman, E P; Grotenhuis, J T C; Koelmans, A A

2013-05-07

In situ activated carbon (AC) amendment is a new direction in contaminated sediment management, yet its effectiveness and safety have never been tested on the level of entire food chains including fish. Here we tested the effects of three different AC treatments on hydrophobic organic chemical (HOC) concentrations in pore water, benthic invertebrates, zooplankton, and fish (Leuciscus idus melanotus). AC treatments were mixing with powdered AC (PAC), mixing with granular AC (GAC), and addition-removal of GAC (sediment stripping). The AC treatments resulted in a significant decrease in HOC concentrations in pore water, benthic invertebrates, zooplankton, macrophytes, and fish. In 6 months, PAC treatment caused a reduction of accumulation of polychlorobiphenyls (PCB) in fish by a factor of 20, bringing pollutant levels below toxic thresholds. All AC treatments supported growth of fish, but growth was inhibited in the PAC treatment, which was likely explained by reduced nutrient concentrations, resulting in lower zooplankton (i.e., food) densities for the fish. PAC treatment may be advised for sites where immediate ecosystem protection is required. GAC treatment may be equally effective in the longer term and may be adequate for vulnerable ecosystems where longer-term protection suffices.

Optimizing the measurement of mitochondrial protein synthesis in human skeletal muscle.

PubMed

Burd, Nicholas A; Tardif, Nicolas; Rooyackers, Olav; van Loon, Luc J C

2015-01-01

The measurement of mitochondrial protein synthesis after food ingestion, contractile activity, and/or disease is often used to provide insight into skeletal muscle adaptations that occur in the longer term. Studies have shown that protein ingestion stimulates mitochondrial protein synthesis in human skeletal muscle. Minor differences in the stimulation of mitochondrial protein synthesis occur after a single bout of resistance or endurance exercise. There appear to be no measurable differences in mitochondrial protein synthesis between critically ill patients and aged-matched controls. However, the mitochondrial protein synthetic response is reduced at a more advanced age. In this paper, we discuss the challenges involved in the measurement of human skeletal muscle mitochondrial protein synthesis rates based on stable isotope amino acid tracer methods. Practical guidelines are discussed to improve the reliability of the measurement of mitochondrial protein synthesis rates. The value of the measurement of mitochondrial protein synthesis after a single meal or exercise bout on the prediction of the longer term skeletal muscle mass and performance outcomes in both the healthy and disease populations requires more work, but we emphasize that the measurements need to be reliable to be of any value to the field.

Comprehension of Navigation Directions

NASA Technical Reports Server (NTRS)

Schneider, Vivian I.; Healy, Alice F.

2000-01-01

In an experiment simulating communication between air traffic controllers and pilots, subjects were given navigation instructions varying in length telling them to move in a space represented by grids on a computer screen. The subjects followed the instructions by clicking on the grids in the locations specified. Half of the subjects read the instructions, and half heard them. Half of the subjects in each modality condition repeated back the instructions before following them,and half did not. Performance was worse for the visual than for the auditory modality on the longer messages. Repetition of the instructions generally depressed performance, especially with the longer messages, which required more output than did the shorter messages, and especially with the visual modality, in which phonological recoding from the visual input to the spoken output was necessary. These results are explained in terms of the degrading effects of output interference on memory for instructions.

Pharmacological Treatment of Binge Eating Disorder: Update Review and Synthesis

PubMed Central

Reas, Deborah L.; Grilo, Carlos M.

2015-01-01

Introduction Binge-eating disorder (BED), a formal eating-disorder diagnosis in the DSM-5, is characterized by recurrent binge-eating, marked distress about binge-eating, and the absence of extreme weight compensatory behaviors. BED is more prevalent than other eating-disorders, with broader distribution across age, sex, and ethnic/racial groups, and is associated strongly with obesity and heightened risk for psychiatric/medical comorbidities. Areas Covered This article provides an overview of pharmacotherapy for BED with a focus on III randomized controlled trials (RCTs). The search with minimal methodological inclusion requirements yielded 22 RCTs investigating several different medication classes; most were pharmacotherapy-only trials with eight trials testing combination approaches with psychological-behavioral methods. Expert Opinion The evidence base regarding pharmacotherapy for BED remains limited, although this year the FDA approved the first medication (i.e., lisdexamfetamine dimesylate; LDX) specifically for moderate-to-severe BED. Data from RCTs suggests certain medications are superior to placebo for reducing binge-eating over the short-term; almost no data exist regarding longer-term effects of pharmacotherapy for BED. Except for topiramate, which significantly reduces both binge-eating and weight, tested medications yield minimal weight loss and LDX is not indicated for weight loss. Psychological-behavioral and combination approaches with certain medications yield superior outcomes to pharmacotherapy-only acutely and over longer-term follow-up. PMID:26044518

Challenges to achieving sustainable community health development within a donor aid business model.

PubMed

Ashwell, Helen; Barclay, Lesley

2010-06-01

This paper explores the paradox of donor aid being delivered through a business model through a case study in Papua New Guinea. A retrospective review of project implementation and an outcome evaluation provided an opportunity to examine the long-term results and sustainability of a large project. Analysis was informed by data collected from 175 interviews (national, provincial, district and village), 93 community discussions and observations across 10 provinces. Problems with the business model of delivering aid were evident from implementation data and in an evaluation conducted two years after project completion (2006). Compounding the business model effect were challenges of over-ambitious project goals with limited flexibility to adapt to changing circumstances, a donor payment system requiring short-term productivity and excessive reporting requirements. An overly ambitious project design, donor dominance within the business model and limited local counterpart capacity created problems in the community initiatives component of the project. Contractual pressures can negatively influence long-term outcomes that require development of local leadership and capacity. Future planning for donor project designs needs to be flexible, smaller in scope and have a longer timeframe of seven to 10 years. Donor-funded projects need to be sufficiently flexible to apply proven principles of community development, build local ownership and allow adequate time to build counterpart knowledge and skills.

How Are They Now? Longer Term Effects of eCoaching through Online Bug-in-Ear Technology

ERIC Educational Resources Information Center

Rock, Marcia L.; Schumacker, Randall E.; Gregg, Madeleine; Howard, Pamela W.; Gable, Robert A.; Zigmond, Naomi

2014-01-01

In this study, using mixed methods, we investigated the longer term effects of eCoaching through advanced online bug-in-ear (BIE) technology. Quantitative data on five dependent variables were extracted from 14 participants' electronically archived video files at three points in time--Spring 1 (i.e., baseline, which was the first semester of…

A Mixed-Methods Evaluation of the Longer-Term Implementation and Utility of a Teacher Classroom Management Training Programme in Irish Primary Schools

ERIC Educational Resources Information Center

Leckey, Yvonne; Hyland, Lynda; Hickey, Gráinne; Lodge, Anne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Donnelly, Michael; McGilloway, Sinéad

2016-01-01

Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the "Incredible Years Teacher [Classroom Management]" programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to…

The Future Is More than Just Tomorrow: Higher Education, the Economy and the Longer Term

ERIC Educational Resources Information Center

Crossick, Geoffrey

2010-01-01

In this commentary the author reflects on longer-term issues facing higher education in the context of recession and crisis in public finance. The views expressed are written from a personal perspective with the aim of stimulating and encouraging a wider and ongoing debate around the themes presented. The author draws upon the findings of three…

CW injection locking for long-term stability of frequency combs

NASA Astrophysics Data System (ADS)

Williams, Charles; Quinlan, Franklyn; Delfyett, Peter J.

2009-05-01

Harmonically mode-locked semiconductor lasers with external ring cavities offer high repetition rate pulse trains while maintaining low optical linewidth via long cavity storage times. Continuous wave (CW) injection locking further reduces linewidth and stabilizes the optical frequencies. The output can be stabilized long-term with the help of a modified Pound-Drever-Hall feedback loop. Optical sidemode suppression of 36 dB has been shown, as well as RF supermode noise suppression of 14 dB for longer than 1 hour. In addition to the injection locking of harmonically mode-locked lasers requiring an external frequency source, recent work shows the viability of the injection locking technique for regeneratively mode-locked lasers, or Coupled Opto-Electronic Oscillators (COEO).

Long-term effectiveness and cost-effectiveness of high versus low-to-moderate intensity resistance and endurance exercise interventions among cancer survivors.

PubMed

Kampshoff, C S; van Dongen, J M; van Mechelen, W; Schep, G; Vreugdenhil, A; Twisk, J W R; Bosmans, J E; Brug, J; Chinapaw, M J M; Buffart, Laurien M

2018-06-01

This study aimed to evaluate the long-term effectiveness and cost-effectiveness of high intensity (HI) versus low-to-moderate intensity (LMI) exercise on physical fitness, fatigue, and health-related quality of life (HRQoL) in cancer survivors. Two hundred seventy-seven cancer survivors participated in the Resistance and Endurance exercise After ChemoTherapy (REACT) study and were randomized to 12 weeks of HI (n = 139) or LMI exercise (n = 138) that had similar exercise types, durations, and frequencies, but different intensities. Measurements were performed at baseline (4-6 weeks after primary treatment), and 12 (i.e., short term) and 64 (i.e., longer term) weeks later. Outcomes included cardiorespiratory fitness, muscle strength, self-reported fatigue, HRQoL, quality-adjusted life years (QALYs) and societal costs. Linear mixed models were conducted to study (a) differences in effects between HI and LMI exercise at longer term, (b) within-group changes from short term to longer term, and (c) the cost-effectiveness from a societal perspective. At longer term, intervention effects on role (β = 5.9, 95% CI = 0.5; 11.3) and social functioning (β = 5.7, 95%CI = 1.7; 9.6) were larger for HI compared to those for LMI exercise. No significant between-group differences were found for physical fitness and fatigue. Intervention-induced improvements in cardiorespiratory fitness and HRQoL were maintained between weeks 12 and 64, but not for fatigue. From a societal perspective, the probability that HI was cost-effective compared to LMI exercise was 0.91 at 20,000€/QALY and 0.95 at 52,000€/QALY gained, mostly due to significant lower healthcare costs in HI exrcise. At longer term, we found larger intervention effects on role and social functioning for HI than for LMI exercise. Furthermore, HI exercise was cost-effective with regard to QALYs compared to LMI exercise. This study is registered at the Netherlands Trial Register [NTR2153 [ http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2153

PubMed Central

2000-01-01

• A cream containing 0.05% tretinoin (Retinova® is approved for treatment of sun-induced skin damage (“photoaging”). • Three trials comparing tretinoin with the excipient show that the effects of tretinoin cream are at best limited and slow to occur. Furthermore, they disappear on treatment cessation, necessitating long-term use. • The 0.05% tretinoin cream has poor local tolerability: most subjects develop irritation and fragile skin and require longer intervals between each application. Systemic adverse effects occur in some circumstances. • There are persistent doubts about whether it is safe to use tretinoin during pregnancy. PMID:10790815

LAW ENFORCEMENT TECHNOLOGY ROADMAP: LESSONS TO DATE FROM THE NORTHWEST TECHNOLOGY DESK AND THE NORTHWEST FADE PILOTS

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

West, Curtis L.; Kreyling, Sean J.

The goal of this report is to provide insight into the information technology needs of law enforcement based on first hand observations as an embedded and active participant over the course of two plus years. This report is intended as a preliminary roadmap for technology and project investment that will benefit the entire law enforcement community nationwide. Some recommendations are immediate and have more of an engineering flavor, while others are longer term and will require research and development to solve.

Results and Analysis from Space Suit Joint Torque Testing

NASA Technical Reports Server (NTRS)

Matty, Jennifer E.; Aitchison, Lindsay

2009-01-01

A space suit s mobility is critical to an astronaut s ability to perform work efficiently. As mobility increases, the astronaut can perform tasks for longer durations with less fatigue. The term mobility, with respect to space suits, is defined in terms of two key components: joint range of motion and joint torque. Individually these measures describe the path which in which a joint travels and the force required to move it through that path. Previous space suits mobility requirements were defined as the collective result of these two measures and verified by the completion of discrete functional tasks. While a valid way to impose mobility requirements, such a method does necessitate a solid understanding of the operational scenarios in which the final suit will be performing. Because the Constellation space suit system requirements are being finalized with a relatively immature concept of operations, the Space Suit Element team elected to define mobility in terms of its constituent parts to increase the likelihood that the future pressure garment will be mobile enough to enable a broad scope of undefined exploration activities. The range of motion requirements were defined by measuring the ranges of motion test subjects achieved while performing a series of joint maximizing tasks in a variety of flight and prototype space suits. The definition of joint torque requirements has proved more elusive. NASA evaluated several different approaches to the problem before deciding to generate requirements based on unmanned joint torque evaluations of six different space suit configurations being articulated through 16 separate joint movements. This paper discusses the experiment design, data analysis and results, and the process used to determine the final values for the Constellation pressure garment joint torque requirements.

Site Inspection Report for Former Nansemond Ordnance Depot, Suffolk, VA

DTIC Science & Technology

2012-01-01

previously addressed, or there is no reason to suspect contamination was ever present at an MRS. Note: HHE MODULE RATING No Longer Required A D HHH HML...Required A D HHH HML MMM Combination Rating E HLL MML MLL F GLLL Evaluation Pending No Longer Required Alternative Module Ratings No Known or

Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review

PubMed Central

Morad, Anna; Sathe, Nila A.; Francis, David O.; McPheeters, Melissa L.

2017-01-01

CONTEXT: The effectiveness of tonsillectomy or adenotonsillectomy (“tonsillectomy”) for recurrent throat infection compared with watchful waiting is uncertain. OBJECTIVE: To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. DATA SOURCES: MEDLINE, Embase, and the Cochrane Library. STUDY SELECTION: Two investigators independently screened studies against predetermined criteria. DATA EXTRACTION: One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. RESULTS: Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. LIMITATIONS: Few studies fully categorized infection/sore throat severity; attrition was high. CONCLUSIONS: Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life. PMID:28096515

Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review.

PubMed

Morad, Anna; Sathe, Nila A; Francis, David O; McPheeters, Melissa L; Chinnadurai, Sivakumar

2017-02-01

The effectiveness of tonsillectomy or adenotonsillectomy ("tonsillectomy") for recurrent throat infection compared with watchful waiting is uncertain. To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. MEDLINE, Embase, and the Cochrane Library. Two investigators independently screened studies against predetermined criteria. One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. Few studies fully categorized infection/sore throat severity; attrition was high. Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life. Copyright © 2017 by the American Academy of Pediatrics.

Clinical outcome of Guillain-Barré syndrome after prolonged mechanical ventilation.

PubMed

van den Berg, Bianca; Storm, Eline F; Garssen, Marcel J P; Blomkwist-Markens, Patricia H; Jacobs, Bart C

2018-04-07

Patients with Guillain-Barré syndrome (GBS) may suffer from respiratory failure for months or longer. The aim of this study was to determine the frequency, clinical course and outcome of patients with GBS requiring prolonged mechanical ventilation (MV). Prospectively collected data from 526 patients with GBS participating in previous trials were analysed to determine the frequency and duration of prolonged MV (longer than 2 months). In addition, a cross-sectional study was conducted in patients with GBS requiring MV to determine the clinical course and long-term outcome with the ability to walk unaided as primary endpoint. In the cohort study, 145 of 526 patients with GBS (28%) required MV, including 33 (6%) patients with prolonged MV. Patients requiring prolonged MV had a lower Medical Research Council sum score and more frequent bulbar involvement and inexcitable nerves compared with shorter ventilated patients. At 6 months, 18% of patients with prolonged MV were able to walk unaided compared with 76% of patients requiring shorter MV (P<0.001). In the cross-sectional study, 63 patients requiring MV were included with a median follow-up of 11 years (range 2-44 years). Twenty-six (41%) of these patients needed prolonged MV (median 93 days, range 62-261). Fifteen (58%) of these patients were able to walk unaided at maximum follow-up and eight (31%) reached this endpoint more than 1 year after diagnosis. Prolonged ventilation in GBS is associated with poor prognosis, yet patients requiring prolonged ventilation may show slow but persistent recovery for years and even reach the ability to walk and live independently. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Proximity Link Design and Performance Options for a Mars Areostationary Relay Satellite

NASA Technical Reports Server (NTRS)

Edwards, Charles D.; Bell, David J.; Biswas, Abhijit; Cheung, Kar-Ming; Lock, Robert E.

2016-01-01

Current and near-term Mars relay telecommunications services are provided by a set of NASA and ESA Mars science orbiters equipped with UHF relay communication payloads employing operationally simple low-gain antennas. These have been extremely successful in supporting a series of landed Mars mission, greatly increasing data return relative to direct-to-Earth lander links. Yet their relay services are fundamentally constrained by the short contact times available from the selected science orbits. Future Mars areostationary orbiters, flying in circular, equatorial, 1- sol orbits, offer the potential for continuous coverage of Mars landers and rovers, radically changing the relay support paradigm. Achieving high rates on the longer slant ranges to areostationary altitude will require steered, high-gain links. Both RF and optical options exist for achieving data rates in excess of 100 Mb/s. Several point designs offer a measure of potential user burden, in terms of mass, volume, power, and pointing requirements for user relay payloads, as a function of desired proximity link performance.

Technical support for Life Sciences communities on a production grid infrastructure.

PubMed

Michel, Franck; Montagnat, Johan; Glatard, Tristan

2012-01-01

Production operation of large distributed computing infrastructures (DCI) still requires a lot of human intervention to reach acceptable quality of service. This may be achievable for scientific communities with solid IT support, but it remains a show-stopper for others. Some application execution environments are used to hide runtime technical issues from end users. But they mostly aim at fault-tolerance rather than incident resolution, and their operation still requires substantial manpower. A longer-term support activity is thus needed to ensure sustained quality of service for Virtual Organisations (VO). This paper describes how the biomed VO has addressed this challenge by setting up a technical support team. Its organisation, tooling, daily tasks, and procedures are described. Results are shown in terms of resource usage by end users, amount of reported incidents, and developed software tools. Based on our experience, we suggest ways to measure the impact of the technical support, perspectives to decrease its human cost and make it more community-specific.

Global Warming: Discussion for EOS Science Writers Workshop

NASA Technical Reports Server (NTRS)

Hansen, James E

1999-01-01

The existence of global warming this century is no longer an issue of scientific debate. But there are many important questions about the nature and causes of long-term climate change, th roles of nature and human-made climate forcings and unforced (chaotic) climate variability, the practical impacts of climate change, and what, if anything, should be done to reduce global warming, Global warming is not a uniform increase of temperature, but rather involves at complex geographically varying climate change. Understanding of global warming will require improved observations of climate change itself and the forcing factors that can lead to climate change. The NASA Terra mission and other NASA Earth Science missions will provide key measurement of climate change and climate forcings. The strategy to develop an understanding of the causes and predictability of long-term climate change must be based on combination of observations with models and analysis. The upcoming NASA missions will make important contributions to the required observations.

Critical analysis of submerged membrane sequencing batch reactor operating conditions.

PubMed

McAdam, Ewan; Judd, Simon J; Gildemeister, René; Drews, Anja; Kraume, Matthias

2005-10-01

To evaluate the Submerged Membrane Sequencing Batch Reactor process, several short-term studies were conducted to define critical flux, membrane aeration and intermittent filtration operation. Critical flux trials indicated that as mixed liquor suspended solids increased in concentration so would the propensity for membrane fouling. Consequently in order to characterise the impact of biomass concentration increase (that develops during permeate withdrawal) upon submerged microfiltration operation, two longer term studies were conducted, one with a falling hydraulic head and another with a continuous hydraulic head (as in membrane bio-reactors). Trans membrane pressure data was used to predict the maximum possible operating periods at 10 and 62 days for the falling hydraulic head and continuous hydraulic head respectively. Further analysis revealed that falling hydraulic head operation would require 21% more aeration to maintain a consistent crossflow velocity than continuous operation and would rely on pumping for full permeate withdrawal 80% earlier. This study concluded that further optimisation would be required to make this technology technically and economically viable.

Prevalence of NRT use and associated nicotine intake in smokers, recent ex-smokers and longer-term ex-smokers.

PubMed

Shahab, Lion; Beard, Emma; Brown, Jamie; West, Robert

2014-01-01

Nicotine replacement therapy (NRT) is used by smokers wanting to reduce their smoking and to quit. However, there are very little data on nicotine intake associated with NRT use in representative population samples. This study aimed to provide estimates for NRT use and associated nicotine exposure among smokers, recent and longer-term ex-smokers in England, a country with a permissive regulatory regime for nicotine substitution. In the Smoking Toolkit Study, a monthly series of representative household surveys of adults aged 16+ in England, current and recent ex-smokers who agreed to be re-contacted were followed up 6 months later and standard socio-demographic and smoking characteristics assessed (N = 5,467, response rate 25.1%). A random sub-sample (N = 1,614; 29.5%) also provided saliva, analysed for cotinine. The sample followed up was broadly representative of the original sample. At follow-up, 11.8% (95%CI 10.9-12.8, N = 565) of current smokers, 34.8% (95%CI 28.9-41.3, N = 77) of recent (≤ 3 months) ex-smokers, and 7.8% (95%CI 5.6-10.6, N = 36) of longer-term (> 3 months) ex-smokers reported using NRT. Smokers who used NRT had similar saliva cotinine concentrations to smokers who did not use NRT (mean ± sd  = 356.0 ± 198.6 ng/ml vs. 313.1 ± 178.4 ng/ml). Recent ex-smokers who used NRT had levels that were somewhat lower, but not significantly so, than current smokers (216.7 ± 179.3 ng/ml). Longer-term ex-smokers using NRT had still lower levels (157.3 ± 227.1 ng/ml), which differed significantly from smokers using NRT (p = 0.024). Concurrent use of nicotine replacement therapy while smoking is relatively uncommon and is not associated with higher levels of nicotine intake. Among ex-smokers, NRT use is common in the short but not longer-term and among longer-term users is associated with lower nicotine intake than in smokers.

Grammar Predicts Procedural Learning and Consolidation Deficits in Children with Specific Language Impairment

PubMed Central

Hedenius, Martina; Persson, Jonas; Tremblay, Antoine; Adi-Japha, Esther; Veríssimo, João; Dye, Cristina D.; Alm, Per; Jennische, Margareta; Tomblin, J. Bruce; Ullman, Michael T.

2011-01-01

The Procedural Deficit Hypothesis (PDH) posits that Specific Language Impairment (SLI) can be largely explained by abnormalities of brain structures that subserve procedural memory. The PDH predicts impairments of procedural memory itself, and that such impairments underlie the grammatical deficits observed in the disorder. Previous studies have indeed reported procedural learning impairments in SLI, and have found that these are associated with grammatical difficulties. The present study extends this research by examining the consolidation and longer-term procedural sequence learning in children with SLI. The Alternating Serial Reaction Time (ASRT) task was given to children with SLI and typically-developing (TD) children in an initial learning session and an average of three days later to test for consolidation and longer-term learning. Although both groups showed evidence of initial sequence learning, only the TD children showed clear signs of consolidation, even though the two groups did not differ in longer-term learning. When the children were re-categorized on the basis of grammar deficits rather than broader language deficits, a clearer pattern emerged. Whereas both the grammar impaired and normal grammar groups showed evidence of initial sequence learning, only those with normal grammar showed consolidation and longer-term learning. Indeed, the grammar-impaired group appeared to lose any sequence knowledge gained during the initial testing session. These findings held even when controlling for vocabulary or a broad non-grammatical language measure, neither of which were associated with procedural memory. When grammar was examined as a continuous variable over all children, the same relationships between procedural memory and grammar, but not vocabulary or the broader language measure, were observed. Overall, the findings support and further specify the PDH. They suggest that consolidation and longer-term procedural learning are impaired in SLI, but that these impairments are specifically tied to the grammatical deficits in the disorder. The possibility that consolidation and longer-term learning are problematic in the disorder suggests a locus of potential study for therapeutic approaches. In sum, this study clarifies our understanding of the underlying deficits in SLI, and suggests avenues for further research. PMID:21840165

Guiding optimal biofuels :

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

Paap, Scott M.; West, Todd H.; Manley, Dawn Kataoka

2013-01-01

In the current study, processes to produce either ethanol or a representative fatty acid ethyl ester (FAEE) via the fermentation of sugars liberated from lignocellulosic materials pretreated in acid or alkaline environments are analyzed in terms of economic and environmental metrics. Simplified process models are introduced and employed to estimate process performance, and Monte Carlo analyses were carried out to identify key sources of uncertainty and variability. We find that the near-term performance of processes to produce FAEE is significantly worse than that of ethanol production processes for all metrics considered, primarily due to poor fermentation yields and higher electricitymore » demands for aerobic fermentation. In the longer term, the reduced cost and energy requirements of FAEE separation processes will be at least partially offset by inherent limitations in the relevant metabolic pathways that constrain the maximum yield potential of FAEE from biomass-derived sugars.« less

The outlook for aeronautics, 1980 - 2000 - Study report. [trends affecting civil air transportation and defense

NASA Technical Reports Server (NTRS)

1976-01-01

Trends in civil and military aviation in the period 1980-2000 are examined in terms of the role that NASA should play in aeronautical research and development during this period. Factors considered include the pattern of industry and government relationships, the character of the aircraft to be developed, and the technology advances that will be required as well as demographic, economic, and social factors. Trends are expressed in terms of the most probable developments in civil air transportation and air defense and several characteristically different directions for future development are defined. The longer term opportunities created by developments in air transporation extending into the next century are also examined. Within this framework, a preferred NASA role and a preferred set of objectives are formulated for the research and technology which should be undertaken by NASA during the period 1976-1985.

The self-management of longer-term depression: learning from the patient, a qualitative study.

PubMed

Chambers, Eleni; Cook, Sarah; Thake, Anna; Foster, Alexis; Shaw, Sue; Hutten, Rebecca; Parry, Glenys; Ricketts, Tom

2015-07-24

Depression is a common mental health condition now viewed as chronic or long-term. More than 50 % of people will have at least one further episode of depression after their first, and therefore it requires long-term management. However, little is known about the effectiveness of self-management in depression, in particular from the patients' perspective. This study aimed to understand how people with longer-term depression manage the condition, how services can best support self-management and whether the principles and concepts of the recovery approach would be advantageous. Semi-structured in depth interviews were carried out with 21 participants, recruited from a range of sources using maximum variation sampling. Interpretative Phenomenological Analysis was used by a diverse team comprised of service users, practitioners and academics. Four super-ordinate themes were found: experience of depression, the self, the wider environment, self-management strategies. Within these, several prominent sub-themes emerged of importance to the participants. These included how aspects of themselves such as hope, confidence and motivation could be powerful agents; and how engaging in a wide range of chosen activities could contribute to their emotional, mental, physical, social, spiritual and creative wellbeing. Services in general were not perceived to be useful in specifically facilitating self-management. Increased choice and control were needed and a greater emphasis on an individualised holistic model. Improved information was needed about how to develop strategies and locate resources, especially during the first episode of depression. These concepts echoed those of the recovery approach, which could therefore be seen as valuable in aiding the self-management of depression.

Finger Injuries in Football and Rugby

PubMed Central

Elzinga, Kate E.; Chung, Kevin C.

2016-01-01

SYNOPSIS Football and rugby athletes are at increased risk of finger injuries given the full contact nature of these sports. Depending on the injury and the position played, some players may return to play early with protective taping, splinting, and casting. Other injuries, particularly in players requiring the full use of their hand for their position, require a longer rehabilitation period and prolonged time away from the field. The treating hand surgeon must carefully weigh the benefits of early return to play for the athlete’s current season and future playing career against the risks of re-injury and long-term morbidity, including post-traumatic arthritis and decreased range of motion and strength. Each player must be comprehensively assessed and managed with an individualized treatment plan. PMID:27886831

Male urethral strictures and their management

PubMed Central

Hampson, Lindsay A.; McAninch, Jack W.; Breyer, Benjamin N.

2014-01-01

Male urethral stricture disease is prevalent and has a substantial impact on quality of life and health-care costs. Management of urethral strictures is complex and depends on the characteristics of the stricture. Data show that there is no difference between urethral dilation and internal urethrotomy in terms of long-term outcomes; success rates range widely from 8–80%, with long-term success rates of 20–30%. For both of these procedures, the risk of recurrence is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures. Analysis has shown that repeated use of urethrotomy is not clinically effective or cost-effective in these patients. Long-term success rates are higher for surgical reconstruction with urethroplasty, with most studies showing success rates of 85–90%. Many techniques have been utilized for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques. PMID:24346008

Enabling science support for better decision-making when responding to chemical spills

USGS Publications Warehouse

Weidhass, Jennifer L.; Dietrich, Andrea M.; DeYonker, Nathan J.; Dupont, R. Ryan; Foreman, William T.; Gallagher, Daniel; Gallagher, Jennifer E. G.; Whelton, Andrew J.; Alexander, William

2016-01-01

Chemical spills and accidents contaminate the environment and disrupt societies and economies around the globe. In the United States there were approximately 172,000 chemical spills that affected US waterbodies from 2004 to 2014. More than 8000 of these spills involved non–petroleum-related chemicals. Traditional emergency responses or incident command structures (ICSs) that respond to chemical spills require coordinated efforts by predominantly government personnel from multiple disciplines, including disaster management, public health, and environmental protection. However, the requirements of emergency response teams for science support might not be met within the traditional ICS. We describe the US ICS as an example of emergency-response approaches to chemical spills and provide examples in which external scientific support from research personnel benefitted the ICS emergency response, focusing primarily on nonpetroleum chemical spills. We then propose immediate, near-term, and long-term activities to support the response to chemical spills, focusing on nonpetroleum chemical spills. Further, we call for science support for spill prevention and near-term spill-incident response and identify longer-term research needs. The development of a formal mechanism for external science support of ICS from governmental and nongovernmental scientists would benefit rapid responders, advance incident- and crisis-response science, and aid society in coping with and recovering from chemical spills.

A sorting system with automated gates permits individual operant experiments with mice from a social home cage.

PubMed

Winter, York; Schaefers, Andrea T U

2011-03-30

Behavioral experiments based on operant procedures can be time-consuming for small amounts of data. While individual testing and handling of animals can influence attention, emotion, and behavior, and interfere with experimental outcome, many operant protocols require individual testing. We developed an RFID-technology- and transponder-based sorting system that allows removing the human factor for longer-term experiments. Identity detectors and automated gates route mice individually from their social home cage to an adjacent operant compartment with 24/7 operation. CD1-mice learnt quickly to individually pass through the sorting system. At no time did more than a single mouse enter the operant compartment. After 3 days of adjusting to the sorting system, groups of 4 mice completed about 50 experimental trials per day in the operant compartment without experimenter intervention. The automated sorting system eliminates handling, isolation, and disturbance of the animals, eliminates experimenter-induced variability, saves experimenter time, and is financially economical. It makes possible a new approach for high-throughput experimentation, and is a viable tool for increasing quality and efficiency of many behavioral and neurobiological investigations. It can connect a social home cage, through individual sorting automation, to diverse setups including classical operant chambers, mazes, or arenas with video-based behavior classification. Such highly automated systems will permit efficient high-throughput screening even for transgenic animals with only subtle neurological or psychiatric symptoms where elaborate or longer-term protocols are required for behavioral diagnosis. Copyright © 2011 Elsevier B.V. All rights reserved.

Effects of Exposures on Superalloys for Space Applications

NASA Technical Reports Server (NTRS)

Gabb, Tim; Garg, Anita; Gayda, John

2007-01-01

The industry is demanding longer term service at high temperatures for nickel-base superalloys in gas turbine engine as well as potential space applications. However, longer term service can severely tax alloy phase stability, to the potential detriment of mechanical properties. Cast Mar-M247LC and wrought Haynes 230 superalloys were exposed and creep tested for extended times at elevated temperature. Microstructure and phase evaluations were then undertaken for comparisons.

42 CFR 137.78 - May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one year? 137.78 Section 137.78 Public Health PUBLIC HEALTH... SERVICES TRIBAL SELF-GOVERNANCE Funding General § 137.78 May a Self-Governance Tribe negotiate a funding...

The Association Between Nutritional Adequacy and Long-Term Outcomes in Critically Ill Patients Requiring Prolonged Mechanical Ventilation: A Multicenter Cohort Study.

PubMed

Wei, Xuejiao; Day, Andrew G; Ouellette-Kuntz, Hélène; Heyland, Daren K

2015-08-01

To examine the association between short-term nutritional adequacy received while in the ICU and long-term outcomes including 6-month survival and health-related quality of life in critically ill patients requiring prolonged mechanical ventilation. Retrospective analysis of data prospectively collected in the context of a multicenter randomized controlled trial. An international sample of ICUs. Adult patients who were mechanically ventilated for more than 8 days in the ICU. None. Nutritional adequacy was obtained from the average proportion of prescribed calories received over the amount prescribed during the first 8 days. Survival status and health-related quality of life as assessed using the Short-Form 36 v2 were obtained at 3- and 6 months post ICU admission. Of the 1,223 patients enrolled in the randomized controlled trial, 475 met the inclusion criteria for this study. At 6-month follow-up, 302 of the 475 patients (64%) were alive. Survival time in those who received low nutritional adequacy was significantly shorter than those who received high nutritional adequacy while adjusting for important covariates (adjusted hazard ratio, 1.7; 95% CI, 1.1-2.6). At 3-month follow-up, a 25% increase in nutritional adequacy was associated with improvements in Physical Functioning and Role Physical of 7.3 (p = 0.02) and 8.3 (p = 0.004) points, respectively. At 6-month follow-up, adjusted increases in Physical Functioning and Role Physical scores for every 25% increase in nutrition adequacy became smaller and were no longer statistically significant (adjusted estimate for Physical Functioning = 4.2, p = 0.14; for Role Physical = 3.2, p = 0.25). Greater amounts of nutritional intake received during the first week in the ICU were associated with longer survival time and faster physical recovery to 3 months but not 6 months post ICU discharge in critically ill patients requiring prolonged mechanical ventilation. Current recommendations to underfeed critically ill patients may cause harm in some long-stay patients.

Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies

PubMed Central

Clarke, David

2017-01-01

Objective To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Design Systematic review and thematic synthesis. Method We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Results Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Conclusions Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties. PMID:28988185

Long-term adaptation to change in implicit contextual learning.

PubMed

Zellin, Martina; von Mühlenen, Adrian; Müller, Hermann J; Conci, Markus

2014-08-01

The visual world consists of spatial regularities that are acquired through experience in order to guide attentional orienting. For instance, in visual search, detection of a target is faster when a layout of nontarget items is encountered repeatedly, suggesting that learned contextual associations can guide attention (contextual cuing). However, scene layouts sometimes change, requiring observers to adapt previous memory representations. Here, we investigated the long-term dynamics of contextual adaptation after a permanent change of the target location. We observed fast and reliable learning of initial context-target associations after just three repetitions. However, adaptation of acquired contextual representations to relocated targets was slow and effortful, requiring 3 days of training with overall 80 repetitions. A final test 1 week later revealed equivalent effects of contextual cuing for both target locations, and these were comparable to the effects observed on day 1. That is, observers learned both initial target locations and relocated targets, given extensive training combined with extended periods of consolidation. Thus, while implicit contextual learning efficiently extracts statistical regularities of our environment at first, it is rather insensitive to change in the longer term, especially when subtle changes in context-target associations need to be acquired.

[Therapeutic use of cannabis derivatives].

PubMed

Benyamina, Amine; Reynaud, Michel

2014-02-01

The therapeutic use of cannabis has generated a lot of interest in the past years, leading to a better understanding of its mechanisms of action. Countries like the United States and Canada have modified their laws in order to make cannabinoid use legal in the medical context. It's also the case in France now, where a recent decree was issued, authorizing the prescription of medication containing "therapeutic cannabis" (decree no. 2013-473, June 5, 2013). Cannabinoids such as dronabinol, Sativex and nabilone have been tested for the treatment of acute and chronic pain. These agents are most promising to relieve chronic pain associated with cancer, with human immunodeficiency virus infection and with multiple sclerosis. However, longer-term studies are required to determine potential long-term adverse effects and risks of misuse and addiction.

Poor Long-Term Outcomes of Adult Liver Transplantation Involving Elderly Living Donors.

PubMed

Tokodai, K; Kawagishi, N; Miyagi, S; Nakanishi, C; Hara, Y; Fujio, A; Kashiwadate, T; Maida, K; Goto, H; Kamei, T; Ohuchi, N

2016-05-01

Donor hepatectomy requires particular care to ensure the safety of the donor and the success of the liver transplantation. The aim of this study was to evaluate the effect of donor age on the postoperative outcomes of liver transplant donors and the long-term graft survival rates. We retrospectively reviewed 56 consecutive adult patients who underwent living donor liver transplantation at our institution between April 2001 and August 2010. Donors and recipients were divided into 2 groups, based on the age of the donor: the elderly donor group (donor age ≥50 years) and the younger donor group (donor age <50 years). Perioperative variables, postoperative complication rates, and long-term graft survival rates were compared between the 2 groups. The average ages in the elderly donor group and younger donor group were 58 years and 32 years, respectively. Baseline data excluding the age of the donor did not differ between the groups, nor did the overall complication rates of the donors. Hospital stays were longer in the elderly donor group than in the younger donor group (25 vs 18 days, P < .05). The 1-, 3-, and 5-year graft survival rates were 80%, 60%, and 50% in the elderly donor group, and 89%, 87%, and 82% in the younger donor group, respectively (P = .0002). Donor hepatectomy can be performed safely in elderly patients. However, compared with younger donors, their hospital stays were longer and the graft survival rates were shorter. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of Gated Audiovisual Speech Identification in Elderly Hearing Aid Users and Elderly Normal-Hearing Individuals

PubMed Central

Lidestam, Björn; Rönnberg, Jerker

2016-01-01

The present study compared elderly hearing aid (EHA) users (n = 20) with elderly normal-hearing (ENH) listeners (n = 20) in terms of isolation points (IPs, the shortest time required for correct identification of a speech stimulus) and accuracy of audiovisual gated speech stimuli (consonants, words, and final words in highly and less predictable sentences) presented in silence. In addition, we compared the IPs of audiovisual speech stimuli from the present study with auditory ones extracted from a previous study, to determine the impact of the addition of visual cues. Both participant groups achieved ceiling levels in terms of accuracy in the audiovisual identification of gated speech stimuli; however, the EHA group needed longer IPs for the audiovisual identification of consonants and words. The benefit of adding visual cues to auditory speech stimuli was more evident in the EHA group, as audiovisual presentation significantly shortened the IPs for consonants, words, and final words in less predictable sentences; in the ENH group, audiovisual presentation only shortened the IPs for consonants and words. In conclusion, although the audiovisual benefit was greater for EHA group, this group had inferior performance compared with the ENH group in terms of IPs when supportive semantic context was lacking. Consequently, EHA users needed the initial part of the audiovisual speech signal to be longer than did their counterparts with normal hearing to reach the same level of accuracy in the absence of a semantic context. PMID:27317667

Oral ketamine for the treatment of pain and treatment-resistant depression†.

PubMed

Schoevers, Robert A; Chaves, Tharcila V; Balukova, Sonya M; Rot, Marije Aan Het; Kortekaas, Rudie

2016-02-01

Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain. Searches in PubMed with the terms 'oral ketamine', 'depression', 'chronic pain', 'neuropathic pain', 'intravenous ketamine', 'intranasal ketamine' and 'subcutaneous ketamine' yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality. Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects. Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials. © The Royal College of Psychiatrists 2016.

Behavioral and Physiological Response of Baleen Whales to Ships and Ship Noise

DTIC Science & Technology

2014-09-30

student Angela Szesciorka) on tag designs to provide longer term deployments of archival tags especially for work with humpback whales off northern...California. 2. Conduct test deployments of dart-attached archival tags in 2014 on humpback whales in Monterey Bay and the Gulf of the Farallones on... humpback whales to tests different dart attachment configurations and develop a new longer term dart-attached archival tag system. 3. Successfully

Articulatory Control in Childhood Apraxia of Speech in a Novel Word-Learning Task.

PubMed

Case, Julie; Grigos, Maria I

2016-12-01

Articulatory control and speech production accuracy were examined in children with childhood apraxia of speech (CAS) and typically developing (TD) controls within a novel word-learning task to better understand the influence of planning and programming deficits in the production of unfamiliar words. Participants included 16 children between the ages of 5 and 6 years (8 CAS, 8 TD). Short- and long-term changes in lip and jaw movement, consonant and vowel accuracy, and token-to-token consistency were measured for 2 novel words that differed in articulatory complexity. Children with CAS displayed short- and long-term changes in consonant accuracy and consistency. Lip and jaw movements did not change over time. Jaw movement duration was longer in children with CAS than in TD controls. Movement stability differed between low- and high-complexity words in both groups. Children with CAS displayed a learning effect for consonant accuracy and consistency. Lack of change in movement stability may indicate that children with CAS require additional practice to demonstrate changes in speech motor control, even within production of novel word targets with greater consonant and vowel accuracy and consistency. The longer movement duration observed in children with CAS is believed to give children additional time to plan and program movements within a novel skill.

A simplified flight-test method for determining aircraft takeoff performance that includes effects of pilot technique

NASA Technical Reports Server (NTRS)

Larson, T. J.; Schweikhard, W. G.

1974-01-01

A method for evaluating aircraft takeoff performance from brake release to air-phase height that requires fewer tests than conventionally required is evaluated with data for the XB-70 airplane. The method defines the effects of pilot technique on takeoff performance quantitatively, including the decrease in acceleration from drag due to lift. For a given takeoff weight and throttle setting, a single takeoff provides enough data to establish a standardizing relationship for the distance from brake release to any point where velocity is appropriate to rotation. The lower rotation rates penalized takeoff performance in terms of ground roll distance; the lowest observed rotation rate required a ground roll distance that was 19 percent longer than the highest. Rotations at the minimum rate also resulted in lift-off velocities that were approximately 5 knots lower than the highest rotation rate at any given lift-off distance.

Adapting to the Weather: Lessons from U.S. History.

PubMed

Bleakley, Hoyt; Hong, Sok Chul

2017-09-01

An important unknown in understanding the impact of climate change is the scope of adaptation, which requires observations on historical time scales. We consider how weather across U.S. history (1860-2000) has affected various measures of productivity. Using cross-sectional and panel methods, we document significant responses of agricultural and individual productivity to weather. We find strong effects of hotter and wetter weather early in U.S. history, but these effects have been attenuated in recent decades. The results suggest that estimates from a given period may be of limited use in forecasting the longer-term impacts of climate change.

Eating in space--from an astronaut's perspective.

PubMed

Kerwin, Joseph; Seddon, Rhea

2002-10-01

Food systems and meal components are constantly under review and development at the National Aerospace and Space Administration. The goal of this work is to generate a diet that meets the nutrient requirements of astronauts and satiates them. The constraints involved in shorter- and longer-term missions are described. The insight provided by observations of astronauts from the Skylab and Shuttle eras will allow researchers to consider the fact that, for any nutritional regimen to work, it must consider the limitations and taste buds of the individuals involved. Otherwise, the best diet design generated by their work may never be consumed.

Eating in space--from an astronaut's perspective

NASA Technical Reports Server (NTRS)

Kerwin, Joseph; Seddon, Rhea

2002-01-01

Food systems and meal components are constantly under review and development at the National Aerospace and Space Administration. The goal of this work is to generate a diet that meets the nutrient requirements of astronauts and satiates them. The constraints involved in shorter- and longer-term missions are described. The insight provided by observations of astronauts from the Skylab and Shuttle eras will allow researchers to consider the fact that, for any nutritional regimen to work, it must consider the limitations and taste buds of the individuals involved. Otherwise, the best diet design generated by their work may never be consumed.

Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients.

PubMed

Attenberger, Corinna; Amsler, Felix; Gross, Thomas

2012-09-01

No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients. Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data. Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.). This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future. Copyright © 2011 Elsevier Ltd. All rights reserved.

Titles in highly ranked multidisciplinary psychology journals 1966-2011: more words and punctuation marks allow for the communication of more information.

PubMed

Whissell, Cynthia

2013-12-01

Titles of articles in seven highly ranked multidisciplinary psychology journals for every fifth year between 1966 and 2011 (inclusive) were studied in terms of title length, word length, punctuation density, and word pleasantness, activation, and concreteness (assessed by the Dictionary of Affect in Language). Titles grew longer (by three words) and were more frequently punctuated (by one colon or comma for every other article) between 1966 and 2011. This may reflect the increasing complexity of psychology and satisfy readers' requirements for more specific information. There were significant differences among journals (e.g., titles in the Annual Review of Psychology were scored by the Dictionary of Affect as the most pleasant, and those in Psychological Bulletin as the least pleasant) and among categories of journals (e.g., titles in review journals employed longer words than those in research or association journals). Differences were stable across time and were employed to successfully categorize titles from a validation sample.

Time scales of tunneling decay of a localized state

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

Ban, Yue; Muga, J. G.; Sherman, E. Ya.

2010-12-15

Motivated by recent time-domain experiments on ultrafast atom ionization, we analyze the transients and time scales that characterize, aside from the relatively long lifetime, the decay of a localized state by tunneling. While the tunneling starts immediately, some time is required for the outgoing flux to develop. This short-term behavior depends strongly on the initial state. For the initial state, tightly localized so that the initial transients are dominated by over-the-barrier motion, the time scale for flux propagation through the barrier is close to the Buettiker-Landauer traversal time. Then a quasistationary, slow-decay process follows, which sets ideal conditions for observingmore » diffraction in time at longer times and distances. To define operationally a tunneling time at the barrier edge, we extrapolate backward the propagation of the wave packet that escaped from the potential. This extrapolated time is considerably longer than the time scale of the flux and density buildup at the barrier edge.« less

Modeling competitive substitution in a polyelectrolyte complex

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

Peng, B.; Muthukumar, M., E-mail: muthu@polysci.umass.edu

2015-12-28

We have simulated the invasion of a polyelectrolyte complex made of a polycation chain and a polyanion chain, by another longer polyanion chain, using the coarse-grained united atom model for the chains and the Langevin dynamics methodology. Our simulations reveal many intricate details of the substitution reaction in terms of conformational changes of the chains and competition between the invading chain and the chain being displaced for the common complementary chain. We show that the invading chain is required to be sufficiently longer than the chain being displaced for effecting the substitution. Yet, having the invading chain to be longermore » than a certain threshold value does not reduce the substitution time much further. While most of the simulations were carried out in salt-free conditions, we show that presence of salt facilitates the substitution reaction and reduces the substitution time. Analysis of our data shows that the dominant driving force for the substitution process involving polyelectrolytes lies in the release of counterions during the substitution.« less

Building carbon–carbon bonds using a biocatalytic methanol condensation cycle

PubMed Central

Bogorad, Igor W.; Chen, Chang-Ting; Theisen, Matthew K.; Wu, Tung-Yun; Schlenz, Alicia R.; Lam, Albert T.; Liao, James C.

2014-01-01

Methanol is an important intermediate in the utilization of natural gas for synthesizing other feedstock chemicals. Typically, chemical approaches for building C–C bonds from methanol require high temperature and pressure. Biological conversion of methanol to longer carbon chain compounds is feasible; however, the natural biological pathways for methanol utilization involve carbon dioxide loss or ATP expenditure. Here we demonstrated a biocatalytic pathway, termed the methanol condensation cycle (MCC), by combining the nonoxidative glycolysis with the ribulose monophosphate pathway to convert methanol to higher-chain alcohols or other acetyl-CoA derivatives using enzymatic reactions in a carbon-conserved and ATP-independent system. We investigated the robustness of MCC and identified operational regions. We confirmed that the pathway forms a catalytic cycle through 13C-carbon labeling. With a cell-free system, we demonstrated the conversion of methanol to ethanol or n-butanol. The high carbon efficiency and low operating temperature are attractive for transforming natural gas-derived methanol to longer-chain liquid fuels and other chemical derivatives. PMID:25355907

Job satisfaction and short-term sickness absence among Dutch workers.

PubMed

Notenbomer, Annette; Roelen, Corné A M; Groothoff, Johan W

2006-06-01

Sickness absence is a considerable economic and social problem. Short-term sickness absence is known to be associated with behavioural attitudes. The correlation between sickness absence and job satisfaction has been studied infrequently and with contradictory results. This study investigated the correlation between short-term sickness absence and both global and specific job satisfaction. We defined short-term sickness absence as spells of up to 42 days. A random sample of 898 Dutch workers from a variety of economic sectors and companies received a self-report questionnaire on their first day of sick leave. The questionnaire measured global and specific job satisfaction. In our regression analysis, we controlled for the confounding factors of age, gender, educational level, perceived workload, job autonomy and decision latitude. The duration of an absence spell was defined as the amount of calendar days between sick leave and return to work. Global job satisfaction did not correlate significantly with the duration of short-term sickness absence. While increasing physical job demands predicted longer absence, increasing job autonomy and educational level predicted shorter absence. Satisfaction with colleagues predicted longer duration absence. Global job satisfaction did not correlate with the duration of short-term absence spells, but specific satisfaction with colleagues was associated with longer sickness spells.

International Space Station Urine Monitoring System Functional Integration and Science Testing

NASA Technical Reports Server (NTRS)

Rodriguez, Branelle R.; Broyan, James Lee, Jr.

2008-01-01

Exposure to microgravity during human spaceflight is required to be defined and understood as the human exploration of space requires longer duration missions. It is known that long term exposure to microgravity causes bone loss. Urine voids are capable of measuring the calcium and other metabolic byproducts in a constituent s urine. The International Space Station (ISS) Urine Monitoring System (UMS) is an automated urine collection device designed to collect urine, separate the urine and air, measure the void volume, and allow for syringe sampling. Accurate measuring and minimal cross contamination is essential to determine bone loss and the effectiveness of countermeasures. The ISS UMS provides minimal cross contamination (<0.7 ml urine) and has volume accuracy of +/-2% between 100 to 1000 ml urine voids.

International Space Station Urine Monitoring System Functional Integration and Science Testing

NASA Technical Reports Server (NTRS)

Cibuzar, Branelle R.; Broyan, James Lee, Jr.

2009-01-01

Exposure to microgravity during human spaceflight is required to be defined and understood as the human exploration of space requires longer duration missions. It is known that long term exposure to microgravity causes bone loss. Urine voids are capable of measuring the calcium and other metabolic byproducts in a constituent s urine. The International Space Station (ISS) Urine Monitoring System (UMS) is an automated urine collection device designed to collect urine, separate the urine and air, measure the void volume, and allow for syringe sampling. Accurate measuring and minimal cross contamination is essential to determine bone loss and the effectiveness of countermeasures. The ISS UMS provides minimal cross contamination (<0.7 ml urine) and has volume accuracy of +/-2% between 100 to 1000 ml urine voids.

The effect of preterm birth on brainstem, middle latency and cortical auditory evoked responses (BMC AERs).

PubMed

Pasman, J W; Rotteveel, J J; de Graaf, R; Stegeman, D F; Visco, Y M

1992-12-01

Recent studies on the maturation of auditory brainstem evoked responses (ABRs) present conflicting results, whereas only sparse reports exist with respect to the maturation of middle latency auditory evoked responses (MLRs) and auditory cortical evoked responses (ACRs). The present study reports the effect of preterm birth on the maturation of auditory evoked responses in low risk preterm infants (27-34 weeks conceptional age). The ABRs indicate a consistent trend towards longer latencies for all individual ABR components and towards longer interpeak latencies in preterm infants. The MLR shows longer latencies for early component P0 in preterm infants. The ACRs show a remarkable difference between preterm and term infants. At 40 weeks CA the latencies of ACR components Na and P2 are significantly longer in term infants, whereas at 52 weeks CA the latencies of the same ACR components are shorter in term infants. The results support the hypothesis that retarded myelination of the central auditory pathway is partially responsible for differences found between preterm infants and term infants with respect to late ABR components and early MLR component P0. Furthermore, mild conductive hearing loss in preterm infants may also play its role. A more complex mechanism is implicated to account for the findings noted with respect to MLR component Na and ACR components Na and P2.

LWIR pupil imaging and longer-term calibration stability

NASA Astrophysics Data System (ADS)

LeVan, Paul D.; Sakoglu, Ünal

2016-09-01

A previous paper described LWIR pupil imaging, and an improved understanding of the behavior of this type of sensor for which the high-sensitivity focal plane array (FPA) operated at higher flux levels includes a reversal in signal integration polarity. We have since considered a candidate methodology for efficient, long-term calibration stability that exploits the following two properties of pupil imaging: (1) a fixed pupil position on the FPA, and (2) signal levels from the scene imposed on significant but fixed LWIR background levels. These two properties serve to keep each pixel operating over a limited dynamic range that corresponds to its location in the pupil and to the signal levels generated at this location by the lower and upper calibration flux levels. Exploiting this property for which each pixel of the Pupil Imager operates over its limited dynamic range, the signal polarity reversal between low and high flux pixels, which occurs for a circular region of pixels near the upper edges of the pupil illumination profile, can be rectified to unipolar integration with a two-level non-uniformity correction (NUC). Images corrected real-time with standard non-uniformity correction (NUC) techniques, are still subject to longer-term drifts in pixel offsets between recalibrations. Long-term calibration stability might then be achieved using either a scene-based non-uniformity correction approach, or with periodic repointing for off-source background estimation and subtraction. Either approach requires dithering of the field of view, by sub-pixel amounts for the first method, or by large off-source motions outside the 0.38 milliradian FOV for the latter method. We report on the results of investigations along both these lines.

Evaluation of Bayesian estimation of a hidden continuous-time Markov chain model with application to threshold violation in water-quality indicators

USGS Publications Warehouse

Deviney, Frank A.; Rice, Karen; Brown, Donald E.

2012-01-01

Natural resource managers require information concerning  the frequency, duration, and long-term probability of occurrence of water-quality indicator (WQI) violations of defined thresholds. The timing of these threshold crossings often is hidden from the observer, who is restricted to relatively infrequent observations. Here, a model for the hidden process is linked with a model for the observations, and the parameters describing duration, return period, and long-term probability of occurrence are estimated using Bayesian methods. A simulation experiment is performed to evaluate the approach under scenarios based on the equivalent of a total monitoring period of 5-30 years and an observation frequency of 1-50 observations per year. Given constant threshold crossing rate, accuracy and precision of parameter estimates increased with longer total monitoring period and more-frequent observations. Given fixed monitoring period and observation frequency, accuracy and precision of parameter estimates increased with longer times between threshold crossings. For most cases where the long-term probability of being in violation is greater than 0.10, it was determined that at least 600 observations are needed to achieve precise estimates.  An application of the approach is presented using 22 years of quasi-weekly observations of acid-neutralizing capacity from Deep Run, a stream in Shenandoah National Park, Virginia. The time series also was sub-sampled to simulate monthly and semi-monthly sampling protocols. Estimates of the long-term probability of violation were unbiased despite sampling frequency; however, the expected duration and return period were over-estimated using the sub-sampled time series with respect to the full quasi-weekly time series.

Effects of full-day kindergarten on the long-term health prospects of children in low-income and racial/ethnic-minority populations: a community guide systematic review.

PubMed

Hahn, Robert A; Rammohan, Veda; Truman, Benedict I; Milstein, Bobby; Johnson, Robert L; Muntañer, Carles; Jones, Camara P; Fullilove, Mindy T; Chattopadhyay, Sajal K; Hunt, Pete C; Abraido-Lanza, Ana F

2014-03-01

Children from low-income and minority families are often behind higher-income and majority children in language, cognitive, and social development even before they enter school. Because educational achievement has been shown to improve long-term health, addressing these delays may foster greater health equity. This systematic review assesses the extent to which full-day kindergarten (FDK), compared with half-day kindergarten (HDK), prepares children, particularly those from low-income and minority families, to succeed in primary and secondary school and improve lifelong health. A meta-analysis (2010) on the effects of FDK versus HDK among U.S. children measured educational achievement at the end of kindergarten. The meta-analysis was concordant with Community Guide criteria. Findings on the longer-term effects of FDK suggested "fade-out" by third grade. The present review used evidence on the longer-term effects of pre-K education to explore the loss of FDK effects over time. FDK improved academic achievement by an average of 0.35 SDs (Cohen's d; 95% CI=0.23, 0.46). The effect on verbal achievement was 0.46 (Cohen's d; 95% CI=0.32, 0.61) and that on math achievement was 0.24 (Cohen's d; 95% CI=0.06, 0.43). Evidence of "fade-out" from pre-K education found that better-designed studies indicated both residual benefits over multiple years and the utility of educational boosters to maintain benefits, suggesting analogous longer-term effects of FDK. There is strong evidence that FDK improves academic achievement, a predictor of longer-term health benefits. To sustain early benefits, intensive elementary school education is needed. If targeted to low-income and minority communities, FDK can advance health equity. Published by Elsevier Inc.

Limitations of Reliability for Long-Endurance Human Spaceflight

NASA Technical Reports Server (NTRS)

Owens, Andrew C.; de Weck, Olivier L.

2016-01-01

Long-endurance human spaceflight - such as missions to Mars or its moons - will present a never-before-seen maintenance logistics challenge. Crews will be in space for longer and be farther way from Earth than ever before. Resupply and abort options will be heavily constrained, and will have timescales much longer than current and past experience. Spare parts and/or redundant systems will have to be included to reduce risk. However, the high cost of transportation means that this risk reduction must be achieved while also minimizing mass. The concept of increasing system and component reliability is commonly discussed as a means to reduce risk and mass by reducing the probability that components will fail during a mission. While increased reliability can reduce maintenance logistics mass requirements, the rate of mass reduction decreases over time. In addition, reliability growth requires increased test time and cost. This paper assesses trends in test time requirements, cost, and maintenance logistics mass savings as a function of increase in Mean Time Between Failures (MTBF) for some or all of the components in a system. In general, reliability growth results in superlinear growth in test time requirements, exponential growth in cost, and sublinear benefits (in terms of logistics mass saved). These trends indicate that it is unlikely that reliability growth alone will be a cost-effective approach to maintenance logistics mass reduction and risk mitigation for long-endurance missions. This paper discusses these trends as well as other options to reduce logistics mass such as direct reduction of part mass, commonality, or In-Space Manufacturing (ISM). Overall, it is likely that some combination of all available options - including reliability growth - will be required to reduce mass and mitigate risk for future deep space missions.

[Hiatal hernias: why and how should they be surgically treated].

PubMed

Braghetto, Italo; Csendes, Attila; Korn, Owen; Musleh, Maher; Lanzarini, Enrique; Saure, Alex; Hananias, Baydir; Valladares, Héctor

2013-01-01

There is controversy in the literature about the choice of expectant medical treatment versus surgical treatment of hiatal hernias, depending on the presence or absence of symptoms. This study presents the results obtained by our group, considering disease duration and postoperative results. A total of 121 patients were included and divided by age, disease duration, type of hiatal hernia and postoperative outcome. In 32% of the patients younger than 70 years, symptom duration was longer than 11 years and 68% of those aged more than 71 years had long-term symptoms (p<.05). Type iv hernias (complex) and those with diameters measuring more than 16 cm were observed in the group with longer symptom duration. Complications were more frequent in the older age group, in those with longer symptom duration and in those with type iv complex hernias. There was no postoperative mortality and only one patient (0.8%) with a type iii hernia and severe oesophagitis required reoperation. We recommend that patients with hiatal hernia undergo surgery at diagnosis to avoid complications and risks. Older patients should not be excluded from surgical indication but should undergo a complete multidisciplinary evaluation to avoid complications and postoperative mortality. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

21 CFR 660.46 - Samples; protocols; official release.

Code of Federal Regulations, 2014 CFR

2014-04-01

... with 125I or unlyophilized HBsAg-coated red blood cells means a sample from each lot of diagnostic test...) One sample until written notification of official release is no longer required under paragraph (c)(2... notification of official release is no longer required under paragraph (c)(2) of this section. The sample...

21 CFR 660.46 - Samples; protocols; official release.

Code of Federal Regulations, 2013 CFR

2013-04-01

... with 125I or unlyophilized HBsAg-coated red blood cells means a sample from each lot of diagnostic test...) One sample until written notification of official release is no longer required under paragraph (c)(2... notification of official release is no longer required under paragraph (c)(2) of this section. The sample...

21 CFR 660.46 - Samples; protocols; official release.

Code of Federal Regulations, 2012 CFR

2012-04-01

... with 125I or unlyophilized HBsAg-coated red blood cells means a sample from each lot of diagnostic test...) One sample until written notification of official release is no longer required under paragraph (c)(2... notification of official release is no longer required under paragraph (c)(2) of this section. The sample...

Perceptual learning of degraded speech by minimizing prediction error.

PubMed

Sohoglu, Ediz; Davis, Matthew H

2016-03-22

Human perception is shaped by past experience on multiple timescales. Sudden and dramatic changes in perception occur when prior knowledge or expectations match stimulus content. These immediate effects contrast with the longer-term, more gradual improvements that are characteristic of perceptual learning. Despite extensive investigation of these two experience-dependent phenomena, there is considerable debate about whether they result from common or dissociable neural mechanisms. Here we test single- and dual-mechanism accounts of experience-dependent changes in perception using concurrent magnetoencephalographic and EEG recordings of neural responses evoked by degraded speech. When speech clarity was enhanced by prior knowledge obtained from matching text, we observed reduced neural activity in a peri-auditory region of the superior temporal gyrus (STG). Critically, longer-term improvements in the accuracy of speech recognition following perceptual learning resulted in reduced activity in a nearly identical STG region. Moreover, short-term neural changes caused by prior knowledge and longer-term neural changes arising from perceptual learning were correlated across subjects with the magnitude of learning-induced changes in recognition accuracy. These experience-dependent effects on neural processing could be dissociated from the neural effect of hearing physically clearer speech, which similarly enhanced perception but increased rather than decreased STG responses. Hence, the observed neural effects of prior knowledge and perceptual learning cannot be attributed to epiphenomenal changes in listening effort that accompany enhanced perception. Instead, our results support a predictive coding account of speech perception; computational simulations show how a single mechanism, minimization of prediction error, can drive immediate perceptual effects of prior knowledge and longer-term perceptual learning of degraded speech.

Perceptual learning of degraded speech by minimizing prediction error

PubMed Central

Sohoglu, Ediz

2016-01-01

Human perception is shaped by past experience on multiple timescales. Sudden and dramatic changes in perception occur when prior knowledge or expectations match stimulus content. These immediate effects contrast with the longer-term, more gradual improvements that are characteristic of perceptual learning. Despite extensive investigation of these two experience-dependent phenomena, there is considerable debate about whether they result from common or dissociable neural mechanisms. Here we test single- and dual-mechanism accounts of experience-dependent changes in perception using concurrent magnetoencephalographic and EEG recordings of neural responses evoked by degraded speech. When speech clarity was enhanced by prior knowledge obtained from matching text, we observed reduced neural activity in a peri-auditory region of the superior temporal gyrus (STG). Critically, longer-term improvements in the accuracy of speech recognition following perceptual learning resulted in reduced activity in a nearly identical STG region. Moreover, short-term neural changes caused by prior knowledge and longer-term neural changes arising from perceptual learning were correlated across subjects with the magnitude of learning-induced changes in recognition accuracy. These experience-dependent effects on neural processing could be dissociated from the neural effect of hearing physically clearer speech, which similarly enhanced perception but increased rather than decreased STG responses. Hence, the observed neural effects of prior knowledge and perceptual learning cannot be attributed to epiphenomenal changes in listening effort that accompany enhanced perception. Instead, our results support a predictive coding account of speech perception; computational simulations show how a single mechanism, minimization of prediction error, can drive immediate perceptual effects of prior knowledge and longer-term perceptual learning of degraded speech. PMID:26957596

Automation and robotics technology for intelligent mining systems

NASA Technical Reports Server (NTRS)

Welsh, Jeffrey H.

1989-01-01

The U.S. Bureau of Mines is approaching the problems of accidents and efficiency in the mining industry through the application of automation and robotics to mining systems. This technology can increase safety by removing workers from hazardous areas of the mines or from performing hazardous tasks. The short-term goal of the Automation and Robotics program is to develop technology that can be implemented in the form of an autonomous mining machine using current continuous mining machine equipment. In the longer term, the goal is to conduct research that will lead to new intelligent mining systems that capitalize on the capabilities of robotics. The Bureau of Mines Automation and Robotics program has been structured to produce the technology required for the short- and long-term goals. The short-term goal of application of automation and robotics to an existing mining machine, resulting in autonomous operation, is expected to be accomplished within five years. Key technology elements required for an autonomous continuous mining machine are well underway and include machine navigation systems, coal-rock interface detectors, machine condition monitoring, and intelligent computer systems. The Bureau of Mines program is described, including status of key technology elements for an autonomous continuous mining machine, the program schedule, and future work. Although the program is directed toward underground mining, much of the technology being developed may have applications for space systems or mining on the Moon or other planets.

Acute neuromuscular respiratory failure: a population-based study of aetiology and outcome in Northern Ireland.

PubMed

Carr, A S; Hoeritzauer, A I; Kee, R; Kinney, M; Campbell, J; Hutchinson, A; McDonnell, G V

2014-04-01

Acute neuromuscular respiratory failure (NMRF) is a life-threatening feature of a variety of neurological conditions that can present in extremis prior to the establishment of a definitive diagnosis, so early clinical decision making is difficult. Population-based data on the frequency, outcome and aetiological spectrum are lacking. To establish accurate epidemiological descriptive statistics in this patient group. The regional Intensive Care National Audit and Research Centre (ICNARC) database was searched for patients admitted with acute NMRF from 1/1/2000 to 31/12/2010. Demographics, diagnosis, length of intensive care unit (ICU) stay, follow-up and outcome (modified Rankin score (mRS)) were recorded. A comparison dataset of all non-NMRF neurology patients admitted to ICU was obtained. 55 patients were identified; age 17-88 (median 66 years), M:F ratio 1:1.5, incidence rate (IR) 2.81 (2.12 to 3.66) cases per million person-years and mortality rate (MR) 0.26 (0.08 to 0.60) deaths per million person-years. Causes included inflammatory neuropathy (65%), myasthenia gravis (18%), rhabdomyolysis (2%) and amyotrophic lateral sclerosis (9%), and 5% were undiagnosed. Follow-up ranged from 0 to 7 years (median 500.5 days); long-term mRS 1 (range 0-6). NMRF patients were older (p<0.0001), had longer ICU stay (p<0.0001), but significantly better outcome (p<0.0001) than 93 non-NMRF neurology patients requiring ICU admission. Inflammatory and degenerative neuromuscular conditions can present in acute NMRF. Long-term outcome is good and MR is low, and significantly better than in other neurology patients requiring ICU admission despite longer ICU stay.

Demonstration Assessment of Light-Emitting Diode (LED) Roadway Lighting, I-35W Bridge, Minneapolis, Minnesota, Phase II Report

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

Kinzey, B. R.; Davis, R. G.

2014-09-30

On the I-35W Bridge in Minneapolis, Minnesota, the GATEWAY program conducted a two-phase demonstration of LED roadway lighting on the main span, which is one of the country's oldest continuously operated exterior LED lighting installations. The Phase II report documents longer-term performance of the LED lighting system that was installed in 2008, and is the first report on the longer-term performance of LED lighting in the field.

NASA earth science and applications division: The program and plans for FY 1988-1989-1990

NASA Technical Reports Server (NTRS)

1988-01-01

Described here are the Division's research goals, priorities and emphases for the next several years and an outline of longer term plans. Included are highlights of recent accomplishments, current activities in FY 1988, research emphases in FY 1989, and longer term future plans. Data and information systems, the Geodynamics Program, the Land Processes Program, the Oceanic Processes Program, the Atmospheric Dynamics and Radiation Program, the Atmospheric Chemistry Program, and space flight programs are among the topic covered.

Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies.

PubMed

Wray, Faye; Clarke, David

2017-10-06

To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Systematic review and thematic synthesis. We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Initiating the 2002 Mars Science Laboratory (MSL) Focused Technology Program

NASA Technical Reports Server (NTRS)

Caffrey, Robert T.; Udomkesmalee, Gabriel; Hayati, Samad A.

2004-01-01

The Mars Science Laboratory (MSL) Project is an aggressive mission launching in 2009 to deliver a new generation of rover safely to the surface of Mars and conduct comprehensive in situ investigations using a new generation of instruments. This system will be designed to land with precision and be capable of operating over a large percentage on the surface of Mars. It will have capabilities that will support NASA's scientific goals into the next decade of exphation. The MSL Technology program is developing a wide-range of technologies needed for this Mission and potentially other space missions. The MSL Technology Program reports to both the MSL Project and the Mars Technology Program (MTP). The dual reporting process creates a challenging management situation, but ensures the new technology meets both the specific MSL requirements and the broader Mars Program requirements. MTP is a NASA-wide technology development program managed by the Jet Propulsion Laboratory (JPL) and is divided into a Focused Program and a Base Program. The Focused Technology Program addresses technologies that are specific and critical to near-term missions, while the Base Technology Program addresses those technologies that are applicable to multiple missions and which can be characterized as longer term, higher risk, and high payoff technologies. The MSL Technology Program is under the Focused Program and is tightly coupled to MSL's mission milestones and deliverables. The technology budget is separate from the flight Project budget, but the technology s requirements and the development process are tightly coordinated with the Project. The Technology Program combines proven management techniques of flight projects with commercial and academic technology management strategies, to create a technology management program that meets the near-term requirements of MSL and the long-term requirements of MTP. This paper examines the initiation of 2002 MSL Technology program. Some of the areas discussed in this paper include technology definition, task selection, technology management, and technology assessment.

Short- and long-term efficacy of forest thinning to mitigate drought impacts in mountain forests in the European Alps.

PubMed

Elkin, Ché; Giuggiola, Arnaud; Rigling, Andreas; Bugmann, Harald

2015-06-01

In many regions of the world, drought is projected to increase under climate change, with potential negative consequences for forests and their ecosystem services (ES). Forest thinning has been proposed as a method for at least temporarily mitigating drought impacts, but its general applicability and longer-term impacts are unclear. We use a process-based forest model to upscale experimental data for evaluating the impacts of forest thinning in a drought-susceptible valley in the interior of the European Alps, with the specific aim of assessing (1) when and where thinning may be most effective and (2) the longer-term implications for forest dynamics. Simulations indicate that forests will be impacted by climate-induced increases in drought across a broad elevation range. At lower elevations, where drought is currently prevalent, thinning is projected to temporarily reduce tree mortality, but to have minor impacts on forest dynamics in the longer term. Thinning may be particularly useful at intermediate and higher elevations as a means of temporarily reducing mortality in drought-sensitive species such as Norway spruce and larch, which currently dominate these elevations. However, in the longer term, even intense thinning will likely not be sufficient to prevent a climate change induced dieback of these species, which is projected to occur under even moderate climate change. Thinning is also projected to have the largest impact on long-term forest dynamics at intermediate elevations, with the magnitude of the impact depending on the timing and intensity of thinning. More intense thinning that is done later is projected to more strongly promote a transition to more drought-tolerant species. We conclude that thinning is a viable option for temporarily reducing the negative drought impacts on forests, but that efficient implementation of thinning should be contingent on a site-specific evaluation of the near term risk of significant drought, and how thinning will impact the rate and direction of climate driven forest conversion.

77 FR 75011 - Revisions to Authorization Validated End-User Provisions: Requirement for Notice of Export...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... Bureau of Industry and Security (BIS) amends the Export Administration Regulations (EAR) by adding a...-specific conditions under Authorization VEU no longer require a license for export or reexport or become eligible for shipment under a license exception, as set forth in the EAR, VEUs are no longer bound by the...

A randomised controlled trial evaluating a brief intervention for deficits in recognising emotional prosody following severe ABI.

PubMed

McDonald, S; Togher, L; Tate, R; Randall, R; English, T; Gowland, A

2013-01-01

Many adults with acquired brain injuries, including traumatic brain injuries (TBI) have impaired emotion perception. Impaired perception of emotion in voice can occur independently to facial expression and represents a specific target for remediation. No research to date has addressed this. The current study used a randomised controlled trial to examine the efficacy of a short treatment (three x two-hour sessions) for improving the ability to recognise emotional prosody for people with acquired brain injury, mostly TBI. Ten participants were allocated to treatment and 10 to waitlist. All participants remained involved for the duration of the study in the groups to which they were allocated. There were no significant treatment effects for group, but analyses of individual performances indicated that six of the treated participants made demonstrable improvements on objective measures of prosody recognition. The reasons why some participants showed improvements while others did not, was not obvious. Improvements on objective lab-based measures did not generalise to relative reports of improvements in everyday communicative ability. Nor was there clear evidence of long-term effects. In conclusion, treatment of emotional prosody was effective in the short-term for half of the participants. Further research is required to determine what conditions are required to optimise generalisability and longer-term gains.

Focusing on Short-Term Achievement Gains Fails to Produce Long-Term Gains

ERIC Educational Resources Information Center

Grissmer, David W.; Ober, David R.; Beekman, John A.

2014-01-01

The short-term emphasis engendered by No Child Left Behind (NCLB) has focused research predominantly on unraveling the complexities and uncertainties in assessing short-term results, rather than developing methods and assessing results over the longer term. In this paper we focus on estimating long-term gains and address questions important to…

Comparison of Gated Audiovisual Speech Identification in Elderly Hearing Aid Users and Elderly Normal-Hearing Individuals: Effects of Adding Visual Cues to Auditory Speech Stimuli.

PubMed

Moradi, Shahram; Lidestam, Björn; Rönnberg, Jerker

2016-06-17

The present study compared elderly hearing aid (EHA) users (n = 20) with elderly normal-hearing (ENH) listeners (n = 20) in terms of isolation points (IPs, the shortest time required for correct identification of a speech stimulus) and accuracy of audiovisual gated speech stimuli (consonants, words, and final words in highly and less predictable sentences) presented in silence. In addition, we compared the IPs of audiovisual speech stimuli from the present study with auditory ones extracted from a previous study, to determine the impact of the addition of visual cues. Both participant groups achieved ceiling levels in terms of accuracy in the audiovisual identification of gated speech stimuli; however, the EHA group needed longer IPs for the audiovisual identification of consonants and words. The benefit of adding visual cues to auditory speech stimuli was more evident in the EHA group, as audiovisual presentation significantly shortened the IPs for consonants, words, and final words in less predictable sentences; in the ENH group, audiovisual presentation only shortened the IPs for consonants and words. In conclusion, although the audiovisual benefit was greater for EHA group, this group had inferior performance compared with the ENH group in terms of IPs when supportive semantic context was lacking. Consequently, EHA users needed the initial part of the audiovisual speech signal to be longer than did their counterparts with normal hearing to reach the same level of accuracy in the absence of a semantic context. © The Author(s) 2016.

Estimation of spatial patterns of urban air pollution over a 4-week period from repeated 5-min measurements

NASA Astrophysics Data System (ADS)

Gillespie, Jonathan; Masey, Nicola; Heal, Mathew R.; Hamilton, Scott; Beverland, Iain J.

2017-02-01

Determination of intra-urban spatial variations in air pollutant concentrations for exposure assessment requires substantial time and monitoring equipment. The objective of this study was to establish if short-duration measurements of air pollutants can be used to estimate longer-term pollutant concentrations. We compared 5-min measurements of black carbon (BC) and particle number (PN) concentrations made once per week on 5 occasions, with 4 consecutive 1-week average nitrogen dioxide (NO2) concentrations at 18 locations at a range of distances from busy roads in Glasgow, UK. 5-min BC and PN measurements (averaged over the two 5-min periods at the start and end of a week) explained 40-80%, and 7-64% respectively, of spatial variation in the intervening 1-week NO2 concentrations for individual weeks. Adjustment for variations in background concentrations increased the percentage of explained variation in the bivariate relationship between the full set of NO2 and BC measurements over the 4-week period from 28% to 50% prior to averaging of repeat measurements. The averages of five 5-min BC and PN measurements made over 5 weeks explained 75% and 33% respectively of the variation in average 1-week NO2 concentrations over the same period. The relatively high explained variation observed between BC and NO2 measured on different time scales suggests that, with appropriate steps to correct or average out temporal variations, repeated short-term measurements can be used to provide useful information on longer-term spatial patterns for these traffic-related pollutants.

Healthier food choices as a result of the revised healthy diet programme Krachtvoer for students of prevocational schools.

PubMed

Bessems, Kathelijne M H H; van Assema, Patricia; Martens, Marloes K; Paulussen, Theo G W M; Raaijmakers, Lieke G M; de Rooij, Mark; de Vries, Nanne K

2012-05-24

Krachtvoer is a Dutch healthy diet programme for prevocational schools, developed in 2001 and revised for a broader target group in 2007, based on the findings of an evaluation of the first version. The goal of this study was to report on the short- and longer-term total and subgroup effects of the revised programme on students' fruit, fruit juice, breakfast, and snack consumption. Schools were randomized to the experimental condition, teaching the Krachtvoer programme, or to the control condition teaching the regular nutrition lessons. Self-reported consumption of fruit, fruit juice, breakfast and snacks was measured at baseline directly before programme implementation, one to four weeks after finishing programme implementation, and after six months. Mixed linear and logistic regression analyses were conducted. In total 1117 students of 13 experimental schools and 758 students of 11 control schools participated in the study. Short- and longer-term favourable intervention effects were found on fruit consumption (mean difference between experimental and control group 0.15 servings at both posttests). Regarding fruit juice consumption, only short-term favourable effects were revealed (mean difference between experimental and control group 0.05 glasses). Intervention effects on breakfast intakes were limited. No changes in snack frequency were reported, but students made healthier snack choices as a result of the programme. Some favourable as well as unfavourable effects occurred in subgroups of students. The effects on fruit consumption and snack choices justify the current nationwide dissemination of the programme. Achieving changes in breakfast consumption may, however, require other strategies.

Long-Term In Vitro Degradation of a High-Strength Brushite Cement in Water, PBS, and Serum Solution

PubMed Central

Ajaxon, Ingrid; Öhman, Caroline; Persson, Cecilia

2015-01-01

Bone loss and fractures may call for the use of bone substituting materials, such as calcium phosphate cements (CPCs). CPCs can be degradable, and, to determine their limitations in terms of applications, their mechanical as well as chemical properties need to be evaluated over longer periods of time, under physiological conditions. However, there is lack of data on how the in vitro degradation affects high-strength brushite CPCs over longer periods of time, that is, longer than it takes for a bone fracture to heal. This study aimed at evaluating the long-term in vitro degradation properties of a high-strength brushite CPC in three different solutions: water, phosphate buffered saline, and a serum solution. Microcomputed tomography was used to evaluate the degradation nondestructively, complemented with gravimetric analysis. The compressive strength, chemical composition, and microstructure were also evaluated. Major changes from 10 weeks onwards were seen, in terms of formation of a porous outer layer of octacalcium phosphate on the specimens with a concomitant change in phase composition, increased porosity, decrease in object volume, and mechanical properties. This study illustrates the importance of long-term evaluation of similar cement compositions to be able to predict the material's physical changes over a relevant time frame. PMID:26587540

THE LONG-TERM EFFICACY OF ACUTE-PHASE PSYCHOTHERAPY FOR DEPRESSION: A META-ANALYSIS OF RANDOMIZED TRIALS.

PubMed

Karyotaki, Eirini; Smit, Yolba; de Beurs, Derek P; Henningsen, Kirsten Holdt; Robays, Jo; Huibers, Marcus J H; Weitz, Erica; Cuijpers, Pim

2016-05-01

Understanding the effectiveness of treatment for depression in both the short term and long term is essential for clinical decision making. The present meta-analysis examined treatment effects on depression and quality of life in acute-phase psychotherapeutic interventions compared to no treatment control groups for adult depression at 6 months or longer postrandomization. A systematic literature search resulted in 44 randomized controlled trials with 6,096 participants. Acute-phase psychotherapy was compared to control groups at 6-month or longer postrandomization. Odds ratios of a positive outcome were calculated. Psychotherapy outperformed control groups at 6 months or longer postrandomization (OR = 1.92, 95% CI: 1.60-2.31, P < .001). Heterogeneity was moderate (I²: 65, 95% CI: 53-74, P < .001). However, effects significantly decreased with longer follow-up periods. Additionally, a small positive effect of psychotherapy was observed for quality of life, while similar effects were obtained in separate analyses of each type of psychotherapy, with the exception of nondirective supportive therapy. Studies that provided booster sessions had better treatment results compared with studies that did not provide any further sessions. Finally, we found that trials on psychotherapy aimed at major depressive disorder (MDD) had better outcomes than those that were aimed at elevated depressive symptoms. There is substantial evidence that acute-phase psychotherapy results in a better treatment effects on depression and quality of life in the long term for adult patients with depression. © 2016 Wiley Periodicals, Inc.

Effect of local cooling on short-term, intense exercise.

PubMed

Kwon, Young S; Robergs, Robert A; Schneider, Suzanne M

2013-07-01

The widespread belief that local cooling impairs short-term, strenuous exercise performance is controversial. Eighteen original investigations involving cooling before and intermittent cooling during short-term, intensive exercise are summarized in this review. Previous literature examining short-term intensive exercise and local cooling primarily has been limited to the effects on muscle performance immediately or within minutes following cold application. Most previous cooling studies used equal and longer than 10 minutes of pre-cooling, and found that cooling reduced strength, performance and endurance. Because short duration, high intensity exercise requires adequate warm-up to prepare for optimal performance, prolonged pre-cooling is not an effective method to prepare for this type of exercise. The literature related to the effect of acute local cooling immediately before short duration, high intensity isotonic exercise such as weight lifting is limited. However, local intermittent cooling during short-term, high intense exercise may provide possible beneficial effects; first, by pain reduction, caused by an "irritation effect" from hand thermal receptors which block pain sensation, or second, by a cooling effect, whereby stimulation of hand thermal receptors or a slight lowering of blood temperature might alter central fatigue.

Emerging Methodologies in Pediatric Palliative Care Research: Six Case Studies

PubMed Central

Nelson, Katherine E.; Gerhardt, Cynthia A.; Rosenberg, Abby R.; Widger, Kimberley; Faerber, Jennifer A.; Feudtner, Chris

2018-01-01

Given the broad focus of pediatric palliative care (PPC) on the physical, emotional, and spiritual needs of children with potentially life-limiting illnesses and their families, PPC research requires creative methodological approaches. This manuscript, written by experienced PPC researchers, describes issues encountered in our own areas of research and the novel methods we have identified to target them. Specifically, we discuss potential approaches to: assessing symptoms among nonverbal children, evaluating medical interventions, identifying and treating problems related to polypharmacy, addressing missing data in longitudinal studies, evaluating longer-term efficacy of PPC interventions, and monitoring for inequities in PPC service delivery. PMID:29495384

Multidisciplinary emergent removal of a metal penoscrotal constriction device.

PubMed

Nason, G J; Abdelsadek, A H; Foran, A T; O'Malley, K J

2017-03-10

Strangulation of the genital organs is a rare presentation to the emergency department which requires urgent intervention to avoid long term complications. Penoscrotal constriction devices are either used for autoerotic stimulus or to increase sexual performance by maintaining an erection for a longer period. We report a case of a man who presented with penile strangulation following the application of a titanium penoscrotal constriction ring during sexual intercourse seven hours previously. The Fire Brigade department attended with an electric operated angle grinder to facilitate removal of the ring as standard medical equipment (orthopaedic saws, bolt and bone cutters) were insufficient. Fully functional recovery was achieved.

Status of Commercial Programs at NASA

NASA Technical Reports Server (NTRS)

Groen, Frank

2011-01-01

NASA's strategy is two-fold: (1) Use Space Act Agreements to support the development of commercial crew transportation capabilities. (2) Use FAR-based contracts for the certification of commercially developed capabilities and for the procurement of crew transportation services to and from the ISS to meet NASA requirements. Focus is on reducing the risk and uncertainties of the development environment and on the incentives provided through competition by separating the design and early development content from the longer-term CTS Certification activities. CCP expects to develop, demonstrate, and certify U.S. commercial crew space transportation capabilities that meet ISS crew transportation needs by the end of FY 2017.

Observations of dusty plasmas with magnetized dust grains

NASA Astrophysics Data System (ADS)

Luo, Q.-Z.; D'Angelo, N.

2000-11-01

We report a newly observed phenomenon in a dusty plasma device of the \\mbox{Q-machine} type. At low plasma densities the time required by the plasma to return to its no-dust conditions, after the dust dispenser is turned off, can be as long as many tens of seconds or longer. A tentative interpretation of this observation in terms of magnetized dust grains is advanced. It appears that an important loss mechanism of fine dust grains is by ion drag along the magnetic field lines. The effect of ion drag is somewhat counteracted by the -µ∇B force present when the magnetic field has a mirror geometry.

Finger Injuries in Football and Rugby.

PubMed

Elzinga, Kate E; Chung, Kevin C

2017-02-01

Football and rugby athletes are at increased risk of finger injuries given the full-contact nature of these sports. Some players may return to play early with protective taping, splinting, and casting. Others require a longer rehabilitation period and prolonged time away from the field. The treating hand surgeon must weigh the benefits of early return to play for the current season and future playing career against the risks of reinjury and long-term morbidity, including post-traumatic arthritis and decreased range of motion and strength. Each player must be comprehensively assessed and managed with an individualized treatment plan. Copyright © 2016 Elsevier Inc. All rights reserved.

Urinary tract infections in women.

PubMed

Johnson, M A

1990-02-01

The clinical conditions that cause dysuria in women can usually be differentiated by the history and selected physical and laboratory examinations. Cystitis can be treated with short-course therapy in uncomplicated cases; pretreatment cultures are usually not necessary, since most infections are caused by Escherichia coli. Outpatient treatment of pyelonephritis is appropriate in selected patients. Follow-up culture after treatment of either cystitis or pyelonephritis is indicated to identify those patients requiring longer treatment or urologic evaluation. Recurrent urinary tract infections can be managed with postcoital antibiotics, long-term prophylaxis or patient self-administration of short-course therapy. Bacteriuria and pyelonephritis in pregnancy must be aggressively diagnosed and treated.

PERIPROSTHETIC FRACTURES IN TOTAL KNEE ARTHROPLASTY

PubMed Central

de Alencar, Paulo Gilberto Cimbalista; De Bortoli, Giovani; Ventura Vieira, Inácio Facó; Uliana, Christiano Saliba

2015-01-01

The increasing number of total knee arthroplasties, in combination with the population's longer life expectancy, has led to a greater number of long-term complications. These add to the poor bone quality of elderly patients and often culminate in periprosthetic fractures. This complex orthopedic problem has a great diversity of clinical presentation. It may affect any of the bones in the knee and, because of the difficulty in finding solutions, may lead to disastrous outcomes. Its treatment requires that orthopedists should have broad knowledge both of arthroplasty techniques and of osteosynthesis, as well as an elaborate therapeutic arsenal including, for example, access to a bone bank. PMID:27022546

Changing sources and environmental factors reduce the rates of decline of organochlorine pesticides in the Arctic Atmosphere

NASA Astrophysics Data System (ADS)

Becker, S.; Halsall, C. J.; Tych, W.; Kallenborn, R.; Schlabach, M.; Manø, S.

2009-01-01

An extensive database of organochlorine (OC) pesticide concentrations measured at the Norwegian Arctic Monitoring Station was analysed to assess longer-term trends in the Arctic atmosphere. Dynamic Harmonic Regression (DHR) is employed to investigate the seasonal and cyclical behaviour of chlordanes, DDTs and hexachlorobenzene (HCB), and to isolate underlying inter-annual trends. Although a simple comparison of annual mean concentrations (1994-2005) suggest a decline for all of the OCs investigated, the longer-term trends identified by DHR only show a significant decline for p,p'-DDT. Indeed, HCB shows an increase from 2003-2005. This is thought to be due to changes in source types and the presence of impurities in current use pesticides, together with retreating sea ice affecting air-water exchange. Changes in source types were revealed by using isomeric ratios for the chlordanes and DDTs. Declining trends in ratios of trans-chlordane/cis-chlordane (TC/CC) indicate a shift from primary sources, to more ''weathered'' secondary sources, whereas an increasing trend in o,p'-DDT/p,p'-DDT ratios indicate a shift from use of technical DDT to dicofol. Continued monitoring of these OC pesticides is required to fully understand the influence of a changing climate on the behaviour and environmental cycling of these chemicals in the Arctic as well as possible impacts from ''new'' sources.

Changing sources and environmental factors reduce the rates of decline of organochlorine pesticides in the Arctic atmosphere

NASA Astrophysics Data System (ADS)

Becker, S.; Halsall, C. J.; Tych, W.; Kallenborn, R.; Schlabach, M.; Manø, S.

2012-05-01

An extensive database of organochlorine (OC) pesticide concentrations measured at the Norwegian Arctic monitoring station at Ny-Ålesund, Svalbard, was analysed to assess longer-term trends in the Arctic atmosphere. Dynamic Harmonic Regression (DHR) is employed to investigate the seasonal and cyclical behaviour of chlordanes, DDTs and hexachlorobenzene (HCB), and to isolate underlying inter-annual trends. Although a simple comparison of annual mean concentrations (1994-2005) suggest a decline for all of the OCs investigated, the longer-term trends identified by DHR only show a significant decline for p,p'-DDT. Indeed, HCB shows an increase from 2003-2005. This is thought to be due to changes in source types and the presence of impurities in current use pesticides, together with retreating sea ice affecting air-water exchange. Changes in source types were revealed by using isomeric ratios for the chlordanes and DDTs. Declining trends in ratios of trans-chlordane/cis-chlordane (TC/CC) indicate a shift from primary sources, to more "weathered" secondary sources, whereas an increasing trend in o,p'-DDT/p,p'-DDT ratios indicate a shift from use of technical DDT to dicofol. Continued monitoring of these OC pesticides is required to fully understand the influence of a changing climate on the behaviour and environmental cycling of these chemicals in the Arctic as well as possible impacts from "new" sources.

Associations between infant feeding and the size, tempo and velocity of infant weight gain: SITAR analysis of the Gemini twin birth cohort

PubMed Central

Johnson, L; van Jaarsveld, C H M; Llewellyn, C H; Cole, T J; Wardle, J

2014-01-01

Objective: Infant growth trajectories, in terms of size, tempo and velocity, may programme lifelong obesity risk. Timing of breastfeeding cessation and weaning are both implicated in rapid infant growth; we examined the association of both simultaneously with a range of growth parameters. Design: Longitudinal population-based twin birth cohort. Subjects: The Gemini cohort provided data on 4680 UK infants with a median of 10 (interquartile range=8–15) weight measurements between birth and a median of 6.5 months. Age at breastfeeding cessation and weaning were reported by parents at mean age 8.2 months (s.d.=2.2, range=4–20). Growth trajectories were modelled using SuperImposition by Translation And Rotation (SITAR) to generate three descriptors of individual growth relative to the average trajectory: size (grams), tempo (weeks, indicating the timing of the peak growth rate) and velocity (% difference from average, reflecting mean growth rate). Complex-samples general linear models adjusting for family clustering and confounders examined associations between infant feeding and SITAR parameters. Results: Longer breastfeeding (>4 months vs never) was independently associated with lower growth velocity by 6.8% (s.e.=1.3%) and delayed growth tempo by 1.0 (s.e.=0.2 weeks), but not with smaller size. Later weaning (⩾6 months vs <4 months) was independently associated with lower growth velocity by 4.9% (s.e.=1.1%) and smaller size by 102 g (s.e.=25 g). Conclusions: Infants breastfed for longer grew slower for longer after birth (later peak growth rate) but were no different in size, while infants weaned later grew slower overall and were smaller but the timing of peak growth did not differ. Slower trajectories with a delayed peak in growth may have beneficial implications for programming later obesity risk. Replication in cohorts with longer follow-up, alternative confounding structures or randomised controlled trials are required to confirm the long-term effects and directionality, and to rule out residual confounding. PMID:24722545

Complications following blunt and penetrating injuries in 216 victims of chest trauma requiring tube thoracostomy.

PubMed

Helling, T S; Gyles, N R; Eisenstein, C L; Soracco, C A

1989-10-01

Tube thoracostomy (TT) is required in the treatment of many blunt and penetrating injuries of the chest. In addition to complications from the injuries, TT may contribute to morbidity by introducing microorganisms into the pleural space or by incomplete lung expansion and evacuation of pleural blood. We have attempted to assess the impact of TT following penetrating and blunt thoracic trauma by examining a consecutive series of 216 patients seen at two urban trauma centers with such injuries who required TT over a 30-month period. Ninety-four patients suffered blunt chest trauma; 122 patients were victims of penetrating wounds. Patients with blunt injuries had longer ventilator requirements (12.6 +/- 14 days vs. 3.7 +/- 7.1 days, p = 0.003), longer intensive care stays (12.2 +/- 12.5 days vs. 4.1 +/- 7.5 days, p = 0.001), and longer periods of TT, (6.5 +/- 4.9 days vs. 5.2 +/- 4.5 days, p = 0.018). Empyema occurred in six patients (3%). Residual hemothorax was found in 39 patients (18%), seven of whom required decortication. Recurrent pneumothorax developed in 51 patients (24%) and ten required repeat TT. Complications occurred in 78 patients (36%). Patients with blunt trauma experienced more complications (44%) than those with penetrating wounds (30%) (p = 0.04). However, only seven of 13 patients developing empyema or requiring decortication had blunt trauma. Despite longer requirements for mechanical ventilation, intensive care, and intubation, victims of blunt trauma seemed to have effective drainage of their pleural space by TT without increased risk of infectious complications.

Mechanisms and modelling of waste-cement and cement-host rock interactions

NASA Astrophysics Data System (ADS)

2017-06-01

Safe and sustainable disposal of hazardous and radioactive waste is a major concern in today's industrial societies. The hazardous waste forms originate from residues of thermal treatment of waste, fossil fuel combustion and ferrous/non-ferrous metal smelting being the most important ones in terms of waste production. Low- and intermediate-level radioactive waste is produced in the course of nuclear applications in research and energy production. For both waste forms encapsulation in alkaline, cement-based matrices is considered to ensure long-term safe disposal. Cementitious materials are in routine use as industrial materials and have mainly been studied with respect to their evolution over a typical service life of several decades. Use of these materials in waste management applications, however, requires assessments of their performance over much longer time periods on the order of thousands to several ten thousands of years.

Psychological benefits for children and adolescents who have undergone transplantation of the heart from participation in the British Transplant Games.

PubMed

Wray, Jo; Lunnon-Wood, Tracy

2008-04-01

The British Transplant Games are held annually for children and adults who have received transplanted organs. The aim of our pilot study was to determine whether participation in such an event had an impact on psychological well-being. We asked 26 children participating in the Games to complete a specifically designed questionnaire before and after the event. The 13 questions covered areas such as state of mood, perceived physical health, fatigue, anxiety, and confidence. There were mean improvements over time on 10 of the 13 questions, and the change in overall score was significant (p = .036). For the majority of young people, participation in the Transplant Games was associated with a positive impact on psychological functioning in the short term. Further evaluation is now required to determine whether such benefits are maintained in the longer term.

Building a strategic security organisation.

PubMed

Howard, Mike

2016-01-01

In everyone's day-to-day jobs there is constant need to deal with current and newly detected matters. This is now a world of immediacy, driven by the cadence of the business and its needs. These concerns should not be ignored, as failing to deal with these issues would not bode well for the future. It is essential that the gears are kept spinning. The challenge for any security organisation is to identify its short-term tactical requirements, while developing longer-term strategic needs. Once done, the differences can be accounted for and strides can be made toward a desired future state. This paper highlights several steps that the author and his team have taken in their own journey. There is no magic answer, each organisation will have its own unique challenges. Nevertheless, some of the approaches to building a strategic security organisation described in this paper are applicable to all organisations, irrespective of their size.

Fecal Microbiota Transplant for Clostridium difficile Infection in a Pregnant Patient.

PubMed

Saeedi, Bejan J; Morison, Doree Gardner; Kraft, Colleen S; Dhere, Tanvi

2017-03-01

Clostridium difficile infection has been associated with negative outcomes in the general population and in pregnant patients. Fecal microbiota transplant has become the standard for treatment of recurrent as well as refractory C difficile infection. We present a case of a 28-year-old pregnant woman who presented with recurrent C difficile infection despite treatment with vancomycin and fidaxomicin and underwent a successful fecal microbiota transplant through colonoscopy at 18 weeks of gestation. She no longer required antibiotics for the remainder of her pregnancy to treat C difficile and had a term vaginal delivery at 39 weeks of gestation. Our pregnant patient tolerated and responded to a fecal microbiota transplant for treatment of recurrent C difficile infection. Future large-scale studies are needed to determine the efficacy, safety, and long-term effects of manipulating the microbiome in pregnant patients and the neonates.

Clustering approaches to improve the performance of low cost air pollution sensors.

PubMed

Smith, Katie R; Edwards, Peter M; Evans, Mathew J; Lee, James D; Shaw, Marvin D; Squires, Freya; Wilde, Shona; Lewis, Alastair C

2017-08-24

Low cost air pollution sensors have substantial potential for atmospheric research and for the applied control of pollution in the urban environment, including more localized warnings to the public. The current generation of single-chemical gas sensors experience degrees of interference from other co-pollutants and have sensitivity to environmental factors such as temperature, wind speed and supply voltage. There are uncertainties introduced also because of sensor-to-sensor response variability, although this is less well reported. The sensitivity of Metal Oxide Sensors (MOS) to volatile organic compounds (VOCs) changed with relative humidity (RH) by up to a factor of five over the range of 19-90% RH and with an uncertainty in the correction of a factor of two at any given RH. The short-term (second to minute) stabilities of MOS and electrochemical CO sensor responses were reasonable. During more extended use, inter-sensor quantitative comparability was degraded due to unpredictable variability in individual sensor responses (to either measurand or interference or both) drifting over timescales of several hours to days. For timescales longer than a week identical sensors showed slow, often downwards, drifts in their responses which diverged across six CO sensors by up to 30% after two weeks. The measurement derived from the median sensor within clusters of 6, 8 and up to 21 sensors was evaluated against individual sensor performance and external reference values. The clustered approach maintained the cost competitiveness of a sensor device, but the median concentration from the ensemble of sensor signals largely eliminated the randomised hour-to-day response drift seen in individual sensors and excluded the effects of small numbers of poorly performing sensors that drifted significantly over longer time periods. The results demonstrate that for individual sensors to be optimally comparable to one another, and to reference instruments, they would likely require frequent calibration. The use of a cluster median value eliminates unpredictable medium term response changes, and other longer term outlier behaviours, extending the likely period needed between calibration and making a linear interpolation between calibrations more appropriate. Through the use of sensor clusters rather than individual sensors, existing low cost technologies could deliver significantly improved quality of observations.

Modified forest rotation lengths: Long-term effects on landscape-scale habitat availability for specialized species.

PubMed

Roberge, Jean-Michel; Öhman, Karin; Lämås, Tomas; Felton, Adam; Ranius, Thomas; Lundmark, Tomas; Nordin, Annika

2018-03-15

We evaluated the long-term implications from modifying rotation lengths in production forests for four forest-reliant species with different habitat requirements. By combining simulations of forest development with habitat models, and accounting both for stand and landscape scale influences, we projected habitat availability over 150 years in a large Swedish landscape, using rotation lengths which are longer (+22% and +50%) and shorter (-22%) compared to current practices. In terms of mean habitat availability through time, species requiring older forest were affected positively by extended rotations, and negatively by shortened rotations. For example, the mean habitat area for the treecreeper Certhia familiaris (a bird preferring forest with larger trees) increased by 31% when rotations were increased by 22%, at a 5% cost to net present value (NPV) and a 7% decrease in harvested volume. Extending rotation lengths by 50% provided more habitat for this species compared to a 22% extension, but at a much higher marginal cost. In contrast, the beetle Hadreule elongatula, which is dependent on sun-exposed dead wood, benefited from shortened rather than prolonged rotations. Due to an uneven distribution of stand-ages within the landscape, the relative amounts of habitat provided by different rotation length scenarios for a given species were not always consistent through time during the simulation period. If implemented as a conservation measure, prolonging rotations will require long-term strategic planning to avoid future bottlenecks in habitat availability, and will need to be accompanied by complementary measures accounting for the diversity of habitats necessary for the conservation of forest biodiversity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Partnerships for Policy Development: A Case Study From Uganda’s Costed Implementation Plan for Family Planning

PubMed Central

Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

2016-01-01

ABSTRACT In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda’s CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda’s CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda’s CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP.

PubMed

Turnbull, Christopher D; Bratton, Daniel J; Craig, Sonya E; Kohler, Malcolm; Stradling, John R

2016-02-01

Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2-4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2-4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2-4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP usage predicted longer term use, there are patients in whom this is not the case, and patients with low initial usage may need to extend their CPAP trial before a decision about longer-term use is made.

Morbidity and Mortality in Late Preterm Infants with Severe Hypoxic Respiratory Failure on ECMO

PubMed Central

Ramachandrappa, Ashwin; Rosenberg, Eli S.; Wagoner, Scott; Jain, Lucky

2011-01-01

Objectives To evaluate morbidity, mortality, and associated risk factors in late preterm term infants (34 0/7-36 6/7 wk) requiring extra-corporeal membrane oxygenation (ECMO). Study design We reviewed a total of 21,218 neonatal ECMO runs in Extracorporeal Life Support Organization (ELSO) registry data from 1986 to 2006. Infants were divided into 3 groups: Late Preterm (34 0/7 to 36 6/7), Early Term (37 0/7 to 38 6/7), and Full Term (39 0/7 to 42 6/7). Results There were 14,528 neonatal ECMO runs which met inclusion criteria. Late preterm infants experienced the highest mortality on ECMO (late preterm 26.2%, early term 18%, full term 11.2%. p<0.001) and had longer ECMO runs; they also had higher rates of serious complications. GA was a highly significant predictor for mortality. Late preterm infants with a primary diagnosis of sepsis and PPHN had 3-fold higher risk of mortality on ECMO than those with meconium aspiration. Conclusion Late preterm infants treated with ECMO havehigher morbidity and mortality than term infants. This underscores the need for special consideration of this vulnerable population in the diagnosis and treatment of hypoxic respiratory failure. PMID:21459387

Solar EUV irradiance for space weather applications

NASA Astrophysics Data System (ADS)

Viereck, R. A.

2015-12-01

Solar EUV irradiance is an important driver of space weather models. Large changes in EUV and x-ray irradiances create large variability in the ionosphere and thermosphere. Proxies such as the F10.7 cm radio flux, have provided reasonable estimates of the EUV flux but as the space weather models become more accurate and the demands of the customers become more stringent, proxies are no longer adequate. Furthermore, proxies are often provided only on a daily basis and shorter time scales are becoming important. Also, there is a growing need for multi-day forecasts of solar EUV irradiance to drive space weather forecast models. In this presentation we will describe the needs and requirements for solar EUV irradiance information from the space weather modeler's perspective. We will then translate these requirements into solar observational requirements such as spectral resolution and irradiance accuracy. We will also describe the activities at NOAA to provide long-term solar EUV irradiance observations and derived products that are needed for real-time space weather modeling.

Image-guided drainage versus antibiotic-only treatment of pelvic abscesses: short-term and long-term outcomes.

PubMed

To, Justin; Aldape, Diana; Frost, Andrei; Goldberg, Gary L; Levie, Mark; Chudnoff, Scott

2014-10-01

To determine the efficacy of image-guided drainage versus antibiotic-only treatment of pelvic abscesses. Retrospective cohort analysis. An academic, inner-city medical center. Women ages 11-49, admitted between 1998 and 2008 with ICD9 code 614.x (inflammatory diseases of ovary, fallopian tube, pelvic cellular tissue, and peritoneum). Medical records search, chart review, and phone survey. Surgical intervention. We identified 6,151 initial patients, of whom 240 patients met inclusion criteria. Of the included patients, 199 women received antibiotic-only treatment, and 41 received additional image-guided drainage. There was no statistically significant difference between the two groups in terms of age, body mass index, parity, incidence of diabetes, obesity, endometriosis, or history of sexually transmitted infection excluding human immunodeficiency virus (HIV). Abscesses in the drainage cohort were noted to be larger in dimension (5.9 cm vs. 8.5 cm); 16.1% of patients who received antibiotics alone required surgical intervention versus only 2.4% of the drainage cohort. Patients who received drainage had longer hospital stays, but the time from treatment to discharge was similar in both groups (7.4 days vs. 6.7 days). We successfully contacted 150 patients, and the differences in long-term pregnancy outcomes, pain, or infertility were not statistically significant. Patients who received antibiotics alone were more likely to require further surgical intervention when compared with patients who additionally received image-guided drainage. There were no observable long-term differences. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Time estimation by patients with frontal lesions and by Korsakoff amnesics.

PubMed

Mimura, M; Kinsbourne, M; O'Connor, M

2000-07-01

We studied time estimation in patients with frontal damage (F) and alcoholic Korsakoff (K) patients in order to differentiate between the contributions of working memory and episodic memory to temporal cognition. In Experiment 1, F and K patients estimated time intervals between 10 and 120 s less accurately than matched normal and alcoholic control subjects. F patients were less accurate than K patients at short (< 1 min) time intervals whereas K patients increasingly underestimated durations as intervals grew longer. F patients overestimated short intervals in inverse proportion to their performance on the Wisconsin Card Sorting Test. As intervals grew longer, overestimation yielded to underestimation for F patients. Experiment 2 involved time estimation while counting at a subjective 1/s rate. F patients' subjective tempo, though relatively rapid, did not fully explain their overestimation of short intervals. In Experiment 3, participants produced predetermined time intervals by depressing a mouse key. K patients underproduced longer intervals. F patients produced comparably to normal participants, but were extremely variable. Findings suggest that both working memory and episodic memory play an individual role in temporal cognition. Turnover within a short-term working memory buffer provides a metric for temporal decisions. The depleted working memory that typically attends frontal dysfunction may result in quicker turnover, and this may inflate subjective duration. On the other hand, temporal estimation beyond 30 s requires episodic remembering, and this puts K patients at a disadvantage.

EAR Program Research Results : Updated through 2013

DOT National Transportation Integrated Search

2013-12-31

The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

EAR Program Research Results: Updated through 2014

DOT National Transportation Integrated Search

2014-12-31

The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

EAR Program Research Results: Updated through 2016

DOT National Transportation Integrated Search

2016-12-31

The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

Long-term EEG in children.

PubMed

Montavont, A; Kaminska, A; Soufflet, C; Taussig, D

2015-03-01

Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. Copyright © 2015. Published by Elsevier SAS.

Measuring single constructs by single items: Constructing an even shorter version of the “Short Five” personality inventory

PubMed Central

Konstabel, Kenn; Lönnqvist, Jan-Erik; Leikas, Sointu; García Velázquez, Regina; Qin, Hiaying; Verkasalo, Markku; Walkowitz, Gari

2017-01-01

The aim of this study was to construct a short, 30-item personality questionnaire that would be, in terms of content and meaning of the scores, as comparable as possible with longer, well-established inventories such as NEO PI-R and its clones. To do this, we shortened the formerly constructed 60-item “Short Five” (S5) by half so that each subscale would be represented by a single item. We compared all possibilities of selecting 30 items (preserving balanced keying within each domain of the five-factor model) in terms of correlations with well-established scales, self-peer correlations, and clarity of meaning, and selected an optimal combination for each domain. The resulting shortened questionnaire, XS5, was compared to the original S5 using data from student samples in 6 different countries (Estonia, Finland, UK, Germany, Spain, and China), and a representative Finnish sample. The correlations between XS5 domain scales and their longer counterparts from well-established scales ranged from 0.74 to 0.84; the difference from the equivalent correlations for full version of S5 or from meta-analytic short-term dependability coefficients of NEO PI-R was not large. In terms of prediction of external criteria (emotional experience and self-reported behaviours), there were no important differences between XS5, S5, and the longer well-established scales. Controlling for acquiescence did not improve the prediction of criteria, self-peer correlations, or correlations with longer scales, but it did improve internal reliability and, in some analyses, comparability of the principal component structure. XS5 can be recommended as an economic measure of the five-factor model of personality at the level of domain scales; it has reasonable psychometric properties, fair correlations with longer well-established scales, and it can predict emotional experience and self-reported behaviours no worse than S5. When subscales are essential, we would still recommend using the full version of S5. PMID:28800630

Measuring single constructs by single items: Constructing an even shorter version of the "Short Five" personality inventory.

PubMed

Konstabel, Kenn; Lönnqvist, Jan-Erik; Leikas, Sointu; García Velázquez, Regina; Qin, Hiaying; Verkasalo, Markku; Walkowitz, Gari

2017-01-01

The aim of this study was to construct a short, 30-item personality questionnaire that would be, in terms of content and meaning of the scores, as comparable as possible with longer, well-established inventories such as NEO PI-R and its clones. To do this, we shortened the formerly constructed 60-item "Short Five" (S5) by half so that each subscale would be represented by a single item. We compared all possibilities of selecting 30 items (preserving balanced keying within each domain of the five-factor model) in terms of correlations with well-established scales, self-peer correlations, and clarity of meaning, and selected an optimal combination for each domain. The resulting shortened questionnaire, XS5, was compared to the original S5 using data from student samples in 6 different countries (Estonia, Finland, UK, Germany, Spain, and China), and a representative Finnish sample. The correlations between XS5 domain scales and their longer counterparts from well-established scales ranged from 0.74 to 0.84; the difference from the equivalent correlations for full version of S5 or from meta-analytic short-term dependability coefficients of NEO PI-R was not large. In terms of prediction of external criteria (emotional experience and self-reported behaviours), there were no important differences between XS5, S5, and the longer well-established scales. Controlling for acquiescence did not improve the prediction of criteria, self-peer correlations, or correlations with longer scales, but it did improve internal reliability and, in some analyses, comparability of the principal component structure. XS5 can be recommended as an economic measure of the five-factor model of personality at the level of domain scales; it has reasonable psychometric properties, fair correlations with longer well-established scales, and it can predict emotional experience and self-reported behaviours no worse than S5. When subscales are essential, we would still recommend using the full version of S5.

Performance of convolutional codes on fading channels typical of planetary entry missions

NASA Technical Reports Server (NTRS)

Modestino, J. W.; Mui, S. Y.; Reale, T. J.

1974-01-01

The performance of convolutional codes in fading channels typical of the planetary entry channel is examined in detail. The signal fading is due primarily to turbulent atmospheric scattering of the RF signal transmitted from an entry probe through a planetary atmosphere. Short constraint length convolutional codes are considered in conjunction with binary phase-shift keyed modulation and Viterbi maximum likelihood decoding, and for longer constraint length codes sequential decoding utilizing both the Fano and Zigangirov-Jelinek (ZJ) algorithms are considered. Careful consideration is given to the modeling of the channel in terms of a few meaningful parameters which can be correlated closely with theoretical propagation studies. For short constraint length codes the bit error probability performance was investigated as a function of E sub b/N sub o parameterized by the fading channel parameters. For longer constraint length codes the effect was examined of the fading channel parameters on the computational requirements of both the Fano and ZJ algorithms. The effects of simple block interleaving in combatting the memory of the channel is explored, using the analytic approach or digital computer simulation.

Crisaborole Ointment 2%: A Review in Mild to Moderate Atopic Dermatitis.

PubMed

Hoy, Sheridan M

2017-12-01

Crisaborole ointment 2% (Eucrisa™) is a novel, anti-inflammatory inhibitor of phosphodiesterase 4 (PDE4) that is available in the USA for the topical treatment of mild to moderate atopic dermatitis in patients aged ≥ 2 years. In two short-term (28 days), identically designed, multicentre, phase III studies in this patient population, topical therapy with crisaborole ointment 2% reduced disease severity and pruritus severity compared with vehicle, with the effect established early and sustained over the course of treatment. Improvements in the other signs of atopic dermatitis (erythema, exudation, excoriation, induration/papulation, and lichenification) were also seen. Crisaborole ointment 2% was generally well tolerated in the short-term studies, with its favorable safety profile maintained over the longer term (up to 52 weeks) in a multicentre, extension study. Most treatment-emergent adverse events (TEAEs) were of mild to moderate severity and considered unrelated to the study medication. Moreover, the incidence of application-site pain following short- and longer-term topical therapy with crisaborole ointment 2% was low. In conclusion, crisaborole ointment 2% is an effective and generally well tolerated new topical option for the management of mild to moderate atopic dermatitis in patients aged ≥ 2 years, with the potential to effectively treat this patient population over the longer term without the safety concerns associated with other current topical anti-inflammatory agents.

The computer simulation of automobile use patterns for defining battery requirements for electric cars

NASA Technical Reports Server (NTRS)

Schwartz, H.-J.

1976-01-01

The modeling process of a complex system, based on the calculation and optimization of the system parameters, is complicated in that some parameters can be expressed only as probability distributions. In the present paper, a Monte Carlo technique was used to determine the daily range requirements of an electric road vehicle in the United States from probability distributions of trip lengths, frequencies, and average annual mileage data. The analysis shows that a daily range of 82 miles meets to 95% of the car-owner requirements at all times with the exception of long vacation trips. Further, it is shown that the requirement of a daily range of 82 miles can be met by a (intermediate-level) battery technology characterized by an energy density of 30 to 50 Watt-hours per pound. Candidate batteries in this class are nickel-zinc, nickel-iron, and iron-air. These results imply that long-term research goals for battery systems should be focused on lower cost and longer service life, rather than on higher energy densities

A neuromorphic circuit mimicking biological short-term memory.

PubMed

Barzegarjalali, Saeid; Parker, Alice C

2016-08-01

Research shows that the way we remember things for a few seconds is a different mechanism from the way we remember things for a longer time. Short-term memory is based on persistently firing neurons, whereas storing information for a longer time is based on strengthening the synapses or even forming new neural connections. Information about location and appearance of an object is segregated and processed by separate neurons. Furthermore neurons can continue firing using different mechanisms. Here, we have designed a biomimetic neuromorphic circuit that mimics short-term memory by firing neurons, using biological mechanisms to remember location and shape of an object. Our neuromorphic circuit has a hybrid architecture. Neurons are designed with CMOS 45nm technology and synapses are designed with carbon nanotubes (CNT).

Duloxetine: a review of its use in the treatment of generalized anxiety disorder.

PubMed

Carter, Natalie J; McCormack, Paul L

2009-01-01

Duloxetine (Cymbalta(R)) is a potent serotonin and noradrenaline (norepinephrine) reuptake inhibitor (SNRI) in the CNS. It is indicated for the treatment of generalized anxiety disorder (GAD) as well as other indications. In patients with GAD of at least moderate severity, oral duloxetine 60-120 mg once daily was effective with regard to improvement from baseline in assessments of anxiety and functional impairment, and numerous other clinical endpoints. Longer-term duloxetine 60-120 mg once daily also demonstrated efficacy in preventing or delaying relapse in responders among patients with GAD. In addition, duloxetine was generally well tolerated, with most adverse events being of mild to moderate severity in patients with GAD in short- and longer-term trials. Additional comparative and pharmacoeconomic studies are required to position duloxetine among other selective serotonin reuptake inhibitors and SNRIs. However, available clinical data, and current treatment guidelines, indicate that duloxetine is an effective first-line treatment option for the management of GAD. Duloxetine is a potent and selective inhibitor of serotonin and noradrenaline transporters, and a weak inhibitor of dopamine transporters. It has a low affinity for neuronal receptors, such as alpha(1)- and alpha(2)-adrenergic, dopamine D(2), histamine H(1), muscarinic, opioid and serotonin receptors, as well as ion channel binding sites and other neurotransmitter transporters, such as choline and GABA transporters. It does not inhibit monoamine oxidase types A or B. The pharmacokinetics of duloxetine in healthy volunteers were dose proportional over the range of 40-120 mg once daily. Steady state was typically reached by day 3 of administration. Duloxetine may be administered without regard to food or time of day. Duloxetine is highly protein bound and is widely distributed throughout tissues. It is rapidly and extensively metabolized in the liver by cytochrome P450 (CYP) 1A2 and 2D6, and its numerous metabolites, which are inactive, are mainly excreted in the urine. The mean elimination half-life of duloxetine is approximately 12 hours. Duloxetine is a substrate for CYP1A2 and CYP2D6 and a moderate inhibitor of CYP2D6. Concomitant use of duloxetine and potent CYP1A2 inhibitors should be avoided and duloxetine should be used with caution in patients receiving drugs that are extensively metabolized by CYP2D6, particularly those with a narrow therapeutic index. Duloxetine was effective in the short-term treatment of patients with primary GAD of at least moderate severity. In four randomized, double-blind, placebo-controlled, multicentre, phase III trials, duloxetine 60-120 mg once daily for 9 or 10 weeks was significantly more effective than placebo with regard to the primary endpoint of mean change in Hamilton Anxiety Rating Scale (HAM-A) total score from baseline to study endpoint. In addition, all other endpoints were generally improved from baseline to a greater extent with duloxetine 60-120 mg once daily than with placebo. Duloxetine also improved patient role functioning (assessed using Sheehan Disability Scale global impairment functioning scores), health-related quality of life and patient well-being compared with placebo. Duloxetine was effective in patients with GAD who were aged >/=65 years. Pooled results of data from the two short-term efficacy trials that also included an active comparator arm showed that the mean change in HAM-A scores with duloxetine relative to placebo were of the same magnitude as those with venlafaxine extended release versus placebo. Duloxetine 60-120 mg once daily was also more effective than placebo in preventing or delaying relapse in responders to duloxetine in a longer-term study. In this study, patients with GAD received duloxetine during a 26-week, open-label, acute treatment phase and responders were then randomized to continue on duloxetine or receive placebo during a 26-week, double-blind, continuation phase. Time to relapse was significantly longer in duloxetine recipients than in placebo recipients. In addition, significantly fewer duloxetine recipients than placebo recipients relapsed during the double-blind phase of the trial and more duloxetine recipients achieved remission. Short- (9-10 weeks) and longer-term (52 weeks) treatment with duloxetine 60-120 mg once daily was generally well tolerated in patients with GAD, with the majority of adverse events being of mild to moderate severity. Nausea, dry mouth, headache, constipation, dizziness and fatigue were among the most common treatment-emergent adverse events. The adverse event profile of duloxetine did not differ with dose or treatment duration. Significantly more patients receiving short-term duloxetine than placebo discontinued treatment because of an adverse event, with nausea being the only event that resulted in significantly more treatment discontinuations in duloxetine recipients than in placebo recipients. Serious adverse events were uncommon with both short- and longer-term duloxetine treatment. Two episodes of attempted suicide and one episode of completed suicide occurred in duloxetine recipients during the 24-week open-label phase of a longer-term trial. No deaths or suicides were reported in any of the short-term trials. Discontinuation-emergent adverse events, most commonly nausea and dizziness, occurred in up to one-third of duloxetine recipients in the short-term trials.

Data Preservation, Information Preservation, and Lifecyle of Information Management at NASA GES DISC

NASA Technical Reports Server (NTRS)

Khayat, Mo; Kempler, Steve; Deshong, Barbara; Johnson, James; Gerasimov, Irina; Esfandiari, Ed; Berganski, Michael; Wei, Jennifer

2014-01-01

Data lifecycle management awareness is common today; planners are more likely to consider lifecycle issues at mission start. NASA remote sensing missions are typically subject to life cycle management plans of the Distributed Active Archive Center (DAAC), and NASA invests in these national centers for the long-term safeguarding and benefit of future generations. As stewards of older missions, it is incumbent upon us to ensure that a comprehensive enough set of information is being preserved to prevent the risk for information loss. This risk is greater when the original data experts have moved on or are no longer available. Preservation of items like documentation related to processing algorithms, pre-flight calibration data, or input-output configuration parameters used in product generation, are examples of digital artifacts that are sometimes not fully preserved. This is the grey area of information preservation; the importance of these items is not always clear and requires careful consideration. Missing important metadata about intermediate steps used to derive a product could lead to serious challenges in the reproducibility of results or conclusions. Organizations are rapidly recognizing that the focus of life-cycle preservation needs to be enlarged from the strict raw data to the more encompassing arena of information lifecycle management. By understanding what constitutes information, and the complexities involved, we are better equipped to deliver longer lasting value about the original data and derived knowledge (information) from them. The NASA Earth Science Data Preservation Content Specification is an attempt to define the content necessary for long-term preservation. It requires new lifecycle infrastructure approach along with content repositories to accommodate artifacts other than just raw data. The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) setup an open-source Preservation System capable of long-term archive of digital content to augment its raw data holding. This repository is being used for such missions as HIRDLS, UARS, TOMS, OMI, among others. We will provide a status of this implementation; report on challenges, lessons learned, and detail our plans for future evolution to include other missions and services.

Implementation of an oxygen therapy clinic to manage users of long-term oxygen therapy.

PubMed

Chaney, John C; Jones, Kevin; Grathwohl, Kurt; Olivier, Kenneth N

2002-11-01

To evaluate the initial benefits of establishing an oxygen therapy clinic (OTC) to manage users of long-term oxygen therapy (LTOT). Cross-sectional observational study. Military-affiliated, tertiary care hospital. Current users of LTOT at our institution and patients with new oxygen prescriptions between June 2000 and May 2001. The OTC evaluation consisted of a focused medical interview and physical examination by a respiratory therapist. Demographic data, indications for supplemental oxygen, oxygen-related diagnoses, cardiopulmonary review of systems, pertinent physical examination findings, pulmonary function testing, and oximetry data were recorded. Patients prescribed oxygen during hospitalization were followed up for recertification within 90 days based on the recommendations of the Fifth Oxygen Consensus Conference. Also, patients with existing oxygen prescriptions and new oxygen prescriptions during the study period were evaluated in the OTC. Data are provided for the initial evaluation in this clinic. A total of 283 patients were evaluated in the OTC during the study period. Ninety-seven patients with a new oxygen prescription during hospitalization were evaluated, with a mean +/- SE time from discharge to evaluation of 2.6 +/- 0.4 months. At follow-up, 50.5% of these patients no longer met Medicare guidelines for LTOT. A significant change in oxygen prescription was required in 27.9% of these patients. A total of 95 outpatients with existing oxygen prescriptions were contacted for recertification in the OTC. Of these patients, 31.6% no longer met Medicare criteria for LTOT and 26% required a significant change to their oxygen prescription. Oxygen therapy was discontinued in 22% of the 91 patients who were referred from other outpatient clinics, and the oxygen prescription was changed in another 29.7%. Results of this initial evaluation suggest that the institution of a respiratory therapist-managed OTC to manage home oxygen patients can significantly decrease inappropriate supplemental oxygen use, which can result in significant cost savings while providing improved health-care delivery. Further evaluation is necessary to identify the long-term benefits and cost savings in this population.

Data Preservation, Information Preservation, and life-cyle of information management at NASA GES DISC

NASA Astrophysics Data System (ADS)

Khayat, M. G.; Deshong, B.; Esfandiari, A. E.; Gerasimov, I. V.; Johnson, J. E.; Kempler, S. J.; Wei, J. C.

2014-12-01

Data lifecycle management awareness is common today; planners are more likely to consider lifecycle issues at mission start. NASA remote sensing missions are typically subject to life cycle management plans of the Distributed Active Archive Center (DAAC), and NASA invests in these national centers for the long-term safeguarding and benefit of future generations. As stewards of older missions, it is incumbent upon us to ensure that a comprehensive enough set of information is being preserved to prevent the risk for "information loss". This risk is greater when the original data experts have moved on or are no longer available. Preservation of items like documentation related to processing algorithms, pre-flight calibration data, or input/output configuration parameters used in product generation, are examples of digital artifacts that are sometimes not fully preserved. This is the grey area of "information preservation"; the importance of these items is not always clear and requires careful consideration. Missing important "metadata" about intermediate steps used to derive a product could lead to serious challenges in the reproducibility of results or conclusions.Organizations are rapidly recognizing that the focus of life-cycle preservation needs to be enlarged from the strict raw data to the more encompassing arena of "information lifecycle management". By understanding what constitutes information, and the complexities involved, we are better equipped to deliver longer lasting value about the original data and derived knowledge (information) from them. The "NASA Earth Science Data Preservation Content Specification" is an attempt to define the content necessary for long-term preservation. It requires new lifecycle infrastructure approach along with content repositories to accommodate artifacts other than just raw data. The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) setup an open-source Preservation System capable of long-term archive of digital content to augment its raw data holding. This repository is being used for such missions as HIRDLS, UARS, TOMS, OMI, among others. We will provide a status of this implementation; report on challenges, lessons learned, and detail our plans for future evolution to include other missions and services.

Gun control saves lives.

PubMed

Matzopoulos, Richard

2016-05-19

Reducing firearm mortality by means of stricter gun control is one of the most important short- to medium-term measures to address the burden of violence in South Africa, while longer-term interventions and policy measures take effect.

Amitraz

EPA Science Inventory

Amitraz (CAS 33089-61-1) is a formamidine insecticide and acaricide used on crops, livestock, and pets. Neurotoxicity is the primary endpoint of concern for short-term exposures in nontarget species. Amitraz has hepatic, reproductive, and developmental effects with longer-term...

Long-Term Effects of a Home-Visiting Intervention for Depressed Mothers and Their Infants

ERIC Educational Resources Information Center

Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; Van Doesum, Karin T. M.; Hoefnagels, Cees

2010-01-01

Background: Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term effects of an intervention for mothers with postpartum…

Development of visuospatial short-term memory in the second half of the 1st year.

PubMed

Pelphrey, Kevin A; Reznick, J Steven; Davis Goldman, Barbara; Sasson, Noah; Morrow, Judy; Donahoe, Andrea; Hodgson, Katharine

2004-09-01

Eighty 5.5- to 12.5-month-old infants participated in 4 delayed-response procedures challenging shortterm visuospatial memory (STVM), 2 that varied the time between presentation and search and 2 that varied the number of locations. Within each type of challenge, 1 task required a gaze response and 1 required a reach response. There was little improvement in STVM performance from 5.5 to 8 months and linear improvement in the percentage correct from 8 to 12 months, with overall STVM performance accounting for 66% of the variance in age. Improvement in searching multiple locations lagged behind improvement in spanning longer delays. Memory scores did not vary for the visual and manual tasks. Perseveration was greatest for reach responses, increased with challenge, and decreased with age. ((c) 2004 APA, all rights reserved) Copyright 2004 American Psychological Association

A gravity gradient stabilized solar power satellite design

NASA Technical Reports Server (NTRS)

Bowden, M. L.

1981-01-01

The concept of a solar power satellite (SPS) is reviewed, and a design proposed for such a satellite taking advantage of solar radiation pressure and gravity gradient forces to eliminate much of the structure from the baseline configuration. The SPS design consists of a solar cell array lying in the orbital plane and a free floating mirror above to reflect sunlight down onto it. The structural modes of the solar cell array are analyzed and found to be well within control limitations. Preliminary calculations concerning the free floating mirror and its position-keeping propellant requirements are also performed. A numerical example is presented, which shows that, even in terms of mass only, this configuration is a competitive design when compared to the conventional Department of Energy reference design. Other advantages, such as easier assembly in orbit, lower position-keeping propellant requirements, possibilities for decreasing necessary solar cell area, and longer solar cell life, may make this design superior.

Short-Time Nonlinear Effects in the Exciton-Polariton System

NASA Astrophysics Data System (ADS)

Guevara, Cristi D.; Shipman, Stephen P.

2018-04-01

In the exciton-polariton system, a linear dispersive photon field is coupled to a nonlinear exciton field. Short-time analysis of the lossless system shows that, when the photon field is excited, the time required for that field to exhibit nonlinear effects is longer than the time required for the nonlinear Schrödinger equation, in which the photon field itself is nonlinear. When the initial condition is scaled by ɛ ^α , it is found that the relative error committed by omitting the nonlinear term in the exciton-polariton system remains within ɛ for all times up to t=Cɛ ^β , where β =(1-α (p-1))/(p+2). This is in contrast to β =1-α (p-1) for the nonlinear Schrödinger equation. The result is proved for solutions in H^s(R^n) for s>n/2. Numerical computations indicate that the results are sharp and also hold in L^2(R^n).

Effects of red-cell storage duration on patients undergoing cardiac surgery.

PubMed

Steiner, Marie E; Ness, Paul M; Assmann, Susan F; Triulzi, Darrell J; Sloan, Steven R; Delaney, Meghan; Granger, Suzanne; Bennett-Guerrero, Elliott; Blajchman, Morris A; Scavo, Vincent; Carson, Jeffrey L; Levy, Jerrold H; Whitman, Glenn; D'Andrea, Pamela; Pulkrabek, Shelley; Ortel, Thomas L; Bornikova, Larissa; Raife, Thomas; Puca, Kathleen E; Kaufman, Richard M; Nuttall, Gregory A; Young, Pampee P; Youssef, Samuel; Engelman, Richard; Greilich, Philip E; Miles, Ronald; Josephson, Cassandra D; Bracey, Arthur; Cooke, Rhonda; McCullough, Jeffrey; Hunsaker, Robert; Uhl, Lynne; McFarland, Janice G; Park, Yara; Cushing, Melissa M; Klodell, Charles T; Karanam, Ravindra; Roberts, Pamela R; Dyke, Cornelius; Hod, Eldad A; Stowell, Christopher P

2015-04-09

Some observational studies have reported that transfusion of red-cell units that have been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoing cardiac surgery may be especially vulnerable to the adverse effects of transfusion. We conducted a randomized trial at multiple sites from 2010 to 2014. Participants 12 years of age or older who were undergoing complex cardiac surgery and were likely to undergo transfusion of red cells were randomly assigned to receive leukocyte-reduced red cells stored for 10 days or less (shorter-term storage group) or for 21 days or more (longer-term storage group) for all intraoperative and postoperative transfusions. The primary outcome was the change in Multiple Organ Dysfunction Score (MODS; range, 0 to 24, with higher scores indicating more severe organ dysfunction) from the preoperative score to the highest composite score through day 7 or the time of death or discharge. The median storage time of red-cell units provided to the 1098 participants who received red-cell transfusion was 7 days in the shorter-term storage group and 28 days in the longer-term storage group. The mean change in MODS was an increase of 8.5 and 8.7 points, respectively (95% confidence interval for the difference, -0.6 to 0.3; P=0.44). The 7-day mortality was 2.8% in the shorter-term storage group and 2.0% in the longer-term storage group (P=0.43); 28-day mortality was 4.4% and 5.3%, respectively (P=0.57). Adverse events did not differ significantly between groups except that hyperbilirubinemia was more common in the longer-term storage group. The duration of red-cell storage was not associated with significant differences in the change in MODS. We did not find that the transfusion of red cells stored for 10 days or less was superior to the transfusion of red cells stored for 21 days or more among patients 12 years of age or older who were undergoing complex cardiac surgery. (Funded by the National Heart, Lung, and Blood Institute; RECESS ClinicalTrials.gov number, NCT00991341.).

Feasibility of four-arm robotic lobectomy as solo surgery in patients with clinical stage I lung cancer.

PubMed

Park, Seong Yong; Suh, Jee Won; Narm, Kyoung Sik; Lee, Chang Young; Lee, Jin Gu; Paik, Hyo Chae; Chung, Kyoung Young; Kim, Dae Joon

2017-06-01

This study was performed to investigate the feasibility of four-arm robotic lobectomy (FARL) as a solo surgical technique in patients with non-small cell lung cancer (NSCLC). Early outcome and long-term survival of FARL were compared with those of video-assisted thoracoscopic lobectomy (VATL). Prospective enrollment of patients with clinical stage I NSCLC undergoing FARL or VATL (20 patients in each group) was planned. Interim analysis for early postoperative outcome was performed after the initial 10 cases in each group. The study was terminated early because of safety issues in the FARL group after enrollment of 12 FARL and 17 VATL patients from 2011 to 2012. There were no differences in clinical characteristics between groups. Lobectomy time and total operation time were significantly longer in the FARL group (P=0.003). There were three life-threatening events in the FARL group (2 bleedings, 1 bronchus tear) that necessitated thoracotomy conversion in 1 patient. There were no differences in other operative outcomes including pain score, complications, or length of hospital stay. Pathologic stage and number of dissected lymph nodes (LNs) were also comparable. During a follow-up of 48.9±9.5 months, recurrence was identified in 2 (16.7%) patients in FARL group and 3 (23.5%) in VATL group. Five-year overall survival (100% vs . 87.5%, P=0.386) and disease-free survival (82.5% vs . 75.6%, P=0.589) were comparable. FARL as solo surgery could not be recommended because of safety issues. It required a longer operation time and had no benefits over VATL in terms of early postoperative outcome or long-term survival.

Health-related quality of life with long-term retention of the PROSthesis of Antibiotic Loaded Acrylic Cement system following infection resolution in low demand patients.

PubMed

Beaupre, Lauren A; Stampe, Kyle; Masson, Edward; O'Connor, Gregory; Clark, Marcia; Joffe, A Mark; Boychuk, Lesia R; Lavoie, Guy

2017-01-01

The study purpose was to (1) evaluate health-related quality of life (HRQL) with the PROSthesis of Antibiotic Loaded Acrylic Cement (PROSTALAC) in situ for infected total hip arthroplasty (THA), (2) determine infection resolution, and (3) compare subjects who underwent second stage surgery with those who retained the PROSTALAC on a longer term basis. Demographics, physical demand level, and comorbidities were recorded prospectively in 29 subjects followed to at least 24 months after initial PROSTALAC insertion. HRQL was evaluated using the Western Ontario McMaster Osteoarthritis Index (WOMAC) and RAND 36-Item Health Survey. Infection resolution was determined using a pre-specified clinical definition. Twenty-five of 29 (86%) subjects' infections resolved. Three subjects died, of whom two had resolved infections. For survivors, 22/26 (85%) completed HRQL evaluations. After PROSTALAC insertion, pain and function improved within 3-6 months and was retained at 24 months. Of those followed to 24 months, 7/22 (32%) subjects underwent second stage surgery. They were higher physical demand subjects ( p = 0.03) than those not undergoing second stage surgery. We found no difference in WOMAC scores at 24 months between those who underwent second stage surgery and those who retained the PROSTALAC ( p > 0.32). The PROSTALAC system for THA appears to allow acceptable HRQL while in situ for at least 2 years in low physical demand patients. Subjects with higher physical demand levels are more likely to undergo second stage surgery. Further evaluation is required to determine whether longer term PROSTALAC retention may be appropriate for specific patient groups.

Calciphylaxis: no longer rare; no longer calciphylaxis? A paradigm shift for wound, ostomy and continence nursing.

PubMed

Feeser, Dianne L

2011-01-01

This article challenges conventional wisdom that calciphylaxis is a rare condition. Rather, emerging evidence suggests that calciphylaxis is neither rare nor uncommon. In addition, the term calciphylaxis is questioned because misrepresents the underlying etiology of the condition. Multiple researchers and clinicians advocate abandoning the use of the term, but nursing literature has not yet followed suit. This article reviews the epidemiology, clinical manifestations, diagnosis, prevention, and treatment of this condition and associated wounds, and suggests areas for future research. The WOC nurse's role as an educator, leader, researcher, clinical expert, and patient advocate is summarized.

Analysis of the Reactor Physics of Low-Enrichment Fuel for the INL Advanced Test Reactor in support of RERTR

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

Mark DeHart; William Skerjanc; Sean Morrell

2012-06-01

Analysis of the performance of the ATR with a LEU fuel design shows promise in terms of a core design that will yield the same neutron sources in target locations. A proposed integral cladding burnable absorber design appears to meet power profile requirements that will satisfy power distributions for safety limits. Performance of this fuel design is ongoing; the current work is the initial evaluation of the core performance of this fuel design with increasing burnup. Results show that LEU fuel may have a longer lifetime that HEU fuel however, such limits may be set by mechanical performance of themore » fuel rather that available reactivity. Changes seen in the radial fuel power distribution with burnup in LEU fuel will require further study to ascertain the impact on neutron fluxes in target locations. Source terms for discharged fuel have also been studied. By its very nature, LEU fuel produces much more plutonium than is present in HEU fuel at discharge. However, the effect of the plutonium inventory appears to have little affect on radiotoxicity or decay heat in the fuel.« less

Short-term vegetation response following mechanical control of saltcedar (Tamarix spp.) on the Virgin River, Nevada, USA

USGS Publications Warehouse

Ostoja, Steven M.; Brooks, Matthew L.; Dudley, Tom; Lee, Steven R.

2014-01-01

and species diversity were very low, suggesting that targets of restoring vegetation to pre-invasion conditions were not met. Longer evaluation periods are needed to adequately evaluate how short-term post-treatment patterns translate to long-term patterns of plant community dynamics.

Resolving semantic and proactive interference in memory over the short-term.

PubMed

Atkins, Alexandra S; Berman, Marc G; Reuter-Lorenz, Patricia A; Lewis, Richard L; Jonides, John

2011-07-01

Interference is a major source of short-term errors of memory. The present investigation explores the relationship between two important forms of interference: proactive interference (PI), induced by the need to reject recently studied items no longer relevant to task performance, and semantic interference (SI), induced by the need to reject lures sharing a meaningful relationship with current memoranda. We explore the possibility that shared cognitive control processes are recruited to resolve both forms of interference. In Experiment 1, we find that the requirement to engage in articulatory suppression during the retention interval of tasks that induce either PI or SI increases both forms of interference similarly and selectively. In Experiment 2, we develop a task to examine PI and SI within the same experimental context. The results show interactive effects between factors that lead to the two forms of interference. Taken together, these findings support contextual-cuing models of short-term remembering (Nairne, Annual Review of Psychology, 53, 53-81 2002), where the context in which retrieval occurs can influence susceptibility to interference. Lastly, we discuss several theoretical hypotheses concerning the cognitive control processes that are recruited to resolve SI and PI in short-term remembering.

Resolving semantic and proactive interference in memory over the short-term

PubMed Central

Reuter-Lorenz, Patricia A.; Lewis, Richard L.; Jonides, John

2011-01-01

Interference is a major source of short-term errors of memory. The present investigation explores the relationship between two important forms of interference: proactive interference (PI), induced by the need to reject recently studied items no longer relevant to task performance, and semantic interference (SI), induced by the need to reject lures sharing a meaningful relationship with current memoranda. We explore the possibility that shared cognitive control processes are recruited to resolve both forms of interference. In Experiment 1, we find that the requirement to engage in articulatory suppression during the retention interval of tasks that induce either PI or SI increases both forms of interference similarly and selectively. In Experiment 2, we develop a task to examine PI and SI within the same experimental context. The results show interactive effects between factors that lead to the two forms of interference. Taken together, these findings support contextual-cuing models of short-term remembering (Nairne, Annual Review of Psychology, 53, 53–81 2002), where the context in which retrieval occurs can influence susceptibility to interference. Lastly, we discuss several theoretical hypotheses concerning the cognitive control processes that are recruited to resolve SI and PI in short-term remembering. PMID:21327614

A two-stage patient enrichment adaptive design in phase II oncology trials.

PubMed

Song, James X

2014-01-01

Illustrated is the use of a patient enrichment adaptive design in a randomized phase II trial which allows the evaluation of treatment benefits by the biomarker expression level and makes interim adjustment according to the pre-specified rules. The design was applied to an actual phase II metastatic hepatocellular carcinoma (HCC) trial in which progression-free survival (PFS) in two biomarker-defined populations is evaluated at both interim and final analyses. As an extension, a short-term biomarker is used to predict the long-term PFS in a Bayesian model in order to improve the precision of hazard ratio (HR) estimate at the interim analysis. The characteristics of the extended design are examined in a number of scenarios via simulations. The recommended adaptive design is shown to be useful in a phase II setting. When a short-term maker which correlates with the long-term PFS is available, the design can be applied in smaller early phase trials in which PFS requires longer follow-up. In summary, the adaptive design offers flexibility in randomized phase II patient enrichment trials and should be considered in an overall personalized healthcare (PHC) strategy. Copyright © 2013 Elsevier Inc. All rights reserved.

Political Mechanisms for Long-Range Survival and Development

NASA Astrophysics Data System (ADS)

Marshall, W.

As the first species aware of extinction and capable of proactively ensuring our long-term survival and development, it is striking that we do not do so with the rigor, formality, and foresight it requires. Only from a reactive posture have we responded to the challenges of global warfare, human rights, environmental concerns, and sustainable development. Despite our awareness of the possibility for extinction and apocalyptic set-backs to our evolution, and despite the existence of long-range studies-which must still be dramatically increased-proactive global policy implementation regarding our long-term survival and development is arguably non-existent. This lack of long-term policy making can be attributed in part to the lack of formal political mechanisms to facilitate longer-range policy making that extends 30 years or more into the future. Political mechanisms for infusing long-range thinking, research, and strategic planning into the policy-making process can help correct this shortcoming and provide the motivation needed to adequately address long-term challenges with the political rigor required to effectively establish and implement long-term policies. There are some efforts that attempt to address longer-range issues, but those efforts often do not connect to the political process, do not extend 30 or more years into the future, are not well-funded, and are not sufficiently systemic. Political mechanisms for long-range survival and prosperity could correct these inadequacies by raising awareness, providing funding, and most importantly, leveraging political rigor to establish and enforce long-range strategic planning and policies. The feasibility of such mechanisms should first be rigorously studied and assessed in a feasibility study, which could then inform implementation. This paper will present the case for such a study and suggest some possible political mechanisms that should be investigated further in the proposed study. This work is being further developed at the Space Generation Summit (SGS), an event at World Space Congress (WSC) which shall unite international students and young professionals to develop a youth vision and strategy for the peaceful uses of space. SGS, endorsed by the United Nations, will take place from October 11-13th, during which the 200 delegates will discuss ongoing youth space activities, particularly those stemming from the UNISPACE-III/SGF and taken forward by the Space Generation Advisory Council. Delegates will address a variety of topics with the goal of devising new recommendations according to the theme, 'Accelerating Our Pace in Space'. The material presented here and in other technical sessions throughout WSC includes the findings of these discussions. Links: http://www.unsgac.org/sgs

Critical Surface Cleaning and Verification Alternatives

NASA Technical Reports Server (NTRS)

Melton, Donald M.; McCool, A. (Technical Monitor)

2000-01-01

As a result of federal and state requirements, historical critical cleaning and verification solvents such as Freon 113, Freon TMC, and Trichloroethylene (TCE) are either highly regulated or no longer 0 C available. Interim replacements such as HCFC 225 have been qualified, however toxicity and future phase-out regulations necessitate long term solutions. The scope of this project was to qualify a safe and environmentally compliant LOX surface verification alternative to Freon 113, TCE and HCFC 225. The main effort was focused on initiating the evaluation and qualification of HCFC 225G as an alternate LOX verification solvent. The project was scoped in FY 99/00 to perform LOX compatibility, cleaning efficiency and qualification on flight hardware.

The Future of Data Reduction at UKIRT

NASA Astrophysics Data System (ADS)

Economou, F.; Bridger, A.; Wright, G. S.; Rees, N. P.; Jenness, T.

The Observatory Reduction and Acquisition Control (ORAC) project is a comprehensive re-implementation of all existing instrument user interfaces and data handling software involved at the United Kingdom Infrared Telescope (UKIRT). This paper addresses the design of the data reduction part of the system. Our main aim is to provide data reduction facilities for the new generation of UKIRT instruments of a similar standard to our current software packages, which have enjoyed success because of their science-driven approach. Additionally we wish to use modern software techniques in order to produce a system that is portable, flexible and extensible so as to have modest maintenance requirements, both in the medium and the longer term.

5 CFR 412.401 - Continuing executive development.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 412.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Executive Development § 412.401 Continuing executive... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial...

5 CFR 412.401 - Continuing executive development.

Code of Federal Regulations, 2011 CFR

2011-01-01

... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial improvement, and organizational results; (2) Address enhancement of existing executive competencies and such other competencies as will strengthen the executive's performance; (3) Outline developmental...

Learning and the Spiral Illusion

ERIC Educational Resources Information Center

Houtman, S. D.

1974-01-01

The purpose of the experiment was to ascertain whether the duration of the spiral illusion could be extended by a 'learning procedure' which would distinguish a longer-term learning effect from short-term adaptive changes due to inhibition. (Author)

Is There a Delay in Diagnosis of Duchenne Muscular Dystrophy Among Preterm-Born Males?

PubMed

Soim, Aida; Smith, Michael G; Kwon, Jennifer M; Mann, Joshua R; Thomas, Shiny; Ciafaloni, Emma

2018-07-01

The objective of this study was to investigate whether males who were born preterm took longer to receive a Duchenne muscular dystrophy diagnosis than term males. Data for males with Duchenne muscular dystrophy identified through a population-based surveillance system were analyzed using a Kaplan-Meier estimator. The first signs and symptoms were noted at a median age of 2 years in both groups. Median age when first signs and symptoms prompted medical evaluation was 2.59 years among preterm and 4.01 years among term males. Median age at definitive diagnosis was 4.25 years and 4.92 years for preterm and term males, respectively. Neither difference was statistically significant. Preterm males tended to be seen for their initial medical evaluation earlier than term males, though they were not diagnosed significantly earlier. It may take clinicians longer after the initial evaluation of preterm males to arrive at a Duchenne muscular dystrophy diagnosis.

Whatever Became of the Learning City?

ERIC Educational Resources Information Center

Yarnit, Martin

2015-01-01

During the 1990s, the UK Learning City Network was a large and influential movement with government support, the most significant national body of its kind anywhere. Yet, less than a decade later, it was in decline and now no longer exists. But while few UK towns or cities any longer use the term "learning city", the notion lives on as…

Pushing typists back on the learning curve: Memory chunking in the hierarchical control of skilled typewriting.

PubMed

Yamaguchi, Motonori; Logan, Gordon D

2016-12-01

Hierarchical control of skilled performance depends on the ability of higher level control to process several lower level units as a single chunk. The present study investigated the development of hierarchical control of skilled typewriting, focusing on the process of memory chunking. In the first 3 experiments, skilled typists typed words or nonwords under concurrent memory load. Memory chunks developed and consolidated into long-term memory when the same typing materials were repeated in 6 consecutive trials, but chunks did not develop when repetitions were spaced. However, when concurrent memory load was removed during training, memory chunks developed more efficiently with longer lags between repetitions than shorter lags. From these results, it is proposed that memory chunking requires 2 representations of the same letter string to be maintained simultaneously in short-term memory: 1 representation from the current trial, and the other from an earlier trial that is either retained from the immediately preceding trial or retrieved from long-term memory (i.e., study state retrieval). (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The Consumer Protection Act: no-fault liability of health care providers.

PubMed

Slabbert, M Nöthling; Pepper, Michael S

2011-11-01

The introduction of no-fault or strict liability by the Consumer Protection Act 68 of 2008 (CPA) poses serious problems in the health care context. With a patient as a 'consumer' in terms of the CPA, health care practitioners may find themselves as 'suppliers' or 'retailers' as part of a supply chain, and potentially liable for harm and loss suffered by a patient in terms of the new no-fault liability provision. The claimant (patient) can sue anyone in the supply chain in terms of this provision, which places the health care practitioner who delivered the care in a very difficult position, as he or she is the most easily and often only identifiable person in the supply chain. Although the causal link between the harm suffered by the complainant will still need to be established on a balance of probabilities, the traditional common law obstacle requiring proof of negligence no longer applies. The article argues that this situation is unsatisfactory, as it places an increasingly onerous burden on certain health care practitioners.

Diagnostics and control of wavenumber stability and purity of tunable diode lasers relevant to their use as local oscillators in heterodyne systems

NASA Technical Reports Server (NTRS)

Poultney, S.; Chen, D.; Steinberg, G.; Wu, F.; Pires, A.; Miller, M. D.; Mcnally, M.

1980-01-01

Initial operation of the tunable diode lasers (TDL) showed that it was not possible to adjust the wavenumber to one selected a priori in the TDL tuning range. During operation, the operating point would change by 0.1/cm over the longer term with even larger changes occurring during some thermal cycles. Most changes during thermal cycling required using lower temperatures and higher currents to reach the former wavenumber (when it could be reached). In many cases, an operating point could be selected by changing TDL current and temperature to give both the desired wavenumber and most of the power in a single mode. The selection procedure had to be used after each thermal cycling. Wavenumber nonlinearities of about 10% over a 0.5 cm tuning range were observed. Diagnostics of the single mode selected by a grating monochromator showed wavenumber fine structure under certain operating conditions. The characteristics due to the TDL environment included short term wavenumber stability, the instrument lineshape function, and intermediate term wavenumber stability.

[Laparoscopic radical cystectomy with enteric urinary diversion. Alternative to open cystectomy?].

PubMed

Lucan, M; Iacob, G; Lucan, V; Măgurean, O; Elec, F; Burghelea, C; Bărbos, A

2005-01-01

Radical cystectomy is the standard therapy for invasive bladder cancer, with best oncological results compared to any other therapeutic alternative. Even if laparoscopic radical cystectomy (LRC) is a well established surgical procedure, performing the urinary diversion completely intracorporeal, is still a challenge due to technical difficulties and associated complications. The aim of our study is to present the first series of LRC with ureterosigmoidostomy. Since May 2004 were performed 7 LRC (5 males and 2 females) (Gr. A). All cases were T2N0 clinical stage. These patients were compared with a retrospective group of 50 patients who underwent open procedure (Gr. B) in term of: operative time, blood loss, analgesic requirements, and hospital stay. LRC has a longer operative time but with statistically significant lower blood loss, less analgesia, and shorter hospital stay. The resection margins of the surgical specimens were tumor free at pathologic examination. Long-term follow-up is pending. On short-term, the results of laparoscopic radical cystectomy are encouraging. When significant experience in laparoscopic surgery is lacking, surgeons should exercise caution with completely intracorporeal urinary diversion.

A direct comparison of short-term audiomotor and visuomotor memory.

PubMed

Ward, Amanda M; Loucks, Torrey M; Ofori, Edward; Sosnoff, Jacob J

2014-04-01

Audiomotor and visuomotor short-term memory are required for an important variety of skilled movements but have not been compared in a direct manner previously. Audiomotor memory capacity might be greater to accommodate auditory goals that are less directly related to movement outcome than for visually guided tasks. Subjects produced continuous isometric force with the right index finger under auditory and visual feedback. During the first 10 s of each trial, subjects received continuous auditory or visual feedback. For the following 15 s, feedback was removed but the force had to be maintained accurately. An internal effort condition was included to test memory capacity in the same manner but without external feedback. Similar decay times of ~5-6 s were found for vision and audition but the decay time for internal effort was ~4 s. External feedback thus provides an advantage in maintaining a force level after feedback removal, but may not exclude some contribution from a sense of effort. Short-term memory capacity appears longer than certain previous reports but there may not be strong distinctions in capacity across different sensory modalities, at least for isometric force.

Identifying Severe Weather Impacts and Damage with Google Earth Engine

NASA Astrophysics Data System (ADS)

Molthan, A.; Burks, J. E.; Bell, J. R.

2015-12-01

Hazards associated with severe convective storms can lead to rapid changes in land surface vegetation. Depending upon the type of vegetation that has been impacted, their impacts can be relatively short lived, such as damage to seasonal crops that are eventually removed by harvest, or longer-lived, such as damage to a stand of trees or expanse of forest that require several years to recover. Since many remote sensing imagers provide their highest spatial resolution bands in the red and near-infrared to support monitoring of vegetation, these impacts can be readily identified as short-term and marked decreases in common vegetation indices such as NDVI, along with increases in land surface temperature that are observed at a reduced spatial resolution. The ability to identify an area of vegetation change is improved by understanding the conditions that are normal for a given time of year and location, along with a typical range of variability in a given parameter. This analysis requires a period of record well beyond the availability of near real-time data. These activities would typically require an analyst to download large volumes of data from sensors such as NASA's MODIS (aboard Terra and Aqua) or higher resolution imagers from the Landsat series of satellites. Google's Earth Engine offers a "big data" solution to these challenges, by providing a streamlined API and option to process the period of record of NASA MODIS and Landsat products through relatively simple Javascript coding. This presentation will highlight efforts to date in using Earth Engine holdings to produce vegetation and land surface temperature anomalies that are associated with damage to agricultural and other vegetation caused by severe thunderstorms across the Central and Southeastern United States. Earth Engine applications will show how large data holdings can be used to map severe weather damage, ascertain longer-term impacts, and share best practices learned and challenges with applying Earth Engine holdings to the analysis of severe weather damage. Other applications are also demonstrated, such as use of Earth Engine to prepare pre-event composites that can be used to subjectively identify other severe weather impacts. Future extension to flooding and wildfires is also proposed.

NCI Workshop Report: Clinical and Computational Requirements for Correlating Imaging Phenotypes with Genomics Signatures.

PubMed

Colen, Rivka; Foster, Ian; Gatenby, Robert; Giger, Mary Ellen; Gillies, Robert; Gutman, David; Heller, Matthew; Jain, Rajan; Madabhushi, Anant; Madhavan, Subha; Napel, Sandy; Rao, Arvind; Saltz, Joel; Tatum, James; Verhaak, Roeland; Whitman, Gary

2014-10-01

The National Cancer Institute (NCI) Cancer Imaging Program organized two related workshops on June 26-27, 2013, entitled "Correlating Imaging Phenotypes with Genomics Signatures Research" and "Scalable Computational Resources as Required for Imaging-Genomics Decision Support Systems." The first workshop focused on clinical and scientific requirements, exploring our knowledge of phenotypic characteristics of cancer biological properties to determine whether the field is sufficiently advanced to correlate with imaging phenotypes that underpin genomics and clinical outcomes, and exploring new scientific methods to extract phenotypic features from medical images and relate them to genomics analyses. The second workshop focused on computational methods that explore informatics and computational requirements to extract phenotypic features from medical images and relate them to genomics analyses and improve the accessibility and speed of dissemination of existing NIH resources. These workshops linked clinical and scientific requirements of currently known phenotypic and genotypic cancer biology characteristics with imaging phenotypes that underpin genomics and clinical outcomes. The group generated a set of recommendations to NCI leadership and the research community that encourage and support development of the emerging radiogenomics research field to address short-and longer-term goals in cancer research.

The effects of chloroquine and verapamil on digestive vacuolar pH of P. falciparum either sensitive or resistant to chloroquine.

PubMed

Ursos, L M; Dzekunov, S M; Roepe, P D

2000-09-01

In the preceding paper, we present a novel method for measuring the digestive vacuolar pH (pH(vac)) of the malarial parasite Plasmodium falciparum, and show that, surprisingly, pH(vac) is lower for chloroquine resistant (CQR) Dd2 parasites relative to chloroquine sensitive (CQS) HB3. These data may have important consequences for elucidating mechanisms of antimalarial drug resistance and for developing new antimalarial therapy. Additional issues central to a better understanding of antimalarial pharmacology and antimalarial drug resistance require detailed comparative data on the effects of key drugs and other compounds on parasite biophysical parameters such as pH(vac), measured under close-to-physiologic conditions. Since the methods we develop in the previous paper allow us to record fluorescence signals from spatially well-defined regions of the living parasite while they are under continuous perfusion, it is relatively straightforward for us to test how antimalarial drugs (e. g. chloroquine, CQ) and other compounds (e.g. the chemoreversal agent verapamil [VPL]) affect pH(vac). In this paper, we measure both short term (i.e. initial perfusion conditions) and longer-term effects of CQ and VPL for living, intraerythrocytic CQS (HB3) and CQR (Dd2) malarial parasites under constant perfusion with physiologically relevant buffers. We find that VPL normalizes pH(vac) for Dd2 to a value near that measured for HB3, but has no effect on pH(vac) for HB3. Longer term CQ exposure is found to alter pH(vac) for HB3 but not Dd2, and short-term exposure to the drug has no significant effect in either strain. The results may help resolve longstanding debate regarding the effects of CQ and VPL on parasite physiology, and further support our evolving hypothesis for the mechanism of CQ resistance.

Positives and pathologies of natural resource management on private land-conservation areas.

PubMed

Clements, Hayley S; Cumming, Graeme S

2017-06-01

In managed natural resource systems, such as fisheries and rangelands, there is a recognized trade-off between managing for short-term benefits and managing for longer term resilience. Management actions that stabilize ecological attributes or processes can improve productivity in the supply of ecosystem goods and services in the short term but erode system resilience at longer time scales. For example, fire suppression in rangelands can increase grass biomass initially but ultimately result in an undesirable, shrub-dominated system. Analyses of this phenomenon have focused largely on how management actions influence slow-changing biophysical system attributes (such as vegetation composition). Data on the frequency of management actions that reduce natural ecological variation on 66 private land-conservation areas (PLCAs) in South Africa were used to investigate how management actions are influenced by manager decision-making approaches, a largely ignored part of the problem. The pathology of natural resource management was evident on some PLCAs: increased focus on revenue-generation in decision making resulted in an increased frequency of actions to stabilize short-term variation in large mammal populations, which led to increased revenues from ecotourism or hunting. On many PLCAs, these management actions corresponded with a reduced focus on ecological monitoring and an increase in overstocking of game (i.e., ungulate species) and stocking of extralimitals (i.e., game species outside their historical range). Positives in natural resource management also existed. Some managers monitored slower changing ecological attributes, which resulted in less-intensive management, fewer extralimital species, and lower stocking rates. Our unique, empirical investigation of monitoring-management relationships illustrates that management decisions informed by revenue monitoring versus ecological monitoring can have opposing consequences for natural resource productivity and sustainability. Promoting management actions that maintain resilience in natural resource systems therefore requires cognizance of why managers act the way they do and how these actions can gradually shift managers toward unsustainable strategies. © 2016 Society for Conservation Biology.

Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual β-cell function.

PubMed

Sherr, Jennifer; Tamborlane, William V; Xing, Dongyuan; Tsalikian, Eva; Mauras, Nelly; Buckingham, Bruce; White, Neil H; Arbelaez, Ana Maria; Beck, Roy W; Kollman, Craig; Ruedy, Katrina

2012-04-01

To determine exposure to hyper- and hypoglycemia using blinded continuous glucose monitoring (CGM) profiles in youth with type 1 diabetes (T1D) with residual β-cell function during the first year of insulin treatment. Blinded, 3-7 day CGM profiles were obtained in 16 short-term T1D patients (age 8-18 years, T1D duration 6-52 weeks) who had peak C-peptide levels ranging from 0.46 to 1.96 nmol/L during a mixed-meal tolerance test. Results in this short-term group were compared with those in 34 patients with well-controlled, longer-term T1D (duration ≥5 years), matched for age and A1C with the short-term T1D group, and with those in 26 age-matched nondiabetic individuals. Despite matching for A1C, and therefore similar mean sensor glucose levels in the two T1D groups, short-term T1D participants had a lower frequency of hypoglycemia (0.3 vs. 7.6%, P < 0.001), a trend toward less hyperglycemia (17 vs. 32%, P = 0.15), and a greater percentage in the target range (median 77 vs. 60%, P = 0.02). Indeed, the percentage of sensor glucose levels ≤70 mg/dL in the short-term T1D group (0.3%) did not differ from those in the nondiabetic group (1.7%, P = 0.73). The coefficient of variation of sensor glucose levels (an index of glucose variability) was lower in short-term vs. longer-term T1D participants (27 vs. 42%, respectively, P < 0.001). In youth with short-term T1D who retain residual β-cell function, there is negligible exposure to hypoglycemia and lower glucose variability than in youth with well-controlled T1D of longer duration.

Surgery for Infective Endocarditis: Outcomes and Predictors of Mortality in 360 Consecutive Patients

PubMed Central

Farag, Mina; Borst, Tobias; Sabashnikov, Anton; Zeriouh, Mohamed; Schmack, Bastian; Arif, Rawa; Beller, Carsten J.; Popov, Aron-Frederik; Kallenbach, Klaus; Ruhparwar, Arjang; Dohmen, Pascal M.; Szabó, Gábor; Karck, Matthias; Weymann, Alexander

2017-01-01

Background A retrospective analysis was conducted of the early and long-term outcomes after surgery for infective endocarditis (IE). Material/Methods We included 360 patients with IE operated upon between 1993 and 2012. The primary endpoint was overall cumulative postoperative survival at 30 days. Secondary endpoints were early postoperative outcomes and complication rates. Factors associated with 30-day mortality were analyzed. Results Mean age was 58.7±14.7 years and 26.9% (n=97) were female. The mean follow-up was 4.41±4.53 years. Postoperative survival was 81.7% at 30 days, 69.4% at 1 year, 63.3% at 5 years, and 63.3% at 10 years. Non-survivors were significantly older (p=0.014), with higher NYHA Class (p=0.002), had higher rates of preoperative diabetes mellitus (p=0.005), renal failure (p=0.001), and hepatic disease (p=0.002). Furthermore, non-survivors had higher baseline alanine aminotransferase (ALT, p=0.048), aspartate transaminase (AST, p=0.027), bilirubin (p=0.013), white cell count (WCC, p=0.034), and CRP (p=0.049). Factors associated with 30-day mortality were longer duration of surgery, CPB, and aortic cross-clamping times (p<0.001, p<0.001, and p=0.003, respectively), as well as higher RBC, FFP, and platelet transfusion requirements (p<0.001, p=0.005, and p<0.001, respectively). Multivariate logistic regression analysis revealed liver cirrhosis (OR 4.583, 95-CI: 1.096–19.170, p=0.037) and longer CPB time (OR 1.025, 95-CI 1.008–1.042, p=0.004) as independent predictors of 30-day mortality. Conclusions Surgical treatment of IE shows satisfactory early, midterm, and long-term results. Multivariate logistic regression analysis revealed cirrhosis and longer CPB time as independent predictors of 30-day mortality. PMID:28740070

Modelling survival and mortality risk to 15 years of age for a national cohort of children with serious congenital heart defects diagnosed in infancy.

PubMed

Knowles, Rachel L; Bull, Catherine; Wren, Christopher; Wade, Angela; Goldstein, Harvey; Dezateux, Carol

2014-01-01

Congenital heart defects (CHDs) are a significant cause of death in infancy. Although contemporary management ensures that 80% of affected children reach adulthood, post-infant mortality and factors associated with death during childhood are not well-characterised. Using data from a UK-wide multicentre birth cohort of children with serious CHDs, we observed survival and investigated independent predictors of mortality up to age 15 years. Data were extracted retrospectively from hospital records and death certificates of 3,897 children (57% boys) in a prospectively identified cohort, born 1992-1995 with CHDs requiring intervention or resulting in death before age one year. A discrete-time survival model accounted for time-varying predictors; hazards ratios were estimated for mortality. Incomplete data were addressed through multilevel multiple imputation. By age 15 years, 932 children had died; 144 died without any procedure. Survival to one year was 79.8% (95% confidence intervals [CI] 78.5, 81.1%) and to 15 years was 71.7% (63.9, 73.4%), with variation by cardiac diagnosis. Importantly, 20% of cohort deaths occurred after age one year. Models using imputed data (including all children from birth) demonstrated higher mortality risk as independently associated with cardiac diagnosis, female sex, preterm birth, having additional cardiac defects or non-cardiac malformations. In models excluding children who had no procedure, additional predictors of higher mortality were younger age at first procedure, lower weight or height, longer cardiopulmonary bypass or circulatory arrest duration, and peri-procedural complications; non-cardiac malformations were no longer significant. We confirm the high mortality risk associated with CHDs in the first year of life and demonstrate an important persisting risk of death throughout childhood. Late mortality may be underestimated by procedure-based audit focusing on shorter-term surgical outcomes. National monitoring systems should emphasise the importance of routinely capturing longer-term survival and exploring the mechanisms of mortality risk in children with serious CHDs.

Investigating surface chemistry-controlled dolomite precipitation in saline, alkaline, and dilute waters

NASA Astrophysics Data System (ADS)

Yoerg, A.; Roberts, J. A.

2017-12-01

Previous experiments have shown carboxylated organic matter facilitates dolomite precipitation at low temperature (< 80°C) in both modern and ancient seawater geochemistries. The efficacy of this mechanism in alternative chemical environments, particularly those typical of modern dolomitic environments, remains unclear. We investigated this question using a series of batch laboratory experiments ranging in duration from hours to several months. Experiments were conducted using fluids representative of environments where dolomite is found/thought to form in the modern, such as evaporative, alkaline lakes, sabkhas, and dilute mixing zones. Results indicate that while carboxylated organic matter promotes mineral precipitation in a variety of chemistries, the resultant mineralogy is primarily a function solution chemistry (i.e. saturation state). Specifically, our results suggest elevated alkalinity may be required to produce a high-Mg phase. In solutions where alkalinity is scarce, only amorphous carbonate phases form in association with organic matter, contrasting the Mg-bearing crystalline phases that result from highly alkaline solutions. Results of high-alkalinity, short-term experiments suggest that initially amorphous material is rapidly transformed into high and low-Mg phases in the presence of carboxylated organic matter, but that within days this mineralogy evolves. Longer timescales or elevated temperature may be necessary to produce an ordered dolomite phase. Additional results from longer term, steady-state experiments and additional analyses (Raman spectroscopy and tender energy spectroscopy) will shed further light on resultant mineralogy and this mechanism of dolomite precipitation.

Trends and Patterns in Unintentional Injury Fatalities in Australian Agriculture.

PubMed

Lower, Tony; Rolfe, Margaret; Monaghan, Noeline

2017-04-26

Agriculture is recognized internationally as a hazardous industry. This article describes the trends and patterns of unintentional farm fatalities in Australia. Data from the National Coronial Information System were analyzed to assess all unintentional farm fatalities for the 2001-2015 period. A secondary comparison with earlier coronial system data from 1989-1992 was also completed to ascertain historical changes. There was no statistically significant change in the rate of work-related fatalities per 100,000 workers in the 2001-2015 period. However, there was a significant curvilinear reduction in all cases of fatality (work and non-work related) per 10,000 agricultural establishments, which decreased from 2001 to 2009-2011 and then increased to 2015. The longer-term data from 1989-2015 revealed a reduction of 30% in work-related cases per 100,000 workers and a reduction of 35% in all cases (work and non-work) per 10,000 agricultural establishments. For both work-related and all cases, there was a statistically significant reduction from 1989 to 2005 and then no change thereafter. The longer-term reduction in farm fatalities ceased in the mid-2000s, and the rate has remained stable since. Fatal injuries continue to impose a significant burden on Australian farming communities, with the rate remaining relatively static for the past ten years. New evidence-based interventions targeting priority areas are required to reduce the incidence of fatalities in Australia agriculture. Copyright© by the American Society of Agricultural Engineers.

Cluster Randomized Controlled Trial: Clinical and Cost-Effectiveness of a System of Longer-Term Stroke Care.

PubMed

Forster, Anne; Young, John; Chapman, Katie; Nixon, Jane; Patel, Anita; Holloway, Ivana; Mellish, Kirste; Anwar, Shamaila; Breen, Rachel; Knapp, Martin; Murray, Jenni; Farrin, Amanda

2015-08-01

We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke. A pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months. Thirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was -0.6 points (95% confidence interval, -1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups. This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice. URL: http://www.controlled-trials.com. Unique identifier: ISRCTN 67932305. © 2015 Bradford Teaching Hospitals NHS Foundation Trust.

Breast feeding and child behaviour in the Millennium Cohort Study.

PubMed

Heikkilä, Katriina; Sacker, Amanda; Kelly, Yvonne; Renfrew, Mary J; Quigley, Maria A

2011-07-01

To examine whether breast feeding is associated with behavioural development in children aged 5 years. The authors used data from a large, prospective, nationally representative UK cohort, the Millennium Cohort Study. 10 037 mother-child pairs from white ethnic background (9525 term and 512 preterm children) were included in the analyses. Duration of breast feeding (at all or exclusively) was ascertained from parental interview at study baseline, when the children were aged 9 months. Child behaviour was assessed using a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ). The authors used logistic regression to investigate the associations of breastfeeding duration with abnormal parent-rated SDQ total and subscores at age 5 in term and preterm children separately. Abnormal SDQ scores were less common in term children (n=1129/9525, 12%) than pre-term (n=78/512, 15%) children. Term children breast fed for 4 months or longer (n=2741/9525, 29%) had lower odds of an abnormal total SDQ score (multivariable-adjusted OR compared with never breastfed children (n=3292/9525, 35%) 0.67, 95% CI: 0.54 to 0.83). This effect was similar for all the SDQ subscores. In preterm children, longer duration of breast feeding was generally associated with lower odds of abnormal SDQ total and subscores but the effect estimates were imprecise. The associations between exclusive breast feeding and abnormal SDQ scores were similar to those of any breast feeding and abnormal SDQ scores. The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years.

Effect of Treatment Modality on Long-Term Outcomes in Attention-Deficit/Hyperactivity Disorder: A Systematic Review

PubMed Central

Arnold, L. Eugene; Hodgkins, Paul; Caci, Hervé; Kahle, Jennifer; Young, Susan

2015-01-01

Background Evaluation of treatments for attention-deficit/hyperactivity disorder (ADHD) previously focused on symptom control, but attention has shifted to functional outcomes. The effect of different ADHD treatment periods and modalities (pharmacological, non-pharmacological, and combination) on long-term outcomes needs to be more comprehensively understood. Methods A systematic search of 12 literature databases using Cochrane’s guidelines yielded 403 English-language peer-reviewed, primary studies reporting long-term outcomes (≥2 years). We evaluated relative effects of treatment modalities and durations and effect sizes of outcomes reported as statistically significantly improved with treatment. Results The highest proportion of improved outcomes was reported with combination treatment (83% of outcomes). Among significantly improved outcomes, the largest effect sizes were found for combination treatment. The greatest improvements were associated with academic, self-esteem, or social function outcomes. A majority of outcomes improved regardless of age of treatment initiation (60%–75%) or treatment duration (62%–72%). Studies with short treatment duration had shorter follow-up times (mean 3.2 years total study length) than those with longer treatment durations (mean 7.1 years total study length). Studies with follow-up times <3 years reported benefit with treatment for 93% of outcomes, whereas those with follow-up times ≥3 years reported treatment benefit for 57% of outcomes. Post-hoc analysis indicated that this result was related to the measurement of outcomes at longer periods (3.2 versus 0.4 years) after treatment cessation in studies with longer total study length. Conclusions While the majority of long-term outcomes of ADHD improve with all treatment modalities, the combination of pharmacological and non-pharmacological treatment was most consistently associated with improved long-term outcomes and large effect sizes. Older treatment initiation age or longer durations did not markedly affect proportion of improved outcomes reported, but measurement of outcomes long periods after treatment cessation may attenuate results. PMID:25714373

18 CFR 806.31 - Term of approvals.

Code of Federal Regulations, 2010 CFR

2010-04-01

... approval issued under this part shall be no longer than 15 years or the anticipated life of the project... AND APPROVAL OF PROJECTS Terms and Conditions of Approval § 806.31 Term of approvals. (a) Approvals... approval of a project shall expire three years from the date of such approval if the withdrawal, diversion...

75 FR 47465 - Pymetrozine; Regulation Denying NRDC's Objections on Remand

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... adverse effects are caused by either short-term (e.g., acute) or longer-term (e.g., chronic) pesticide... correspondingly levels of concern, for both short and long exposure periods as well as for the different routes of..., short-term, chronic, and cancer risks and EPA quantitatively assessed these risks in making its safety...

In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP

PubMed Central

Bratton, Daniel J.; Craig, Sonya E.; Kohler, Malcolm; Stradling, John R.

2016-01-01

Background Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. Methods The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2–4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. Results One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2–4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2–4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. Conclusions In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP usage predicted longer term use, there are patients in whom this is not the case, and patients with low initial usage may need to extend their CPAP trial before a decision about longer-term use is made. PMID:26904268

Feasibility of antiretroviral treatment monitoring in the era of decentralized HIV care: a systematic review.

PubMed

Pham, Minh D; Romero, Lorena; Parnell, Bruce; Anderson, David A; Crowe, Suzanne M; Luchters, Stanley

2017-01-19

Regular monitoring of HIV patients who are receiving antiretroviral therapy (ART) is required to ensure patient benefits and the long-term effectiveness and sustainability of ART programs. Prompted by WHO recommendations for expansion and decentralization of HIV treatment and care in low and middle income countries, we conducted a systematic review to assess the feasibility of treatment monitoring in these settings. A comprehensive search strategy was developed using a combination of MeSH and free text terms relevant to HIV treatment and care, health service delivery, health service accessibility, decentralization and other relevant terms. Five electronic databases and two conference websites were searched to identify relevant studies conducted in LMICs, published in English between Jan 2006 and Dec 2015. Outcomes of interest included the proportion of patients who received treatment monitoring and health system factors related to monitoring of patients on ART under decentralized HIV service delivery models. From 5363 records retrieved, twenty studies were included in the review; all but one was conducted in sub-Saharan African countries. The majority of studies (15/20) had relatively short follow-up duration (≤24 months), and only two studies were specifically designed to assess treatment monitoring practices. The most frequently studied follow-up period was 12 months and a wide range of treatment monitoring coverage was observed. The reported proportions of patients on ART who received CD4 monitoring ranged from very low (6%; N = 2145) to very high (95%; N = 488). The median uptake of viral load monitoring was 86% with studies in program settings reporting coverage as low as 14%. Overall, the longer the follow-up period, the lower the proportion of patients who received regular monitoring tests; and programs in rural areas reported low coverage of laboratory monitoring. Moreover, uptake in the context of research had significantly better where monitoring was done by dedicated research staff. In the absence of point of care (POC) testing, the limited capacity for blood sample transportation between clinic and laboratory and poor quality of nursing staff were identified as a major barrier for treatment monitoring practice. There is a paucity of data on the uptake of treatment monitoring, particularly with longer-term follow-up. Wide variation in access to both virological and immunological regular monitoring was observed, with some clinics in well-resourced settings supported by external donors achieving high coverage. The feasibility of treatment monitoring, particularly in decentralized settings of HIV treatment and care may thus be of concern and requires further study. Significant investment in POC diagnostic technologies and, improving the quality of and training for nursing staff is required to ensure effective scale up of ART programs towards the targets of 90-90-90 by the year 2020.

Broad-spectrum Antibiotic Plus Metronidazole May Not Prevent the Deterioration of Necrotizing Enterocolitis From Stage II to III in Full-term and Near-term Infants

PubMed Central

Luo, Li-Juan; Li, Xin; Yang, Kai-Di; Lu, Jiang-Yi; Li, Lu-Quan

2015-01-01

Abstract Necrotizing enterocolitis (NEC) is the most common and frequently dangerous neonatal gastrointestinal disease. Studies have shown broad-spectrum antibiotics plus anaerobic antimicrobial therapy did not prevent the deterioration of NEC among very low birth preterm infants. However, few studies about this therapy which focused on full-term and near-term infant with NEC has been reported. The aim of this study was to evaluate the effect of broad-spectrum antibiotic plus metronidazole in preventing the deterioration of NEC from stage II to III in full-term and near-term infants. A retrospective cohort study based on the propensity score (PS) 1:1 matching was performed among the full-term and near-term infants with NEC (Bell stage ≥II). All infants who received broad-spectrum antibiotics were divided into 2 groups: group with metronidazole treatment (metronidazole was used ≥4 days continuously, 15 mg/kg/day) and group without metronidazole treatment. The depraved rates of stage II NEC between the 2 groups were compared. Meanwhile, the risk factors associated with the deterioration of stage II NEC were analyzed by case-control study in the PS-matched cases. A total of 229 infants met the inclusion criteria. Before PS-matching, we found the deterioration of NEC rate in the group with metronidazole treatment was higher than that in the group without metronidazole treatment (18.1% [28/155] vs 8.1% [6/74]; P = 0.048). After PS-matching, 73 pairs were matched, and the depraved rate of NEC in the group with metronidazole treatment was not lower than that in the group without metronidazole treatment (15.1% vs 8.2%; P = 0.2). Binary logistic regression analysis showed that sepsis after NEC (odds ratio [OR] 3.748, 95% confidence interval [CI] 1.171–11.998, P = 0.03), the need to use transfusion of blood products after diagnosis of NEC (OR 8.003, 95% CI 2.365–27.087, P = 0.00), and the need of longer time for nasogastric suction were risk factors for stage II NEC progressing to stage III (OR 1.102, 95% CI 1.004–1.21, P = 0.04). Broad-spectrum antibiotic plus metronidazole may not prevent the deterioration of NEC in full-term and near-term infants. Those infants who had sepsis required transfusion of blood products, and needed longer time for nasogastric suction after stage II NEC was more likely to progress to stage III. PMID:26496340

Lansoprazole for secondary prevention of gastric or duodenal ulcers associated with long-term non-steroidal anti-inflammatory drug (NSAID) therapy: results of a prospective, multicenter, double-blind, randomized, double-dummy, active-controlled trial.

PubMed

Sugano, Kentaro; Kontani, Teiji; Katsuo, Shinichi; Takei, Yoshinori; Sakaki, Nobuhiro; Ashida, Kiyoshi; Mizokami, Yuji; Asaka, Masahiro; Matsui, Shigeyuki; Kanto, Tatsuya; Soen, Satoshi; Takeuchi, Tsutomu; Hiraishi, Hideyuki; Hiramatsu, Naoki

2012-05-01

Low-dose lansoprazole has not been intensively evaluated for its efficacy in the prevention of recurrent gastric or duodenal ulcers in patients receiving long-term non-steroidal anti-inflammatory drug (NSAID) therapy for pain relief in such diseases as rheumatoid arthritis, osteoarthritis, and low back pain. This multi-center, prospective, double-blind, randomized, active-controlled study involving 99 sites in Japan was designed to compare the efficacy of lansoprazole (15 mg daily) with gefarnate (50 mg twice daily). Patients with a history of gastric or duodenal ulcers who required long-term NSAID therapy were randomized to receive lansoprazole 15 mg daily (n = 185) or gefarnate 50 mg twice daily (n = 181) and followed up for 12 months or longer prospectively. The cumulative incidence of gastric or duodenal ulcer at days 91, 181, and 361 from the start of the study was calculated by the Kaplan-Meier method as 3.3, 5.9, and 12.7%, respectively, in the lansoprazole group versus 18.7, 28.5, and 36.9%, respectively, in the gefarnate group. The risk for ulcer development was significantly (log-rank test, P < 0.0001) lower in the lansoprazole group than in the gefarnate group, with the hazard ratio being 0.2510 (95% CI 0.1400-0.4499). A long-term follow-up study showed an acceptable safety profile for low-dose lansoprazole therapy, with diarrhea as the most frequent adverse event. Lansoprazole was superior to gefarnate in reducing the risk of gastric or duodenal ulcer recurrence in patients with a definite history of gastric or duodenal ulcers who required long-term NSAID therapy.

Sacral neurostimulation for urinary retention: 10-year experience from one UK centre.

PubMed

Datta, Soumendra N; Chaliha, Charlotte; Singh, Anubha; Gonzales, Gwen; Mishra, Vibhash C; Kavia, Rajesh B C; Kitchen, Neil; Fowler, Clare J; Elneil, Sohier

2008-01-01

To report our 10-year experience of sacral neurostimulation (SNS) for women in urinary retention, comparing the original one-stage with the newer two-stage technique, as SNS therapy is a well-established treatment for urinary retention secondary to urethral sphincter overactivity (Fowler's syndrome). Between 1996 and 2006, 60 patients with urinary retention had a SNS device inserted; their case records were reviewed and data on efficacy, follow-up, need for continued clean intermittent self-catheterization (CISC), complications and operative revision rate were assessed. Overall, 43 of 60 (72%) women were voiding spontaneously, with a mean postvoid residual volume of 100 mL; 30 (50%) no longer needed to use CISC. During a total of 2878 months of SNS experience, adverse event episodes included lead migration in 20, 'box-site' pain in 19, leg pain/numbness in 18 and loss of response/failure in 18 patients; 53% of the women required a surgical revision related to their implanted stimulator. The efficacy of the two-stage was similar to that of the one-stage procedure (73% vs 70%). Women with a normal urethral sphincter electromyogram had worse outcomes than women with an abnormal test (43% vs 76%). Although the efficacy was no different in those taking analgesia/antidepressant medication, this group of women had a higher surgical revision rate. Failure and complications for the one-stage procedure were not restricted to the early follow-up period. The mean battery life of the implant was 7.31 years. SNS has sustained long-term efficacy but the procedure has a significant complication rate. At present, the two-stage technique has comparable efficacy to the one-stage technique but a longer-term follow-up is required. The National Institute of Clinical Excellence recommended the use of SNS in women with urinary incontinence who fail to respond adequately to anticholinergic therapy, but patients choosing this treatment should be made aware of the high complication rate associated with the procedure.

Long Term Outcomes of Laparoscopic and Open Modified Lich-Gregoir Reimplantation in Adults: A multicentric comparative study.

PubMed

Atar, Arda; Eksi, Mithat; Güler, Ahmet Faysal; Tuncer, Murat; Akkas, Fatih; Tugcu, Volkan

2017-01-01

Obstructive ureteral pathologies in adult patients are most commonly due to ureteral strictures and secondary to surgical interventions. In this study, we aimed to compare open and laparoscopic modified Lich-Gregoir ureteral reimplantation with regards to outcomes in benign ureteral pathologies in adult patients. Between December 2008 and December 2014, 32 open cases and 29 laparoscopic cases were performed as per the data retrieved from surgical databases. All laparoscopic procedures were performed in Bakirkoy Dr. Sadi Konuk Training and Research Hospital(BEAH) and all open ureteral reimplantation procedures in Kartal Dr Lutfi Kirdar Training and Research Hospital(KEAH) and Okmeydani Training and Research Hospital(OEAH). The mean operation time was significantly lower in the group of patients operated with open group (142.5 minutes versus 188.9 minutes; P< 0.0001). The mean duration of follow-up was longer in the laparoscopy group (31 versus 28 months; p< 0.0001). The mean amount of operation associated blood loss was significantly lower in patients operated laparoscopically (93.7 mL versus 214 mL; P< 0.0001). The mean VAS score obtained six hours after surgery was 6.6 ± 0.8 in open group, and 5.8 ± 0.7 in laparoscopic group (p=0.0004). The mean VAS scores measured at post-operative day 1 was 4.5 ± 0.7 in open group and 3.7 ± 0.9 in laparoscopy group. Time required to achieve the pre-operative capability of daily activities was significantly longer in open group (15 ± 1.4 days vs 11 ± 1.4 days; p< 0.0001). Despite open techniques provide shorter operation time and laparoscopic techniques require long learning curve, we think that laparoscopic techniques are superior to open ones since that they provide a better post-operative comfort and are better tolerated in terms of complications.

Long Term Outcomes of Laparoscopic and Open Modified Lich-Gregoir Reimplantation in Adults: A multicentric comparative study

PubMed Central

Atar, Arda; Eksi, Mithat; Güler, Ahmet Faysal; Tuncer, Murat; Akkas, Fatih; Tugcu, Volkan

2017-01-01

Background & Objective: Obstructive ureteral pathologies in adult patients are most commonly due to ureteral strictures and secondary to surgical interventions. In this study, we aimed to compare open and laparoscopic modified Lich-Gregoir ureteral reimplantation with regards to outcomes in benign ureteral pathologies in adult patients. Methods: Between December 2008 and December 2014, 32 open cases and 29 laparoscopic cases were performed as per the data retrieved from surgical databases. All laparoscopic procedures were performed in Bakirkoy Dr. Sadi Konuk Training and Research Hospital(BEAH) and all open ureteral reimplantation procedures in Kartal Dr Lutfi Kirdar Training and Research Hospital(KEAH) and Okmeydani Training and Research Hospital(OEAH). Results: The mean operation time was significantly lower in the group of patients operated with open group (142.5 minutes versus 188.9 minutes; P< 0.0001). The mean duration of follow-up was longer in the laparoscopy group (31 versus 28 months; p< 0.0001). The mean amount of operation associated blood loss was significantly lower in patients operated laparoscopically (93.7 mL versus 214 mL; P< 0.0001). The mean VAS score obtained six hours after surgery was 6.6 ± 0.8 in open group, and 5.8 ± 0.7 in laparoscopic group (p=0.0004). The mean VAS scores measured at post-operative day 1 was 4.5 ± 0.7 in open group and 3.7 ± 0.9 in laparoscopy group. Time required to achieve the pre-operative capability of daily activities was significantly longer in open group (15 ± 1.4 days vs 11 ± 1.4 days; p< 0.0001). Conclusion: Despite open techniques provide shorter operation time and laparoscopic techniques require long learning curve, we think that laparoscopic techniques are superior to open ones since that they provide a better post-operative comfort and are better tolerated in terms of complications. PMID:29067040

26 CFR 25.2512-5A - Valuation of annuities, unitrust interests, interests for life or term of years, and remainder or...

Code of Federal Regulations, 2010 CFR

2010-04-01

... Estate and Gift Tax,” (Rev. 5-59). This publication is no longer available for purchase from the... (CONTINUED) ESTATE AND GIFT TAXES GIFT TAX; GIFTS MADE AFTER DECEMBER 31, 1954 Actuarial Tables Applicable... One and Two Lives” (12-70). These publications are no longer available for purchase from the...

How does temperature affect forest "fungus breath"? Diurnal non-exponential temperature-respiration relationship, and possible longer-term acclimation in fungal sporocarps

Treesearch

Erik A. Lilleskov

2017-01-01

Fungal respiration contributes substantially to ecosystem respiration, yet its field temperature response is poorly characterized. I hypothesized that at diurnal time scales, temperature-respiration relationships would be better described by unimodal than exponential models, and at longer time scales both Q10 and mass-specific respiration at 10 °...

Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness: Green Skills Training for Workers. Hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eleventh Congress, First Session on Examining Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness, Focusing on Green Skills Training for Workers (April 21, 2009). Senate Hearing 111-813

ERIC Educational Resources Information Center

US Senate, 2011

2011-01-01

Among the topics discussed in this hearing were: what constitutes green energy, how workers can best be provided the skills to thrive in green industries, and the future of America's energy and environmental policies. Statements were presented by: Honorable Patty Murray, a U.S. Senator from the State of Washington, opening statement; Honorable…

A new initiative on precision medicine.

PubMed

Collins, Francis S; Varmus, Harold

2015-02-26

President Obama has announced a research initiative that aims to accelerate progress toward a new era of precision medicine, with a near-term focus on cancers and a longer-term aim to generate knowledge applicable to the whole range of health and disease.

Correlation Lengths for Estimating the Large-Scale Carbon and Heat Content of the Southern Ocean

NASA Astrophysics Data System (ADS)

Mazloff, M. R.; Cornuelle, B. D.; Gille, S. T.; Verdy, A.

2018-02-01

The spatial correlation scales of oceanic dissolved inorganic carbon, heat content, and carbon and heat exchanges with the atmosphere are estimated from a realistic numerical simulation of the Southern Ocean. Biases in the model are assessed by comparing the simulated sea surface height and temperature scales to those derived from optimally interpolated satellite measurements. While these products do not resolve all ocean scales, they are representative of the climate scale variability we aim to estimate. Results show that constraining the carbon and heat inventory between 35°S and 70°S on time-scales longer than 90 days requires approximately 100 optimally spaced measurement platforms: approximately one platform every 20° longitude by 6° latitude. Carbon flux has slightly longer zonal scales, and requires a coverage of approximately 30° by 6°. Heat flux has much longer scales, and thus a platform distribution of approximately 90° by 10° would be sufficient. Fluxes, however, have significant subseasonal variability. For all fields, and especially fluxes, sustained measurements in time are required to prevent aliasing of the eddy signals into the longer climate scale signals. Our results imply a minimum of 100 biogeochemical-Argo floats are required to monitor the Southern Ocean carbon and heat content and air-sea exchanges on time-scales longer than 90 days. However, an estimate of formal mapping error using the current Argo array implies that in practice even an array of 600 floats (a nominal float density of about 1 every 7° longitude by 3° latitude) will result in nonnegligible uncertainty in estimating climate signals.

Chronic effects of an invasive species on an animal community.

PubMed

Doody, J Sean; Rhind, David; Green, Brian; Castellano, Christina; McHenry, Colin; Clulow, Simon

2017-08-01

Invasive species can trigger trophic cascades in animal communities, but published cases involving their removal of top predators are extremely rare. An exception is the invasive cane toad (Rhinella marina) in Australia, which has caused severe population declines in monitor lizards, triggering trophic cascades that facilitated dramatic and sometimes unexpected increases in several prey of the predators, including smaller lizards, snakes, turtles, crocodiles, and birds. Persistence of isolated populations of these predators with a decades-long sympatry with toads suggests the possibility of recovery, but alternative explanations are possible. Confirming predator recovery requires longer-term study of populations with both baseline and immediate post-invasion densities. Previously, we quantified short-term impacts of invasive cane toads on animal communities over seven years at two sites in tropical Australia. Herein, we test the hypothesis that predators have begun to recover by repeating the study 12 yr after the initial toad invasion. The three predatory lizards that experienced 71-97% declines in the short-term study showed no sign of recovery, and indeed a worse fate: two of the three species were no longer detectable in 630 km of river surveys, suggesting local extirpation. Two mesopredators that had increased markedly in the short term due to these predator losses showed diverse responses in the medium term; a small lizard species increased by ~500%, while populations of a snake species showed little change. Our results indicate a system still in ecological turmoil, having not yet reached a "new equilibrium" more than a decade after the initial invasion; predator losses due to this toxic invasive species, and thus downstream effects, were not transient. Given that cane toads have proven too prolific to eradicate or control, we suggest that recovery of impacted predators must occur unassisted by evolutionary means: dispersal into extinction sites from surviving populations with alleles for toxin resistance or toad avoidance. Evolution and subsequent dispersal may be the only solution for a number of species or communities affected by invasive species for which control is either prohibitively expensive, or not possible. © 2017 by the Ecological Society of America.

Interventions to reduce discrimination and stigma: the state of the art.

PubMed

Gronholm, Petra C; Henderson, Claire; Deb, Tanya; Thornicroft, Graham

2017-03-01

There is a rich literature on the nature of mental health-related stigma and the processes by which it severely affects the life chances of people with mental health problems. However, applying this knowledge to deliver and evaluate interventions to reduce discrimination and stigma in a lasting way is a complex and long-term challenge. We conducted a narrative synthesis of systematic reviews published since 2012, and supplemented this with papers published subsequently as examples of more recent work. There is evidence for small to moderate positive impacts of both mass media campaigns and interventions for target groups in terms of stigma-related knowledge, attitudes, and intended behaviour in terms of desire for contact. However, the limited evidence from longer follow-up times suggests that it is not clear whether short-term contact interventions have a lasting impact. The risk that short-term interventions may only have a short-term impact suggests a need to study longer term interventions and to use interim process and outcome data to improve interventions along the way. There is scope for more thorough application of intergroup contact theory whenever contact is used and of evidence-based teaching and assessment methods when skills training is used for target groups.

Long-term outcomes of children undergoing video-assisted gastrostomy.

PubMed

Salö, Martin; Santimano, Ana; Helmroth, Sofia; Stenström, Pernilla; Arnbjornsson, Einar Ólafur

2017-01-01

The aims of this study were to assess the short- and long-term complication rates after video-assisted gastrostomy (VAG), the effects of age and gender on long-term complications and the effect of duration of gastrostomy tube retention on the need for gastroraphy when the gastrostomy device was removed. This was a retrospective study of children undergoing VAG at a single institution. Children who died or moved from the area were excluded. The rates of short- and long-term complications developing at 3-6 months or 2 or more years, respectively, were compared. A total of 170 children were studied, out of a cohort of 303 children. The median age at surgery was 2 years. The median duration of postoperative long-term follow-up was 5 years (2-9 years). The complications at the respective short and long-term follow-ups were as follows: granulation tissue, leakage, infection and vomiting. There were no differences in the short- versus long-term complication rates for gender and age. Children needing gastroraphy had used a gastrostomy device significantly longer compared with children with spontaneous closure. Complications after VAG decrease over time. A longer duration of gastrostomy device retention leads to increased need for gastroraphy.

Laparoscopic partial vs total splenectomy in children with hereditary spherocytosis.

PubMed

Morinis, Julia; Dutta, Sanjeev; Blanchette, Victor; Butchart, Sheila; Langer, Jacob C

2008-09-01

Open partial splenectomy provides reversal of anemia and relief of symptomatic splenomegaly while theoretically retaining splenic immune function for hereditary spherocytosis. We recently developed a laparoscopic approach for partial splenectomy. The purpose of the present study is to compare the outcomes in a group of patients undergoing laparoscopic partial splenectomy (LPS) with those in a group of children undergoing laparoscopic total splenectomy (LTS) over the same period. Systematic chart review was conducted of all children with hereditary spherocytosis who had LTS or LPS from 2000 to 2006 at the Hospital for Sick Children, Toronto, Ontario, Canada. T tests were used for continuous data, and chi(2) for proportional data; P value of less than .05 was considered significant. There were 9 patients (14 males) in each group. Groups were similar in sex, age, concomitant cholecystectomy, and preoperative hospitalizations, transfusions, and spleen size. Estimated blood loss was greater in the LPS group (188 + 53 vs 67 + 17 mL; P = .02), but transfusion requirements were similar (1/9 vs 0/9). Complication rate was similar between groups. The LPS group had higher morphine use (4.1 + 0.6 vs 2.4 + 0.2 days; P = .03), greater time to oral intake (4.4 + 0.7 vs 2.0 + 0.2 days; P = .01), and longer hospital stay (6.3 + 1.0 vs 2.7 + 0.3 days; P = .005) than the LTS group. Nuclear scan 6 to 8 weeks postoperatively demonstrated residual perfused splenic tissue in all LPS patients. No completion splenectomy was necessary after a mean follow-up of 25 months. These data suggest that LPS is as effective as LTS for control of symptoms. However, LPS is associated with more pain, longer time to oral intake, and longer hospital stay. These disadvantages may be balanced by retained splenic immune function, but further studies are required to assess long-term splenic function in these patients.

Australian Institute of Sport and Australian Medical Association position statement on concussion in sport.

PubMed

Elkington, Lisa J; Hughes, David C

2017-01-16

Sport-related concussion is a growing health concern in Australia. Public concern is focused on the incidence and potential long term consequences of concussion. Children may be more prone to concussion and take longer to recover. The Australian Institute of Sport and the Australian Medical Association have collaborated to present the most contemporary evidence-based information in a format appropriate for all stakeholders. This position statement aims to ensure that participant safety and welfare is paramount when dealing with concussion in sport.First aid principles apply in the management of the athlete with suspected concussion, including protection of the cervical spine. Tools exist for use by members of the community, allowing identification of key symptoms and signs that raise the suspicion of concussion. Medical professionals should use the Sport Concussion Assessment Tool 3, in conjunction with clinical assessment for the diagnosis of concussion. Clinical assessment includes mechanism of injury, symptoms and signs, cognitive functioning, and neurological assessment including balance testing. In any situation where concussion is suspected, the athlete must be immediately removed from sport and not be allowed to return to activity until they have been assessed by a medical practitioner. "If in doubt, sit them out."A diagnosis of concussion requires immediate physical and cognitive rest, followed by a structured, graduated return to physical activity. Children require a longer period of recovery from concussion. Algorithms are provided for use by medical and non-medically trained stakeholders in the recognition and management of concussion.

Aligning Assessment with Long-Term Learning. Special Issue: Learning-Oriented Assessment: Principles and Practice

ERIC Educational Resources Information Center

Boud, David; Falchikov, Nancy

2006-01-01

Assessment in higher education is commonly held to contribute to feedback to students on their learning and the certification of their achievement. This paper argues that this short-term focus must be balanced against a longer-term emphasis for learning-oriented assessment to foster future learning after graduation. The paper proposes that…

The Long-Term Pavement Performance Program Roadmap: A Strategic Plan

DOT National Transportation Integrated Search

1995-09-01

The goal of the ongoing, 20-year long-term pavement performance (LTPP) studies is to give State and Provincial transportation departments- the owners and customers of the LTPP program-the information and tools they need to build and maintain longer-l...

POLLUTION CONTROL FOR UTILITY POWER GENERATION, 1990-2020

EPA Science Inventory

The paper discusses pollution control for utility power generation between the years 1990 and 2020, when the major anticipated environmental challenges facing the utility industry will be acid deposition control in the near term and global warming mitigation in the longer term. T...

Precision Education Initiative: Moving toward Personalized Education

ERIC Educational Resources Information Center

Hart, Sara A.

2016-01-01

This article proposes the Precision Education Initiative, which is the tailoring of education to the specific characteristics of the individual student. Mirroring precision medicine, the author lays out both near-term and longer term goals that educational research, and importantly educational practice, should follow.

Assessment of beach and dune erosion and accretion using LiDAR: Impact of the stormy 2013-14 winter and longer term trends on the Sefton Coast, UK

NASA Astrophysics Data System (ADS)

Pye, Kenneth; Blott, Simon J.

2016-08-01

An important question for coastal management concerns the importance of individual storms and clusters of storms on longer term beach sediment budgets, beach and dune erosion, and coastal flood risk. Between October 2013 and March 2014 a series of deep Atlantic low pressure systems crossed the Northeast Atlantic, and strong winds, high waves and high water levels affected many coastal areas in the UK and other parts of western Europe. Net dune recession of up to 12.1 m occurred around Formby Point. On 5 December 2013 the highest water level ever recorded at Liverpool (6.22 m ODN) coincided with waves of Hs of 4.55 m and Tp of 9.3 s in Liverpool Bay. Wave trimming of the dune toe occurred along the entire length of the Sefton coast, but significant dune erosion occurred only where the upper beach (between the mean high water spring tide level and the dune toe) was < 25 m wide. Sediment budget calculations based on LiDAR surveys in October 2013 and May 2014 indicated a net loss of 127 × 103 m3 of sediment from the beach (above 0 m ODN) and a loss of 268 × 103 m3 from the frontal dune system, mostly at Formby Point. However, some parts of the beach to the south of Formby Point gained sediment, indicating net north to south transport over the winter. When considered in a longer term context, the 2013-14 winter represents only a small perturbation on the longer-term coast trend of erosion at Formby Point and progradation to the north and south. Analysis of LiDAR data over a longer time period 1999-2014 indicated upper beach and dune sediment loss of 780 × 103 m3 from the north-central part of Formby Point, with net gains of 806 × 103 m3 and 2116 × 103 m3 in areas to the north and south, respectively. This indicates a net onshore transport of 2142 × 103 m3 from Liverpool Bay towards the coast between Birkdale and Altcar, with a further net total of 210 × 103 m3 transported towards the shore between Altcar and Crosby. In view of the demonstrated value of airborne LiDAR surveys for the quantification of storm impacts and longer term coastal changes, it is recommended that such surveys should be undertaken before and after each winter storm period, covering the area between mean low water spring tide level and a line 200 m landward of the dune toe, of as a part of the regional coastal monitoring programme.

Lacosamide: A Review in Focal-Onset Seizures in Patients with Epilepsy.

PubMed

Hoy, Sheridan M

2018-05-01

Lacosamide (Vimpat ® ) is a functionalized amino acid (available orally and intravenously) approved in the EU and the USA for use as monotherapy and adjunctive therapy for the treatment of focal-onset seizures in adults, adolescents and children aged ≥ 4 years with epilepsy. In adults and adolescents (aged ≥ 16 years), oral lacosamide as adjunctive therapy to other antiepileptic drugs was generally effective in reducing seizure frequency during short-term (up to 18 weeks) treatment, with efficacy sustained over the longer-term (up to 8 years). Moreover, patients were effectively switched from adjunctive oral lacosamide to the same dosage of intravenous lacosamide. Oral lacosamide was an effective conversion to monotherapy agent in this patient population and as monotherapy demonstrated noninferiority to carbamazepine controlled release in terms of seizure freedom. Antiepileptic benefits were maintained during longer-term (≤ 2 years) monotherapy. The antiepileptic efficacy of lacosamide in children aged ≥ 4 years has been extrapolated from data from adults and adolescents, with a similar response expected provided paediatric dosage adaptations are used and safety is demonstrated. Indeed, preliminary data demonstrated the efficacy of short-term (16 weeks) adjunctive lacosamide in patients aged ≥ 4 to < 17 years. Oral lacosamide was generally well tolerated over the short- and longer-term when administered as adjunctive therapy, a conversion to monotherapy agent and monotherapy in adults and adolescents and when administered as adjunctive therapy in children aged ≥ 4 years. Thus, lacosamide is a useful option for the management of focal-onset seizures across a broad age range, starting as early as 4 years of age.

Synthetic fuels for ground transportation with special emphasis on hydrogen

NASA Technical Reports Server (NTRS)

Singh, J. J.

1975-01-01

The role of various synthetic fuels, for ground transportation in the United States, was examined for the near term (by 1985) and the longer term applications (1985-2000 and beyond 2000). Feasible options include synthetic oil, methanol, electric propulsion, and hydrogen. It is concluded that (1) the competition during the next 50 years will be for the fuels of all types, rather than among the fuels; (2) extensive domestic oil and gas exploration should be initiated concurrent with the development of several alternate fuels and related ancillaries; and (3) hydrogen, as an automotive fuel, seems to be equivalent to gasoline for optimum fuel to air mixtures. As a pollution free, high energy density fuel, hydrogen deserves consideration as the logical replacement for the hydrocarbons. Several research and development requirements, essential for the implementation of hydrogen economy for ground transportation, were identified. Extensive engineering development and testing activities should be initiated to establish hydrogen as the future automotive fuel, followed by demonstration projects and concerted efforts at public education.

Reinforcements: The key to high performance composite materials

NASA Technical Reports Server (NTRS)

Grisaffe, Salvatore J.

1990-01-01

Better high temperature fibers are the key to high performance, light weight composite materials. However, current U.S. and Japanese fibers still have inadequate high temperature strength, creep resistance, oxidation resistance, modulus, stability, and thermal expansion match with some of the high temperature matrices being considered for future aerospace applications. In response to this clear deficiency, both countries have research and development activities underway. Once successful fibers are identified, their production will need to be taken from laboratory scale to pilot plant scale. In such efforts it can be anticipated that the Japanese decisions will be based on longer term criteria than those applied in the U.S. Since the initial markets will be small, short term financial criteria may adversely minimize the number and strength of U.S. aerospace materials suppliers to well into the 21st century. This situation can only be compounded by the Japanese interests in learning to make commercial products with existing materials so that when the required advanced fibers eventually do arrive, their manufacturing skills will be developed.

An investigation into the potential of low head hydro power in Northern Ireland for the production of electricity

NASA Astrophysics Data System (ADS)

Redpath, David; Ward, Michael J.

2017-07-01

The maximum exploitable potential for low head hydroelectric sites (gross head≤10 m) in Northern Ireland (NI) was determined as 12.07 MW using a simple payback analysis for 304 potential sites investigated to derive a classification scheme in terms of economic viability. A techno-economic analysis with validated numerical models from previous research estimated the capital investment required for the development of a hydroelectric plant, using the low head Michell-Banki cross flow turbine, for the 304 sites investigated. The number of potentially viable sites in NI for low head hydro ranged from 198 to 286 with an estimated installed capacity ranging from 11.95 to 12.05 MW. Sites with a limited installed capacity were not economically viable unless increased government support in the form of longer term (25-50 years) low interest loans as well as the current (Renewables Obligations Certificates) Renewables Obligation Certificates scheme is provided and sustained.

Modelling impacts and recovery in benthic communities exposed to localised high CO2.

PubMed

Lessin, Gennadi; Artioli, Yuri; Queirós, Ana M; Widdicombe, Stephen; Blackford, Jerry C

2016-08-15

Regulations pertaining to carbon dioxide capture with offshore storage (CCS) require an understanding of the potential localised environmental impacts and demonstrably suitable monitoring practices. This study uses a marine ecosystem model to examine a comprehensive range of hypothetical CO2 leakage scenarios, quantifying both impact and recovery time within the benthic system. Whilst significant mortalities and long recovery times were projected for the larger and longer term scenarios, shorter-term or low level exposures lead to reduced projected impacts. This suggests that efficient monitoring and leak mitigation strategies, coupled with appropriate selection of storage sites can effectively limit concerns regarding localised environmental impacts from CCS. The feedbacks and interactions between physiological and ecological responses simulated reveal that benthic responses to CO2 leakage could be complex. This type of modelling investigation can aid the understanding of impact potential, the role of benthic community recovery and inform the design of baseline and monitoring surveys. Copyright © 2016 Elsevier Ltd. All rights reserved.

Current treatment paradigms in rheumatoid arthritis.

PubMed

Fries, J F

2000-06-01

Rheumatoid arthritis (RA) has traditionally been treated using the pyramid approach, in which non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment and disease-modifying anti-rheumatic drugs (DMARDs) are introduced relatively late in the disease. This approach is no longer valid. Previously regarded as a benign disease, RA is now recognized as causing substantial morbidity and mortality, as do the NSAIDs used in treatment. DMARDs are more effective in controlling the pain and disability of RA than NSAIDs, and are often no more toxic. The current treatment paradigm emphasizes early, consistent use of DMARDs. A 'sawtooth' strategy of DMARD use has been proposed, in which a rising but low level of disability triggers a change in therapy. Determining the most clinically useful DMARD combinations and the optimal sequence of DMARD use requires effectiveness studies, Bayesian approaches and analyses of long-term outcomes. Such approaches will allow optimization of multiple drug therapies in RA, and should substantially improve the long-term outcome for many patients.

Advanced Environment Friendly Nanotechnologies

NASA Astrophysics Data System (ADS)

Figovsky, O.; Beilin, D.; Blank, N.

The economic, security, military and environmental implications of molecular manufacturing are extreme. Unfortunately, conflicting definitions of nanotechnology and blurry distinctions between significantly different fields have complicated the effort to understand those differences and to develop sensible, effective policy for each. The risks of today's nanoscale technologies cannot be treated the same as the risks of longer-term molecular manufacturing. It is a mistake to put them together in one basket for policy consideration — each is important to address, but they offer different problems and will require far different solutions. As used today, the term nanotechnology usually refers to a broad collection of mostly disconnected fields. Essentially, anything sufficiently small and interesting can be called nanotechnology. Much of it is harmless. For the rest, much of the harm is of familiar and limited quality. Molecular manufacturing, by contrast, will bring unfamiliar risks and new classes of problems. The advanced environment friendly nanotechnologies elaborated by Israel Company Polymate Ltd. — International Research Center are illustrated.

Recombination and phenotype evolution dynamics of Helicobacter pylori in colonized hosts.

PubMed

Shafiee, Ahmad; Amini, Massoud; Emamirad, Hassan; Abadi, Amin Talebi Bezmin

2016-07-01

The ample genetic diversity and variability of Helicobater pylori, and therefore its phenotypic evolution, relate not only to frequent mutation and selection but also to intra-specific recombination. Webb and Blaser applied a mathematical model to distinguish the role of selection and mutation for Lewis antigen phenotype evolution during long-term gastric colonization in infected animal hosts (mice and gerbils). To investigate the role of recombination in Lewis antigen phenotype evolution, we have developed a prior population dynamic by adding recombination term to the model. We simulate and interpret the new model simulation's results with a comparative analysis of biological aspects. The main conclusions are as follows: (i) the models and consequently the hosts with higher recombination rate require a longer time for stabilization; and (ii) recombination and mutation have opposite effects on the size of H. pylori populations with phenotypes in the range of the most-fit ones (i.e. those that have a selective advantage) due to natural selection, although both can increase phenotypic diversity.

Energy in higher-dimensional spacetimes

NASA Astrophysics Data System (ADS)

Barzegar, Hamed; Chruściel, Piotr T.; Hörzinger, Michael

2017-12-01

We derive expressions for the total Hamiltonian energy of gravitating systems in higher-dimensional theories in terms of the Riemann tensor, allowing a cosmological constant Λ ∈R . Our analysis covers asymptotically anti-de Sitter spacetimes, asymptotically flat spacetimes, as well as Kaluza-Klein asymptotically flat spacetimes. We show that the Komar mass equals the Arnowitt-Deser-Misner (ADM) mass in stationary asymptotically flat spacetimes in all dimensions, generalizing the four-dimensional result of Beig, and that this is no longer true with Kaluza-Klein asymptotics. We show that the Hamiltonian mass does not necessarily coincide with the ADM mass in Kaluza-Klein asymptotically flat spacetimes, and that the Witten positivity argument provides a lower bound for the Hamiltonian mass—and not for the ADM mass—in terms of the electric charge. We illustrate our results on the five-dimensional Rasheed metrics, which we study in some detail, pointing out restrictions that arise from the requirement of regularity, which have gone seemingly unnoticed so far in the literature.

Proposed water-supply investigations in Sidamo Province, Ethiopia

USGS Publications Warehouse

Phoenix, David A.

1966-01-01

The present report describes the results of an air and ground hydrologic reconnaissance of some 32,000 square kilometers in Sidamo Province of southern Ethiopia. Existing (1966) water resources developments, chiefly for livestock and village supplies, include surface reservoirs, a few drilled wells, several clusters of dug wells in the Mega area, several scattered springs, and the perennial Dawa Parma River. Surface-water reservoirs range from hand-dug ponds of a few hundred cubic meters capacity to large machine-constructed excavations built to hold 62,000 cubic meters of water. All the existing drilled wells tap saturated alluvium at depths of less than 120 meters. The dug wells tap water-bearing zones in tuffaceous lacustrine deposits or stream-channel alluvium generally at depths of less than 30 meters. The springs mostly rise from fractured Precambrian quartzite and individual discharges are all less than 75 liters per minute. The report also outlines the terms of reference for a longer term water-resources investigation of the region including staffing, housing and equipment requirements and other logistic support.

On configurational forces for gradient-enhanced inelasticity

NASA Astrophysics Data System (ADS)

Floros, Dimosthenis; Larsson, Fredrik; Runesson, Kenneth

2018-04-01

In this paper we discuss how configurational forces can be computed in an efficient and robust manner when a constitutive continuum model of gradient-enhanced viscoplasticity is adopted, whereby a suitably tailored mixed variational formulation in terms of displacements and micro-stresses is used. It is demonstrated that such a formulation produces sufficient regularity to overcome numerical difficulties that are notorious for a local constitutive model. In particular, no nodal smoothing of the internal variable fields is required. Moreover, the pathological mesh sensitivity that has been reported in the literature for a standard local model is no longer present. Numerical results in terms of configurational forces are shown for (1) a smooth interface and (2) a discrete edge crack. The corresponding configurational forces are computed for different values of the intrinsic length parameter. It is concluded that the convergence of the computed configurational forces with mesh refinement depends strongly on this parameter value. Moreover, the convergence behavior for the limit situation of rate-independent plasticity is unaffected by the relaxation time parameter.

Global models for synthetic fuels planning

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

Lamontagne, J.

1983-10-01

This study was performed to identify the set of existing global models with the best potential for use in the US Synthetic Fuels Corporation's strategic planning process, and to recommend the most appropriate model. The study was limited to global models with representations that encompass time horizons beyond the year 2000, multiple fuel forms, and significant regional detail. Potential accessibility to the Synthetic Fuels Corporation and adequate documentation were also required. Four existing models (LORENDAS, WIM, IIASA, and IEA/ORAU) were judged to be the best candidates for the SFC's use at this time; none of the models appears to bemore » ideal for the SFC's purposes. On the basis of currently available information, the most promising short-term option open to the SFC is the use of LORENDAS, with careful attention to definition of alternative energy demand scenarios. Longer-term options which deserve further study are coupling LORENDAS with an explicit model of energy demand, and modification of the IEA/ORAU model to include finer time-period definition and additional technological detail.« less

Application of Grey Model GM(1, 1) to Ultra Short-Term Predictions of Universal Time

NASA Astrophysics Data System (ADS)

Lei, Yu; Guo, Min; Zhao, Danning; Cai, Hongbing; Hu, Dandan

2016-03-01

A mathematical model known as one-order one-variable grey differential equation model GM(1, 1) has been herein employed successfully for the ultra short-term (<10days) predictions of universal time (UT1-UTC). The results of predictions are analyzed and compared with those obtained by other methods. It is shown that the accuracy of the predictions is comparable with that obtained by other prediction methods. The proposed method is able to yield an exact prediction even though only a few observations are provided. Hence it is very valuable in the case of a small size dataset since traditional methods, e.g., least-squares (LS) extrapolation, require longer data span to make a good forecast. In addition, these results can be obtained without making any assumption about an original dataset, and thus is of high reliability. Another advantage is that the developed method is easy to use. All these reveal a great potential of the GM(1, 1) model for UT1-UTC predictions.

Management of menopause in women with breast cancer.

PubMed

Vincent, A J

2015-10-01

Increasing breast cancer incidence and decreasing mortality have highlighted the importance of survivorship issues related to breast cancer. A consideration of the issues related to menopause is therefore of great importance to both women and clinicians. Menopause/menopausal symptoms, with significant negative effects on quality of life and potential long-term health impacts, may in women with breast cancer be associated with: (1) natural menopause occurring concurrently with a breast cancer diagnosis; (2) recurrence of menopausal symptoms following cessation of hormone replacement therapy; (3) treatment-induced menopause (chemotherapy, ovarian ablation/suppression) and adjuvant endocrine therapy. A variety of non-hormonal pharmacological and non-pharmacological therapies have been investigated as therapeutic options for menopausal symptoms with mixed results, and ongoing research is required. This review presents a summary of the causes, common problematic symptoms of menopause (vasomotor, genitourinary and sexual dysfunction), and longer-term consequences (cardiovascular disease and osteoporosis) related to menopause. It proposes an evidenced-based multidisciplinary approach to the management of menopause/menopausal symptoms in women with breast cancer.

An Evaluation of High Temperature Airframe Seals for Advanced Hypersonic Vehicles

NASA Technical Reports Server (NTRS)

DeMange, Jeffrey J.; Dunlap, Patrick H.; Steinetz, Bruce M.; Drlik, Gary J.

2007-01-01

High temperature seals are required for advanced hypersonic airframe applications. In this study, both spring tube thermal barriers and innovative wafer seal systems were evaluated under relevant hypersonic test conditions (temperatures, pressures, etc.) via high temperature compression testing and room temperature flow assessments. Thermal barriers composed of a Rene 41 spring tube filled with Saffil insulation and overbraided with a Nextel 312 sheath showed acceptable performance at 1500 F in both short term and longer term compression testing. Nextel 440 thermal barriers with Rene 41 spring tubes and Saffil insulation demonstrated good compression performance up to 1750 F. A silicon nitride wafer seal/compression spring system displayed excellent load performance at temperatures as high as 2200 F and exhibited room temperature leakage values that were only 1/3 those for the spring tube rope seals. For all seal candidates evaluated, no significant degradation in leakage resistance was noted after high temperature compression testing. In addition to these tests, a superalloy seal suitable for dynamic seal applications was optimized through finite element techniques.

Endovascular Treatment of Iatrogenic and Traumatic Carotid Artery Dissection

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

Schulte, Stefan; Donas, Konstantinos P., E-mail: k.donas@gmx.at; Pitoulias, Georgios A.

This paper reports on the early and midterm results of endovascular treatment of acute carotid artery dissections, its specific problems, and its limitations. We encountered seven patients with symptomatic extracranial carotid artery dissection, three cases of which occurred after carotid endarterectomy, two after carotid angioplasty and stenting, and two after trauma. Balloon-expandable and self-expanding stents were placed using a transfemoral approach. Success in restoring the carotid lumen was achieved in all patients. No procedure-related complications occurred. All patients experienced significant clinical improvement while in the hospital and achieved complete long-term recovery. At follow-up (mean, 22.4 months), good luminal patency ofmore » the stented segments was observed. In conclusion, in this small series, primary stent-supported angioplasty seems to be a safe and effective strategy in the treatment of selected patients having acute traumatic extracranial carotid artery dissection, with excellent early and midterm results. Larger series and longer-term follow-up are required before definitive recommendations can be made.« less

Experience of Care as a Critical Component of Health System Performance Measurement: Recommendations for Moving Forward.

PubMed

Kuluski, Kerry; Nelson, Michelle L A; Tracy, C Shawn; Alloway, Carole Ann; Shorrock, Charles; Shearkhani, Sara; Upshur, Ross E G

2017-10-01

People's experiences can provide critical guidance on how to better meet their quality of life and care needs and deploy resources more appropriately. To maximize the utility of experience data and to advance the current debate, we present four recommendations: (1) measuring experiences outside the healthcare system can provide insight into what needs to change within the healthcare system; (2) focusing on patient experience is necessary but insufficient, (family) caregiver insights and experiences require attention and can provide insight into the needs of the patient; (3) moving from "one time/single sector" measurement of experience to iterative, ongoing measurement across sectors better reflects the true lived experience of patients (especially those with complex care needs) and their caregivers; and (4) embedding measurement within engagement-capable environments that adequately resource patients, caregivers, and providers to work together is required to move from collection to meaningful change. Applying these recommendations requires a longer-term vision, shifting from provider-centred to person-centred models of care, and a deep understanding of the structural, cultural, and normative barriers to measuring care experiences. © 2017 Longwoods Publishing.

Investigating the Female Subaltern, Colonial Discourse and False Consciousness: A Spivakian Marxist-Postcolonialist Reading of Chinua Achebe's "Things Fall Apart" and "No Longer at Ease"

ERIC Educational Resources Information Center

Mostafaee, Jalal

2016-01-01

The present research study attempts to investigate Chinua Achebe's "Things Fall Apart" and "No Longer at Ease" in terms of Gayatri Spivak Marxist-Post colonialist conceptions of subaltern, colonial discourse and false consciousness. In Postmodernist fiction, there is anxiety that historical concerns such as the scale of…

Multiwavelength Opportunities for GeV and TeV Telescopes

NASA Technical Reports Server (NTRS)

Thompson, David J.

2010-01-01

With AGILE and Fermi now in orbit and TeV telescopes continuing to improve their performance, a variety of multiwavelength opportunities is increasingly available. One goal of such programs is to take advantage of the complementary capabilities of the two types of telescopes: the wide field surveys of the satellite detectors and the high sensitivity and resolution of the ground-based telescopes. Some aspects of these multiwavelength efforts will be carried out in near-real-time but must be anticipated with advance preparation. These include gamma-ray burst follow-ups and flare campaigns. Other projects such as long-term variability studies and gammaray source identification require deep observations and cooperative work with astrophysicists at longer wavelengths, along with the theoretical studies that tie the observations together.

Hydrographic Data Curation and Stewardship: GO-SHIP

NASA Astrophysics Data System (ADS)

Stephen, Diggs; Lynne, Talley; Martin, Kramp; Bernadette, Sloyan

2014-05-01

Expert data management (access, formats, data life-cycle) facilitates the successful re-use of information which address many important scientific questions such as detecting decadal and longer-term changes in global ocean heat and freshwater content. Modern hydrographic data management has its origins in the WOCE program where new and existing distributed resources were identified and organized into an effective "super DAC". Data from this program are referenced in hundreds of scientific papers. The distributed hydrographic data system, now under the name GO-SHIP, exists today and has adapted to the new geoscience demands of the 21st century. This presentation will describe science drivers and the required data center resources (CCHDO, CDIAC, JCOMMOPS) which together provide reliable access for the global research community.

A systemic approach to occupational and environmental health.

PubMed

Spitzer, Skip

2005-01-01

As the corporate role in occupational and public health receives increased scrutiny, it is essential to recognize that it is not sufficient to identify specific acts of malfeasance or influence, or even to campaign to address them. A more comprehensive and systemic framework for understanding the role of corporations requires consideration of corporate power and its effects as endemic features of national socioeconomic systems and the rapidly integrating global order. The underlying social structures that produce social and environmental problems, and undermine reform, make systemic change necessary. Identifying this "structure of harm" provides important implications for researchers, policymakers, activists, and others trying to address environmental and social problems, particularly with regard to integrating efforts to address immediate impacts with those for longer-term, systemic change.

Determinants of longer job tenure among home care aides: what makes some stay on the job while others leave?

PubMed

Butler, Sandra S; Brennan-Ing, Mark; Wardamasky, Sara; Ashley, Alison

2014-03-01

An inadequate supply of direct care workers and a high turnover rate in the workforce has resulted in a "care gap" in our long-term care system. As people are increasingly choosing community-based care, retention of home care workers is particularly important. The mixed-method study described herein explored determinants of longer job tenure for home care aides (n = 261). Study participants were followed for 18 months, completing two mail surveys and one telephone interview each. Predictors of longer job tenure included older age, living rurally, lower physical function, higher wages, a greater sense of autonomy on the job, and less frequent feelings of personal accomplishment. Thematic analysis of telephone interviews revealed long-term stayers to be less concerned about low wages and inconsistent hours than those who left their jobs within a year; both groups of workers reported high levels of job satisfaction. Policy implications of study findings are discussed.

Extending the timescale for using beryllium 7 measurements to document soil redistribution by erosion

NASA Astrophysics Data System (ADS)

Walling, D. E.; Schuller, P.; Zhang, Y.; Iroumé, A.

2009-02-01

The need for spatially distributed information on soil mobilization, transfer, and deposition within the landscape by erosion has focused attention on the potential for using fallout radionuclides (i.e., 137Cs, excess 210Pb, and 7Be) to document soil redistribution rates. Whereas 137Cs and excess 210Pb are used to estimate medium- and longer-term erosion rates (i.e., approximately 45 years and 100 years, respectively), 7Be, by virtue of its short half-life (53 days), provides potential for estimating short-term soil redistribution on bare soils. However, the approach commonly used with this radionuclide means that it can only be applied to individual events or short periods of heavy rain. In addition, it is also frequently difficult to ensure that the requirement for spatially uniform 7Be inventories across the study area immediately prior to the study period is met. If the existing approach is applied to longer periods with several rainfall events (e.g., several weeks or more) soil redistribution is likely to be substantially underestimated. These problems limit the potential for using the 7Be approach, particularly in investigations where there is a need to assemble representative information on soil redistribution occurring during the entire wet season. This paper reports the development of a new or refined model for converting radionuclide measurements to estimates of soil redistribution (conversion model) for use with 7Be measurements, which permits much longer periods to be studied. This refined model aims to retain much of the simplicity of the existing approach, but takes account of the temporal distribution of both 7Be fallout and erosion during the study period and of the evolution of the 7Be depth distribution during this period. The approach was successfully tested using 7Be measurements from a study of short-term soil redistribution undertaken within an area of recently harvested forest located near Valdivia in Southern Chile. The study period extended over about 3 months and included the main part of the winter wet season of 2006. The estimates of soil redistribution obtained using the new conversion model were consistent with those obtained from erosion pins deployed within the same study area and were two to three times greater than those obtained using the approach and conversion model employed in existing studies.

Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence.

PubMed

Bird, Mike; Anderson, Katrina; MacPherson, Sarah; Blair, Annaliese

2016-12-01

Common sense suggests and research indicates relationships between staff factors in residential dementia care and quality of life (QOL) for residents, with poor care increasing suffering. However, we do not have a coherent picture of which staff interventions have an impact on quality of care (QOC) or resident QOL. A comprehensive search of 20 years' peer-reviewed literature using Medline, PsycINFO, Embase, PubMed, CINAHL, and the Cochrane, Campbell Collaboration identified 4,760 studies meriting full text review. Forty-six met the inclusion criteria, namely interventions in long-term facilities helping staff develop their capacity to provide better care and/or QOL for residents with dementia. Thirty-five other papers comprised an associated predictor review. Conclusions from these limited data are further compromised because nine studies failed to measure effects on residents and only half assessed effects after the project team withdrew. Of these, excellent studies produced change over the medium (3-4 months) or longer term, including reduction in challenging behavior and restraint use but this applied only to a minority. A number of studies failed to measure effects on QOC, limiting conclusions about mechanisms underlying change. In general, level of intervention required depended on the target. For outcomes like restraint use, structured education sessions with some support appear adequate. Programs to reduce pain require more support. For complicated issues like challenging behavior and increasing co-operation in showering, detailed, supportive, on-site interventions are required. Improvements in restraint and staff/resident interactions were the most promising findings. (Review registration number: PROSPERO 2014:CRD42014015224).

Long-term precommercial thinning effects on Larix occidentalis (western larch) tree and stand characteristics

Treesearch

Michael S. Schaedel; Andrew J. Larson; David L. R. Affleck; R. Travis Belote; John M. Goodburn; David K. Wright; Elaine Kennedy Sutherland

2017-01-01

Precommercial thinning (PCT) is used to increase tree size and shorten harvest rotation time. Short-term results from PCT studies often show a trade-off between individual-tree growth and net stand yield, while longer-term effects of PCT on tree growth and stand yield are less well documented. We used a 54-year-old PCT study to test long-term effects of forest density...

Racial Disparities in Access to Care Under Conditions of Universal Coverage.

PubMed

Siddiqi, Arjumand A; Wang, Susan; Quinn, Kelly; Nguyen, Quynh C; Christy, Antony Dennis

2016-02-01

Racial disparities in access to regular health care have been reported in the U.S., but little is known about the extent of disparities in societies with universal coverage. To investigate the extent of racial disparities in access to care under conditions of universal coverage by observing the association between race and regular access to a doctor in Canada. Racial disparities in access to a regular doctor were calculated using the largest available source of nationally representative data in Canada--the Canadian Community Health Survey. Surveys from 2000-2010 were analyzed in 2014. Multinomial regression analyses predicted odds of having a regular doctor for each racial group compared to whites. Analyses were stratified by immigrant status--Canadian-born versus shorter-term immigrant versus longer-term immigrants--and controlled for sociodemographics and self-rated health. Racial disparities in Canada, a country with universal coverage, were far more muted than those previously reported in the U.S. Only among longer-term Latin American immigrants (OR=1.90, 95% CI=1.45, 2.08) and Canadian-born Aboriginals (OR=1.34, 95% CI=1.22, 1.47) were significant disparities noted. Among shorter-term immigrants, all Asians were more likely than whites, and among longer-term immigrants, South Asians were more like than whites, to have a regular doctor. Universal coverage may have a major impact on reducing racial disparities in access to health care, although among some subgroups, other factors may also play a role above and beyond health insurance. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Making the hard work of recovery more attractive for those with substance use disorders

PubMed Central

McKay, James R.

2016-01-01

Background Research has led to improvements in the effectiveness of interventions for substance use disorders (SUD), but for the most part progress has been modest, particularly with regard to longer-term outcomes. Moreover, most individuals with SUD do not seek out treatment. Argument/analysis This paper presents two recommendations on how to improve treatment engagement and long-term outcomes for those with SUD. First, treatments should go beyond a focus on reducing or eliminating substance use to target greater access to and more time spent in experiences that will be enjoyable or otherwise rewarding to clients. Second, there must be sufficient incentives in the environment to justify the effort needed to sustain long-term abstinence for individuals who often have limited access to such incentives. Conclusions To increase rates of long-term recovery from substance misuse, treatments should link clients to reinforcers that will make continued abstinence more appealing. This work needs to extend beyond interventions focused on the individual or family to include the local community and national policy in an effort to more strongly incentivize longer-term recoveries. PMID:27535787

Making the hard work of recovery more attractive for those with substance use disorders.

PubMed

McKay, James R

2017-05-01

Research has led to improvements in the effectiveness of interventions for substance use disorders (SUD), but for the most part progress has been modest, particularly with regard to longer-term outcomes. Moreover, most individuals with SUD do not seek out treatment. This paper presents two recommendations on how to improve treatment engagement and long-term outcomes for those with SUD. First, treatments should go beyond a focus on reducing or eliminating substance use to target greater access to and more time spent in experiences that will be enjoyable or otherwise rewarding to clients. Secondly, there must be sufficient incentives in the environment to justify the effort needed to sustain long-term abstinence for individuals who often have limited access to such incentives. To increase rates of long-term recovery from substance misuse, treatments should link clients to reinforcers that will make continued abstinence more appealing. This work needs to extend beyond interventions focused on the individual or family to include the local community and national policy in an effort to incentivize longer-term recoveries more strongly. © 2016 Society for the Study of Addiction.

3D bioprint me: a socioethical view of bioprinting human organs and tissues

PubMed Central

Vermeulen, Niki; Haddow, Gill; Seymour, Tirion; Faulkner-Jones, Alan; Shu, Wenmiao

2017-01-01

In this article, we review the extant social science and ethical literature on three-dimensional (3D) bioprinting. 3D bioprinting has the potential to be a ‘game-changer’, printing human organs on demand, no longer necessitating the need for living or deceased human donation or animal transplantation. Although the technology is not yet at the level required to bioprint an entire organ, 3D bioprinting may have a variety of other mid-term and short-term benefits that also have positive ethical consequences, for example, creating alternatives to animal testing, filling a therapeutic need for minors and avoiding species boundary crossing. Despite a lack of current socioethical engagement with the consequences of the technology, we outline what we see as some preliminary practical, ethical and regulatory issues that need tackling. These relate to managing public expectations and the continuing reliance on technoscientific solutions to diseases that affect high-income countries. Avoiding prescribing a course of action for the way forward in terms of research agendas, we do briefly outline one possible ethical framework ‘Responsible Research Innovation’ as an oversight model should 3D bioprinting promises are ever realised. 3D bioprinting has a lot to offer in the course of time should it move beyond a conceptual therapy, but is an area that requires ethical oversight and regulation and debate, in the here and now. The purpose of this article is to begin that discussion. PMID:28320774

Achilles' ear? Inferior human short-term and recognition memory in the auditory modality.

PubMed

Bigelow, James; Poremba, Amy

2014-01-01

Studies of the memory capabilities of nonhuman primates have consistently revealed a relative weakness for auditory compared to visual or tactile stimuli: extensive training is required to learn auditory memory tasks, and subjects are only capable of retaining acoustic information for a brief period of time. Whether a parallel deficit exists in human auditory memory remains an outstanding question. In the current study, a short-term memory paradigm was used to test human subjects' retention of simple auditory, visual, and tactile stimuli that were carefully equated in terms of discriminability, stimulus exposure time, and temporal dynamics. Mean accuracy did not differ significantly among sensory modalities at very short retention intervals (1-4 s). However, at longer retention intervals (8-32 s), accuracy for auditory stimuli fell substantially below that observed for visual and tactile stimuli. In the interest of extending the ecological validity of these findings, a second experiment tested recognition memory for complex, naturalistic stimuli that would likely be encountered in everyday life. Subjects were able to identify all stimuli when retention was not required, however, recognition accuracy following a delay period was again inferior for auditory compared to visual and tactile stimuli. Thus, the outcomes of both experiments provide a human parallel to the pattern of results observed in nonhuman primates. The results are interpreted in light of neuropsychological data from nonhuman primates, which suggest a difference in the degree to which auditory, visual, and tactile memory are mediated by the perirhinal and entorhinal cortices.

Zero-G life support for Space Station Freedom

NASA Technical Reports Server (NTRS)

Kolodney, Matthew; Dall-Bauman, L.

1992-01-01

Optimal design of spacecraft environmental control and life support systems (ECLSS) for long duration missions requires an understanding of microgravity and its long-term influence on ECLSS performance characteristics. This understanding will require examination of the fundamental processes associated with air revitalization and water recovery in a microgravity environment. Short term testing can be performed on NASA's reduced gravity aircraft (a KC-135), but longer tests will need to be conducted on the shuttle or Space Station Freedom. Conceptual designs have been prepared for ECLSS test beds that will allow extended testing of equipment under microgravity conditions. Separate designs have been formulated for air revitalization and water recovery test beds. In order to allow testing of a variety of hardware with minimal alteration of the beds themselves, the designs include storage tanks, plumbing, and limited instrumentation that would be expected to be common to all air (or water) treatment equipment of interest. In the interest of minimizing spacecraft/test bed interface requirements, the beds are designed to recycle process fluids to the greatest extent possible. In most cases, only cooling water and power interfaces are required. A volume equal to that of two SSF lockers was allowed for each design. These bed dimensions would limit testing to equipment with a 0.5- to 1.5-person-equivalent throughput. The mass, volume, and power requirements for the air revitalization test bed are estimated at 125-280 kg, 1.0- 1.4 cubic meters, and 170 min 1070 W. Corresponding ranges for the water recovery test bed are 325-375 kg, 1.0- 1.1 cubic meters, and 350-850 W. These figures include individual test articles and accompanying hardware as well as the tanks, plumbing, and instrumentation included in the bed designs. Process fluid weight (i.e., water weight) is also included.

Neural Protein Synthesis during Aging: Effects on Plasticity and Memory

PubMed Central

Schimanski, Lesley A.; Barnes, Carol A.

2010-01-01

During aging, many experience a decline in cognitive function that includes memory loss. The encoding of long-term memories depends on new protein synthesis, and this is also reduced during aging. Thus, it is possible that changes in the regulation of protein synthesis contribute to the memory impairments observed in older animals. Several lines of evidence support this hypothesis. For instance, protein synthesis is required for a longer period following learning to establish long-term memory in aged rodents. Also, under some conditions, synaptic activity or pharmacological activation can induce de novo protein synthesis and lasting changes in synaptic transmission in aged, but not young, rodents; the opposite results can be observed in other conditions. These changes in plasticity likely play a role in manifesting the altered place field properties observed in awake and behaving aged rats. The collective evidence suggests a link between memory loss and the regulation of protein synthesis in senescence. In fact, pharmaceuticals that target the signaling pathways required for induction of protein synthesis have improved memory, synaptic plasticity, and place cell properties in aged animals. We suggest that a better understanding of the mechanisms that lead to different protein expression patterns in the neural circuits that change as a function of age will enable the development of more effective therapeutic treatments for memory loss. PMID:20802800

Strengthening health information systems to address health equity challenges.

PubMed Central

Nolen, Lexi Bambas; Braveman, Paula; Dachs, J. Norberto W.; Delgado, Iris; Gakidou, Emmanuela; Moser, Kath; Rolfe, Liz; Vega, Jeanette; Zarowsky, Christina

2005-01-01

Special studies and isolated initiatives over the past several decades in low-, middle- and high-income countries have consistently shown inequalities in health among socioeconomic groups and by gender, race or ethnicity, geographical area and other measures associated with social advantage. Significant health inequalities linked to social (dis)advantage rather than to inherent biological differences are generally considered unfair or inequitable. Such health inequities are the main object of health development efforts, including global targets such as the Millennium Development Goals, which require monitoring to evaluate progress. However, most national health information systems (HIS) lack key information needed to assess and address health inequities, namely, reliable, longitudinal and representative data linking measures of health with measures of social status or advantage at the individual or small-area level. Without empirical documentation and monitoring of such inequities, as well as country-level capacity to use this information for effective planning and monitoring of progress in response to interventions, movement towards equity is unlikely to occur. This paper reviews core information requirements and potential databases and proposes short-term and longer term strategies for strengthening the capabilities of HIS for the analysis of health equity and discusses HIS-related entry points for supporting a culture of equity-oriented decision-making and policy development. PMID:16184279

A possible connection between thermal comfort and health

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

Stoops, John L.

It is a well-established fact that cardiovascular health requires periodic exercise during which the human body often experiences significant physical discomfort. It is not obvious to the exerciser that the short-term pain and discomfort has a long-term positive health impact. Many cultures have well-established practices that involve exposing the body to periodic thermal discomfort. Scandinavian saunas and American Indian sweat lodges are two examples. Both are believed to promote health and well-being. Vacations often intentionally include significant thermal discomfort as part of the experience (e.g., sunbathing, and downhill skiing). So people often intentionally make themselves thermally uncomfortable yet the entiremore » foundation of providing the thermal environment in our buildings is done to minimize the percentage of people thermally dissatisfied. We must provide an environment that does not negatively impact short-term health and we need to consider productivity but are our current thermal comfort standards too narrowly defined and do these standards actually contribute to longer-term negative health impacts? This paper examines the possibility that the human body thermoregulatory system has a corollary relationship to the cardiovascular system. It explores the possibility that we have an inherent need to exercise our thermoregulatory system. Potential, physiological, sociological and energy ramifications of these possibilities are discussed.« less

75 FR 75539 - Agency Information Collection Activities; Revision of a Currently-Approved Information Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

... Request: Training Certification for Drivers of Longer Combination Vehicles AGENCY: Federal Motor Carrier..., ``Training Certification for Drivers of Longer Combination Vehicles.'' This ICR is necessary because the training certificates drivers are required to present to prospective employers serve as proof the drivers...

Long-Term Biological Consequences of Nuclear War.

ERIC Educational Resources Information Center

Ehrlich, Paul R.; And Others

1983-01-01

Presents evidence suggesting that the longer-term biological effects resulting from climactic changes may be at least as serious as the immediate ones. Primarily considers results of a nuclear war in which sufficient dust/soot are injected into the atmosphere to attenuate most incident solar radiation. (JN)

12 CFR 370.5 - Participation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

12 CFR 370.5 - Participation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

12 CFR 370.5 - Participation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

12 CFR 370.5 - Participation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

Clinical outcomes of a 2-y soy isoflavone supplementation in menopausal women

USDA-ARS?s Scientific Manuscript database

Soy isoflavones are naturally occurring phytochemicals with weak estrogenic cellular effects. Despite numerous clinical trials of short-term isoflavone supplementation, there is a paucity of data regarding longer-term outcomes and safety. Our aim was to evaluate the clinical outcomes of soy hypocoty...

Value of Underground Storage in Today's Natural Gas Industry, The

EIA Publications

1995-01-01

This report explores the significant and changing role of storage in the industry by examining the value of natural gas storage; short-term relationships between prices, storage levels, and weather; and some longer term impacts of the Federal Energy Regulatory Commission's (FERC) Order 636.

Psychodynamic group psychotherapy: impact of group length and therapist professional characteristics on development of therapeutic alliance.

PubMed

Lorentzen, Steinar; Bakali, Jan Vegard; Hersoug, Anne Grete; Hagtvet, Knut A; Ruud, Torleif; Høglend, Per

2012-09-01

Little research has been done on therapeutic alliance in group psychotherapy, especially the impact of treatment duration and therapist professional characteristics. Therapeutic alliance was rated by patients on the Working Alliance Inventory-Short Form at three time points (sessions 3, 10 and 17) in a randomized controlled trial of short-term and long-term psychodynamic group psychotherapy. As predictors we selected therapist clinical experience and length of didactic training, which have demonstrated ambiguous results in previous research. Linear latent variable growth curve models (structural equation modeling) were developed for the three Working Alliance Inventory-Short Form subscales bond, task and goal. We found a significant variance in individual growth curves (intercepts and slopes) but no differential development due to group length. Longer therapist formal training had a negative impact on early values of subscale task in both treatments. There was an interaction between length of the therapists' clinical experience and group length on early bond, task and goal: therapists with longer clinical experience were rated lower on initial bond in the long-term group but less so in the short-term group. Longer clinical experience influenced initial task and goal positively in the short-term group but was unimportant for task or significantly negative for goal in the long-term group. There was no mean development of alliance, and group length did not differentially impact the alliance during 6 months. Early ratings of the three Working Alliance Inventory-Short Form subscales partly reflected different preparations of patients in the two group formats, partly therapist characteristics, but more research is needed to see how these aspects impact alliance development and outcome. Therapists should pay attention to all three aspects of the alliance, when they prepare patients for group therapy. In psychodynamic groups, length of therapy does not differentiate the overall level or the development of member-leader alliance. Within psychodynamic groups, each individual appear to have their unique perception of the member-leader alliance. Therapists with longer formal psychotherapy training may be less successful in establishing early agreement with patients on the tasks of psychodynamic group psychotherapy. Patients perceive a somewhat lower degree of early emotional bonding with the more clinically experienced therapists in long-term psychodynamics groups. Therapists with more clinical experience may contribute to a stronger degree of initial agreement with patients on the tasks and goals of short-term group psychotherapy. Copyright © 2011 John Wiley & Sons, Ltd.

Commercial kidney transplantation is an important risk factor in long-term kidney allograft survival.

PubMed

Prasad, G V Ramesh; Ananth, Sailesh; Palepu, Sneha; Huang, Michael; Nash, Michelle M; Zaltzman, Jeffrey S

2016-05-01

Transplant tourism, a form of transplant commercialization, has resulted in serious short-term adverse outcomes that explain reduced short-term kidney allograft survival. However, the nature of longer-term outcomes in commercial kidney transplant recipients is less clear. To study this further, we identified 69 Canadian commercial transplant recipients of 72 kidney allografts transplanted during 1998 to 2013 who reported to our transplant center for follow-up care. Their outcomes to 8 years post-transplant were compared with 702 domestic living donor and 827 deceased donor transplant recipients during this period using Kaplan-Meier survival plots and multivariate Cox regression analysis. Among many complications, notable specific events included hepatitis B or C seroconversion (7 patients), active hepatitis and/or fulminant hepatic failure (4 patients), pulmonary tuberculosis (2 patients), and a type A dissecting aortic aneurysm. Commercial transplantation was independently associated with significantly reduced death-censored kidney allograft survival (hazard ratio 3.69, 95% confidence interval 1.88-7.25) along with significantly delayed graft function and eGFR 30 ml/min/1.73 m(2) or less at 3 months post-transplant. Thus, commercial transplantation represents an important risk factor for long-term kidney allograft loss. Concerted arguments and efforts using adverse recipient outcomes among the main premises are still required in order to eradicate transplant commercialization. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Why continuous simulation? The role of antecedent moisture in design flood estimation

NASA Astrophysics Data System (ADS)

Pathiraja, S.; Westra, S.; Sharma, A.

2012-06-01

Continuous simulation for design flood estimation is increasingly becoming a viable alternative to traditional event-based methods. The advantage of continuous simulation approaches is that the catchment moisture state prior to the flood-producing rainfall event is implicitly incorporated within the modeling framework, provided the model has been calibrated and validated to produce reasonable simulations. This contrasts with event-based models in which both information about the expected sequence of rainfall and evaporation preceding the flood-producing rainfall event, as well as catchment storage and infiltration properties, are commonly pooled together into a single set of "loss" parameters which require adjustment through the process of calibration. To identify the importance of accounting for antecedent moisture in flood modeling, this paper uses a continuous rainfall-runoff model calibrated to 45 catchments in the Murray-Darling Basin in Australia. Flood peaks derived using the historical daily rainfall record are compared with those derived using resampled daily rainfall, for which the sequencing of wet and dry days preceding the heavy rainfall event is removed. The analysis shows that there is a consistent underestimation of the design flood events when antecedent moisture is not properly simulated, which can be as much as 30% when only 1 or 2 days of antecedent rainfall are considered, compared to 5% when this is extended to 60 days of prior rainfall. These results show that, in general, it is necessary to consider both short-term memory in rainfall associated with synoptic scale dependence, as well as longer-term memory at seasonal or longer time scale variability in order to obtain accurate design flood estimates.

Laparoscopic sleeve gastrectomy in patients with abdominoplasty: a case-control study.

PubMed

Saber, Alan A; Shoar, Saeed; El-Matbouly, Moamena; Karem, Mohsen; Bashah, Moataz M; Al Najjar, Ahmad; Alkuwari, Mohammad J; Soltanian, Hooman

2017-02-01

Abdominoplasty is increasingly performed after weight loss surgery. However, performing a laparoscopic sleeve gastrectomy (LSG) after abdominoplasty poses technical challenges. The present study aimed to compare operative events and postoperative outcomes between LSG patients with and without a history of prior abdominoplasty. University hospital, Qatar. A case-control study was conducted on 2 groups of patients with (n = 33) and without (n = 69) prior abdominoplasty who underwent LSG. Patient demographics, baseline characteristics, as well as operative and postoperative events were compared between the 2 groups. A total of 102 patients with an average age of 39.6±7.7 years and body mass index (BMI) of 42.8±5.9 kg/m 2 were included. There were no significant differences between the 2 groups in terms of demographic characteristics, preoperative BMI, and co-morbidities. The number of ports required was significantly higher in the LSG patients with a history of prior abdominoplasty than in the nonabdominoplasty patients. The operation time was also significantly longer in the abdominoplasty patients than in the nonabdominoplasty patients (90.3±36.7 minutes versus 57.1±17.7 minutes; P<.0001). However, no significant differences were observed in terms of postoperative complications, length of hospital stay, and weight loss results. LSG after abdominoplasty is associated with longer operative times and the need for additional port placement to overcome the decreased working space. However, operative strategies should be considered to overcome the technical challenges during LSG in patients who underwent a prior abdominoplasty. Copyright © 2017. Published by Elsevier Inc.

Regulation of substrate adhesion dynamics during cell motility.

PubMed

Kaverina, Irina; Krylyshkina, Olga; Small, J Victor

2002-07-01

The movement of a metazoan cell entails the regulated creation and turnover of adhesions with the surface on which it moves. Adhesion sites form as a result of signaling between the extracellular matrix on the outside and the actin cytoskeleton on the inside, and they are associated with specific assembles of actin filaments. Two broad categories of adhesion sites can be distinguished: (1) "focal complexes" associated with lamellipodia and filopodia that support protrusion and traction at the cell front; and (2) "focal adhesions" at the termini of stress fibre bundles that serve in longer term anchorage. Focal complexes are signaled via Rac1 or Cdc42 and can either turnover on a minute scale or differentiate, via intervention of the RhoA pathway, into longer-lived focal adhesions. All classes of adhesion sites depend on the stress in the actin cytoskeleton for their formation and maintenance. Different cell types use different adhesion strategies to move, in terms of the relative engagement of filopodia and lamellipodia in focal complex formation and protrusion and the extent of focal adhesion formation. These differences can be attributed to variations in the relative activities of Rho family members. However, the Rho GTPases alone are unable to signal asymmetry in the actin cytoskeleton, necessary for polarisation and movement. Polarisation requires the collaboration of the microtubule cytoskeleton. Changes in the polymerisation state of microtubules influences the activities of both Rac1 and RhoA and microtubules interact directly with adhesion foci and promote their turnover. Possible mechanisms of cross-talk between the microtubule and actin cytoskeletons in determining polarity are discussed.

Carbon amendment stimulates benthic nitrogen cycling during the bioremediation of particulate aquaculture waste

NASA Astrophysics Data System (ADS)

Robinson, Georgina; MacTavish, Thomas; Savage, Candida; Caldwell, Gary S.; Jones, Clifford L. W.; Probyn, Trevor; Eyre, Bradley D.; Stead, Selina M.

2018-03-01

The treatment of organic wastes remains one of the key sustainability challenges facing the growing global aquaculture industry. Bioremediation systems based on coupled bioturbation-microbial processing offer a promising route for waste management. We present, for the first time, a combined biogeochemical-molecular analysis of the short-term performance of one such system that is designed to receive nitrogen-rich particulate aquaculture wastes. Using sea cucumbers (Holothuria scabra) as a model bioturbator we provide evidence that adjusting the waste C : N from 5 : 1 to 20 : 1 promoted a shift in nitrogen cycling pathways towards the dissimilatory nitrate reduction to ammonium (DNRA), resulting in net NH4+ efflux from the sediment. The carbon amended treatment exhibited an overall net N2 uptake, whereas the control receiving only aquaculture waste exhibited net N2 production, suggesting that carbon supplementation enhanced nitrogen fixation. The higher NH4+ efflux and N2 uptake was further supported by meta-genome predictions that indicate that organic-carbon addition stimulated DNRA over denitrification. These findings indicate that carbon addition may potentially result in greater retention of nitrogen within the system; however, longer-term trials are necessary to determine whether this nitrogen retention is translated into improved sea cucumber biomass yields. Whether this truly constitutes a remediation process is open for debate as there remains the risk that any increased nitrogen retention may be temporary, with any subsequent release potentially raising the eutrophication risk. Longer and larger-scale trials are required before this approach may be validated with the complexities of the in-system nitrogen cycle being fully understood.

The Historical Context of the 2017 Hurricane Season's Ocean Warmth

NASA Astrophysics Data System (ADS)

Jacobs, P.; Akella, S.; Trenberth, K. E.; Lijing, C.; Abraham, J. P.

2017-12-01

Public discussion of the unusually active 2017 North Atlantic Hurricane Season quickly focused on the role of sea surface temperatures (SSTs) in the North Atlantic. Some meteorologists characterized them as near-normal, while climate-focused voices tended to characterize them as warmer than average, placing them in the context of anthropogenic warming. Much of this divergence in views can be explained by the relatively recent, relatively warm baseline (1981-2010) used for daily SST information, such as provided by OISSTv2. Longer term records of SSTs, such as HadISST, HadSST, and ERSST only attempt to provide monthly averages, while tropical cyclones have lifetimes on the timescale of days. Further, hurricanes create a cold wake which can impact storm movement and intensity, as well as subsequent storms, but is gradually wiped out by the sun. This process is further complicated by the role of ocean heat content (OHC), an increase in which can mitigate the impact of upwelled water. Here we examine the statistical characteristics of daily SSTs and OHC during the satellite record, including their temporal autocorrelation, and use this information in conjunction with longer term monthly records to bound what we can and cannot confidently say about the longer term historical context of the storms Harvey, Irma, and Maria.

Professionals' views of fetal-monitoring support the development of devices to provide objective longer-term assessment of fetal wellbeing.

PubMed

Brown, Rebecca; Johnstone, Edward D; Heazell, Alexander E P

2016-01-01

Continuous longer-term fetal monitoring has been proposed to address limitations of current technologies in the detection of fetal compromise. We aimed to assess professionals' views regarding current fetal-monitoring techniques and proposed longer-term continuous fetal monitoring. A questionnaire was designed and validated to assess obstetricians' and midwives' use of current fetal-monitoring techniques and their views towards continuous monitoring. 125 of 173 received responses (72% obstetricians, 28% midwives) were analysed. Professionals had the strongest views about supporting evidence for the most commonly employed fetal-monitoring techniques (maternal awareness of fetal movements, ultrasound assessment of fetal growth and umbilical artery Doppler). 45.1% of professionals agreed that a continuous monitoring device would be beneficial (versus 28.7% who disagreed); this perceived benefit was not influenced by professionals' views regarding current techniques or professional background. Professionals have limited experience of continuous fetal monitoring, but most respondents believed that it would increase maternal anxiety (64.3%) and would have concerns with its use in clinical practice (81.7%). Continuous fetal monitoring would be acceptable to the majority of professionals. However, development of these technologies must be accompanied by extended examination of professionals' and women's views to determine barriers to its introduction.

Continuous Timescale Long-Short Term Memory Neural Network for Human Intent Understanding

PubMed Central

Yu, Zhibin; Moirangthem, Dennis S.; Lee, Minho

2017-01-01

Understanding of human intention by observing a series of human actions has been a challenging task. In order to do so, we need to analyze longer sequences of human actions related with intentions and extract the context from the dynamic features. The multiple timescales recurrent neural network (MTRNN) model, which is believed to be a kind of solution, is a useful tool for recording and regenerating a continuous signal for dynamic tasks. However, the conventional MTRNN suffers from the vanishing gradient problem which renders it impossible to be used for longer sequence understanding. To address this problem, we propose a new model named Continuous Timescale Long-Short Term Memory (CTLSTM) in which we inherit the multiple timescales concept into the Long-Short Term Memory (LSTM) recurrent neural network (RNN) that addresses the vanishing gradient problem. We design an additional recurrent connection in the LSTM cell outputs to produce a time-delay in order to capture the slow context. Our experiments show that the proposed model exhibits better context modeling ability and captures the dynamic features on multiple large dataset classification tasks. The results illustrate that the multiple timescales concept enhances the ability of our model to handle longer sequences related with human intentions and hence proving to be more suitable for complex tasks, such as intention recognition. PMID:28878646

Long-term room temperature stability of TlBr gamma detectors

NASA Astrophysics Data System (ADS)

Conway, A. M.; Voss, L. F.; Nelson, A. J.; Beck, P. R.; Graff, R. T.; Nikolic, R. J.; Payne, S. A.; Kim, H.; Cirignano, L. J.; Shah, K.

2011-09-01

TlBr is a material of interest for use in room temperature gamma ray detector applications due to is wide bandgap 2.7 eV and high average atomic number (Tl 81, Br 35). Researchers have achieved energy resolutions of 1.3 % at 662 keV, demonstrating the potential of this material system. However, these detectors are known to polarize using conventional configurations, limiting their use. Continued improvement of room temperature, high-resolution gamma ray detectors based on TlBr requires further understanding of the degradation mechanisms. While high quality material is a critical starting point for excellent detector performance, we show that the room temperature stability of planar TlBr gamma spectrometers can be significantly enhanced by treatment with both hydrofluoric and hydrochloric acid. By incorporating F or Cl into the surface of TlBr, current instabilities are eliminated and the longer term current of the detectors remains unchanged. 241Am spectra are also shown to be more stable for extended periods; detectors have been held at 2000 V/cm for 52 days with less than 10% degradation in peak centroid position. In addition, evidence for the long term degradation mechanism being related to the contact metal is presented.

The OPTICON technology roadmap for optical and infrared astronomy

NASA Astrophysics Data System (ADS)

Cunningham, Colin; Melotte, David; Molster, Frank

2010-07-01

The Key Technology Network (KTN) within the OPTICON programme has been developing a roadmap for the technology needed to meet the challenges of optical and infrared astronomy over the next few years, with particular emphasis on the requirements of Extremely Large Telescopes. The process and methodology so far will be described, along with the most recent roadmap. The roadmap shows the expected progression of ground-based astronomy facilities and the technological developments which will be required to realise these new facilities. The roadmap highlights the key stages in the development of these technologies. In some areas, such as conventional optics, gradual developments in areas such as light-weighting of optics will slowly be adopted into future instruments. In other areas, such as large area IR detectors, more rapid progress can be expected as new processing techniques allow larger and faster arrays. Finally, other areas such as integrated photonics have the potential to revolutionise astronomical instrumentation. Future plans are outlined, in particular our intention to look at longer term development and disruptive technologies.

Space station propulsion requirements study

NASA Technical Reports Server (NTRS)

Wilkinson, C. L.; Brennan, S. M.

1985-01-01

Propulsion system requirements to support Low Earth Orbit (LEO) manned space station development and evolution over a wide range of potential capabilities and for a variety of STS servicing and space station operating strategies are described. The term space station and the overall space station configuration refers, for the purpose of this report, to a group of potential LEO spacecraft that support the overall space station mission. The group consisted of the central space station at 28.5 deg or 90 deg inclinations, unmanned free-flying spacecraft that are both tethered and untethered, a short-range servicing vehicle, and a longer range servicing vehicle capable of GEO payload transfer. The time phasing for preferred propulsion technology approaches is also investigated, as well as the high-leverage, state-of-the-art advancements needed, and the qualitative and quantitative benefits of these advancements on STS/space station operations. The time frame of propulsion technologies applicable to this study is the early 1990's to approximately the year 2000.

Report on ESA Topical Team on the Large Radius Human Centrifuge: "The Human Hypergravity Habitat; H3"

NASA Astrophysics Data System (ADS)

van Loon, Jack J. W. A.; Bücker, N.; Berte, J.; Bok, K.; Bos, J.; Boyle, R.; Bravenoer, N.; Chouker, A.; Clement, G.; Cras, P.; Denise, D.; Eekhoff, M.; Felsenberg, D.; Fong, K.; Fuller, C.; Groen, E.; Heer, M.; Hinghofer-Szalkay, H.; Iwase, S.; Karemaker, J. M.; Linnarsson, D.; Lüthen, C.; Narici, M.; Norsk, P.; Paloski, W.; Rutten, M.; Saggini, R.; Stephan, A.; Ullrich, O.; Vautmans, V.; Wuyts, F.; Young, L.

Over the last decades a significant amount of knowledge has been accumulated on the adap-tation of the human body going into near weightless conditions and on its re-adaptation to 1g Earth conditions after space flight. Ground-based paradigms for microgravity simulation have been developed such as head down tilted bed rest and dry-immersion. In such systems the adaptations to long term immobilization and to head-ward fluid shifts have been studied. Questions we address here are: can long-term ground-based centrifugation help us to under-stand and even predict the adaptations to long-term increased gravity conditions? How does the body adapt to chronic (days, weeks or longer) exposure to a hypergravity environment? And, once the body has fully adapted to a hypergravity environment, how does it re-adapt going from a hypergravity state back to a relatively hypo-gravity condition of 1g, or even going from a centrifuge / hypergravity environment into a bed-rest setting? Can such transitions in well-controlled studies bring us closer to understanding the consequences of gravity transitions that the crews will likely experience going to the Moon or to Mars. Is hypergravity a good model to study the effect of re-entry in gravitational environments after long duration space flight? In an ESA -supported Topical Team we address all organ systems known so far to change directly or indirectly by altered gravity conditions. We will identify to which gravity levels the human body can be exposed for longer periods of time and what protocols could be applied to address the questions at hand. We also identify the technology required to ac-complish such long duration hypergravity and re-adaptation studies. Issues like ethics, safety and required logistics should be addressed. As there is limited experience with exposure of hu-man test subjects to prolonged periods of moderately increased g-forces, unexpected harm may occur. Therefore, the information, disclosure and informed consent procedures need special attention. The final outcome of the Topical Team will be a clear answer about the feasibility of the use of hypergravity as a tool and analogue for space research, and if and how hypergravity studies can provide useful knowledge to support future space flight on the one hand and current medical issues in the ageing population (osteoporosis, cardiovascular diseases, obesity) on the other hand.

Increasing the interval between neoadjuvant chemoradiotherapy and surgery in esophageal cancer: a meta-analysis of published studies.

PubMed

Lin, G; Han, S-Y; Xu, Y-P; Mao, W-M

2016-11-01

The aim of this meta-analysis was to clarify whether a longer interval between the end of neoadjuvant chemoradiotherapy (nCRT) and surgery is associated with better outcomes in esophageal cancer. nCRT followed by surgery is the most common approach for patients with resectable esophageal cancer. Operations are performed within 2-8 weeks after nCRT; however, the optimal interval between nCRT and surgery for esophageal cancer is unknown. We performed a systematic literature search in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Clinical Trials database for studies published between January 2000 and December 2014. Eligible studies were prospective or retrospective studies of esophageal cancer that assessed the effects of intervals longer or shorter than 7-8 weeks between the end of nCRT and surgery. The primary end-points were the overall survival (OS) and pathologic complete response (pCR). Secondary end-points were anastomotic leak, R0 resection, and postoperative mortality rate. A meta-analysis was performed to estimate odds ratios (ORs) using fixed-effect and random-effect models, with Review Manager 5.2. The five studies that met the eligibility requirements included 1,016 patients: 520 in the shorter interval group (≤7-8 weeks) and 496 in the longer interval group (>7-8 weeks). The results of our meta-analysis indicate that a longer interval between nCRT and surgery may be disadvantageous for 2-year OS (OR = 1.40, 95% confidence interval [CI]: 1.09-1.80, P = 0.010) and R0 resection rate (OR = 1.71, 95% CI: 1.14-2.22, P = 0.009). The pCR, anastomotic leak rate, and postoperative morbidity were similar in the two groups. A longer interval (more than the standard 7-8 weeks) from the end of preoperative nCRT to surgery did not increase the rate of pCR in esophageal cancer, and the different intervals had similar effects on anastomotic leak rate and postoperative mortality rates. However, the longer interval between nCRT and surgery may be disadvantageous for long-term OS. These results should be validated prospectively in a randomized trial. © 2015 International Society for Diseases of the Esophagus.

Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

PubMed

Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, José Miguel; Cardoso, Graça; King, Michael

2012-01-01

The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these settings may promote service users' autonomy.

24 CFR 578.51 - Rental assistance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... months of rent; medium-term, for 3 to 24 months of rent; or long-term, for longer than 24 months of rent... been a victim of domestic violence, dating violence, sexual assault, or stalking, and who reasonably believe they are imminently threatened by harm from further domestic violence, dating violence, sexual...

24 CFR 578.51 - Rental assistance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... months of rent; medium-term, for 3 to 24 months of rent; or long-term, for longer than 24 months of rent... been a victim of domestic violence, dating violence, sexual assault, or stalking, and who reasonably believe they are imminently threatened by harm from further domestic violence, dating violence, sexual...

ModSAF-based development of operational requirements for light armored vehicles

NASA Astrophysics Data System (ADS)

Rapanotti, John; Palmarini, Marc

2003-09-01

Light Armoured Vehicles (LAVs) are being developed to meet the modern requirements of rapid deployment and operations other than war. To achieve these requirements, passive armour is minimized and survivability depends more on sensors, computers, countermeasures and communications to detect and avoid threats. The performance, reliability, and ultimately the cost of these systems, will be determined by the technology trends and the rates at which they mature. Defining vehicle requirements will depend upon an accurate assessment of these trends over a longer term than was previously needed. Modelling and simulation are being developed to study these long-term trends and how they contribute to establishing vehicle requirements. ModSAF is being developed for research and development, in addition to the original requirement of Simulation and Modelling for Acquisition, Rehearsal, Requirements and Training (SMARRT), and is becoming useful as a means for transferring technology to other users, researchers and contractors. This procedure eliminates the need to construct ad hoc models and databases. The integration of various technologies into a Defensive Aids Suite (DAS) can be designed and analyzed by combining field trials and laboratory data with modelling and simulation. ModSAF (Modular Semi-Automated Forces,) is used to construct the virtual battlefield and, through scripted input files, a "fixed battle" approach is used to define and implement contributions from three different sources. These contributions include: models of technology and natural phenomena from scientists and engineers, tactics and doctrine from the military and detailed analyses from operations research. This approach ensures the modelling of processes known to be important regardless of the level of information available about the system. Survivability of DAS-equipped vehicles based on future and foreign technology can be investigated by ModSAF and assessed relative to a test vehicle. A vehicle can be modelled phenomenologically until more information is available. These concepts and approach will be discussed in the paper.

Understanding phonological memory deficits in boys with attention-deficit/hyperactivity disorder (ADHD): dissociation of short-term storage and articulatory rehearsal processes.

PubMed

Bolden, Jennifer; Rapport, Mark D; Raiker, Joseph S; Sarver, Dustin E; Kofler, Michael J

2012-08-01

The current study dissociated and examined the two primary components of the phonological working memory subsystem--the short-term store and articulatory rehearsal mechanism--in boys with ADHD (n = 18) relative to typically developing boys (n = 15). Word lists of increasing length (2, 4, and 6 words per trial) were presented to and recalled by children following a brief (3 s) interval to assess their phonological short-term storage capacity. Children's ability to utilize the articulatory rehearsal mechanism to actively maintain information in the phonological short-term store was assessed using word lists at their established memory span but with extended rehearsal times (12 s and 21 s delays). Results indicate that both phonological shortterm storage capacity and articulatory rehearsal are impaired or underdeveloped to a significant extent in boys with ADHD relative to typically developing boys, even after controlling for age, SES, IQ, and reading speed. Larger magnitude deficits, however, were apparent in short-term storage capacity (ES = 1.15 to 1.98) relative to articulatory rehearsal (ES = 0.47 to 1.02). These findings are consistent with previous reports of deficient phonological short-term memory in boys with ADHD, and suggest that future attempts to develop remedial cognitive interventions for children with ADHD will need to include active components that require children to hold increasingly more information over longer time intervals.

Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study.

PubMed

Dobbie, Fiona; Hiscock, Rosemary; Leonardi-Bee, Jo; Murray, Susan; Shahab, Lion; Aveyard, Paul; Coleman, Tim; McEwen, Andy; McRobbie, Hayden; Purves, Richard; Bauld, Linda

2015-11-01

NHS Stop Smoking Services (SSSs) provide free at the point of use treatment for smokers who would like to stop. Since their inception in 1999 they have evolved to offer a variety of support options. Given the changes that have happened in the provision of services and the ongoing need for evidence on effectiveness, the Evaluating Long-term Outcomes for NHS Stop Smoking Services (ELONS) study was commissioned. The main aim of the study was to explore the factors that determine longer-term abstinence from smoking following intervention by SSSs. There were also a number of additional objectives. The ELONS study was an observational study with two main stages: secondary analysis of routine data collected by SSSs and a prospective cohort study of service clients. The prospective study had additional elements on client satisfaction, well-being and longer-term nicotine replacement therapy (NRT) use. The setting for the study was SSSs in England. For the secondary analysis, routine data from 49 services were obtained. For the prospective study and its added elements, nine services were involved. The target population was clients of these services. There were 202,804 cases included in secondary analysis and 3075 in the prospective study. A combination of behavioural support and stop smoking medication delivered by SSS practitioners. Abstinence from smoking at 4 and 52 weeks after setting a quit date, validated by a carbon monoxide (CO) breath test. Just over 4 in 10 smokers (41%) recruited to the prospective study were biochemically validated as abstinent from smoking at 4 weeks (which was broadly comparable with findings from the secondary analysis of routine service data, where self-reported 4-week quit rates were 48%, falling to 34% when biochemical validation had occurred). At the 1-year follow-up, 8% of prospective study clients were CO validated as abstinent from smoking. Clients who received specialist one-to-one behavioural support were twice as likely to have remained abstinent than those who were seen by a general practitioner (GP) practice and pharmacy providers [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.2 to 4.6]. Clients who received group behavioural support (either closed or rolling groups) were three times more likely to stop smoking than those who were seen by a GP practice or pharmacy providers (OR 3.4, 95% CI 1.7 to 6.7). Satisfaction with services was high and well-being at baseline was found to be a predictor of abstinence from smoking at longer-term follow-up. Continued use of NRT at 1 year was rare, but no evidence of harm from longer-term use was identified from the data collected. Stop Smoking Services in England are effective in helping smokers to move away from tobacco use. Using the 52-week CO-validated quit rate of 8% found in this study, we estimate that in the year 2012-13 the services supported 36,249 clients to become non-smokers for the remainder of their lives. This is a substantial figure and provides one indicator of the ongoing value of the treatment that the services provide. The study raises a number of issues for future research including (1) examining the role of electronic cigarettes (e-cigarettes) in smoking cessation for service clients [this study did not look at e-cigarette use (except briefly in the longer-term NRT study) but this is a priority for future studies]; (2) more detailed comparisons of rolling groups with other forms of behavioural support; (3) further exploration of the role of practitioner knowledge, skills and use of effective behaviour change techniques in supporting service clients to stop smoking; (4) surveillance of the impact of structural and funding changes on the future development and sustainability of SSSs; and (5) more detailed analysis of well-being over time between those who successfully stop smoking and those who relapse. Further research on longer-term use of non-combustible nicotine products that measures a wider array of biomarkers of smoking-related harm such as lung function tests or carcinogen metabolites. The National Institute for Health Research Health Technology Assessment programme. The UK Centre for Tobacco and Alcohol Studies provided funding for the longer-term NRT study.

40 CFR 1065.410 - Maintenance limits for stabilized test engines.

Code of Federal Regulations, 2013 CFR

2013-07-01

... engineering grade tools to identify bad engine components. Any equipment, instruments, or tools used for... no longer use it as an emission-data engine. Also, if your test engine has a major mechanical failure... your test engine has a major mechanical failure that requires you to take it apart, you may no longer...

40 CFR 1065.410 - Maintenance limits for stabilized test engines.

Code of Federal Regulations, 2012 CFR

2012-07-01

... engineering grade tools to identify bad engine components. Any equipment, instruments, or tools used for... no longer use it as an emission-data engine. Also, if your test engine has a major mechanical failure... your test engine has a major mechanical failure that requires you to take it apart, you may no longer...

Double-blind optimization of subcallosal cingulate deep brain stimulation for treatment-resistant depression: a pilot study.

PubMed

Ramasubbu, Rajamannar; Anderson, Susan; Haffenden, Angela; Chavda, Swati; Kiss, Zelma H T

2013-09-01

Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is reported to be a safe and effective new treatment for treatment-resistant depression (TRD). However, the optimal electrical stimulation parameters are unknown and generally selected by trial and error. This pilot study investigated the relationship between stimulus parameters and clinical effects in SCC-DBS treatment for TRD. Four patients with TRD underwent SCC-DBS surgery. In a double-blind stimulus optimization phase, frequency and pulse widths were randomly altered weekly, and corresponding changes in mood and depression were evaluated using a visual analogue scale (VAS) and the 17-item Hamilton Rating Scale for Depression (HAM-D-17). In the open-label postoptimization phase, depressive symptoms were evaluated biweekly for 6 months to determine long-term clinical outcomes. Longer pulse widths (270-450 μs) were associated with reductions in HAM-D-17 scores in 3 patients and maximal happy mood VAS responses in all 4 patients. Only 1 patient showed acute clinical or mood effects from changing the stimulation frequency. After 6 months of open-label therapy, 2 patients responded and 1 patient partially responded. Limitations include small sample size, weekly changes in stimulus parameters, and fixed-order and carry-forward effects. Longer pulse width stimulation may have a role in stimulus optimization for SCC-DBS in TRD. Longer pulse durations produce larger apparent current spread, suggesting that we do not yet know the optimal target or stimulus parameters for this therapy. Investigations using different stimulus parameters are required before embarking on large-scale randomized sham-controlled trials.

Army Logistician. Volume 41, Issue 4, July-August 2009

DTIC Science & Technology

2009-08-01

misuse the terms associated with targeting to fit sustainment, we run the risk of misusing the original term when it is used in the context of lethal...but as the term became a “catch- all” for Army operations, the original concept lost its intended purpose. We no longer use the term because of its...the detriment of its original purpose in Army plan- ning and operations. Rather than change terminology, the sustainment community needs to focus on

Strange Words: Autistic Traits and the Processing of Non-Literal Language.

PubMed

McKenna, Peter E; Glass, Alexandra; Rajendran, Gnanathusharan; Corley, Martin

2015-11-01

Previous investigations into metonymy comprehension in ASD have confounded metonymy with anaphora, and outcome with process. Here we show how these confounds may be avoided, using data from non-diagnosed participants classified using Autism Quotient. Participants read sentences containing target words with novel or established metonymic senses (e.g., Finland, Vietnam) in literal- or figurative-supporting contexts. Participants took longer to read target words in figurative contexts, especially where the metonymic sense was novel. Importantly, participants with higher AQs took longer still to read novel metonyms. This suggests a focus for further exploration, in terms of potential differences between individuals diagnosed with ASD and their neurotypical counterparts, and more generally in terms of the processes by which comprehension is achieved.

Social Memory Formation Rapidly and Differentially Affects the Motivation and Performance of Vocal Communication Signals in the Bengalese Finch (Lonchura striata var. domestica).

PubMed

Toccalino, Danielle C; Sun, Herie; Sakata, Jon T

2016-01-01

Cognitive processes like the formation of social memories can shape the nature of social interactions between conspecifics. Male songbirds use vocal signals during courtship interactions with females, but the degree to which social memory and familiarity influences the likelihood and structure of male courtship song remains largely unknown. Using a habituation-dishabituation paradigm, we found that a single, brief (<30 s) exposure to a female led to the formation of a short-term memory for that female: adult male Bengalese finches were significantly less likely to produce courtship song to an individual female when re-exposed to her 5 min later (i.e., habituation). Familiarity also rapidly decreased the duration of courtship songs but did not affect other measures of song performance (e.g., song tempo and the stereotypy of syllable structure and sequencing). Consistent with a contribution of social memory to the decrease in courtship song with repeated exposures to the same female, the likelihood that male Bengalese finches produced courtship song increased when they were exposed to a different female (i.e., dishabituation). Three consecutive exposures to individual females also led to the formation of a longer-term memory that persisted over days. Specifically, when courtship song production was assessed 2 days after initial exposures to females, males produced fewer and shorter courtship songs to familiar females than to unfamiliar females. Measures of song performance, however, were not different between courtship songs produced to familiar and unfamiliar females. The formation of a longer-term memory for individual females seemed to require at least three exposures because males did not differentially produce courtship song to unfamiliar females and females that they had been exposed to only once or twice. Taken together, these data indicate that brief exposures to individual females led to the rapid formation and persistence of social memories and support the existence of distinct mechanisms underlying the motivation to produce and the performance of courtship song.

Cognitive outcome in childhood of birth weight discordant monochorionic twins: the long-term effects of fetal growth restriction.

PubMed

Swamy, Ravi Shankar; McConachie, Helen; Ng, Jane; Rankin, Judith; Korada, Murthy; Sturgiss, Stephen; Embleton, Nicholas D

2018-03-02

Intrauterine growth restriction (IUGR) is associated with poorer outcomes in later life. We used a monochorionic twin model with IUGR in one twin to determine its impact on growth and neurocognitive outcomes. Monochorionic twins with ≥20% birth weight discordance born in the north of England were eligible. Cognitive function was assessed using the British Ability Scales. The Strength and Difficulties Questionnaire was used to identify behavioural problems. Auxological measurements were collected. Generalised estimating equations were used to determine the effects of birth weight on cognition. Fifty-one monochorionic twin pairs were assessed at a mean age of 6.3 years. Mean birth weight difference was 664 g at a mean gestation of 34.7 weeks. The lighter twin had a General Conceptual Ability (GCA) score that was three points lower (Twin L -105.4 vs Twin H -108.4, 95% CI -0.9 to -5.0), and there was a significant positive association (B 0.59) of within-pair birth weight differences and GCA scores. Mathematics and memory skills showed the largest differences. The lighter twin at school age was shorter (mean difference 2.1 cm±0.7) and lighter (mean difference 1.9 kg±0.6). Equal numbers of lighter and heavier twins were reported to have behavioural issues. In a monochorionic twin cohort, fetal growth restriction results in lower neurocognitive scores in early childhood, and there remain significant differences in size. Longer term follow-up will be required to determine whether growth or cognitive differences persist in later child or adulthood, and whether there are any associated longer term metabolic sequelae. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Clinical value of chest pain presentation and prodromes on the assessment of cardiovascular disease: a cohort study.

PubMed

Robson, John; Ayerbe, Luis; Mathur, Rohini; Addo, Juliet; Wragg, Andrew

2015-04-15

The recognition of coronary artery disease (CAD) among patients who report chest pain remains difficult in primary care. This study investigates the association between chest pain (specified, unspecified or musculoskeletal) and prodromes (dyspepsia, fatigue or dyspnoea), with first-ever acute CAD, and increased longer term cardiovascular risk. Cohort study. Anonymised clinical data recorded electronically by general practitioners from 140 primary care surgeries in London (UK) between April 2008 and April 2013. Data were extracted for all patients aged 30 years and over at the beginning of the study period, registered in the surgeries. Clinical data included chest pain, dyspepsia, dyspnoea and fatigue, first-ever CAD and long-term cardiovascular risk (QRisk2). Regression models were used to analyse the association between chest pain together with prodromes and CAD and QRisk2≥20%. 354,052 patients were included in the study. 4842 patients had first-ever CAD of which 270 reported chest pain in the year before the acute event. 257,019 patients had QRisk2 estimations. Chest pain was associated with a higher risk of CAD. HRs: 21.12 (16.68 to 26.76), p<0.001; 7.51 (6.49 to 8.68), p<0.001; and 1.84 (1.14 to 3.00), p<0.001 for specified, unspecified and musculoskeletal chest pain. Dyspepsia, dyspnoea or fatigue was also associated with a higher risk of CAD. Chest pain of all subtypes, dyspepsia and dyspnoea were also associated with an increased 10-year cardiovascular risk of 20% or more. All patients with chest pain, including those with atypical symptoms, require careful assessment for acute and longer term cardiovascular risk. Prodromes may have independent diagnostic value in the estimation of cardiovascular disease risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Radiocesium in migratory aquatic game birds using contaminated U.S. Department of Energy reactor-cooling reservoirs: A long-term perspective.

PubMed

Kennamer, Robert A; Oldenkamp, Ricki E; Leaphart, James C; King, Joshua D; Bryan, A Lawrence; Beasley, James C

2017-05-01

Low-level releases of radiocesium into former nuclear reactor cooling-reservoirs on the U.S. Department of Energy's Savannah River Site (SRS) in South Carolina, USA, dating primarily to the late 1950s and early 1960s, have allowed examination of long-term contaminant attenuation in biota occupying these habitats. Periodic collections of migratory game birds since the 1970s have documented 137 Cs (radiocesium) activity concentrations in birds of SRS reservoirs, including mainly Par Pond and Pond B. In this study, during 2014 and 2015 we released wild-caught American coots (Fulica americana) and ring-necked ducks (Aythya collaris) onto Pond B. We made lethal collections of these same birds with residence times ranging from 32 to 173 days to examine radiocesium uptake and estimate the rate of natural attenuation. The two species achieved asymptotic whole-body activity concentrations of radiocesium at different times, with ring-necked ducks requiring almost three times longer than the 30-35 days needed by coots. We estimated ecological half-life (T e ) for Pond B coots over a 28-yr period as 16.8 yr (95% CI = 12.9-24.2 yr). Pond B coot T e was nearly four times longer than T e for coots at nearby Par Pond where radiocesium bioavailability had been constrained for decades by pumping of potassium-enriched river water into that reservoir. T e could not be estimated from long-term data for radiocesium in Pond B diving ducks, including ring-necked ducks, likely because of high variability in residence times of ducks on Pond B. Our results highlight the importance: (1) for risk managers to understand site-specific bio-geochemistry of radiocesium for successful implementation of countermeasures at contaminated sites and (2) of residence time as a critical determinant of observed radiocesium activity concentrations in highly mobile wildlife inhabiting contaminated habitats. Copyright © 2017 Elsevier Ltd. All rights reserved.

Spatial and temporal variations in landscape evolution: historic and longer-term sediment flux through global catchments

USGS Publications Warehouse

Covault, Jacob A.; Craddock, William H.; Romans, Brian W.; Fildani, Andrea; Gosai, Mayur

2013-01-01

Sediment generation and transport through terrestrial catchments influence soil distribution, geochemical cycling of particulate and dissolved loads, and the character of the stratigraphic record of Earth history. To assess the spatiotemporal variation in landscape evolution, we compare global compilations of stream gauge–derived () and cosmogenic radionuclide (CRN)–derived (predominantly 10Be; ) denudation of catchments (mm/yr) and sediment load of rivers (Mt/yr). Stream gauges measure suspended sediment loads of rivers during several to tens of years, whereas CRNs provide catchment-integrated denudation rates at 102–105-yr time scales. Stream gauge–derived and CRN-derived sediment loads in close proximity to one another (<500 km) exhibit broad similarity ( stream gauge samples; CRN samples). Nearly two-thirds of CRN-derived sediment loads exceed historic loads measured at the same locations (). Excessive longer-term sediment loads likely are a result of longer-term recurrence of large-magnitude sediment-transport events. Nearly 80% of sediment loads measured at approximately the same locations exhibit stream gauge loads that are within an order of magnitude of CRN loads, likely as a result of the buffering capacity of large flood plains. Catchments in which space for deposition exceeds sediment supply have greater buffering capacity. Superior locations in which to evaluate anthropogenic influences on landscape evolution might be buffered catchments, in which temporary storage of sediment in flood plains can provide stream gauge–based sediment loads and denudation rates that are applicable over longer periods than the durations of gauge measurements. The buffering capacity of catchments also has implications for interpreting the stratigraphic record; delayed sediment transfer might complicate the stratigraphic record of external forcings and catchment modification.

Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders

NASA Technical Reports Server (NTRS)

Slack, Kelley J.; Schneiderman, Jason S.; Leveton, Lauren B.; Whitmire, Alexandra M.; Picano, James J.

2015-01-01

The NASA commitment to human space flight includes continuing to fly astronauts on the ISS until it is decommissioned as well as possibly returning astronauts to the moon or having astronauts venture to an asteroid or Mars. As missions leave low Earth orbit and explore deeper space, BHP supports and conducts research to enable a risk posture that considers the risk of adverse cognitive or behavioral conditions and psychiatric disorders “acceptable given mitigations,” for pre-, in, and post-flight.The Human System Risk Board (HSRB) determines the risk of various mission scenarios using a likelihood (per person per year) by consequences matrix examining those risks across two categories—long term health and operational (within mission). Colors from a stoplight signal are used by HSRB and quickly provide a means of assessing overall perceived risk for a particular mission scenario. Risk associated with the current six month missions on the ISS are classified as “accepted with monitoring” while planetary missions, such as a mission to Mars, are recognized to be a “red” risk that requires mitigation to ensure mission success.Currently, the HSRB deems that the risk of adverse cognitive or behavioral conditions and psychiatric outcomes requires mitigation for planetary missions owing to long duration isolation and radiation exposure (see Table 1). While limited research evidence exists from spaceflight, it is well known anecdotally that the shift from the two week shuttle missions to the six month ISS missions renders the psychological stressors of space as more salient over longer duration missions. Shuttle astronauts were expected just to tolerate any stressors that arose during their mission and were successful at doing so (Whitmire et al, 2013). While it is possible to deal with stressors such as social isolation and to live with incompatible crewmembers for two weeks on shuttle, “ignoring it” is much less likely to be a successful coping mechanism on station. For the longer missions of the ISS, astronauts require a larger, more robust set of coping skills and more psychological support. Evidence of this are the number of BHP’s Operational Psychology (Op Psy) staff who have been awarded silver Snoopys by long duration astronauts†, in the statements of praise for the Op Psy and Family Support Office teams, and in the written and oral statements from flown astronauts regarding difficulty of longer missions and how much Op Psy helped.

 Alkaline phosphatase normalization is a biomarker of improved survival in primary sclerosing cholangitis.

PubMed

Hilscher, Moira; Enders, Felicity B; Carey, Elizabeth J; Lindor, Keith D; Tabibian, James H

2016-01-01

 Introduction. Recent studies suggest that serum alkaline phosphatase may represent a prognostic biomarker in patients with primary sclerosing cholangitis. However, this association remains poorly understood. Therefore, the aim of this study was to investigate the prognostic significance and clinical correlates of alkaline phosphatase normalization in primary sclerosing cholangitis. This was a retrospective cohort study of patients with a new diagnosis of primary sclerosing cholangitis made at an academic medical center. The primary endpoint was time to hepatobiliaryneoplasia, liver transplantation, or liver-related death. Secondary endpoints included occurrence of and time to alkaline phosphatase normalization. Patients who did and did not achieve normalization were compared with respect to clinical characteristics and endpoint-free survival, and the association between normalization and the primary endpoint was assessed with univariate and multivariate Cox proportional-hazards analyses. Eighty six patients were included in the study, with a total of 755 patient-years of follow-up. Thirty-eight patients (44%) experienced alkaline phosphatase normalization within 12 months of diagnosis. Alkaline phosphatase normalization was associated with longer primary endpoint-free survival (p = 0.0032) and decreased risk of requiring liver transplantation (p = 0.033). Persistent normalization was associated with even fewer adverse endpoints as well as longer survival. In multivariate analyses, alkaline phosphatase normalization (adjusted hazard ratio 0.21, p = 0.012) and baseline bilirubin (adjusted hazard ratio 4.87, p = 0.029) were the only significant predictors of primary endpoint-free survival. Alkaline phosphatase normalization, particularly if persistent, represents a robust biomarker of improved long-term survival and decreased risk of requiring liver transplantation in patients with primary sclerosing cholangitis.

Technical note: Design flood under hydrological uncertainty

NASA Astrophysics Data System (ADS)

Botto, Anna; Ganora, Daniele; Claps, Pierluigi; Laio, Francesco

2017-07-01

Planning and verification of hydraulic infrastructures require a design estimate of hydrologic variables, usually provided by frequency analysis, and neglecting hydrologic uncertainty. However, when hydrologic uncertainty is accounted for, the design flood value for a specific return period is no longer a unique value, but is represented by a distribution of values. As a consequence, the design flood is no longer univocally defined, making the design process undetermined. The Uncertainty Compliant Design Flood Estimation (UNCODE) procedure is a novel approach that, starting from a range of possible design flood estimates obtained in uncertain conditions, converges to a single design value. This is obtained through a cost-benefit criterion with additional constraints that is numerically solved in a simulation framework. This paper contributes to promoting a practical use of the UNCODE procedure without resorting to numerical computation. A modified procedure is proposed by using a correction coefficient that modifies the standard (i.e., uncertainty-free) design value on the basis of sample length and return period only. The procedure is robust and parsimonious, as it does not require additional parameters with respect to the traditional uncertainty-free analysis. Simple equations to compute the correction term are provided for a number of probability distributions commonly used to represent the flood frequency curve. The UNCODE procedure, when coupled with this simple correction factor, provides a robust way to manage the hydrologic uncertainty and to go beyond the use of traditional safety factors. With all the other parameters being equal, an increase in the sample length reduces the correction factor, and thus the construction costs, while still keeping the same safety level.

Flame Retardant Fibers for Human Space Exploration - Past, Present, and Future

NASA Technical Reports Server (NTRS)

Orndoff, Evelyne

2017-01-01

The National Aeronautics and Space Administration (NASA) has led the development of unique flame retardant fibers for the specific requirements of different space programs. Three of these fibers have greatly contributed to the safety of all the space missions since the Apollo program. Beta alumina-silica microfiber developed for the outer layer of the space suit after the Apollo 1 fire is no longer used and has been replaced by other glass fibers. Expanded polytetrafluoroethylene (e-PTFE) fiber used in the current spacesuit is mostly known today through its trade mark Gore-Tex®. Polybenzimidazole (PBI) filament fiber used in many applications from the Apollo to the Space Shuttle program is no longer available. More recently, TOR"TM" copolymer of polyimide fiber developed during the space shuttle program to resist the atomic oxygen present in Low Earth Orbit has been barely used. The high cost and narrow range of aeronautical and aerospace applications have, however, led to a limited production of these fibers. Only fibers that found niche markets survived. Yet, deep space exploration will require more of these inherently flame retardant fibers than what is available today. There is a need for new flame retardant fabrics inside the space vehicles as well as a need for logistics reduction for long term space missions. Materials like modacrylic and polyimide are good candidates for future flame retardant aerospace fabrics. New fabrics must be developed for astronauts' clothing, as well as crew quarters and habitat. Therefore, both staple and filament fibers of various linear densities are needed for a three years mission to Mars.

[Cost-effectiveness of laparoscopic versus open cholecystectomy].

PubMed

Fajardo, Roosevelt; Valenzuela, José Ignacio; Olaya, Sandra Catalina; Quintero, Gustavo; Carrasquilla, Gabriel; Pinzón, Carlos Eduardo; López, Catalina; Ramírez, Juan Camilo

2011-01-01

Cholecystectomy has been the subject of several clinical and cost comparison studies. The results of open or laparoscopy cholecystectomy were compared in terms of cost and effectiveness from the perspective of health care institutions and from that of the patients. The cost-effectiveness study was undertaken at two university hospitals in Bogotá, Colombia. The approach was to select the type of cholecystectomy retrospectively and then assess the result prospectively. The cost analysis used the combined approach of micro-costs and daily average cost. Patient resource consumption was gathered from the time of surgery room entry to time of discharge. A sample of 376 patients with cholelithiasis/cystitis (May 2005-June 2006) was selected--156 underwent open cholecystectomy and 220 underwent laparoscopic cholecystectomy. The following data were tabulated: (1) frequency of complications and mortality, post-surgical hospital stay, (2) reincorporation to daily activities, (3) surgery duration, (4) direct medical costs, (5) costs to the patient, and (6) mean and incremental cost-effectiveness ratios. Frequency of complications was 13.5% for open cholecystectomy and 6.4% for laparoscopic cholecystectomy (p=0.02); hospital stay was longer in open cholecystectomy than in laparoscopic cholecystectomy (p=0.003) as well as the reincorporation to daily activities reported by the patients (p<0.001). The duration of open cholecystectomy was 22 min longer than laparoscopic cholecystectomy (p<0.001). The average cost of laparoscopic cholecystectomy was lower than open cholecystectomy and laparoscopic cholecystectomy was more cost-effective than open cholecystectomy (US$ 995 vs. US$ 1,048, respectively). The patient out-of-pocket expenses were greater in open cholecystectomy compared to laparoscopic cholecystectomy (p=0.015). Mortality was zero. The open laparoscopy procedure was associated with longer hospital stays, where as the cholecystectomy procedure required a longer surgical duration. The direct cost of the latter was lower for both for the health care institution and patients. The cost-effectiveness for both procedures was comparable.

Feasibility study of a take-home array-based functional electrical stimulation system with automated setup for current functional electrical stimulation users with foot-drop.

PubMed

Prenton, Sarah; Kenney, Laurence P; Stapleton, Claire; Cooper, Glen; Reeves, Mark L; Heller, Ben W; Sobuh, Mohammad; Barker, Anthony T; Healey, Jamie; Good, Timothy R; Thies, Sibylle B; Howard, David; Williamson, Tracey

2014-10-01

To investigate the feasibility of unsupervised community use of an array-based automated setup functional electrical stimulator for current foot-drop functional electrical stimulation (FES) users. Feasibility study. Gait laboratory and community use. Participants (N=7) with diagnosis of unilateral foot-drop of central neurologic origin (>6mo) who were regular users of a foot-drop FES system (>3mo). Array-based automated setup FES system for foot-drop (ShefStim). Logged usage, logged automated setup times for the array-based automated setup FES system and diary recording of problems experienced, all collected in the community environment. Walking speed, ankle angles at initial contact, foot clearance during swing, and the Quebec User Evaluation of Satisfaction with Assistive Technology version 2.0 (QUEST version 2.0) questionnaire, all collected in the gait laboratory. All participants were able to use the array-based automated setup FES system. Total setup time took longer than participants' own FES systems, and automated setup time was longer than in a previous study of a similar system. Some problems were experienced, but overall, participants were as satisfied with this system as their own FES system. The increase in walking speed (N=7) relative to no stimulation was comparable between both systems, and appropriate ankle angles at initial contact (N=7) and foot clearance during swing (n=5) were greater with the array-based automated setup FES system. This study demonstrates that an array-based automated setup FES system for foot-drop can be successfully used unsupervised. Despite setup's taking longer and some problems, users are satisfied with the system and it would appear as effective, if not better, at addressing the foot-drop impairment. Further product development of this unique system, followed by a larger-scale and longer-term study, is required before firm conclusions about its efficacy can be reached. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Hemiarch versus total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis

PubMed Central

Poon, Shi Sum; Theologou, Thomas; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung

2016-01-01

Background Despite recent advances in aortic surgery, acute type A aortic dissection remains a surgical emergency associated with high mortality and morbidity. Appropriate management is crucial to achieve satisfactory outcomes but the optimal surgical approach is controversial. The present systematic review and meta-analysis sought to access cumulative data from comparative studies between hemiarch and total aortic arch replacement in patients with acute type A aortic dissection. Methods A systematic review of the literature using six databases. Eligible studies include comparative studies on hemiarch versus total arch replacement reporting short, medium and long term outcomes. A meta-analysis was performed on eligible studies reporting outcome of interest to quantify the effects of hemiarch replacement on mortality and morbidity risk compared to total arch replacement. Result Fourteen retrospective studies met the inclusion criteria and 2,221 patients were included in the final analysis. Pooled analysis showed that hemiarch replacement was associated with a lower risk of post-operative renal dialysis [risk ratio (RR) =0.72; 95% confidence interval (CI): 0.56–0.94; P=0.02; I2=0%]. There was no significant difference in terms of in-hospital mortality between the two groups (RR =0.84; 95% CI: 0.65–1.09; P=0.20; I2=0%). Cardiopulmonary bypass, aortic cross clamp and circulatory arrest times were significantly longer in total arch replacement. During follow up, no significant difference was reported from current studies between the two operative approaches in terms of aortic re-intervention and freedom from aortic reoperation. Conclusions Within the context of publication bias by high volume aortic centres and non-randomized data sets, there was no difference in mortality outcomes between the two groups. This analysis serves to demonstrate that for those centers doing sufficient total aortic arch activity to allow for publication, excellent and equivalent outcomes are achievable. Conclusions on differences in longer term outcome data are required. We do not, however, advocate total arch as a primary approach by all centers and surgeons irrespective of patient characteristics, but rather, a tailored approach based on surgeon and center experience and patient presentation. PMID:27386403

Steady, modest slip over multiple earthquake cycles on the Owens Valley and Little Lake fault zones

NASA Astrophysics Data System (ADS)

Amos, C. B.; Haddon, E. K.; Burgmann, R.; Zielke, O.; Jayko, A. S.

2015-12-01

A comprehensive picture of current plate-boundary deformation requires integration of short-term geodetic records with longer-term geologic strain. Comparing rates of deformation across these time intervals highlights potential time-dependencies in both geodetic and geologic records and yields critical insight into the earthquake deformation process. The southern Walker Lane Belt in eastern California represents one location where short-term strain recorded by geodesy apparently outpaces longer-term geologic fault slip measured from displaced rocks and landforms. This discrepancy persists both for individual structures and across the width of the deforming zone, where ~1 cm/yr of current dextral shear exceeds Quaternary slip rates summed across individual faults. The Owens Valley and Little Lake fault systems form the western boundary of the southern Walker Lane and host a range of published slip rate estimates from ~1 - 7 mm/yr over varying time intervals based on both geodetic and geologic measurements. New analysis of offset geomorphic piercing lines from airborne lidar and field measurements along the Owens Valley fault provides a snapshot of deformation during individual earthquakes and over many seismic cycles. Viewed in context of previously reported ages from pluvial and other landforms in Owens Valley, these offsets suggest slip rates of ~0.6 - 1.6 mm/yr over the past 103 - 105 years. Such rates agree with similar estimates immediately to the south on the Little Lake fault, where lidar measurements indicate dextral slip averaging ~0.6 - 1.3 mm/yr over comparable time intervals. Taken together, these results suggest steady, modest slip in the absence of significant variations over the Mid-to-Late Quaternary for a ~200 km span of the southwestern Walker Lane. Our findings argue against the presence of long-range fault interactions and slip-rate variations for this portion of the larger, regional fault network. This result also suggests that faster slip-rate estimates from geodetic measurements reflect transients over much shorter time scales. Additionally, the persistence of relatively faster geodetic shear in comparison with time-averaged fault slip leaves open the possibility of significant off-fault deformation or slip on subsidiary structures across the Owens Valley.

Detection time for global and regional sea level trends and accelerations

NASA Astrophysics Data System (ADS)

Jordà, G.

2014-10-01

Many studies analyze trends on sea level data with the underlying purpose of finding indications of a long-term change that could be interpreted as the signature of anthropogenic climate change. The identification of a long-term trend is a signal-to-noise problem where the natural variability (the "noise") can mask the long-term trend (the "signal"). The signal-to-noise ratio depends on the magnitude of the long-term trend, on the magnitude of the natural variability, and on the length of the record, as the climate noise is larger when averaged over short time scales and becomes smaller over longer averaging periods. In this paper, we evaluate the time required to detect centennial sea level linear trends and accelerations at global and regional scales. Using model results and tide gauge observations, we find that the averaged detection time for a centennial linear trend is 87.9, 76.0, 59.3, 40.3, and 25.2 years for trends of 0.5, 1.0, 2.0, 5.0, and 10.0 mm/yr, respectively. However, in regions with large decadal variations like the Gulf Stream or the Circumpolar current, these values can increase up to a 50%. The spatial pattern of the detection time for sea level accelerations is almost identical. The main difference is that the length of the records has to be about 40-60 years longer to detect an acceleration than to detect a linear trend leading to an equivalent change after 100 years. Finally, we have used a new sea level reconstruction, which provides a more accurate representation of interannual variability for the last century in order to estimate the detection time for global mean sea level trends and accelerations. Our results suggest that the signature of natural variability in a 30 year global mean sea level record would be less than 1 mm/yr. Therefore, at least 2.2 mm/yr of the recent sea level trend estimated by altimetry cannot be attributed to natural multidecadal variability. This article was corrected on 19 NOV 2014. See the end of the full text for details.

Mixing Appropriations and Private Financing to Meet Federal Energy Management Goals

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

Shonder, John A

2012-06-01

This report compares several strategies for mixing appropriations and private financing in a typical federal agency that has identified $100 million in required energy conservation measures (ECMs) at its facilities. The analysis shows that in order to maximize savings and minimize overall life-cycle cost, the best strategy for the agency is to use private financing to fund as many of the ECMs as possible within the statutory maximum 25-year project term, beginning with the ECMs with the shortest paybacks. Available appropriations should either be applied to a privately financed project as a one-time payment from savings (i.e., as a buydownmore » ) or used to directly fund longer-payback ECMs that cannot be included in the privately financed project.« less

Analysis of Impulse Load on VEGA SRM Nozzle During Ignition Transient and Effects on TVC Actuators

NASA Astrophysics Data System (ADS)

Fotino, Domenico; Leofanti, Jose Luis; Serraglia, Ferruccio

2012-07-01

During the VEGA development phase and in particular during the Zefiro 23 (second stage motor) on-ground firing tests, values of impulse load on the actuators very close to the requirement were experienced. As a consequence, an activity for the extrapolation of these loads in the flight configuration (longer nozzle and vacuum conditions) was carried out and a mathematical model has been developed with this aim. After providing an overview on the differences between the ground and flight case from the fluid dynamic point of view, the paper describes the results of the mathematical model both in terms of correlation with respect to ground tests and of extrapolation of the loads to the flight configuration. The main effects of this load on the actuators is also addressed.

The balance of protein expression and degradation: an ESCRTs point of view.

PubMed

Babst, Markus; Odorizzi, Greg

2013-08-01

Endosomal sorting complexes required for transport (ESCRTs) execute the biogenesis of late endosomal multivesicular bodies (MVBs). The ESCRT pathway has traditionally been viewed as a means by which transmembrane proteins are degraded in vacuoles/lysosomes. More recent studies aimed at understanding the broader functions of ESCRTs have uncovered unexpected links with pathways that control cellular metabolism. Central to this communication is TORC1, the kinase complex that controls many of the catabolic and anabolic systems. The connection between TORC1 activity and ESCRTs allows cells to quickly adapt to the stress of nutrient limitations until the longer-term autophagic pathway is activated. Increasing evidence also points to ESCRTs regulating RNA interference (RNAi) pathways that control translation. Copyright © 2013 Elsevier Ltd. All rights reserved.

The North American Energy System: Overview of the 3rd Chapter of SOCCR-2

NASA Astrophysics Data System (ADS)

Marcotullio, P. J.

2016-12-01

North America, including Canada, Mexico and the United States, has a large and complex energy system, which includes the extraction and conversion of primary energy sources and their storage, transmission, distribution and ultimate end use in the building, transportation and industrial sectors. The chapter overviews this system focusing on our understanding of the energy trends and system feedback dynamics, key drivers of change, and subsequent carbon emissions and the basis for carbon management. We also put the carbon emissions from the North American system in global context. Highlights include the changes to the system (sources, fuel mix, drivers, infrastructure, etc.,) over the past decade, and a review of scenarios that provide glimpses into future emissions levels and meeting the requirements for decarbonization in the medium and longer term.

Atmospheric composition - Influence of biology

NASA Technical Reports Server (NTRS)

Mcelroy, M. B.

1983-01-01

The variability of atmospheric constituents influenced by biological organisms over various time scales is examined, together with the human contribution to atmospheric sulfur. The biogeochemistry of nitrogen is discussed, with an emphasis on N2O, NO, and microbially mediated reactions in soil and water. Carbon species are bound up mainly in sediments and the deep ocean, but human activities involving combustion may cause a doubling of the atmospheric levels of CO2 in the near future, which could produce a general low-level atmospheric warming. Longer term measurements are required to assess the effects of CH4 augmentation in the atmosphere through fuel combustion. Coal burning effectively doubles the amount of SO2 produced by natural sources, and reduces the pH of rainwater, thus posing hazards to fish, plankton, and mollusc life.

Like your labels?

PubMed

Field, Michele

2010-01-01

The descriptive “conventions” used on food labels are always evolving. Today, however, the changes are so complicated (partly driven by legislation requiring disclosures about environmental impacts, health issues, and geographical provenance) that these labels more often baffle buyers than enlighten them. In a light-handed manner, the article points to how sometimes reading label language can be like deciphering runes—and how if we are familiar with the technical terms, we can find a literal meaning, but still not see the implications. The article could be ten times longer because food labels vary according to cultures—but all food-exporting cultures now take advantage of our short attention-span when faced with these texts. The question is whether less is more—and if so, in this contest for our attention, what “contestant” is voted off.

49 CFR 383.115 - Requirements for double/triple trailers endorsement.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS COMMERCIAL DRIVER'S LICENSE STANDARDS; REQUIREMENTS AND PENALTIES Required Knowledge and Skills... problems the motor vehicle creates for other motorists due to slower speeds on steep grades, longer passing...

Evaluative Processing of Food Images: A Conditional Role for Viewing in Preference Formation

PubMed Central

Wolf, Alexandra; Ounjai, Kajornvut; Takahashi, Muneyoshi; Kobayashi, Shunsuke; Matsuda, Tetsuya; Lauwereyns, Johan

2018-01-01

Previous research suggested a role of gaze in preference formation, not merely as an expression of preference, but also as a causal influence. According to the gaze cascade hypothesis, the longer subjects look at an item, the more likely they are to develop a preference for it. However, to date the connection between viewing and liking has been investigated predominately with self-paced viewing conditions in which the subjects were required to select certain items from simultaneously presented stimuli on the basis of perceived visual attractiveness. Such conditions might promote a default, but non-mandatory connection between viewing and liking. To explore whether the connection is separable, we examined the evaluative processing of single naturalistic food images in a 2 × 2 design, conducted completely within subjects, in which we varied both the type of exposure (self-paced versus time-controlled) and the type of evaluation (non-exclusive versus exclusive). In the self-paced exclusive evaluation, longer viewing was associated with a higher likelihood of a positive evaluation. However, in the self-paced non-exclusive evaluation, the trend reversed such that longer viewing durations were associated with lesser ratings. Furthermore, in the time-controlled tasks, both with non-exclusive and exclusive evaluation, there was no significant relationship between the viewing duration and the evaluation. The overall pattern of results was consistent for viewing times measured in terms of exposure duration (i.e., the duration of stimulus presentation on the screen) and in terms of actual gaze duration (i.e., the amount of time the subject effectively gazed at the stimulus on the screen). The data indicated that viewing does not intrinsically lead to a higher evaluation when evaluating single food images; instead, the relationship between viewing duration and evaluation depends on the type of task. We suggest that self-determination of exposure duration may be a prerequisite for any influence from viewing time on evaluative processing, regardless of whether the influence is facilitative. Moreover, the purported facilitative link between viewing and liking appears to be limited to exclusive evaluation, when only a restricted number of items can be included in a chosen set. PMID:29942273

Evaluative Processing of Food Images: A Conditional Role for Viewing in Preference Formation.

PubMed

Wolf, Alexandra; Ounjai, Kajornvut; Takahashi, Muneyoshi; Kobayashi, Shunsuke; Matsuda, Tetsuya; Lauwereyns, Johan

2018-01-01

Previous research suggested a role of gaze in preference formation, not merely as an expression of preference, but also as a causal influence. According to the gaze cascade hypothesis, the longer subjects look at an item, the more likely they are to develop a preference for it. However, to date the connection between viewing and liking has been investigated predominately with self-paced viewing conditions in which the subjects were required to select certain items from simultaneously presented stimuli on the basis of perceived visual attractiveness. Such conditions might promote a default, but non-mandatory connection between viewing and liking. To explore whether the connection is separable, we examined the evaluative processing of single naturalistic food images in a 2 × 2 design, conducted completely within subjects, in which we varied both the type of exposure (self-paced versus time-controlled) and the type of evaluation (non-exclusive versus exclusive). In the self-paced exclusive evaluation, longer viewing was associated with a higher likelihood of a positive evaluation. However, in the self-paced non-exclusive evaluation, the trend reversed such that longer viewing durations were associated with lesser ratings. Furthermore, in the time-controlled tasks, both with non-exclusive and exclusive evaluation, there was no significant relationship between the viewing duration and the evaluation. The overall pattern of results was consistent for viewing times measured in terms of exposure duration (i.e., the duration of stimulus presentation on the screen) and in terms of actual gaze duration (i.e., the amount of time the subject effectively gazed at the stimulus on the screen). The data indicated that viewing does not intrinsically lead to a higher evaluation when evaluating single food images; instead, the relationship between viewing duration and evaluation depends on the type of task. We suggest that self-determination of exposure duration may be a prerequisite for any influence from viewing time on evaluative processing, regardless of whether the influence is facilitative. Moreover, the purported facilitative link between viewing and liking appears to be limited to exclusive evaluation, when only a restricted number of items can be included in a chosen set.

75 FR 58285 - Short-Term, Small Amount Loans

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... believed that a longer term was necessary to enable borrowers to pay back a loan in small, more manageable... drive borrowers back to payday lenders. After considering these comments the Board has determined to... for a higher number of loans, the Board disagrees that a limited number of loans will push borrowers...

An Assessment of the Effects of the Endocrine Disrupting Chemical 17ß-Trenbolone on Japanese Medaka Fish in a Multigenerational Exposure

EPA Science Inventory

Presently the research emphasis for endocrine disrupting chemicals has been on the development of short-term screening assays. However, assessing effect concentrations of the most sensitive developmental stages impacted in longer-term and multi-generation tests remains to be det...

Working Together Internationally

ERIC Educational Resources Information Center

Freedman, Terry

2009-01-01

To a large extent, schools encourage collaboration all the time, especially in countries such as the United States, Britain, and Australia. Much of what goes on in schools is fairly short-term. There are, however, an increasing number of teachers who are seeing the potential value in longer-term projects in which students have to work together.…

26 CFR 1.7702B-2 - Special rules for pre-1997 long-term care insurance contracts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... defined in section 4 of the National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance Model Act, as in effect on August 21, 1996), regardless of the terminology used by the State in... actually becomes effective is substantially longer than under the insurance company's usual business...

An Integrated Model of Choices and Response Times in Absolute Identification

ERIC Educational Resources Information Center

Brown, Scott D.; Marley, A. A. J.; Donkin, Christopher; Heathcote, Andrew

2008-01-01

Recent theoretical developments in the field of absolute identification have stressed differences between relative and absolute processes, that is, whether stimulus magnitudes are judged relative to a shorter term context provided by recently presented stimuli or a longer term context provided by the entire set of stimuli. The authors developed a…

Mining. Industry Training Monograph No. 2.

ERIC Educational Resources Information Center

Dumbrell, Tom

Mining is the second smallest industry division in terms both of employment and number of business units in Australia. Employment accounts for less than 1 percent of all jobs. The outlook for employment is clouded by continuing uncertainty in Australia's main Asian markets and by the longer-term impact of environmental concerns. Mining industry…

Hawai'i Youth at Risk? Conceptual Challenges in Communicating a Statewide Mentoring Initiative.

ERIC Educational Resources Information Center

Pollard, Vincent Kelly

This paper discusses several issues considered as part of a statewide mentoring initiative. It is divided into three sections. The first section summarizes the key issues associated with short-term mentoring and mentoring in a longer-term, socially transformative context. Data from Comprehensive School Alienation Program is discussed concerning…

Impacts of insect biological control on soil N transformations in Tamarix-invaded ecosystems in the Great Basin, USA

USDA-ARS?s Scientific Manuscript database

Understanding the impacts of insect biological control of Tamarix spp. on soil nitrogen (N) transformations is important because changes to N supply could alter plant community succession. We investigated short-term and longer-term impacts of herbivory by the northern tamarisk beetle (Diorhabda cari...

Impacts of insect biological control on soil N transformations in Tamarix-invaded ecosystems in the Great Basin

USDA-ARS?s Scientific Manuscript database

Understanding the impacts of insect biological control of Tamarix spp. on soil nitrogen (N) transformations is important because changes to N supply could alter plant community succession. We investigated short-term and longer-term impacts of herbivory by the northern tamarisk beetle (Diorhabda cari...

Making Decisions in a Time of Fiscal Stringency: The Longer-Term Implications.

ERIC Educational Resources Information Center

Bowen, Frank M.

The concept of traditional planning, programming, and budgeting systems (PPBS) is defined and compared with imperative planning, a term used to refer to whatever procedures higher education officials use to integrate program planning and budgeting. The University of Wisconsin system is described as an example of emerging budgetary practice in…

Long-term outcomes of forest restoration in an urban park

Treesearch

Brady L. Simmons; Richard A. Hallett; Nancy Falxa Sonti; D. S. N. Auyeung; Jacqueline W. T. Lu

2016-01-01

Creating, restoring, and sustaining forests in urban areas are complicated by habitat fragmentation, invasive species, and degraded soils. Although there is some research on the outcomes of urban reforestation plantings during the first 5 years, there is little research on longer term outcomes. Here, we compare the successional trajectories of restored and unrestored...

Can Oregon marshes keep up with the rising tide? A study of short and long term marsh accretion - CERF 2015

EPA Science Inventory

More frequent inundation of Oregon coastal marshlands associated with rising sea level threatens these important and diverse habitats. Accretion rates determined by the marker horizon method and longer term peak Cs137 detection in nine marsh systems from Coquille to Tillamook we...

Can Oregon Marshes Keep Up With The Rising Tide? A Study of Short and Long Term Marsh Accretion.

EPA Science Inventory

More frequent inundation of Oregon coastal marshlands associated with rising sea level threatens these important and diverse habitats. Study plot accretion rates determined by the marker horizon method and longer term peak Cs137 detection in eight marsh systems from Coquille to ...

Involuntary Attention and Physiological Arousal Evoked by Structural Features and Emotional Content in TV Commercials.

ERIC Educational Resources Information Center

Lang, Annie

1990-01-01

Examines how emotional content in televised messages intensifies physiological attentional responses. Explains that heart rate data indicating both shorter-term responses and longer-term arousal were collected from 10 female and 4 male advertising students. Finds that emotional content increases physiological arousal in viewers and that heart…

76 FR 12648 - Lowering Miners' Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... be appropriate to use on a short-term basis. 13. The proposed rule addresses (1) which occupations... for respirable coal mine dust, provide for full- shift sampling, redefine the term ``normal production... respect to their availability. If shorter or longer timeframes are recommended, please provide the...

Do we care about sustainability? An analysis of time sensitivity of social preferences under environmental time-persistent effects.

PubMed

Faccioli, Michela; Hanley, Nick; Torres, Cati; Font, Antoni Riera

2016-07-15

Environmental cost-benefit analysis has traditionally assumed that the value of benefits is sensitive to their timing and that outcomes are valued higher, the sooner in time they occur following implementation of a project or policy. Though, this assumption might have important implications especially for the social desirability of interventions aiming at counteracting time-persistent environmental problems, whose impacts occur in the long- and very long-term, respectively involving the present and future generations. This study analyzes the time sensitivity of social preferences for preservation policies of adaptation to climate change stresses. Results show that stated preferences are time insensitive, due to sustainability issues: individuals show insignificant differences in benefits they can experience within their own lifetimes compared to those which occur in the longer term, and which will instead be enjoyed by future generations. Whilst these results may be specific to the experimental design employed here, they do raise interesting questions regarding choices over time-persistent environmental problems, particularly in terms of the desirability of interventions which produce longer-term benefits. Copyright © 2016 Elsevier Ltd. All rights reserved.

Laparoscopic and open subtotal colectomies have similar short-term results.

PubMed

Hoogenboom, Froukje J; Bosker, Robbert J I; Groen, Henk; Meijerink, Wilhelmus J H J; Lamme, Bas; Pierie, Jean Pierre E N

2013-01-01

Laparoscopic subtotal colectomy (STC) is a complex procedure. It is possible that short-term benefits for segmental resections cannot be attributed to this complex procedure. This study aims to assess differences in short-term results for laparoscopic versus open STC during a 15-year single-institute experience. We reviewed consecutive patients undergoing laparoscopic or open elective or subacute STC from January 1997 to December 2012. Fifty-six laparoscopic and 50 open STCs were performed. The operation time was significantly longer in the laparoscopic group, median 266 min (range 121-420 min), compared to 153 min (range 90-408 min) in the open group (p < 0.001). Median hospital stay showed no statistical difference, 14 days (range 1-129 days) in the laparoscopic and 13 days (range 1-85 days) in the open group. Between-group postoperative complications were not statistically different. Laparoscopic STC has short-term results similar to the open procedure, except for a longer operation time. The laparoscopic approach for STC is therefore only advisable in selected patients combined with extensive preoperative counseling. Copyright © 2013 S. Karger AG, Basel.

Long-term EEG in patients with the ring chromosome 20 epilepsy syndrome.

PubMed

Freire de Moura, Maria; Flores-Guevara, Roberto; Gueguen, Bernard; Biraben, Arnaud; Renault, Francis

2016-05-01

The recognizable electroencephalography (EEG) pattern of ring chromosome 20 epilepsy syndrome can be missing in patients with r(20) chromosomal anomaly, and may be found in patients with frontal lobe epilepsy of other origin. This study aims to search for more specific EEG signs by using long-term recordings and measuring the duration of paroxysmal anomalies. The series included 12 adult patients with r(20) anomaly, and 12 controls without any chromosomal aberration. We measured the duration of every paroxysmal burst and calculated the sum of their durations for each long-term EEG recording. We compared patients to controls using the Mann-Whitney U-test. Every patient showed long-lasting paroxysmal EEG bursts, up to 60 min; controls did not show any bursts longer than 60 s (p < 0.0001). The total duration of paroxysmal anomalies was significantly longer in patients (31-692 min) compared to controls (0-48 min) (p < 0.0001). Thus, long-term recordings enhance the contribution of EEG methods for characterizing the ring 20 chromosome epilepsy syndrome. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Acute and Chronic Stress: The Effects of Loss of Control

DTIC Science & Technology

1996-07-31

stressor affecting the health and well-being of the unemployed and their families. This study was designed to test how loss of control associated with...status: short-term ( unemployed for less than two months); long-term ( unemployed for longer than two months); and, employed controls. Perceptions of...the laboratory stressor resulting in performance deficits and helpless behavior. As predicted. compared to the other two groups. long-term unemployed

Maintenance of smoking cessation in the postpartum period: which interventions work best in the long-term?

PubMed

Su, Anny; Buttenheim, Alison M

2014-04-01

Smoking during pregnancy has been linked to a variety of adverse outcomes for both maternal and child health. Decades of studies have sought to increase cessation antepartum and reduce relapse postpartum. A number of effective interventions exist to significantly reduce smoking rates during pregnancy; however, less is known about how to prevent relapse in the postpartum period. This review investigates interventions to prevent relapse in the long-term postpartum period. We focus specifically on nonspontaneous quitters (individuals who quit smoking as a result of an external intervention) to reveal differences in long-term response to interventions for this population compared to spontaneous quitters. A systematic literature search yielded 32 relevant studies of pharmacological, behavioral, and incentives-based interventions. Results were compiled, analyzed, and compared in order to evaluate success factors in maintaining cessation postpartum. Though intervention groups showed consistently higher quit rates during pregnancy than control groups, none of the intervention types were effective at preventing relapse in the longer-term postpartum period. One study maintained significantly higher abstinence in the longer-term period postpartum using a mix of behavioral and incentives strategies. Additional research in this area is needed to identify optimal intervention strategies to reduce long-term postpartum relapse, particularly for nonspontaneous quitters.

76 FR 65118 - Drawbridge Operation Regulation; Bear Creek, Sparrows Point, MD

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... the openings of the drawbridge. After 1998, because the bridge can no longer be opened, there became no need for a regulation governing openings. It has come to the attention of the Coast Guard that the... requirements for the opening of a bridge that, in fact, can no longer open. This change does not affect vessel...

An exploration of factors affecting the long term psychological impact and deterioration of mental health in flooded households.

PubMed

Lamond, Jessica Elizabeth; Joseph, Rotimi D; Proverbs, David G

2015-07-01

The long term psychological effect of the distress and trauma caused by the memory of damage and losses associated with flooding of communities remains an under researched impact of flooding. This is particularly important for communities that are likely to be repeatedly flooded where levels of mental health disorder will damage long term resilience to future flooding. There are a variety of factors that affect the prevalence of mental health disorders in the aftermath of flooding including pre-existing mental health, socio-economic factors and flood severity. However previous research has tended to focus on the short term impacts immediately following the flood event and much less focus has been given to the longer terms effects of flooding. Understanding of factors affecting the longer term mental health outcomes for flooded households is critical in order to support communities in improving social resilience. Hence, the aim of this study was to explore the characteristics associated with psychological distress and mental health deterioration over the longer term. The research examined responses from a postal survey of households flooded during the 2007 flood event across England. Descriptive statistics, correlation analysis and binomial logistic regression were applied to data representing household characteristics, flood event characteristics and post-flood stressors and coping strategies. These factors were related to reported measures of stress, anxiety, depression and mental health deterioration. The results showed that household income, depth of flooding; having to move out during reinstatement and mitigating actions are related to the prevalence of psycho-social symptoms in previously flooded households. In particular relocation and household income were the most predictive factors. The practical implication of these findings for recovery after flooding are: to consider the preferences of households in terms of the need to move out during restorative building works and the financial resource constraints that may lead to severe mental hardship. In addition the findings suggest that support with installing mitigation measures may lead to improved mental health outcomes for communities at risk. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The elimination of fox rabies from Europe: determinants of success and lessons for the future

PubMed Central

Freuling, Conrad M.; Hampson, Katie; Selhorst, Thomas; Schröder, Ronald; Meslin, Francois X.; Mettenleiter, Thomas C.; Müller, Thomas

2013-01-01

Despite perceived challenges to controlling an infectious disease in wildlife, oral rabies vaccination (ORV) of foxes has proved a remarkably successful tool and a prime example of a sophisticated strategy to eliminate disease from wildlife reservoirs. During the past three decades, the implementation of ORV programmes in 24 countries has led to the elimination of fox-mediated rabies from vast areas of Western and Central Europe. In this study, we evaluated the efficiency of 22 European ORV programmes between 1978 and 2010. During this period an area of almost 1.9 million km² was targeted at least once with vaccine baits, with control taking between 5 and 26 years depending upon the country. We examined factors influencing effort required both to control and eliminate fox rabies as well as cost-related issues of these programmes. The proportion of land area ever affected by rabies and an index capturing the size and overlap of successive ORV campaigns were identified as factors having statistically significant effects on the number of campaigns required to both control and eliminate rabies. Repeat comprehensive campaigns that are wholly overlapping much more rapidly eliminate infection and are less costly in the long term. Disproportionally greater effort is required in the final phase of an ORV programme, with a median of 11 additional campaigns required to eliminate disease once incidence has been reduced by 90 per cent. If successive ORV campaigns span the entire affected area, rabies will be eliminated more rapidly than if campaigns are implemented in a less comprehensive manner, therefore reducing ORV expenditure in the longer term. These findings should help improve the planning and implementation of ORV programmes, and facilitate future decision-making by veterinary authorities and policy-makers. PMID:23798690

The elimination of fox rabies from Europe: determinants of success and lessons for the future.

PubMed

Freuling, Conrad M; Hampson, Katie; Selhorst, Thomas; Schröder, Ronald; Meslin, Francois X; Mettenleiter, Thomas C; Müller, Thomas

2013-08-05

Despite perceived challenges to controlling an infectious disease in wildlife, oral rabies vaccination (ORV) of foxes has proved a remarkably successful tool and a prime example of a sophisticated strategy to eliminate disease from wildlife reservoirs. During the past three decades, the implementation of ORV programmes in 24 countries has led to the elimination of fox-mediated rabies from vast areas of Western and Central Europe. In this study, we evaluated the efficiency of 22 European ORV programmes between 1978 and 2010. During this period an area of almost 1.9 million km² was targeted at least once with vaccine baits, with control taking between 5 and 26 years depending upon the country. We examined factors influencing effort required both to control and eliminate fox rabies as well as cost-related issues of these programmes. The proportion of land area ever affected by rabies and an index capturing the size and overlap of successive ORV campaigns were identified as factors having statistically significant effects on the number of campaigns required to both control and eliminate rabies. Repeat comprehensive campaigns that are wholly overlapping much more rapidly eliminate infection and are less costly in the long term. Disproportionally greater effort is required in the final phase of an ORV programme, with a median of 11 additional campaigns required to eliminate disease once incidence has been reduced by 90 per cent. If successive ORV campaigns span the entire affected area, rabies will be eliminated more rapidly than if campaigns are implemented in a less comprehensive manner, therefore reducing ORV expenditure in the longer term. These findings should help improve the planning and implementation of ORV programmes, and facilitate future decision-making by veterinary authorities and policy-makers.

45 CFR 149.350 - Maintenance of records.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.350 Maintenance of records..., or longer if otherwise required by law. (b) The records that must be retained are as follows— (1) All...

45 CFR 149.350 - Maintenance of records.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.350 Maintenance of records..., or longer if otherwise required by law. (b) The records that must be retained are as follows— (1) All...

45 CFR 149.350 - Maintenance of records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.350 Maintenance of records..., or longer if otherwise required by law. (b) The records that must be retained are as follows— (1) All...

Comment on "Influence of shaft length on golf driving performance".

PubMed

Glazier, Paul S

2009-06-01

Kenny et al. (2008) reported that low-handicap golfers were able to produce longer carry distances with longer drivers with no concomitant decrease in accuracy. However, it was not clear whether these increments in performance were an artefact of shaft length or some other unaccounted for characteristic of the experimental drivers used. Furthermore, it was difficult to determine whether these performance gains were experienced by all or only a few of the golfers studied. Additional research is required to substantiate these findings and also to establish how shaft length is related to performance and technique in less accomplished golfers. Regardless of skill level, the realization of the potential performance benefits associated with longer drivers is, to some degree, likely to be individual-specific. Accordingly, suitable research designs emphasizing the individual--with appropriate sample and trial sizes to achieve the requisite level of statistical significance, effect size, and power--are required.

The longer term impact of a novel rural mental health recruitment strategy: A quasi-experimental study.

PubMed

Sutton, Keith P; Maybery, Darryl; Patrick, Kent J

2015-12-01

This study examines the longer term impact of the Gippsland Mental Health Vacation School program, an initiative designed to orientate preregistration allied health and nursing students to rural mental health employment and career opportunities. Student participants from vacation schools held from July 2010 to August 2013 were invited to complete on-line surveys prior to, immediately following and 6 months after the event. Participant rating of Interest in rural work, mental health work and rural mental health work and responses to the student attitudes to rural practice and life questionnaire were analyzed using repeated measure analyses of variance. There was a large and significant positive increase in pre to post scores for student interest and attitudes to working in and career in the rural mental health sector. These gains in interest and attitudes fell away by approximately 50% in the six months following the program. The changes in attitudes toward rural work remained significant six months after the program, while attitudes to rural life at six months following the program were not-significantly different to the preprogram scores. The findings highlight that although a short term program designed to attract students to rural mental health work can positively change participants' interest in and attitudes toward rural work and life, the change diminishes over time. However, interest in rural work and career and rural work attitudes generally maintain significant improvement in the longer term. These differential findings have important implications for developing strategies to overcome rural mental health workforce shortages. © 2015 Wiley Publishing Asia Pty Ltd.

The use of 137Cs to establish longer-term soil erosion rates on footpaths in the UK.

PubMed

Rodway-Dyer, S J; Walling, D E

2010-10-01

There is increasing awareness of the damage caused to valuable and often unique sensitive habitats by people pressure as degradation causes a loss of plant species, disturbance to wildlife, on-site and off-site impacts of soil movement and loss, and visual destruction of pristine environments. This research developed a new perspective on the problem of recreational induced environmental degradation by assessing the physical aspects of soil erosion using the fallout radionuclide caesium-137 ((137)Cs). Temporal sampling problems have not successfully been overcome by traditional research methods monitoring footpath erosion and, to date, the (137)Cs technique has not been used to estimate longer-term soil erosion in regard to sensitive recreational habitats. The research was based on-sites within Dartmoor National Park (DNP) and the South West Coast Path (SWCP) in south-west England. (137)Cs inventories were reduced on the paths relative to the reference inventory (control), indicating loss of soil from the path areas. The Profile Distribution Model estimated longer-term erosion rates (ca. 40 years) based on the (137)Cs data and showed that the combined mean soil loss for all the sites on 'paths' was 1.41 kg m(-2) yr(-1) whereas the combined 'off path' soil loss was 0.79 kg m(-2) yr(-1), where natural (non-recreational) soil redistribution processes occur. Recreational pressure was shown to increase erosion in the long-term, as greater soil erosion occurred on the paths, especially where there was higher visitor pressure. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter?

PubMed Central

Zenk, Shannon N.; Tarlov, Elizabeth; Wing, Coady; Tong, Hao; Jones, Kelly K.; Powell, Lisa M.

2018-01-01

This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person’s home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m2, p < 0.001), 18 months (0.069 kg/m2, p < 0.001), and 24 months (0.067 kg/m2, p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m2 at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes. PMID:29373556

Appraising the role of the virtual patient for therapeutics health education.

PubMed

Baumann-Birkbeck, Lyndsee; Florentina, Fiona; Karatas, Onur; Sun, Jianbe; Tang, Tingna; Thaung, Victor; McFarland, Amelia; Bernaitis, Nijole; Khan, Sohil A; Grant, Gary; Anoopkumar-Dukie, Shailendra

2017-09-01

Face-to-face instruction, paper-based case-studies and clinical placements remain the most commonly used teaching methods for therapeutics curricula. Presenting clinical content in a didactic manner presents challenges in engaging learners and developing their clinical reasoning skills which may be overcome by inclusion of the virtual patient (VP). Currently there is limited literature examining the use of the VP in therapeutics teaching and learning. This review aimed to determine the role of VPs in therapeutics education, specifically the impact on student experiences, performance, and clinical skills. A search of primary literature was conducted with search terms including virtual patient, education, health, AND learning. Boolean operators were applied to include studies from health relevant fields with article titles and abstracts vetted. Nine of the 21 included studies were control-matched, and all but one compared VPs to traditional teaching. VPs enhanced the learning experience in all 17 studies that measured this outcome. Fourteen studies measured performance and clinical skills and 12 found VPs were beneficial, while two did not. The VP was not superior to traditional teaching in all studies, but the VP appeared beneficial to the student learning experience. Discrepancy was found between the impact of VPs on short- and long-term knowledge. The VP appears to enhance the student learning experience and has a role in therapeutics education, however a blended-learning (BL) approach may be required to account for individual learning styles. Additional investigation is required to clarify the efficacy of the VP, particularly as a component of BL, on longer-term knowledge retention. Copyright © 2017 Elsevier Inc. All rights reserved.

Chest physiotherapy during anesthesia for children with cystic fibrosis: effects on respiratory function.

PubMed

Tannenbaum, E; Prasad, S A; Dinwiddie, R; Main, Eleanor

2007-12-01

Physiotherapists sometimes use elective surgical procedures for children with cystic fibrosis as an opportunity to perform physiotherapy treatments during anesthesia. These treatments theoretically facilitate direct endotracheal airway clearance and compensate for any post-operative respiratory deterioration related to the anaesthetic and surgery. MATERIALS, PATIENTS, AND METHODS: Children were randomized either to receive physiotherapy or not following anesthesia and intubation. Respiratory mechanics (C(rs) and R(rs)), tidal volume, and peak inspiratory pressure (PIP) were measured immediately before and after physiotherapy. FEV(1) was measured before and after surgery and post-operative physiotherapy requirements were recorded. Eighteen patients, mean age 12 years (range 2.8-15 years) were recruited, with nine in each group. Both groups showed a non-significant decline in FEV(1) the day after surgery compared with pre-operative values (-5.8%: physiotherapy and -7.1%: control). Both PIP and R(rs) increased significantly following physiotherapy (within- and between-groups, P < 0.05). In addition, there was a significant within-group reduction in C(rs) after physiotherapy which approached significance between-groups (P = 0.07). There were no significant within- or between-group differences in tidal volume following treatment in either group. The unanticipated decline in respiratory function immediately following physiotherapy was short-lived and not discernible in longer term outcomes measured by FEV(1) or physiotherapy requirements post-operatively. If respiratory physiotherapy under anesthesia is considered necessary and the benefits of removing secretions are deemed to outweigh the short-term risks, it may be necessary for the anaesthetist to consider modifying ventilatory support to counteract any short-term negative effects of the treatment.

Short-term infection in cuffed versus noncuffed small bore central catheters: a randomized trial.

PubMed

Trerotola, Scott O; Patel, Aalpen A; Shlansky-Goldberg, Richard D; Solomon, Jeffrey A; Mondschein, Jeffrey I; Stavropoulos, S William; Soulen, Michael C; Itkin, Maxim; Chittams, Jesse

2010-02-01

To determine if a polyester cuff offered benefit in jugular small-bore central catheters (SBCCs). Eighty-four patients were randomly assigned to receive a 5-F single- or 6-F dual-lumen SBCC with (n = 42) or without (n = 42) a polyester cuff. Follow-up was performed at 2 weeks, 1 month, and 3 months or at catheter removal, whichever came first. At scheduled follow-up, catheter function, patient satisfaction, and infection were determined. At catheter removal, tip culture was performed to determine colonization and jugular vein patency was determined with ultrasonography (US). The overall infection rate was 0.4 per 1,000 catheter days. There was one clinical infection (noncuffed catheter). Colonization occurred in two noncuffed catheters and one cuffed catheter. There was one catheter dislodgment in the noncuffed group and none in the cuffed group. Cuffed catheters were no more difficult to insert but took slightly longer to remove (6 minutes +/- 4.7 vs 5 minutes +/- 3, P = .39) and often required local anesthesia for removal, whereas noncuffed catheters did not (41% vs 0%, P = .001). Partial (two cuffed, 0 noncuffed) or complete (two cuffed, one noncuffed) jugular thrombosis was seen on five of 58 completion US studies (8.6%). A polyester cuff on a SBCC confers no significant benefit in short-term colonization rates. Infection in SBCCs is uncommon. Despite their small diameters, SBCCs can result in jugular thrombosis, an important consideration in any patient requiring long-term venous access. Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved.

Changes in racial identity among African American college students following the election of Barack Obama.

PubMed

Fuller-Rowell, Thomas E; Burrow, Anthony L; Ong, Anthony D

2011-11-01

The current study considered the influence of the 2008 presidential election on the racial identity of African American college students (M(age) = 19.3 years; 26.3% male). The design of the study consisted of 2 components: longitudinal and daily. The longitudinal component assessed 3 dimensions of racial identity (centrality, private regard, and public regard) 2 weeks before and 5 months after the election, and the daily diary component assessed racial identity and identity exploration on the days immediately before and after the election. Daily items measuring identity exploration focused on how much individuals thought about issues relating to their race. Analyses considered the immediate effects of the election on identity exploration and the extent to which changes in exploration were shaped by racial identity measured prior to the election. We also considered immediate and longer term changes in racial identity following the election and the extent to which longer term changes were conditioned by identity exploration. Findings suggest that the election served as an "encounter" experience (Cross, 1991, 1995, pp. 60-61), which led to increases in identity exploration. Moreover, analyses confirmed that changes in identity exploration were most pronounced among those with higher levels of racial centrality. Results also suggest that the election had both an immediate and a longer term influence on racial identity, which in some instances was conditioned by identity exploration.

Knee injuries related to sports in young adult males during military service - incidence and risk factors.

PubMed

Kuikka, P-I; Pihlajamäki, H K; Mattila, V M

2013-06-01

The population-based incidence and risk factors for knee injuries in young adults were assessed in Finnish male conscripts performing their compulsory military service (n = 128,584). The main outcome variables were (1) hospitalization due to knee injuries overall and (2) hospitalization due to knee disorders as categorized into specific International Classification of Diseases, tenth revision diagnoses (cruciate and collateral ligament tears, meniscal tears, traumatic chondral lesions, and patellar dislocations). Person-time injury-incidence rates were calculated by dividing the number of persons with a diagnosed knee injury by the total exposure time of 97,503 person-years. The number of subjects with surgical operations and military service class changes indicative of longer term notable disability are also reported. Risk factor analyses were performed by logistic regression. The person-based incidence of hospitalizations for knee injury was 11 cases per 1000 person-years [95% confidence interval (CI): 10.4-11.7]. The most important risk factors were higher age (odds ratio 1.7; 95% CI: 1.3-2.2) and obesity (odds ratio 1.6; 95% CI: 1.03-2.5). Two thirds of all subjects hospitalized for knee injuries had surgery, and one third had longer term notable disability. These findings indicate that knee injuries cause a significant burden of hospitalizations, often leading to surgery and longer term disability. © 2011 John Wiley & Sons A/S.

15 CFR 971.400 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Issuance/Transfer: Terms... on that action, within 180 days (or such longer period of time as the Administrator may establish for...

Suited versus unsuited analog astronaut performance using the Aouda.X space suit simulator: the DELTA experiment of MARS2013.

PubMed

Soucek, Alexander; Ostkamp, Lutz; Paternesi, Roberta

2015-04-01

Space suit simulators are used for extravehicular activities (EVAs) during Mars analog missions. Flight planning and EVA productivity require accurate time estimates of activities to be performed with such simulators, such as experiment execution or traverse walking. We present a benchmarking methodology for the Aouda.X space suit simulator of the Austrian Space Forum. By measuring and comparing the times needed to perform a set of 10 test activities with and without Aouda.X, an average time delay was derived in the form of a multiplicative factor. This statistical value (a second-over-second time ratio) is 1.30 and shows that operations in Aouda.X take on average a third longer than the same operations without the suit. We also show that activities predominantly requiring fine motor skills are associated with larger time delays (between 1.17 and 1.59) than those requiring short-distance locomotion or short-term muscle strain (between 1.10 and 1.16). The results of the DELTA experiment performed during the MARS2013 field mission increase analog mission planning reliability and thus EVA efficiency and productivity when using Aouda.X.

Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials.

PubMed

Xu, L; Chen, H; Lin, G; Ge, Q; Qi, H; He, X

2016-12-01

The aim of this study was to analyse the outcomes of transanal hemorrhoidal dearterialization with mucopexy (THDm) versus open hemorrhoidectomy (OH) in the management of hemorrhoids. Randomized controlled trials in English were found by searching PubMed, Web of science, EMBASE, and the Cochrane Library database. Trials that compared THDm with OH were identified. Data were extracted independently for each study, and a meta-analysis was performed using fixed and random effects models. Four trials, including 316 patients, met the inclusion criteria. No statistically significant differences were noted in either total complications or postoperative bleeding, incontinence, recurrent prolapse, and urinary retention rate. Operative time was significantly longer for THDm with Doppler guidance than for THDm without Doppler guidance. Patients returned to normal activities faster after THDm than after OH. No statistically significant differences between THDm and OH were noted with regard to recurrence and reoperation rates. Our meta-analysis shows that THDm and OH are equally effective and can be attempted for the management of hemorrhoids. However, for THDm with Doppler guidance, more instruments and a longer operative time are required. Future large-scale, high-quality, multicenter trials with long-term outcomes are needed to prove these results and determine whether Doppler guidance in THD is truly necessary or not.

Climatic forcing of carbon-oxygen isotopic covariance in temperate-region marl lakes

NASA Technical Reports Server (NTRS)

Drummond, C. N.; Patterson, W. P.; Walker, J. C.

1995-01-01

Carbon and oxygen stable isotopic compositions of lacustrine carbonate from a southeastern Michigan marl lake display linear covariance over a range of 4.0% Peedee belemnite (PDB) in oxygen and 3.9% (PDB) in carbon. Mechanisms of delta 13 C-delta 18 O coupling conventionally attributed to lake closure in arid-region basins are inapplicable to hydrologically open lake systems. Thus, an alternative explanation of isotopic covariance in temperate region dimictic marl lakes is required. We propose that isotopic covariance is a direct record of change in regional climate. In short-residence-time temperate-region lake basins, summer meteoric precipitation is enriched in 18O relative to winter values, and summer organic productivity enriches epilimnic dissolved inorganic carbon in 13C. Thus, climate change toward longer summers and/or shorter winters could result in greater proportions of warm-month meteoric precipitation, longer durations of warm-month productivity, and net long-term enrichment in carbonate 18O and 13C. Isotopic covariance observed in the Michigan marl lake cores is interpreted to reflect postglacial warming from 10 to 3 ka followed by cooler mean annual temperature, a shift toward greater proportions of seasonal summer precipitation, a shortening of the winter season, or some combination of these three factors.

[Physiotherapy and ergotherapy are indispensable. Concrete prescription of remedies - without recourse].

PubMed

Engel, J-M

2012-07-01

Physical therapy and occupational therapy are essential for the treatment of inflammatory rheumatic diseases equal in rank to any drug therapy. They have enough evidence and are part of all current guidelines even if mostly not specified. In the German social security system the doctor prescribing physical therapy or occupational therapy has to act according to the different rules and forms as described in the current "Heilmittel Richtlinie" (Remedy directive) effective since July 2011. The multiple formal conditions and requirements of prescriptions are described in detail. Of special interest is that the global diagnosis of rheumatoid arthritis can no longer be used as the reason or justification for the individual prescription but detailed sub-diagnoses, regarding the essential ICF domains of structural damage, functional impairment, activity limitation and participation restriction as well as individual context factors are necessary. Of special interest is the fact that the prescribing doctor is no longer responsible for the formal correctness of prescriptions but the performing therapist, who will not be reimbursed if the prescription shows even minor formal errors. Another important improvement is the newly introduced long-term prescription of physical and occupational therapy. This facilitates the application of these therapies in the multimodal treatment regimen of rheumatic diseases.

Results of thoracic endovascular aortic repair 6 years after United States Food and Drug Administration approval.

PubMed

Shah, Asad A; Barfield, Michael E; Andersen, Nicholas D; Williams, Judson B; Shah, Julie A; Hanna, Jennifer M; McCann, Richard L; Hughes, G Chad

2012-11-01

Since United States Food and Drug Administration approval in 2005, the short-term safety and efficacy of thoracic endovascular aortic repair (TEVAR) have been established. However, longer-term follow-up data remain lacking. The objective of this study is to report 6-year outcomes of TEVAR in clinical practice. A prospective cohort review was performed of all patients undergoing TEVAR at a single referral institution between March 2005 and May 2011. Rates of reintervention were noted. Overall and aortic-specific survival were determined using Kaplan-Meier methods. Log-rank tests were used to compare survival between groups. During the study interval, 332 TEVAR procedures were performed in 297 patients. Reintervention was required after 12% of procedures at a mean of 8 ± 14 months after initial TEVAR and was higher in the initial tercile of patients (15.0% vs 9.9%). The 6-year freedom from reintervention was 84%. Type I endoleak was the most common cause of reintervention (5%). Six-year overall survival was 54%, and aorta-specific survival was 92%. Long-term survival was significantly lower than that of an age- and sex-matched United States population (p < 0.001). Survival was similar between patients requiring a reintervention vs those not (p = 0.26). Survival was different based on indication for TEVAR (p = 0.007), and patients with degenerative aneurysms had the lowest survival (47% at 6 years). Cardiopulmonary pathologies were the most common cause of death (27 of 93 total deaths). Long-term aortic-related survival after TEVAR is high, and the need for reintervention is infrequent. However, overall long-term survival is low, particularly for patients with degenerative aneurysms, and additional work is needed to identify patients unlikely to derive a survival benefit from TEVAR. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The postural stability of children with foetal alcohol spectrum disorders during one-leg stance: A feasibility study

PubMed Central

2018-01-01

Background Postural control may be impaired in children with foetal alcohol spectrum disorders (FASD). The study assessed the protocol feasibility in terms of (1) recruiting children with FASD in a rural, small town; (2) using the measurement instruments in a real-life setting; (3) the one-leg standing (OLS) task and (4) presenting preliminary results on postural stability of children with and without FASD. Methods Nine-year-old children diagnosed with and without FASD were invited to participate. Twenty-eight children performed OLS. Feasibility outcomes included recruitment, measurement instrument use and task instruction. Postural stability outcomes included standing duration, centre of pressure (COP) and body segment acceleration. Results Participants recruitment was feasible in terms of the (1) ability to sample a reasonable participant number in a rural town setting and the capacity to increase the sample size if more schools are included in the sampling frame and (2) use of assent and consent forms that were appropriate for this population. The measurement instruments were user-friendly, cost-effective and time-efficient. Instructions for the task require amendment to address foot placement of the non-weight–bearing leg. There was a significant difference between cases and controls on mean COP velocity (p = 0.001) and the pelvis segment acceleration in the mediolateral direction (p = 0.01) and the anteroposterior direction (p = 0.027). The control children took longer to achieve postural control. The girls demonstrated a significant difference for the COP anteroposterior displacement (p = 0.008) and velocity (p = 0.049). Conclusions The recruitment of children with and without FASD in a rural, small town and the administration of measurement instruments in a real-life, school-based setting was feasible. However, the verbal instructions for the task require revision. The male control group took longer to achieve postural control because the task was performed differently between the two groups. However, the case girls were slower to achieve postural control than control girls though performing the task similarly. PMID:29707515

Etanercept provides an effective, safe and flexible short- and long-term treatment regimen for moderate-to-severe psoriasis: a systematic review of current evidence.

PubMed

Strohal, Robert; Chimenti, Sergio; Vena, Gino Antonio; Girolomoni, Giampiero

2013-06-01

The treatment of psoriasis requires long-lasting intervention. Conventional treatments for psoriasis comprise topical, phototherapeutic and systemic modalities, such as methotrexate or cyclosporine. Biological therapies are advocated by treatment guidelines for the use in moderate-to-severe psoriasis, when conventional treatments have failed, are contraindicated or are associated with severe adverse events. Etanercept is an anti-TNF recombinant fusion protein that has emerged as a standard biologic treatment option for moderate-to-severe psoriasis. The present review summarizes data from pivotal and post-marketing randomized controlled etanercept trials to treat moderate-to-severe psoriasis for 24 weeks and longer. During the first 12 weeks, etanercept can be administered in different dosing regimens: 50 mg twice weekly (BIW) and 50 mg once weekly. Although both regimens are effective, it has been shown that the 50 mg BIW dosage leads to higher response rates at week 24. In addition, after 24 weeks' treatment etanercept provides the unique possibility of continuous or intermittent long-term treatment programmes. The medium- to long-term efficacy of etanercept was consistent, regardless of whether etanercept therapy was interrupted or continuous. Taking the chronic nature of psoriasis into account, this flexibility in dosing regimen bestows a key advantage in facilitating individualisation of long-term treatment according to patient needs.

Long-term effects of drinking-water treatment residuals on dissolved phosphorus export from vegetated buffer strips.

PubMed

Habibiandehkordi, Reza; Quinton, John N; Surridge, Ben W J

2015-04-01

The export of dissolved phosphorus (P) in surface runoff from agricultural land can lead to water quality degradation. Surface application of aluminium (Al)-based water treatment residuals (Al-WTRs) to vegetated buffer strip (VBS) soils can enhance P removal from surface runoff during single runoff events. However, the longer-term effects on P removal in VBSs following application of products such as Al-WTR remain uncertain. We used field experimental plots to examine the long-term effects of applying a freshly generated Al-WTR to VBSs on dissolved P export during multiple runoff events, occurring between 1 day and 42 weeks after the application of Al-WTR. Vegetated buffer strip plots amended with Al-WTR significantly reduced soluble reactive P and total dissolved P concentrations in surface runoff compared to both unamended VBS plots and control plots. However, the effectiveness of Al-WTR decreased over time, by approximately 70% after 42 weeks compared to a day following Al-WTR application. Reduced performance did not appear to be due to drying of Al-WTR in the field. Instead, the development of preferential flow paths as well as burying of Al-WTR with freshly deposited sediments may explain these observations. Better understanding of the processes controlling long-term P removal by Al-WTR is required for effective management of VBSs.

Protocol for Short- and Longer-term Spatial Learning and Memory in Mice

PubMed Central

Willis, Emily F.; Bartlett, Perry F.; Vukovic, Jana

2017-01-01

Studies on the role of the hippocampus in higher cognitive functions such as spatial learning and memory in rodents are reliant upon robust and objective behavioral tests. This protocol describes one such test—the active place avoidance (APA) task. This behavioral task involves the mouse continuously integrating visual cues to orientate itself within a rotating arena in order to actively avoid a shock zone, the location of which remains constant relative to the room. This protocol details the step-by-step procedures for a novel paradigm of the hippocampal-dependent APA task, measuring acquisition of spatial learning during a single 20-min trial (i.e., short-term memory), with spatial memory encoding and retrieval (i.e., long-term memory) assessed by trials conducted over consecutive days. Using the APA task, cognitive flexibility can be assessed using the reversal learning paradigm, as this increases the cognitive load required for efficient performance in the task. In addition to a detailed experimental protocol, this paper also describes the range of its possible applications, the expected key results, as well as the analytical methods to assess the data, and the pitfalls/troubleshooting measures. The protocol described herein is highly robust and produces replicable results, thus presenting an important paradigm that enables the assessment of subtle short-term changes in spatial learning and memory, such as those observed for many experimental interventions. PMID:29089878

The Effect of Local Anesthetic Infiltration Around Nephrostomy Tract on Postoperative Pain Control after Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis.

PubMed

Wang, Jiawu; Zhang, Chengyao; Tan, Dan; Tan, Guangzhong; Yang, Bo; Chen, Wenkai; Tang, Guoqiang

2016-01-01

To assess the safety and efficacy of local anesthetic infiltration around nephrostomy tract on postoperative pain control after percutaneous nephrolithotomy. This systematic review was performed based on randomized clinic trials about local anesthetic infiltration around nephrostomy tract on postoperative pain control. The weighted mean difference (WMD), with their corresponding 95% CI, was calculated to compare continuous variables. Our results showed that the consumption of analgesic was less in the experimental group than in the control group (WMD -25.32, 95% CI -48.09 to -2.55, p = 0.003). There was no significant difference between the mean Visual Analog Scale (VAS) in the experimental group than the control group after 6 h while significantly lower after 24 h. The time of first analgesic demand was significantly longer in the experimental group (WMD 2.19, 95% CI 0.98-3.41). There was no significant difference between 2 groups in terms of operation time, hemoglobin (Hb) alteration, and hospital stay. Local anesthetic infiltration around nephrostomy tract had similar efficacy in the control group in terms of operation time, Hb alteration, and hospital stay, but offers some potential advantages in terms of analgesia requirement, the time of first analgesic demand, and VAS-24 h. However, good quality and large studies with long-term follow-up are warranted for further research. © 2016 S. Karger AG, Basel.

Outcome of Laparoscopic Versus Open Resection for Transverse Colon Cancer.

PubMed

Zeng, Wei-Gen; Liu, Meng-Jia; Zhou, Zhi-Xiang; Hou, Hui-Rong; Liang, Jian-Wei; Wang, Zheng; Zhang, Xing-Mao; Hu, Jun-Jie

2015-10-01

Laparoscopic resection for transverse colon cancer remains controversial. The aim of this study is to investigate the short- and long-term outcomes of laparoscopic surgery for transverse colon cancer. A total of 278 patients with transverse colon cancer from a single institution were included. All patients underwent curative surgery, 156 patients underwent laparoscopic resection (LR), and 122 patients underwent open resection (OR). The short- and long-term results were compared between two groups. Baseline demographic and clinical characteristics were comparable between two groups. Conversions were required in eight (5.1 %) patients. LR group was associated with significantly longer median operating time (180 vs. 140 min; P < 0.001). Median estimated blood loss was significantly less in LR group (90 vs. 100 ml; P = 0.001). Time to first flatus and oral intake was significantly earlier in LR group. Perioperative mortality and morbidity rate were not significantly different between two groups. Tumor size, number of lymph nodes harvested, length of proximal, and distal resection margin were comparable between two groups. Postoperative hospital stay was significantly shorter in LR group (9 vs. 10d; P < 0.001). Five-year disease-free survival and overall survival rate were similar between two groups. Laparoscopic resection for transverse colon cancer is associated with better short-term outcomes and equivalent long-term oncologic outcomes.

Physical and chemical stability of pemetrexed in infusion solutions.

PubMed

Zhang, Yanping; Trissel, Lawrence A

2006-06-01

Pemetrexed is a multitargeted, antifolate, antineoplastic agent that is indicated for single-agent use in locally advanced or metastatic non-small-cell lung cancer after prior chemotherapy and in combination with cisplatin for the treatment of malignant pleural mesothelioma not treatable by surgery. Currently, there is no information on the long-term stability of pemetrexed beyond 24 hours. To evaluate the longer-term physical and chemical stability of pemetrexed 2, 10, and 20 mg/mL in polyvinyl chloride (PVC) bags of dextrose 5% injection and NaCl 0.9% injection. Triplicate samples of pemetrexed were prepared in the concentrations and infusion solutions required. Evaluations for physical and chemical stability were performed initially and over 2 days at 23 degrees C protected from light and exposed to fluorescent light, and over 31 days of storage at 4 degrees C protected from light. Physical stability was assessed using turbidimetric and particulate measurement as well as visual observation. Chemical stability was evaluated by HPLC. All pemetrexed solutions remained chemically stable, with little or no loss of pemetrexed over 2 days at 23 degrees C, protected from light and exposed to fluorescent light, and over 31 days of storage at 4 degrees C, protected from light. The room temperature samples were physically stable throughout the 48 hour test period. However, pemetrexed admixtures developed large numbers of microparticulates during refrigerated storage exceeding 24 hours. Pemetrexed is chemically stable for 2 days at room temperature and 31 days refrigerated in dextrose 5% injection and NaCl 0.9% injection. However, substantial numbers of microparticulates may form in pemetrexed diluted in the infusion solutions in PVC bags, especially during longer periods of refrigerated storage. Limiting the refrigerated storage period to the manufacturer-recommended 24 hours will limit particulate formation.

Variation in urinary spot sample, 24 h samples, and longer-term average urinary concentrations of short-lived environmental chemicals: implications for exposure assessment and reverse dosimetry

PubMed Central

Aylward, Lesa L; Hays, Sean M; Zidek, Angelika

2017-01-01

Population biomonitoring data sets such as the Canadian Health Measures Survey (CHMS) and the United States National Health and Nutrition Examination Survey (NHANES) collect and analyze spot urine samples for analysis for biomarkers of exposure to non-persistent chemicals. Estimation of population intakes using such data sets in a risk-assessment context requires consideration of intra- and inter-individual variability to understand the relationship between variation in the biomarker concentrations and variation in the underlying daily and longer-term intakes. Two intensive data sets with a total of 16 individuals with collection and measurement of serial urine voids over multiple days were used to examine these relationships using methyl paraben, triclosan, bisphenol A (BPA), monoethyl phthalate (MEP), and mono-2-ethylhexyl hydroxyl phthalate (MEHHP) as example compounds. Composited 24 h voids were constructed mathematically from the individual collected voids, and concentrations for each 24 h period and average multiday concentrations were calculated for each individual in the data sets. Geometric mean and 95th percentiles were compared to assess the relationship between distributions in spot sample concentrations and the 24 h and multiday collection averages. In these data sets, spot sample concentrations at the 95th percentile were similar to or slightly higher than the 95th percentile of the distribution of all 24 h composite void concentrations, but tended to overestimate the maximum of the multiday concentration averages for most analytes (usually by less than a factor of 2). These observations can assist in the interpretation of population distributions of spot samples for frequently detected analytes with relatively short elimination half-lives. PMID:27703149

Characteristics of exercise training interventions to improve cardiorespiratory fitness after stroke: a systematic review with meta-analysis.

PubMed

Marsden, Dianne L; Dunn, Ashlee; Callister, Robin; Levi, Christopher R; Spratt, Neil J

2013-01-01

Cardiorespiratory fitness is low after stroke. Improving fitness has the potential to improve function and reduce secondary cardiovascular events. . This review with meta-analysis aims to identify characteristics and determine the effectiveness of interventions to improve cardiorespiratory fitness after stroke. A systematic search and review with meta-analysis was undertaken. Key inclusion criteria were the following: peer-reviewed articles published in English, adult stroke survivors, an intervention with the potential to improve cardiorespiratory fitness, and peak oxygen consumption (VO2peak) assessed preintervention and postintervention via a progressive aerobic exercise test. From 3209 citations identified, 28 studies were included, reporting results for 920 participants. Studies typically included chronic, ambulant participants with mild to moderate deficits; used an aerobic or mixed (with an aerobic component) intervention; and prescribed 3 sessions per week for 30 to 60 minutes per session at a given intensity. Baseline VO2peak values were low (8-23 mL/kg/min). Meta-analysis of the 12 randomized controlled trials demonstrated overall improvements in VO2peak of 2.27 (95% confidence interval = 1.58, 2.95) mL/kg/min postintervention. A similar 10% to 15% improvement occurred with both aerobic and mixed interventions and in shorter (≤ 3 months) and longer (>3 months) length programs. Only 1 study calculated total dose received and only 1 included long-term follow-up. The results demonstrate that interventions with an aerobic component can improve cardiorespiratory fitness poststroke. Further investigation is required to determine effectiveness in those with greater impairment and comorbidities, optimal timing and dose of intervention, whether improvements can be maintained in the longer term, and whether improved fitness results in better function and reduced risk of subsequent cardiovascular events.

Reading a 400,000-year record of earthquake frequency for an intraplate fault

NASA Astrophysics Data System (ADS)

Williams, Randolph T.; Goodwin, Laurel B.; Sharp, Warren D.; Mozley, Peter S.

2017-05-01

Our understanding of the frequency of large earthquakes at timescales longer than instrumental and historical records is based mostly on paleoseismic studies of fast-moving plate-boundary faults. Similar study of intraplate faults has been limited until now, because intraplate earthquake recurrence intervals are generally long (10s to 100s of thousands of years) relative to conventional paleoseismic records determined by trenching. Long-term variations in the earthquake recurrence intervals of intraplate faults therefore are poorly understood. Longer paleoseismic records for intraplate faults are required both to better quantify their earthquake recurrence intervals and to test competing models of earthquake frequency (e.g., time-dependent, time-independent, and clustered). We present the results of U-Th dating of calcite veins in the Loma Blanca normal fault zone, Rio Grande rift, New Mexico, United States, that constrain earthquake recurrence intervals over much of the past ˜550 ka—the longest direct record of seismic frequency documented for any fault to date. The 13 distinct seismic events delineated by this effort demonstrate that for >400 ka, the Loma Blanca fault produced periodic large earthquakes, consistent with a time-dependent model of earthquake recurrence. However, this time-dependent series was interrupted by a cluster of earthquakes at ˜430 ka. The carbon isotope composition of calcite formed during this seismic cluster records rapid degassing of CO2, suggesting an interval of anomalous fluid source. In concert with U-Th dates recording decreased recurrence intervals, we infer seismicity during this interval records fault-valve behavior. These data provide insight into the long-term seismic behavior of the Loma Blanca fault and, by inference, other intraplate faults.

Head and Neck Squamous Cell Carcinoma in Adolescents and Young Adults: Survivorship Patterns and Disparities.

PubMed

Challapalli, Sai D; Simpson, Matthew C; Adjei Boakye, Eric; Pannu, Jay S; Costa, Dary J; Osazuwa-Peters, Nosayaba

2018-05-10

Adolescent and young adult (AYA) head and neck cancer (HNC) patients require longer term follow-ups as they age; yet, little is known about factors associated with survivorship in this population. We aimed to describe nonclinical factors associated with HNC survivorship among AYAs. In this retrospective cohort study, the Surveillance, Epidemiology and End Results 18 database from 2007 to 2014 was queried. Eligible cases were 15-39-year-old primary HNC patients with known cause of death (n = 1777). Kaplan-Meier survival curves stratified by age group (15-29, 30-34, and 35-39) and by health insurance status tested differences in HNC survival among groups with a log-rank test. Variables, including age, sex, race/ethnicity, county-level poverty, anatomic site, stage, and treatment, were controlled for in a competing risk proportional hazards model. Patients were mostly male (64%), with mean age of 33.4 years. Survival rate was 73% after 8 years of follow-up. There were no significant survival differences based on age at diagnosis. However, AYAs who were on Medicaid (adjusted hazard ratio [aHR] = 1.61, 95% confidence interval [CI] 1.22-2.12) or uninsured (aHR = 1.51, 95% CI 1.03-2.21), had an increased hazard of death from HNC, compared with those with private insurance. Health insurance status is the main nonclinical factor associated with survival among AYAs with HNC, and individuals with Medicaid do not fare better than the uninsured. With a potential longer term follow-up in this AYA population, there is need to optimize survivorship irrespective of health insurance status.

Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients.

PubMed

Belcaro, Gianni; Cesarone, Maria Rosaria; Dugall, Mark; Pellegrini, Luciano; Ledda, Andrea; Grossi, Maria Giovanna; Togni, Stefano; Appendino, Giovanni

2010-12-01

In a previous three-month study of Meriva, a proprietary curcumin-phosphatidylcholine phytosome complex, decreased joint pain and improvement in joint function were observed in 50 osteoarthritis (OA) patients. Since OA is a chronic condition requiring prolonged treatment, the long-term efficacy and safety of Meriva were investigated in a longer (eight months) study involving 100 OA patients. The clinical end points (Western Ontario and McMaster Universities [WOMAC] score, Karnofsky Performance Scale Index, and treadmill walking performance) were complemented by the evaluation of a series of inflammatory markers (interleukin [IL]-1beta, IL-6, soluble CD40 ligand [sCD40L], soluble vascular cell adhesion molecule (sVCAM)-1, and erythrocyte sedimentation rate [ESR]). This represents the most ambitious attempt, to date, to evaluate the clinical efficacy and safety of curcumin as an anti-inflammatory agent. Significant improvements of both the clinical and biochemical end points were observed for Meriva compared to the control group. This, coupled with an excellent tolerability, suggests that Meriva is worth considering for the long-term complementary management of osteoarthritis.

A Microarray Tool Provides Pathway and GO Term Analysis.

PubMed

Koch, Martin; Royer, Hans-Dieter; Wiese, Michael

2011-12-01

Analysis of gene expression profiles is no longer exclusively a task for bioinformatic experts. However, gaining statistically significant results is challenging and requires both biological knowledge and computational know-how. Here we present a novel, user-friendly microarray reporting tool called maRt. The software provides access to bioinformatic resources, like gene ontology terms and biological pathways by use of the DAVID and the BioMart web-service. Results are summarized in structured HTML reports, each presenting a different layer of information. In these report, contents of diverse sources are integrated and interlinked. To speed up processing, maRt takes advantage of the multi-core technology of modern desktop computers by using parallel processing. Since the software is built upon a RCP infrastructure it might be an outset for developers aiming to integrate novel R based applications. Installer, documentation and various kinds of tutorials are available under LGPL license at the website of our institute http://www.pharma.uni-bonn.de/www/mart. This software is free for academic use. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective

PubMed Central

Johnson, Robert W.; Alvarez-Pasquin, Marie-José; Bijl, Marc; Franco, Elisabetta; Gaillat, Jacques; Clara, João G.; Labetoulle, Marc; Michel, Jean-Pierre; Naldi, Luigi; Sanmarti, Luis S.; Weinke, Thomas

2015-01-01

Herpes zoster (HZ) is primarily a disease of nerve tissue but the acute and longer-term manifestations require multidisciplinary knowledge and involvement in their management. Complications may be dermatological (e.g. secondary bacterial infection), neurological (e.g. long-term pain, segmental paresis, stroke), ophthalmological (e.g. keratitis, iridocyclitis, secondary glaucoma) or visceral (e.g. pneumonia, hepatitis). The age-related increased incidence of HZ and its complications is thought to be a result of the decline in cell-mediated immunity (immunosenescence), higher incidence of comorbidities with age and social-environmental changes. Individuals who are immunocompromised as a result of disease or therapy are also at increased risk, independent of age. HZ and its complications (particularly postherpetic neuralgia) create a significant burden for the patient, carers, healthcare systems and employers. Prevention and treatment of HZ complications remain a therapeutic challenge despite recent advances. This is an overview of the multidisciplinary implications and management of HZ in which the potential contribution of vaccination to reducing the incidence HZ and its complications are also discussed. PMID:26478818

Developmental phenotypic plasticity helps bridge stochastic weather events associated with climate change.

PubMed

Burggren, Warren

2018-05-10

The slow, inexorable rise in annual average global temperatures and acidification of the oceans are often advanced as consequences of global change. However, many environmental changes, especially those involving weather (as opposed to climate), are often stochastic, variable and extreme, particularly in temperate terrestrial or freshwater habitats. Moreover, few studies of animal and plant phenotypic plasticity employ realistic (i.e. short-term, stochastic) environmental change in their protocols. Here, I posit that the frequently abrupt environmental changes (days, weeks, months) accompanying much longer-term general climate change (e.g. global warming over decades or centuries) require consideration of the true nature of environmental change (as opposed to statistical means) coupled with an expansion of focus to consider developmental phenotypic plasticity. Such plasticity can be in multiple forms - obligatory/facultative, beneficial/deleterious - depending upon the degree and rate of environmental variability at specific points in organismal development. Essentially, adult phenotypic plasticity, as important as it is, will be irrelevant if developing offspring lack sufficient plasticity to create modified phenotypes necessary for survival. © 2018. Published by The Company of Biologists Ltd.

Biological nitrogen fixation in non-legume plants.

PubMed

Santi, Carole; Bogusz, Didier; Franche, Claudine

2013-05-01

Nitrogen is an essential nutrient in plant growth. The ability of a plant to supply all or part of its requirements from biological nitrogen fixation (BNF) thanks to interactions with endosymbiotic, associative and endophytic symbionts, confers a great competitive advantage over non-nitrogen-fixing plants. Because BNF in legumes is well documented, this review focuses on BNF in non-legume plants. Despite the phylogenic and ecological diversity among diazotrophic bacteria and their hosts, tightly regulated communication is always necessary between the microorganisms and the host plant to achieve a successful interaction. Ongoing research efforts to improve knowledge of the molecular mechanisms underlying these original relationships and some common strategies leading to a successful relationship between the nitrogen-fixing microorganisms and their hosts are presented. Understanding the molecular mechanism of BNF outside the legume-rhizobium symbiosis could have important agronomic implications and enable the use of N-fertilizers to be reduced or even avoided. Indeed, in the short term, improved understanding could lead to more sustainable exploitation of the biodiversity of nitrogen-fixing organisms and, in the longer term, to the transfer of endosymbiotic nitrogen-fixation capacities to major non-legume crops.

New Topical Treatment Options for Actinic Keratosis: A Systematic Review.

PubMed

Stockfleth, Eggert; Sibbring, Gillian C; Alarcon, Ivette

2016-01-01

This systematic review compared the relative efficacy of 5-fluorouracil 0.5% in salicylic acid 10% (5-FU/SA), ingenol mebutate (IMB) and imiquimod 2.5%/3.75% (IMI) for actinic keratosis on the face, forehead or scalp. Only 11 publications, relating to 7 randomised controlled trials, met inclusion criteria and it was only possible to compare the effect of all 3 treatments on complete clinical clearance, and the effect of 5-FU/SA and IMB on actinic keratosis recurrence rate. Despite a higher vehicle response rate for 5-FU/SA, complete clinical clearance was higher than IMB and IMI (55.4, 42.2, and 25.0-30.6/34.0-35.6%, [corrected] respectively). 5-FU/SA was also associated with lower actinic keratosis recurrence rate than IMB at 12 months post-treatment (32.7 vs. 53.9%). Although qualitative assessment suggested a numerical advantage of 5-FU/SA over IMB and IMI in terms of complete clinical clearance and sustained clearance, clinical data from longer term trials, with comparable outcome measures, are required to corroborate these findings.

Does in utero exposure of antiepileptic drugs lead to failure to reach full cognitive potential?

PubMed

McCorry, D; Bromley, R

2015-05-01

A clinical scenario of a young female on 800 mg of sodium valproate (VPA) who has recently failed lamotrigine (LTG) and levetiracetam (LEV) and who is currently planning a pregnancy is presented. Currently available data pertaining to the longer-term development of children exposed to antiepileptic drugs (AEDs) are reviewed along with considerations around the methodology and interpretation of such research. There is an accumulation of data highlighting significant risks associated with prenatal exposed to VPA, with the level of risk being mediated by dose. The majority of published evidence does not find a significant risk associated with carbamazepine (CBZ) exposure in utero for global cognitive abilities however the evidence for more specific cognitive skills are unclear. Limited data indicate that LTG may be a preferred treatment to VPA in terms of foetal outcome but further evidence is required. Too little data pertaining to LEV exposure is available and a lack of evidence regarding risk of this and other new AEDs should not be interpreted as evidence of safety. Copyright © 2015. Published by Elsevier Ltd.

Climate change and elevated extinction rates of reptiles from Mediterranean Islands.

PubMed

Foufopoulos, Johannes; Kilpatrick, A Marm; Ives, Anthony R

2011-01-01

Recent climate change has caused the distributions of many species to shift poleward, yet few empirical studies have addressed which species will be vulnerable to longer-term climate changes. To investigate past consequences of climate change, we calculated the population extinction rates of 35 reptile species from 87 Greek land-bridge islands in the Mediterranean that occurred over the past 16,000 years. Population extinction rates were higher for those species that today have more northern distributions. We further found that northern species requiring cool, mesic habitats had less available suitable habitat among islands, implicating loss of suitable habitat in their elevated extinction rates. These extinctions occurred in the context of increasing habitat fragmentation, with islands shrinking and separating as sea levels rose. Thus, the circumstances faced by reptiles on the islands are similar to challenges for numerous species today that must cope with a changing climate while living in an increasingly human-fragmented landscape. Our island-biogeographical approach to investigating historical population extinctions gives insight into the long-term patterns of species responses to climate change.

Risk assessment and psychosocial interventions for suicidal patients

PubMed Central

Chesin, Megan; Stanley, Barbara

2013-01-01

Objectives Suicide is a leading cause of death in the US. Although factors elevating long-term risk for suicide are known and include bipolar disorder, signs of imminent suicide risk are difficult to study and not well-specified. Acute risk determinations must be made to determine the appropriate level of care to safeguard patients. To increase safety among at-risk patients in the short term and to decrease risk over time, psychosocial interventions to prevent suicide have been developed and tested in acute care and outpatient settings. Methods A narrative review of studies of imminent risk factors for suicide, suicide risk decision making, and psychosocial suicide prevention interventions was conducted. Results While some long-term risk factors of suicide have been established, accurate identification of individuals at imminent risk for suicide is difficult. Therefore, prevention efforts targeting individuals at high suicide behavior risk discharging from acute care settings tend to be generic and focus on psychoeducation and supportive follow-up contact. Data regarding the effectiveness of brief interventions (i.e., those not requiring more than one individualized treatment session) is mixed, showing better outcomes in the shorter term and when incidence of suicidal behavior or ideation is the outcome. With respect to longer term suicide prevention interventions (i.e., those with a minimum of 10 sessions), Dialectical Behavior Therapy has the largest evidence base. Conclusions To improve suicide prevention efforts, more rigorous study of imminent risk factors and psychosocial interventions is needed. Adaptations specific to individuals with bipolar disorder are possible and needed. PMID:23782460

The War on Poverty’s Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans†

PubMed Central

Bailey, Martha J.; Goodman-Bacon, Andrew

2015-01-01

This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest that increased access to primary care has longer-term benefits, even for populations with near universal health insurance. (JEL H75, I12, I13, I18, I32, I38, J14) PMID:25999599

10 CFR 603.905 - Record retention requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... retention requirements. A TIA must require participants to keep records related to the TIA (for which the... final financial status report for an expenditure-based TIA or final program performance report for a fixed-support TIA, with the following exceptions: (a) The participant must keep records longer than...

Air temperature optimisation for humidity-controlled cold storage of the predatory mites Neoseiulus californicus and Phytoseiulus persimilis (Acari: Phytoseiidae).

PubMed

Ghazy, Noureldin Abuelfadl; Suzuki, Takeshi; Amano, Hiroshi; Ohyama, Katsumi

2014-03-01

Humidity-controlled cold storage, in which the water vapour pressure is saturated, can prolong the survival of the predatory mites Neoseiulus californicus (McGregor) and Phytoseiulus persimilis Athias-Henriot (Acari: Phytoseiidae). However, information on the optimum air temperature for long-term storage by this method is limited. The authors evaluated the survival of mated adult females of N. californicus and P. persimilis at 5.0, 7.5, 10.0 and 12.5 °C under saturated water vapour condition (vapour pressure deficit 0.0 kPa). N. californicus showed a longer survival time than P. persimilis at all the air temperatures. The longest mean survival time of N. californicus was 11 weeks at 7.5 °C, whereas that of P. persimilis was 8 weeks at 5.0 °C. After storage at 7.5 °C for 8 weeks, no negative effect on post-storage oviposition was observed in N. californicus, whereas the oviposition of P. persimilis stored at 5.0 °C for 8 weeks was significantly reduced. The interspecific variation in the response of these predators to low air temperature might be attributed to their natural habitat and energy requirements. These results may be useful for the long-term storage of these predators, which is required for cost-effective biological control. © 2013 Society of Chemical Industry.

Agulhas leakage dynamics affects decadal variability in Atlantic overturning circulation.

PubMed

Biastoch, A; Böning, C W; Lutjeharms, J R E

2008-11-27

Predicting the evolution of climate over decadal timescales requires a quantitative understanding of the dynamics that govern the meridional overturning circulation (MOC). Comprehensive ocean measurement programmes aiming to monitor MOC variations have been established in the subtropical North Atlantic (RAPID, at latitude 26.5 degrees N, and MOVE, at latitude 16 degrees N) and show strong variability on intraseasonal to interannual timescales. Observational evidence of longer-term changes in MOC transport remains scarce, owing to infrequent sampling of transoceanic sections over past decades. Inferences based on long-term sea surface temperature records, however, supported by model simulations, suggest a variability with an amplitude of +/-1.5-3 Sv (1 Sv = 10(6) m(3) s(-1)) on decadal timescales in the subtropics. Such variability has been attributed to variations of deep water formation in the sub-arctic Atlantic, particularly the renewal rate of Labrador Sea Water. Here we present results from a model simulation that suggest an additional influence on decadal MOC variability having a Southern Hemisphere origin: dynamic signals originating in the Agulhas leakage region at the southern tip of Africa. These contribute a MOC signal in the tropical and subtropical North Atlantic that is of the same order of magnitude as the northern source. A complete rationalization of observed MOC changes therefore also requires consideration of signals arriving from the south.

Quality of life after major trauma with multiple rib fractures.

PubMed

Marasco, Silvana; Lee, Geraldine; Summerhayes, Robyn; Fitzgerald, Mark; Bailey, Michael

2015-01-01

Rib fractures are a common injury presenting to major trauma centres and community hospitals. Aside from the acute impact of rib fracture injury, longer-term morbidity of pain, disability and deformity have been described. Despite this, the mainstay of management for the vast majority of rib fracture injuries remains supportive only with analgesia and where required respiratory support. This study aimed to document the long-term quality of life in a cohort of major trauma patients with rib fracture injury over 24 months. Retrospective review (July 2006-July 2011) of 397 major trauma patients admitted to The Alfred Hospital with rib fractures and not treated with operative rib fixation. The main outcome measures were quality of life over 24 months post injury assessed using the Glasgow Outcome Scale Extended and SF12 health assessment forms and a pain questionnaire. Assessment over 24 months of major trauma patients with multiple rib fractures demonstrated significantly lower quality of life compared with published Australian norms at all time points measured. Return to work rates were poor with only 71% of those who were working prior to their accident, returning to any work. This study demonstrates a significant reduction in quality of life for rib fracture patients requiring admission to hospital, which does not return to the level of Australian norms for at least two years. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Anoxia stimulates microbially catalyzed metal release from Animas River sediments.

PubMed

Saup, Casey M; Williams, Kenneth H; Rodríguez-Freire, Lucía; Cerrato, José M; Johnston, Michael D; Wilkins, Michael J

2017-04-19

The Gold King Mine spill in August 2015 released 11 million liters of metal-rich mine waste to the Animas River watershed, an area that has been previously exposed to historical mining activity spanning more than a century. Although adsorption onto fluvial sediments was responsible for rapid immobilization of a significant fraction of the spill-associated metals, patterns of longer-term mobility are poorly constrained. Metals associated with river sediments collected downstream of the Gold King Mine in August 2015 exhibited distinct presence and abundance patterns linked to location and mineralogy. Simulating riverbed burial and development of anoxic conditions, sediment microcosm experiments amended with Animas River dissolved organic carbon revealed the release of specific metal pools coupled to microbial Fe- and SO 4 2- -reduction. Results suggest that future sedimentation and burial of riverbed materials may drive longer-term changes in patterns of metal remobilization linked to anaerobic microbial metabolism, potentially driving decreases in downstream water quality. Such patterns emphasize the need for long-term water monitoring efforts in metal-impacted watersheds.

Computer-Delivered Interventions to Reduce College Student Drinking: A Meta-Analysis

PubMed Central

Carey, Kate B.; Scott-Sheldon, Lori A. J.; Elliott, Jennifer C.; Bolles, Jamie R.; Carey, Michael P.

2009-01-01

Aims This meta-analysis evaluates the efficacy and moderators of computer-delivered interventions (CDIs) to reduce alcohol use among college students. Methods We included 35 manuscripts with 43 separate interventions, and calculated both between-group and within-group effect sizes for alcohol consumption and alcohol-related problems. Effects sizes were calculated for short-term (≤ 5 weeks) and longer-term (≥ 6 weeks) intervals. All studies were coded for study descriptors, participant characteristics, and intervention components. Results The effects of CDIs depended on the nature of the comparison condition: CDIs reduced quantity and frequency measures relative to assessment-only controls, but rarely differed from comparison conditions that included alcohol content. Small-to-medium within-group effect sizes can be expected for CDIs at short- and longer-term follow-ups; these changes are less than or equivalent to the within-group effect sizes observed for more intensive interventions. Conclusions CDIs reduce the quantity and frequency of drinking among college students. CDIs are generally equivalent to alternative alcohol-related comparison interventions. PMID:19744139

Does earmarked donor funding make it more or less likely that developing countries will allocate their resources towards programmes that yield the greatest health benefits?

PubMed

Waddington, Catriona

2004-09-01

It should not be assumed that earmarked donor funding automatically increases the allocation of developing-country resources towards programmes that yield the greatest health benefits. Sometimes it does, sometimes it does not--how the funding is designed can influence this. This is true particularly in the longer term, once the earmarked funding has ended. Even in the short term, total funding does not necessarily increase because of fungibility (i.e. recipient governments adjust their spending to offset donor funding preferences). The author explores six problems with earmarked funding: the multiplicity of earmarked funds confuses the situation for decision-makers; earmarking works against the spirit of the sectorwide approach; from the national perspective, it makes sense not to double-fund activities; local ownership of an activity is often compromised; earmarking can lead governments to accept interventions which they cannot afford in the longer term; and earmarking can distort local resource allocation.

Variable solar irradiance as a plausible agent for multidecadal variations in the Arctic-wide surface air temperature record of the past 130 years

NASA Astrophysics Data System (ADS)

Soon, Willie W.-H.

2005-08-01

This letter offers new evidence motivating a more serious consideration of the potential Arctic temperature responses as a consequence of the decadal, multidecadal and longer-term persistent forcing by the ever-changing solar irradiance both in terms of total solar irradiance (TSI, i.e., integrated over all wavelengths) and the related UV irradiance. The support for such a solar modulator can be minimally derived from the large (>75%) explained variance for the decadally-smoothed Arctic surface air temperatures (SATs) by TSI and from the time-frequency structures of the TSI and Arctic SAT variability as examined by wavelet analyses. The reconstructed Arctic SAT time series based on the inverse wavelet transform, which includes decadal (5-15 years) and multidecadal (40-80 years) variations and a longer-term trend, contains nonstationary but persistent features that are highly correlated with the Sun's intrinsic magnetic variability especially on multidecadal time scales.

Federal Public Health Service: In Retrospect and Prospects

ERIC Educational Resources Information Center

Kolbe, Lloyd J.

2016-01-01

In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated…

Gender Inequality in the Primary Classroom: Will Interactive Whiteboards Help?

ERIC Educational Resources Information Center

Smith, Fay; Hardman, Frank; Higgins, Steve

2007-01-01

This paper sets out to investigate (i) gender differences in whole class classroom interaction with a sample of teachers who were not using interactive whiteboards (IWBs) in their lessons; and (ii) the short-term and longer term impact of IWB use upon gender differences in classroom interaction. The study focused upon teacher-student interaction…

U.S. - African Partnerships: Advancing Common Interests

DTIC Science & Technology

2017-12-01

discussions on: – Governance, institutions, and effective partnerships – Prospects for enhancing economic partnerships – Opportunities and challenges in...U.S. administrations, emphasizing peace and security, countering terrorism, increasing economic growth, and promoting democracy and good governance...often focused on short- term security or economic objectives, while neglecting infrastructure projects and longer term programs that would empower

Schools as Incubators of Democratic Participation: Building Long-Term Political Efficacy with Civic Education

ERIC Educational Resources Information Center

Pasek, Josh; Feldman, Lauren; Romer, Daniel; Jamieson, Kathleen Hall

2008-01-01

Despite a growing consensus that civic education is an important aspect of political socialization, little research has prospectively examined how gains made during civics courses are maintained after high school. This study used a quasi-experimental design to examine longer-term effects of the Student Voices program, which was originally…

Hearing out Children's Narrative Pathways to Adulthood: Young People as Interpreters of Their Own Childhoods in Diverging Working-Class Scottish Communities

ERIC Educational Resources Information Center

Cross, Beth

2009-01-01

Participatory research with children in the main focuses on short-term interactions. As this practice develops, questions about longer-term consequences for participants have arisen, examining the empowering claims for this research approach. This article reports the findings from continued contact with participants of an ethnographic…

Inflation with a Weyl term, or ghosts at work

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

Deruelle, Nathalie; Youssef, Ahmed; Sasaki, Misao

2011-03-01

In order to assess the role of ghosts in cosmology, we study the evolution of linear cosmological perturbations during inflation when a Weyl term is added to the action. Our main results are that vector perturbations can no longer be ignored and that scalar modes diverge in the newtonian gauge but remain bounded in the comoving slicing.

Gender Relations, Family Relations and Long-Term Youth Unemployment.

ERIC Educational Resources Information Center

Jenkins, Richard; Hutson, Susan

The relationship between long-term youth unemployment and family relationships and that between youth unemployment and courtship and marriage patterns were examined in a study conducted in two towns in South Wales. Thirty-seven young men and 26 young women between the ages of 18 and 25 who had been unemployed for 6 months or longer were…

AN INVESTIGATION OF SITE CHARACTERISTICS CONTROLLING AIRFLOW INTO AND OUT OF THE SHALLOW UNSATURATED ZONE IN RESPONSE TO ATMOSPHERIC PRESSURE CHANGES

EPA Science Inventory

Atmospheric pressure near the land surface is constantly changing, due both to short-term diurnal temperature fluctuations as well as longer-term cycles due to the passage of high-and-low-pressure weather systems. Depending upon soil properties, such as air-filled porosity and a...

The Ever-Changing Meanings of Retirement

ERIC Educational Resources Information Center

McVittie, Chris; Goodall, Karen

2012-01-01

Shultz and Wang (April 2011) drew attention to the ways in which understandings of retirement have changed over time, both in terms of the place of retirement in the lives of individuals and in terms of how retirement can no longer usefully be taken to comprise a single defining event. As the authors pointed out, psychological research has…

Effects of Subependymal and Mild Intraventricular Lesions on Visual Attention and Memory in Premature Infants.

ERIC Educational Resources Information Center

Ross, Gail; And Others

1992-01-01

Premature infants with subependymal or intraventricular hemorrhage took longer to habituate on a habituation task, and scored lower on a measure of mental development, than did other premature infants or full-term infants. Both groups of premature infants were less successful than full-term infants on an object permanence task. (BC)

Developing School-Scientist Partnerships: Lessons for Scientists from Forests-of-Life

ERIC Educational Resources Information Center

Falloon, Garry; Trewern, Ann

2013-01-01

The concept of partnerships between schools and practicing scientists came to prominence in the United States in the mid 1980s. The call by government for greater private sector involvement in education to raise standards in science achievement saw a variety of programmes developed, ranging from short-term sponsorships through to longer-term,…

Long-Term Priming of Visual Search Prevails against the Passage of Time and Counteracting Instructions

ERIC Educational Resources Information Center

Kruijne, Wouter; Meeter, Martijn

2016-01-01

Studies on "intertrial priming" have shown that in visual search experiments, the preceding trial automatically affects search performance: facilitating it when the target features repeat and giving rise to switch costs when they change--so-called (short-term) intertrial priming. These effects also occur at longer time scales: When 1 of…

Doing More with Less: Civic Practices for Longer-Term Impact in Global Service-Learning

ERIC Educational Resources Information Center

Alonso García, Nuria; Longo, Nicholas V.

2017-01-01

This essay explores the potential value of short-term study abroad experiences within the unique framework of a new global service-learning program at Providence College which connects international with local engagement as a way to "do more with less." The authors first introduce a typology for global service-learning, illustrating how…

Validation of NE-TWIGS for tolerant hardwood stands in Ontario

Treesearch

Jacek Bankowski; Daniel C. Dey; Eric Boysen; Murray Woods; Jim Rice

1996-01-01

The individual-tree, distance-independent stand growth simulator NE-TWIGS has been tested for Ontario's tolerant hardwood stands using data from long-term permanent sample plots. NE-TWIGS provides reliable short-term (5-year) predictions of stand basal area (modelling efficiency from 77% to 99%), but in longer projections the efficiency of the model drops...

Preface: long-term response of a forest watershed ecosystem, clearcutting in the Southern Appalachians

Treesearch

Wayne Swank; Jackson Webster

2014-01-01

Our North American forests are no longer the wild areas of past centuries; they are an economic and ecological resource undergoing changes from both natural and management disturbances. A watershed-scale and long-term perspective of forest ecosystem responses is requisite to understanding and predicting cause and effect relationships. This book synthesizes...

The Varied Impact of Couple Relationship Breakdown on Children: Implications for Practice and Policy

ERIC Educational Resources Information Center

Coleman, Lester; Glenn, Fiona

2010-01-01

This review of international literature assesses the impacts that the relationship breakdown of parents has on children and factors that can provide support should this occur. The parental separation process causes significant albeit short-term distress for most children, with a minority reporting longer-term outcomes such as socio-economic…

The Treatment for Adolescents with Depression Study (TADS): Methods and Message at 12 Weeks

ERIC Educational Resources Information Center

March, John; Silva, Susan; Vitiello, Benedetto

2006-01-01

Funded by the National Institute of Mental Health, the Treatment for Adolescents With Depression Study (TADS) is intended to evaluate the short-term (12 weeks) and longer-term (36 weeks) effectiveness of four treatments for adolescents with DSM-IV major depressive disorder: clinical management with fluoxetine (FLX), cognitive-behavioral therapy…

77 FR 71860 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Designation of Longer...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68312; File No. SR-NSX-2012-015] Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Designation of Longer Period for Commission Action on a Proposed Rule Change Relating to Adoption of Listing Standards for Compensation Committees and Advisors as Required by Rule 10C-1...

77 FR 71852 - Self-Regulatory Organizations; Chicago Stock Exchange, Inc.; Notice of Designation of Longer...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68311; File No. SR-CHX-2012-013] Self-Regulatory Organizations; Chicago Stock Exchange, Inc.; Notice of Designation of Longer Period for Commission Action on a Proposed Rule Change Relating to Adoption of Listing Standards for Compensation Committees and Advisors as Required by Rule 10C-1...

A Possible Link between Supra-Second Open-Ended Timing Sensitivity and Obsessive-Compulsive Tendencies

PubMed Central

Gilaie-Dotan, Sharon; Ashkenazi, Hamutal; Dar, Reuven

2016-01-01

One of the main characteristics of obsessive-compulsive disorder (OCD) is the persistent feeling of uncertainty, affecting many domains of actions and feelings. It was recently hypothesized that OCD uncertainty is related to attenuated access to internal states. As supra-second timing is associated with bodily and interoceptive awareness, we examined whether supra-second timing would be associated with OC tendencies. We measured supra-second (~9 s) and sub-second (~450 ms) timing along with control non-temporal perceptual tasks in a group of 60 university students. Supra-second timing was measured either with fixed criterion tasks requiring to temporally discriminate between two predefined fixed interval durations (9 vs. 9.9 s), or with an open-ended task requiring to discriminate between 9 s and longer intervals which were of varying durations that were not a priori known to the participants. The open-ended task employed an adaptive Bayesian procedure that efficiently estimated the duration difference required to discriminate 9 s from longer intervals. We also assessed symptoms of OCD, depression, and anxiety. Open-ended supra-second temporal sensitivity was correlated with OC tendencies, as predicted (even after controlling for depression and anxiety), whereas the other tasks were not. Higher OC tendencies were associated with lower timing sensitivity to 9 s intervals such that participants with higher OC tendency scores required longer interval differences to discriminate 9 s from longer intervals. While these results need to be substantiated in future research, they suggest that open-ended timing tasks, as those encountered in real-life (e.g., estimating how long it would take to complete a task), might be adversely affected in OCD. PMID:27445725

Cryogenic Fluid Management Technology Development Roadmaps

NASA Technical Reports Server (NTRS)

Stephens, J. R.; Johnson, W. L.

2017-01-01

Advancement in Cryogenic Fluid Management (CFM) Technologies is essential for achieving NASA's future long duration missions. Propulsion systems utilizing cryogens are necessary to achieve mission success. Current State Of the Art (SOA) CFM technologies enable cryogenic propellants to be stored for several hours. However, some envisioned mission architectures require cryogens to be stored for two years or longer. The fundamental roles of CFM technologies are long term storage of cryogens, propellant tank pressure control and propellant delivery. In the presence of heat, the cryogens will "boil-off" over time resulting in excessive pressure buildup, off-nominal propellant conditions, and propellant loss. To achieve long term storage and tank pressure control, the CFM elements will intercept and/or remove any heat from the propulsion system. All functions are required to perform both with and without the presence of a gravitational field. Which CFM technologies are required is a function of the cryogens used, mission architecture, vehicle design and propellant tank size. To enable NASA's crewed mission to the Martian surface, a total of seventeen CFM technologies have been identified to support an In-Space Stage and a Lander/Ascent Vehicle. Recognizing that FY2020 includes a Decision Point regarding the In-Space Stage Architecture, a set of CFM Technology Development Roadmaps have been created identifying the current Technology Readiness Level (TRL) of each element, current technology "gaps", and existing technology development efforts. The roadmaps include a methodical approach and schedule to achieve a flight demonstration in FY2023, hence maturing CFM technologies to TRL 7 for infusion into the In-Space Stage Preliminary Design.

Technical and financial evaluation of assays for progesterone in canine practice in the UK.

PubMed

Moxon, R; Copley, D; England, G C W

2010-10-02

The concentration of progesterone was measured in 60 plasma samples from bitches at various stages of the oestrous cycle, using commercially available quantitative and semi-quantitative ELISA test kits, as well as by two commercial laboratories undertaking radioimmunoassay (RIA). The RIA, which was assumed to be the 'gold standard' in terms of reliability and accuracy, was the most expensive method when analysing more than one sample per week, and had the longest delay in obtaining results, but had minimal requirements for practice staff time. When compared with the RIA, the quantitative ELISA had a strong positive correlation (r=0.97, P<0.05) and a sensitivity and specificity of 70.6 per cent and 100.0 per cent, respectively, and positive and negative predictive values of 100.0 per cent and 71.0 per cent, respectively, with an overall accuracy of 90.0 per cent. This method was the least expensive when analysing five or more samples per week, but had longer turnaround times than that of the semi-quantitative ELISA and required more staff time. When compared with the RIA, the semi-quantitative ELISA had a sensitivity and specificity of 100.0 per cent and 95.5 per cent, respectively, and positive and negative predictive values of 73.9 per cent and 77.8 per cent, respectively, with an overall accuracy of 89.2 per cent. This method was more expensive than the quantitative ELISA when analysing five or more samples per week, but had the shortest turnaround time and low requirements in terms of staff time.

Optimizing Fire Department Operations Through Work Schedule Analysis, Alternative Staffing, and Nonproductive Time Reduction

DTIC Science & Technology

2014-09-01

hour work shift. A longer shift offers more time off between shifts, which can improve the employee’s family life , and personal emotional stress . On...Enhancing Work / Life Balance ,” Conn.L.Rev. 42 (2010): 1081–1527. 19 Nicole Jansen et al., “Need for Recovery from Work : Evaluating Short-Term Effects...24-hour work shift. A longer shift offers more time off between shifts that can improve the employee’s family life and personal emotional stress

EAR Program Research Results

DOT National Transportation Integrated Search

2013-01-01

The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for longterm improvements to transportation systems-improvements in planning, building, renewing, and operating safe, congesti...

Fires: Pushing the Reset Button or a Flash in the Pan?

NASA Astrophysics Data System (ADS)

MacDonald, L. H.; Wagenbrenner, J. W.; Robichaud, P. R.; Nelson, P. A.; Kampf, S. K.; Brogan, D. J.

2016-12-01

High and moderate severity wildfires can reduce infiltration rates to less than 10 mm/hr, and the resulting surface runoff can increase small-scale peak flows by one or more orders of magnitude. Fires can increase hillslope erosion rates by several orders of magnitude, but this increase is less linear with rainfall intensity because it also depends on sediment supply and detachment processes as well as transport capacity. These localized and shorter-term effects have been relatively well documented, but there is much more uncertainty in how these fire-induced changes can lead to larger-scale and/or longer-term effects. The goal of this presentation is to provide a process-based analysis of how, where, and when wildfires can cause either longer-term or larger-scale changes, effectively resetting the system as opposed to a more transient "flash in the pan". An understanding of vegetation, climatic, and geomorphic dynamics are are critical for predicting larger-scale and longer-term effects. First is the potential for the vegetation to return to pre-fire conditions, and this depends on vegetation type, spatial extent of the fire, and if the pre-fire vegetation is marginalized by climate change, land use, or other factors. The trajectory of post-fire regrowth controls the duration of increased runoff and erosion as well as the size and severity of future fires, which then sets the scene for longer-term hydrologic and geomorphic change. Climate defines the dominant storm type and how they match up with the spatial extent of a fire. Historic data help estimate the extent and magnitude of post-fire rainfall, but there is a strong stochastic component and the more extreme events are of greatest concern. Geomorphic controls on larger-scale effects include the valley and drainage network characteristics that help govern the storage and delivery of water and sediment. Assessing each component involves multiple site factors, but the biggest problem is understanding their complex interactions to predict resource impacts, landscape change over different temporal and spatial scales, and the potential to ameliorate adverse impacts. Data from multiple field studies are used to illustrate the range of post-fire effects, selected interactions of the different components, and identify key research needs.

Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms.

PubMed

Halldorsdottir, Thorhildur; Ollendick, Thomas H

2016-05-01

The objectives were twofold: (a) examine long-term treatment effects in youth receiving 1-session treatment (OST) or educational support (EST) for a specific phobia (SP) and (b) examine the differential predictive and moderation effects of attention-deficit/hyperactivity disorder (ADHD) symptoms on immediate and long-term outcomes following the interventions. Eighty-three children (ages 6-15, 47% female, 89% White) with a SP were randomly assigned to receive OST or EST. Follow up assessments occurred at 1 week, 6 months, 1 year, and 4 years. Hierarchical linear growth modeling (HLGM) was used to explore the association of parent-reported ADHD symptoms, the 2 treatment conditions (i.e., OST vs. EST), and the trajectory of change in the severity of the SP from pretreatment to the 4-year follow-up. Age, conduct problems and learning problems were controlled for in all analyses. A greater immediate reduction in severity rating of the SP was observed in the OST compared to EST, whereas the trajectory of long-term outcomes was similar across conditions over time. Higher levels of ADHD symptoms predicted poor immediate and long-term treatment outcomes across treatment conditions. ADHD symptoms, however, did not moderate the relationship between treatment condition and immediate or long-term treatment outcomes. The results of the study need to be interpreted in light of several study limitations. However, if confirmed, the findings suggest that anxious youth with comorbid ADHD symptoms are less likely to benefit from brief, intensive psychotherapy and may require either longer, standard CBT treatment or adjunctive pharmacotherapy. (c) 2016 APA, all rights reserved).

78 FR 67402 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses and Combined Licenses...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... the requirement for organizational independence of the operations, health physics, and quality... personnel will no longer be required to protect public health and safety. 1. Does the proposed change...

47 CFR 90.551 - Construction requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Construction requirements. 90.551 Section 90...-775 and 793-805 MHz Bands § 90.551 Construction requirements. Each station authorized under this..., licensees may request a longer construction period, up to but not exceeding 5 years, pursuant to § 90.155(b...

47 CFR 90.551 - Construction requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Construction requirements. 90.551 Section 90...-775 and 793-805 MHz Bands § 90.551 Construction requirements. Each station authorized under this..., licensees may request a longer construction period, up to but not exceeding 5 years, pursuant to § 90.155(b...

77 FR 51459 - Suspension of End-Use Certificate Program Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

... indefinitely the Farm Service Agency (FSA) regulation requiring end-use certificates and tracking of wheat... Canadian produced wheat are no longer required to provide FSA end-use certificates or consumption and resale reports on wheat produced in Canada. DATES: Effective August 31, 2012. FOR FURTHER INFORMATION...

Human parathyroid hormone-(1-38) restores cancellous bone to the immobilized, osteopenic proximal tibial metaphysis in rats

NASA Technical Reports Server (NTRS)

Ma, Y. F.; Jee, W. S. S.; Ke, H. Z.; Lin, B. Y.; Liang, X. G.; Li, M.; Yamamoto, N.

1994-01-01

The purpose of this study was to determine if human parathyroid hormone-(1-38) (PTH) can restore cancellous bone mass to the established osteopenic, immobilized proximal tibial metaphyses (PTM) of female rats. The right hindlimbs of six-month-old female Sprague-Dawley rats were immobilized by bandaging the right hindlimbs to the abdomen. After 30 days of right hindlimb immobilization (RHLI), the rats were subcutaneously injected with 200 microgram hPTH(1-38)/kg/day for 15 (short-term) or 75 (longer-term) days. Static bone histomorphometry was performed on the primary spongiosa, while both static and dynamic histomorphometry were performed on the secondary spongiosa of the right PTM. Immobilization for 30 days without treatment decreased trabecular bone area, number and thickness in both primary and secondary spongiosa, and induced an increase in eroded perimeter and a decrease in tissue referent-bone formation rate (BFR/TV) in the secondary spongios. These changes reached a new steady state thereafter. Treatment with 200 microgram hPTH(1-38)/kg/day for 15 days, beginning at 30 days post immobilization (IM), significantly increased trabecular bone area, thickness and number in both primary and secondary spongiosa despite continuous IM when compared to the age-related and IM controls. The short-term (15 days) PTH treatment significantly increased labeling perimeter, mineral apposition rate and BFR/TV in the secondary spongiosa and stimulated longitudinal bone growth as compared to the age-related and IM controls. PTH treatment for longer-term (75 days) further increased trabecular bone area, thickness and number as compared to aging and IM controls and short-term (15 days) PTH treated groups. The bone formation indices in the secondary spongiosa of these longer-term treated rats were lower than that of short-term (15 days) PTH treated group, but they were still higher than those of IM and age-related controls. Our findings indicate that PTH treatment stimulates cancellous bone formation, restores and adds extra cancellous bone to the established, disuse-osteopenic proximal tibial metaphysis of continuously RHLI female rats. These results suggest that PTH may be a useful agent in treatment disuse-induced osteoporosis in humans.

Role of the Truview EVO2 laryngoscope in the airway management of elective surgical patients: A comparison with the Macintosh laryngoscope

PubMed Central

Saxena, Arpita; Madan, Manish; Shrivastava, Uma; Mittal, Apurva; Dwivedi, Yogita; Agrawal, Archna; Puri, Rajeev

2013-01-01

Background: The Truview EVO2(C) laryngoscope (TL) is a recently introduced optical device designed to provide an unmagnified anterior image of the glottic opening and allow indirect laryngoscopy. Aim: This study is designed to determine whether the TL is a better alternative to the Macintosh laryngoscope (ML) for routine endotracheal intubations in patients with usual airway characteristics. Methods: We compared the Truview EVO2(C) and MLs in 140 elective surgical patients requiring general anaesthesia and intubation in a prospective crossover fashion. The two blades were compared in terms of Cormack and Lehane grades, time required for intubation, anaesthetists’ assessment of ease of intubation, intubation difficulty score, attempts at intubation, success rate, soft tissue damage and arterial oxygen saturation during laryngoscopy. The Student t test and Chi-square test were used to determine the statistical significance of parametric data and categorical data, respectively. Results: The Truview EVO2(C) blade provided a better laryngoscopic view than the Macintosh blade as suggested by improved Cormack and Lehane grades (in 48 patients), but required a longer time for intubation than the Macintosh blade (34.1 vs. 22.4 s), i.e., an improved view at the cost of longer mean intubation time. In spite of lower intubation difficulty scores, Truview EVO2(C) was considered as difficult to use on subjective assessment by the anaesthesiologist when compared with Macintosh. There was no difference observed between the two groups in attempts at intubation, success rate, soft tissue damage and arterial oxygen saturation during laryngoscopy. Conclusion: We opine that although Truview provides a better laryngoscopic view than Macintosh in difficult cases, it does not have an extra benefit over Macintosh otherwise, further indicating the need for more experience with the use of a Truview laryngoscope. PMID:23983287

Mercuric oxide poisoning

MedlinePlus

Mercuric oxide may be found in some: Button batteries (batteries containing mercury are no longer sold in the ... long-term injury Any person who swallowed a battery will need immediate x-rays to make sure ...

7 CFR 1486.207 - What is the Technical Issues Resolution Fund?

Code of Federal Regulations, 2010 CFR

2010-01-01

... strategic areas of longer term interest. Funding decisions are determined primarily through a review process... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS EMERGING MARKETS...

Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well.

PubMed

Howell, Doris D

2018-03-01

As individuals are living longer with cancer as a chronic disease, they face new health challenges that require the application of self-management behaviors and skills that may not be in their usual repertoire of self-regulatory health behaviors. Increasing attention is focused on supported self-management (SSM) programs to enable survivors in managing the long-term biopsychosocial consequences and health challenges of survivorship. This review explores current directions and evidence for SSM programs that enable survivors to manage these consequences and optimize health. Cancer survivors face complex health challenges that affect daily functioning and well being. Multiple systematic reviews show that SSM programs have positive effects on health outcomes in typical chronic diseases. However, the efficacy of these approaches in cancer survivors are in their infancy; and the 'one-size' fits all approach for chronic disease self-management may not be adequate for cancer as a complex chronic illness. This review suggests that SSM has promising potential for improving health and well being of cancer survivors, but there is a need for standardizing SSM for future research. Although there is increasing enthusiasm for SSM programs tailored to cancer survivors, there is a need for further research of their efficacy on long-term health outcomes.

Comparison of short-term response to two spinal manipulation techniques for patients with low back pain in a military beneficiary population.

PubMed

Sutlive, Thomas G; Mabry, Lance M; Easterling, Emmanuel J; Durbin, Jose D; Hanson, Stephen L; Wainner, Robert S; Childs, John D

2009-07-01

To determine whether military health care beneficiaries with low back pain (LBP) who are likely to respond successfully to spinal manipulation experience a difference in short-term clinical outcomes based on the manipulation technique that is used. Sixty patients with LBP identified as likely responders to manipulation underwent a standardized clinical examination and were randomized to receive a lumbopelvic (LP) or lumbar neutral gap (NG) manipulation technique. Outcome measures were a numeric pain rating scale and the modified Oswestry Disability Questionnaire. Both the LP and NG groups experienced statistically significant reductions in pain and disability at 48 hours postmanipulation. The improvements seen in each group were small because of the short follow-up. There were no statistically significant or clinically meaningful differences in pain or disability between the two groups. The two manipulation techniques used in this study were equally effective at reducing pain and disability when compared at 48 hours posttreatment. Clinicians may employ either technique for the treatment of LBP and can expect similar outcomes in those who satisfy the clinical prediction rule (CPR). Further research is required to determine whether differences exist at longer-term follow-up periods, after multiple treatment sessions, or in different clinical populations.

Effects of temporal averaging on short-term irradiance variability under mixed sky conditions

NASA Astrophysics Data System (ADS)

Lohmann, Gerald M.; Monahan, Adam H.

2018-05-01

Characterizations of short-term variability in solar radiation are required to successfully integrate large numbers of photovoltaic power systems into the electrical grid. Previous studies have used ground-based irradiance observations with a range of different temporal resolutions and a systematic analysis of the effects of temporal averaging on the representation of variability is lacking. Using high-resolution surface irradiance data with original temporal resolutions between 0.01 and 1 s from six different locations in the Northern Hemisphere, we characterize the changes in representation of temporal variability resulting from time averaging. In this analysis, we condition all data to states of mixed skies, which are the most potentially problematic in terms of local PV power volatility. Statistics of clear-sky index k* and its increments Δk*τ (i.e., normalized surface irradiance and changes therein over specified intervals of time) are considered separately. Our results indicate that a temporal averaging time scale of around 1 s marks a transition in representing single-point irradiance variability, such that longer averages result in substantial underestimates of variability. Higher-resolution data increase the complexity of data management and quality control without appreciably improving the representation of variability. The results do not show any substantial discrepancies between locations or seasons.

Modernization of the NASA scientific and technical information program

NASA Technical Reports Server (NTRS)

Cotter, Gladys A.; Hunter, Judy F.; Ostergaard, K.

1993-01-01

The NASA Scientific and Technical Information Program utilizes a technology infrastructure assembled in the mid 1960s to late 1970s to process and disseminate its information products. When this infrastructure was developed it placed NASA as a leader in processing STI. The retrieval engine for the STI database was the first of its kind and was used as the basis for developing commercial, other U.S., and foreign government agency retrieval systems. Due to the combination of changes in user requirements and the tremendous increase in technological capabilities readily available in the marketplace, this infrastructure is no longer the most cost-effective or efficient methodology available. Consequently, the NASA STI Program is pursuing a modernization effort that applies new technology to current processes to provide near-term benefits to the user. In conjunction with this activity, we are developing a long-term modernization strategy designed to transition the Program to a multimedia, global 'library without walls.' Critical pieces of the long-term strategy include streamlining access to sources of STI by using advances in computer networking and graphical user interfaces; creating and disseminating technical information in various electronic media including optical disks, video, and full text; and establishing a Technology Focus Group to maintain a current awareness of emerging technology and to plan for the future.

Flavan-3-ols, theobromine, and the effects of cocoa and chocolate on cardiometabolic risk factors.

PubMed

Berends, Lindsey M; van der Velpen, Vera; Cassidy, Aedin

2015-02-01

Although there is growing interest surrounding the potential health benefits of cocoa and chocolate, the relative contribution of bioactive constituents for these effects remains unclear. This review summarizes the recent research on the cardiometabolic effects of cocoa and chocolate with a focus on two key constituents: flavan-3-ols and theobromine. Recent meta-analyses suggest beneficial cardiometabolic effects of chocolate following short-term intake, including improvements in flow-mediated dilatation, blood pressure, lipoprotein levels and biomarkers of insulin resistance. Flavan-3-ols may play a role, but it is currently unclear which specific compounds or metabolites are key. Theobromine has also been shown to improve lipoprotein levels in trials, although these findings need verification at habitual intake levels. Longer term dose-response randomized controlled trials are required to determine the sustainability of the short-term effects and the optimal dose. Quantifying levels of bioactives in intervention products and their metabolites in biological samples will facilitate the assessment of their relative impact and the underlying mechanisms of action. Promising data support the beneficial cardiometabolic effects of cocoa and chocolate intake, with significant interest in the flavan-3-ol and theobromine content. Validated biomarkers of intake together with more relevant mechanistic insights from experimental models using physiologically relevant concentrations and metabolites will continue to inform this research field.

Xenon Acquisition Strategies for High-Power Electric Propulsion NASA Missions

NASA Technical Reports Server (NTRS)

Herman, Daniel A.; Unfried, Kenneth G.

2015-01-01

The benefits of high-power solar electric propulsion (SEP) for both NASA's human and science exploration missions combined with the technology investment from the Space Technology Mission Directorate have enabled the development of a 50kW-class SEP mission. NASA mission concepts developed, including the Asteroid Redirect Robotic Mission, and those proposed by contracted efforts for the 30kW-class demonstration have a range of xenon propellant loads from 100's of kg up to 10,000 kg. A xenon propellant load of 10 metric tons represents greater than 10% of the global annual production rate of xenon. A single procurement of this size with short-term delivery can disrupt the xenon market, driving up pricing, making the propellant costs for the mission prohibitive. This paper examines the status of the xenon industry worldwide, including historical xenon supply and pricing. The paper discusses approaches for acquiring on the order of 10 MT of xenon propellant considering realistic programmatic constraints to support potential near-term NASA missions. Finally, the paper will discuss acquisitions strategies for mission campaigns utilizing multiple high-power solar electric propulsion vehicles requiring 100's of metric tons of xenon over an extended period of time where a longer term acquisition approach could be implemented.

Plasticity of Neuron-Glial Transmission: Equipping Glia for Long-Term Integration of Network Activity.

PubMed

Croft, Wayne; Dobson, Katharine L; Bellamy, Tomas C

2015-01-01

The capacity of synaptic networks to express activity-dependent changes in strength and connectivity is essential for learning and memory processes. In recent years, glial cells (most notably astrocytes) have been recognized as active participants in the modulation of synaptic transmission and synaptic plasticity, implicating these electrically nonexcitable cells in information processing in the brain. While the concept of bidirectional communication between neurons and glia and the mechanisms by which gliotransmission can modulate neuronal function are well established, less attention has been focussed on the computational potential of neuron-glial transmission itself. In particular, whether neuron-glial transmission is itself subject to activity-dependent plasticity and what the computational properties of such plasticity might be has not been explored in detail. In this review, we summarize current examples of plasticity in neuron-glial transmission, in many brain regions and neurotransmitter pathways. We argue that induction of glial plasticity typically requires repetitive neuronal firing over long time periods (minutes-hours) rather than the short-lived, stereotyped trigger typical of canonical long-term potentiation. We speculate that this equips glia with a mechanism for monitoring average firing rates in the synaptic network, which is suited to the longer term roles proposed for astrocytes in neurophysiology.

Is there a 'pig cycle' in the labour supply of doctors? How training and immigration policies respond to physician shortages.

PubMed

Chojnicki, Xavier; Moullan, Yasser

2018-03-01

Many OECD countries are faced with the considerable challenge of a physician shortage. This paper investigates the strategies that OECD governments adopt and determines whether these policies effectively address these medical shortages. Due to the amount of time medical training requires, it takes longer for an expansion in medical school capacity to have an effect than the recruitment of foreign-trained physicians. Using data obtained from the OECD (2014) and Bhargava et al. (2011), we constructed a unique country-level panel dataset that includes annual data for 17 OECD countries on physician shortages, the number of medical school graduates and immigration and emigration rates from 1991 to 2004. By calculating panel fixed-effect estimates, we find that after a period of medical shortages, OECD governments produce more medical graduates in the long run but in the short term, they primarily recruit from abroad; however, at the same time, certain practising physicians choose to emigrate. Simulation results show the limits of recruiting only abroad in the long term but also highlight its appropriateness for the short term when there is a recurrent cycle of shortages/surpluses in the labour supply of physicians (pig cycle theory). Copyright © 2018 Elsevier Ltd. All rights reserved.

Short-term stability of T1 and T2 relaxation measures in multiple sclerosis normal appearing white matter.

PubMed

Liang, Alice L W; Vavasour, Irene M; Mädler, Burkhard; Traboulsee, Anthony L; Lang, Donna J; Li, David K B; MacKay, Alex L; Laule, Cornelia

2012-06-01

The presence of diffuse and widespread abnormalities within the 'normal appearing' white matter (NAWM) of multiple sclerosis (MS) brain has been established. T(1) histogram analysis has revealed increased T(1) (related to water content) in segmented NAWM, while quantitative assessment of T(2) relaxation measures has demonstrated decreased myelin water fraction (MWF, related to myelin content) and increased geometric mean T(2) (GMT(2)) of the intra/extracellular water pool. Previous studies with follow-up periods of 1-5 years have demonstrated longitudinal changes in T(1) histogram metrics over time; however, longitudinal changes in MWF and GMT(2) of segmented NAWM have not been examined. We examined the short-term evolution of MWF, GMT(2) and T(1) in MS NAWM based on monthly scanning over 6 months in 18 relapsing remitting (RR) MS subjects. Histogram metrics demonstrated short-term stability of T(1), MWF and remitting (RR) MS subjects. We observed no change in MWF, GMT(2) or T(1) histogram metrics in NAWM in RRMS over the course of 6 months. Longer follow-up periods may be required to establish demonstrable changes in NAWM based on of MWF, GMT(2) and T(1) metrics.

Laparoscopic treatment of rectal cancer and lateral pelvic lymph node dissection. Are they obsolete?

PubMed

Toda, Shigeo; Kuroyanagi, Hiroya; Matoba, Shuichiro; Hiramatsu, Kosuke; Okazaki, Naoto; Tate, Tomohiro; Tomizawa, Kenji; Hanaoka, Yutaka; Moriyama, Jin

2018-05-24

Laparoscopic surgery for rectal cancer offers favorable short term results without compromising long term oncological outcomes so far, according to the data from major trials. Therefore it is being considered as a standard option for rectal cancer surgery. The learning curve of laparoscopic rectal cancer surgery is generally longer compared to colon cancer. Appropriate standardization and training of laparoscopic rectal cancer surgery is required. Several RCTs suggested the potential negative effect on quality of resected specimen, which can increase local recurrence. The long term outcomes especially local recurrence rate of these RCTs are awaited. Lateral pelvic lymph node dissection (LPLND) has a certain effect of reducing local recurrence of rectal cancer even after neoadjuvant radiotherapy. Since LPLND is associated with postoperative morbidity, we should carefully select the candidate to maximize the effect of LPLND and minimize the morbidity caused by LPLND. Recent advancement in imaging study such as CT and MRI enables us to find the suitable candidates for LPLND. The morbidity caused by LPLND could be reduced by minimally invasive surgeries such as laparoscopic surgery and robotic surgery. We have to improve oncological outcomes and reduce morbidity by the multidisciplinary strategy for rectal cancer including total mesorectal excision, neoadjuvant chemoradiotherapy and LPLND together with laparoscopic surgery.

Auditory-Cortex Short-Term Plasticity Induced by Selective Attention

PubMed Central

Jääskeläinen, Iiro P.; Ahveninen, Jyrki

2014-01-01

The ability to concentrate on relevant sounds in the acoustic environment is crucial for everyday function and communication. Converging lines of evidence suggests that transient functional changes in auditory-cortex neurons, “short-term plasticity”, might explain this fundamental function. Under conditions of strongly focused attention, enhanced processing of attended sounds can take place at very early latencies (~50 ms from sound onset) in primary auditory cortex and possibly even at earlier latencies in subcortical structures. More robust selective-attention short-term plasticity is manifested as modulation of responses peaking at ~100 ms from sound onset in functionally specialized nonprimary auditory-cortical areas by way of stimulus-specific reshaping of neuronal receptive fields that supports filtering of selectively attended sound features from task-irrelevant ones. Such effects have been shown to take effect in ~seconds following shifting of attentional focus. There are findings suggesting that the reshaping of neuronal receptive fields is even stronger at longer auditory-cortex response latencies (~300 ms from sound onset). These longer-latency short-term plasticity effects seem to build up more gradually, within tens of seconds after shifting the focus of attention. Importantly, some of the auditory-cortical short-term plasticity effects observed during selective attention predict enhancements in behaviorally measured sound discrimination performance. PMID:24551458

Theory and computation of optimal low- and medium-thrust transfers

NASA Technical Reports Server (NTRS)

Chuang, C.-H.

1994-01-01

This report presents two numerical methods considered for the computation of fuel-optimal, low-thrust orbit transfers in large numbers of burns. The origins of these methods are observations made with the extremal solutions of transfers in small numbers of burns; there seems to exist a trend such that the longer the time allowed to perform an optimal transfer the less fuel that is used. These longer transfers are obviously of interest since they require a motor of low thrust; however, we also find a trend that the longer the time allowed to perform the optimal transfer the more burns are required to satisfy optimality. Unfortunately, this usually increases the difficulty of computation. Both of the methods described use small-numbered burn solutions to determine solutions in large numbers of burns. One method is a homotopy method that corrects for problems that arise when a solution requires a new burn or coast arc for optimality. The other method is to simply patch together long transfers from smaller ones. An orbit correction problem is solved to develop this method. This method may also lead to a good guidance law for transfer orbits with long transfer times.

Driver usage and understanding of adaptive cruise control.

PubMed

Larsson, Annika F L

2012-05-01

Automation, in terms of systems such as adaptive/active cruise control (ACC) or collision warning systems, is increasingly becoming a part of everyday driving. These systems are not perfect though, and the driver has to be prepared to reclaim control in situations very similar to those the system easily handles by itself. This paper uses a questionnaire answered by 130 ACC users to discuss future research needs in the area of driver assistance systems. Results show that the longer drivers use their systems, the more aware of its limitations they become. Moreover, the drivers report that ACC forces them to take control intermittently. According to theory, this might actually be better than a more perfect system, as it provides preparation for unexpected situations requiring the driver to reclaim control. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

If We Can't Predict Solar Cycle 24, What About Solar Cycle 34?

NASA Technical Reports Server (NTRS)

Pesnell. William Dean

2008-01-01

Predictions of solar activity in Solar Cycle 24 range from 50% larger than SC 23 to the onset of a Grand Minimum. Because low levels of solar activity are associated with global cooling in paleoclimate and isotopic records, anticipating these extremes is required in any longterm extrapolation of climate variability. Climate models often look forward 100 or more years, which would mean 10 solar cycles into the future. Predictions of solar activity are derived from a number of methods, most of which, such as climatology and physics-based models, will be familiar to atmospheric scientists. More than 50 predictions of the maximum amplitude of SC 24 published before solar minimum will be discussed. Descriptions of several methods that result in the extreme predictions and some anticipation of even longer term predictions will be presented.

An air-breathing enzymatic cathode with extended lifetime by continuous laccase supply.

PubMed

Kipf, Elena; Sané, Sabine; Morse, Daniel; Messinger, Thorsten; Zengerle, Roland; Kerzenmacher, Sven

2018-04-22

We present a novel concept of an air-breathing enzymatic biofuel cell cathode combined with continuous supply of unpurified laccase-containing supernatant of the white-rot fungus Trametes versicolor for extended lifetime. The air-breathing cathode design obviates the need for energy-intensive active aeration. In a corresponding long-term experiment at a constant current density of 50 µA cm -2 , we demonstrated an increased lifetime of 33 days (cathode potential above 0.430 V vs. SCE), independent of enzyme degradation. The obtained data suggest that theoretically a longer lifetime is feasible. However, further engineering efforts are required to prevent clogging and fouling of the supply tubes. These results represent an important step towards the realization of enzymatic biofuel cell cathodes with extended lifetime and enhanced performance. Copyright © 2018 Elsevier Ltd. All rights reserved.

The need for economic evaluation of telemedicine to evolve: the experience in Alberta, Canada.

PubMed

Hailey, David; Jennett, Penny

2004-01-01

Economic evaluation of telemedicine applications is required to provide decision makers in health care with appropriate information on costs and benefits of this information and communications technology. The level of economic evaluation should evolve as telemedicine applications mature. At the basic level, economic evaluation may include basic cost analysis and primarily observational data on nonmonetary benefits. The focus will change as telemedicine programs develop. At this intermediate level, practice patterns and workforce issues are addressed as they affect utilization and costs of telemedicine services. Longer-term economic evaluation, thus far not achieved in telemedicine assessment, should focus on assessment of health outcomes and economic impact. Alberta, Canada has made progress assessing telemedicine applications in psychiatry, radiology, rheumatology, and rehabilitation. Data availability and analytic resources continue to present challenges to economic assessment of telemedicine.

NASA Virtual Glovebox: An Immersive Virtual Desktop Environment for Training Astronauts in Life Science Experiments

NASA Technical Reports Server (NTRS)

Twombly, I. Alexander; Smith, Jeffrey; Bruyns, Cynthia; Montgomery, Kevin; Boyle, Richard

2003-01-01

The International Space Station will soon provide an unparalleled research facility for studying the near- and longer-term effects of microgravity on living systems. Using the Space Station Glovebox Facility - a compact, fully contained reach-in environment - astronauts will conduct technically challenging life sciences experiments. Virtual environment technologies are being developed at NASA Ames Research Center to help realize the scientific potential of this unique resource by facilitating the experimental hardware and protocol designs and by assisting the astronauts in training. The Virtual GloveboX (VGX) integrates high-fidelity graphics, force-feedback devices and real- time computer simulation engines to achieve an immersive training environment. Here, we describe the prototype VGX system, the distributed processing architecture used in the simulation environment, and modifications to the visualization pipeline required to accommodate the display configuration.

The in-depth safety assessment (ISA) pilot projects in Ukraine.

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

Kot, C. A.

1998-02-10

Ukraine operates pressurized water reactors of the Soviet-designed type, VVER. All Ukrainian plants are currently operating with annually renewable permits until they update their safety analysis reports (SARs). After approval of the SARS by the Ukrainian Nuclear Regulatory Authority, the plants will be granted longer-term operating licenses. In September 1995, the Nuclear Regulatory Authority and the Government Nuclear Power Coordinating Committee of Ukraine issued a new contents requirement for the safety analysis reports of VVERs in Ukraine. It contains requirements in three major areas: design basis accident (DBA) analysis, probabilistic risk assessment (PRA), and beyond design-basis accident (BDBA) analysis. Themore » DBA requirements are an expanded version of the older SAR requirements. The last two requirements, on PRA and BDBA, are new. The US Department of Energy (USDOE), through the International Nuclear Safety Program (INSP), has initiated an assistance and technology transfer program to Ukraine to assist their nuclear power stations in developing a Western-type technical basis for the new SARS. USDOE sponsored In-Depth Safety Assessments (ISAs) have been initiated at three pilot nuclear reactor units in Ukraine, South Ukraine Unit 1, Zaporizhzhya Unit 5, and Rivne Unit 1. USDOE/INSP have structured the ISA program in such a way as to provide maximum assistance and technology transfer to Ukraine while encouraging and supporting the Ukrainian plants to take the responsibility and initiative and to perform the required assessments.« less

Predictors of adalimumab drug survival in psoriasis differ by reason for discontinuation: long-term results from the Bio-CAPTURE registry.

PubMed

van den Reek, J M P A; Tummers, M; Zweegers, J; Seyger, M M B; van Lümig, P P M; Driessen, R J B; van de Kerkhof, P C M; Kievit, W; de Jong, E M G J

2015-03-01

Drug survival is an indicator for treatment success; insight in predictors associated with drug survival is important. To analyse the long-term drug survival for adalimumab in patients with psoriasis treated in daily practice and (II) to identify predictors of prolonged drug survival for adalimumab split for different reasons of discontinuation. Data were extracted from a prospective psoriasis cohort and analysed using Kaplan-Meier survival curves split for reasons of discontinuation. Baseline predictors associated with longer drug survival were identified using multivariate Cox-regression analysis. One hundred and sixteen patients were included with a total of 208 patient-years. Overall drug survival was 76% after 1 year and 52% after 4.5 years. In patients who stopped due to ineffectiveness, longer drug survival was associated with the absence of specific comorbidities (P = 0.03). In patients who stopped due to side-effects, longer drug survival was associated with male gender (P = 0.02). Predictors of adalimumab drug survival in psoriasis differ by reason for discontinuation. Strong, specific predictors can lead to patient-tailored treatment. © 2014 European Academy of Dermatology and Venereology.

Temporal and acoustic characteristics of Greek vowels produced by adults with cerebral palsy

NASA Astrophysics Data System (ADS)

Botinis, Antonis; Orfanidou, Ioanna; Fourakis, Marios; Fourakis, Marios

2005-09-01

The present investigation examined the temporal and spectral characteristics of Greek vowels as produced by speakers with intact (NO) versus cerebral palsy affected (CP) neuromuscular systems. Six NO and six CP native speakers of Greek produced the Greek vowels [i, e, a, o, u] in the first syllable of CVCV nonsense words in a short carrier phrase. Stress could be on either the first or second syllable. There were three female and three male speakers in each group. In terms of temporal characteristics, the results showed that: vowels produced by CP speakers were longer than vowels produced by NO speakers; stressed vowels were longer than unstressed vowels; vowels produced by female speakers were longer than vowels produced by male speakers. In terms of spectral characteristics the results showed that the vowel space of the CP speakers was smaller than that of the NO speakers. This is similar to the results recently reported by Liu et al. [J. Acoust. Soc. Am. 117, 3879-3889 (2005)] for CP speakers of Mandarin. There was also a reduction of the acoustic vowel space defined by unstressed vowels, but this reduction was much more pronounced in the vowel productions of CP speakers than NO speakers.

May duration of untreated illness influence the long-term course of major depressive disorder?

PubMed

Altamura, A Carlo; Dell'osso, Bernardo; Vismara, Serena; Mundo, Emanuela

2008-03-01

The aim of this naturalistic study was to investigate the possible influence of the duration of untreated illness (DUI) on the long-term course of Major Depressive Disorder (MDD). One hundred and thirteen patients with recurrent MDD, according to DSM-IV-TR criteria, followed up for 5 years, were selected, interviewed and their clinical charts were reviewed. The DUI was defined as the interval between the onset of the first depressive episode and the first adequate antidepressant treatment. The sample was divided into two groups according to the DUI: one group with a DUI12 months (n=38). The main demographic and clinical course variables were compared between the two groups using Student's t-tests or chi-square tests. Patients with a longer DUI showed an earlier age at onset (t=2.82, p=0.006) and a longer duration of illness (t=3.20, p=0.002) compared to patients with a shorter DUI. In addition, the total number of depressive episodes occurring before the first antidepressant treatment was higher in the group with a longer DUI (t=-2.223, p<0.03). Even though limited by the retrospective nature of the study, these preliminary findings would suggest that a longer DUI may negatively influence the course of MDD. Larger prospective studies are warranted to further investigate the role of the DUI within MDD.

Assessing Global Learning in Short-Term Study Abroad: Population, Environment, and Society in Shanghai

ERIC Educational Resources Information Center

Core, Rachel S.

2017-01-01

This teaching note suggests that a short-term study abroad program embedded within a longer course can be a tool for enhancing global learning. The work uses the Association of American Colleges and Universities (AAC&U) Global Learning VALUE rubric to evaluate student work from a spring break seminar to Shanghai, China. The seminar was…

Long-Term Consequences for Teens with Older Sexual Partners. Fact Sheet. Publication #2008-16

ERIC Educational Resources Information Center

Schelar, Erin; Ryan, Suzanne; Manlove, Jennifer

2008-01-01

Existing research on the risks of having sex at a young age with an older partner has focused on poorer reproductive health outcomes in the adolescent years, but scant attention has been paid to the longer-term implications of these relationships. Using survey data from high school students, this "Fact Sheet" presents findings from recent Child…

The shelf-life of airborne laser scanning data for enhancing forest inventory inferences

Treesearch

Ronald E. McRoberts; Qi Chen; Dale D. Gormanson; Brian F. Walters

2018-01-01

The term shelf-life is used to characterize the elapsed time beyond which a commodity loses its usefulness. The term is most often used with reference to foods and medicines, but herein it is used to characterize the elapsed time beyond which airborne laser scanning (ALS) data are no longer useful for enhancing inferences for forest inventory...

Woody plant regeneration after blowdown, salvage logging, and prescribed fire in a northern Minnesota forest

Treesearch

Brian J. Palik; Doug Kastendick

2009-01-01

Salvage logging after natural disturbance has received increased scrutiny in recent years because of concerns over detrimental effects on tree regeneration and increased fine fuel levels. Most research on tree regeneration after salvage logging comes from fire-prone systems and is short-term in scope. Limited information is available on longer term responses to salvage...

HYPOXIA IN CHESAPEAKE BAY, 1950-2001: LONG-TERM CHANGE IN RELATION TO NUTRIENT LOADING AND RIVER FLOW

EPA Science Inventory

A 52-yr record of dissolved oxygen in Chesapeake Bay (1950 to 2001) and a record of nitrate (NO3^-) loading by the Susquehanna River spanning a longer period (1903, 1945 to 2001) were assembled to describe the long-term pattern of hypoxia and anoxia in Chesapeake Bay an...

Factors Affecting the Design of Short-Term Study-Abroad Programs: An Exploratory Study of Two Business Schools

ERIC Educational Resources Information Center

Ramakrishna, Hindupur; Sarkar, Avijit; Vijayaraman, Bindiganavale

2016-01-01

Study-abroad programs have played a significant role in globalization of business curricula over the years. Short-term study-abroad programs (STSAPs) are proliferating in business schools and provide a viable alternative of studying abroad to students who are unable to participate in programs of longer durations due to disruption in family, work,…

Substance Use: Determinants and Opportunities for Prevention in the Family and School Context

ERIC Educational Resources Information Center

Kleinjan, Marloes; Engels, Rutger C. M. E.

2014-01-01

During adolescence, teenagers try a range of risk behaviors including smoking, drinking, and the use of soft drugs. Because substance use contributes to an unhealthy lifestyle of teenagers on the short term and can lead to serious health problems on the longer term, prevention in this target group is important. This chapter provides an overview of…

Long-term effects of prescribed fire on mixed conifer forest structure in the Sierra Nevada, California

Treesearch

Phillip J. Van Mantgem; Nathan L. Stephenson; Eric Knapp; John Barrles; Jon E. Keeley

2011-01-01

The capacity of prescribed fire to restore forest conditions is often judged by changes in forest structure within a few years following burning. However, prescribed fire might have longer-term effects on forest structure, potentially changing treatment assessments. We examined annual changes in forest structure in five 1 ha old-growth plots immediately before...