Patient-Centered Collaborative Care: The Impact of a New Approach to Postpartum Rounds on Residents' Perception of Their Work Environment

PubMed Central

Baldwin, Maureen; Hashima, Jason; Guise, Jeanne-Marie; Gregory, William Thomas; Edelman, Alison; Segel, Sally

2010-01-01

Objective At our institution, traditional postpartum rounds consisted of separate visits from all members of the obstetric team. This led to patient care inefficiencies and miscommunication. In an effort to improve patient care, patient-centered collaborative care (PCCC) was established, whereby physicians, residents, medical students, nurses, case managers, and social workers conduct rounds as a team. The goal of this observational study was to evaluate how PCCC rounds affected resident physicians' assessment of their work environment. Methods Obstetrics and gynecology residents completed a 13-question written survey designed to assess their sense of workflow, education, and workplace cohesion. Surveys were completed before and 6 months after the implementation of PCCC. Responses were compared in aggregate for preintervention and postintervention with Pearson χ2 test. Results Ninety-two percent of the obstetrics residents (n  =  23) completed the preintervention survey, and 79% (n  =  19) completed the postintervention survey. For most measures, there was no difference in resident perception between the 2 time points. After implementation of PCCC rounds, fewer residents felt that rounds were educational (preintervention  =  39%, postintervention  =  7%; P  =  .03). Conclusion Residents did not report negative impacts on workflow, cohesion, or general well-being after the implementation of PCCC rounds. However, there was a perception that PCCC rounds negatively impacted the educational value of postpartum rounds. This information will help identify ways to improve the resident physician experience in the obstetric service while optimizing patient care. PMID:21975886

Acoustic telemetry reveals cryptic residency of whale sharks

PubMed Central

Cagua, E. Fernando; Cochran, Jesse E. M.; Rohner, Christoph A.; Prebble, Clare E. M.; Sinclair-Taylor, Tane H.; Pierce, Simon J.; Berumen, Michael L.

2015-01-01

Although whale sharks (Rhincodon typus) have been documented to move thousands of kilometres, they are most frequently observed at a few predictable seasonal aggregation sites. The absence of sharks at the surface during visual surveys has led to the assumption that sharks disperse to places unknown during the long ‘off-seasons’ at most of these locations. Here we compare 2 years of R. typus visual sighting records from Mafia Island in Tanzania to concurrent acoustic telemetry of tagged individuals. Sightings revealed a clear seasonal pattern with a peak between October and February and no sharks observed at other times. By contrast, acoustic telemetry demonstrated year-round residency of R. typus. The sharks use a different habitat in the off-season, swimming deeper and further away from shore, presumably in response to prey distributions. This behavioural change reduces the sharks' visibility, giving the false impression that they have left the area. We demonstrate, for the first time to our knowledge, year-round residency of unprovisioned, individual R. typus at an aggregation site, and highlight the importance of using multiple techniques to study the movement ecology of marine megafauna. PMID:25832816

Patient Safety Leadership WalkRounds.

PubMed

Frankel, Allan; Graydon-Baker, Erin; Neppl, Camilla; Simmonds, Terri; Gustafson, Michael; Gandhi, Tejal K

2003-01-01

In the WalkRounds concept, a core group, which includes the senior executives and/or vice presidents, conducts weekly visits to different areas of the hospital. The group, joined by one or two nurses in the area and other available staff, asks specific questions about adverse events or near misses and about the factors or systems issues that led to these events. ANALYSIS OF EVENTS: Events in the Walkrounds are entered into a database and classified according to the contributing factors. The data are aggregated by contributing factors and priority scores to highlight the root issues. The priority scores are used to determine QI pilots and make best use of limited resources. Executives are surveyed quarterly about actions they have taken as a direct result of WalkRounds and are asked what they have learned from the rounds. As of September 2002, 47 Patient Safety Leadership WalkRounds visited a total of 48 different areas of the hospital, with 432 individual comments. The WalkRounds require not only knowledgeable and invested senior leadership but also a well-organized support structure. Quality and safety personnel are needed to collect data and maintain a database of confidential information, evaluate the data from a systems approach, and delineate systems-based actions to improve care delivery. Comments of frontline clinicians and executives suggested that WalkRounds helps educate leadership and frontline staff in patient safety concepts and will lead to cultural changes, as manifested in more open discussion of adverse events and an improved rate of safety-based changes.

Identifying Psychological Contract Breaches to Guide Improvements in Faculty Recruitment, Retention, and Development

PubMed Central

Desselle, Shane P.; Draugalis, JoLaine R.; Spies, Alan R.; Davis, Tamra S.; Bolino, Mark

2012-01-01

Objective. To identify pharmacy faculty members’ perceptions of psychological contract breaches that can be used to guide improvements in faculty recruitment, retention, and development. Methods. A list of psychological contract breaches was developed using a Delphi procedure involving a panel of experts assembled through purposive sampling. The Delphi consisted of 4 rounds, the first of which elicited examples of psychological contract breaches in an open-ended format. The ensuing 3 rounds consisting of a survey and anonymous feedback on aggregated group responses. Results. Usable responses were obtained from 11 of 12 faculty members who completed the Delphi procedure. The final list of psychological contract breaches included 27 items, after modifications based on participant feedback in subsequent rounds. Conclusion. The psychological contract breach items generated in this study provide guidance for colleges and schools of pharmacy regarding important aspects of faculty recruitment, retention, and development. PMID:22919084

Identifying psychological contract breaches to guide improvements in faculty recruitment, retention, and development.

PubMed

Peirce, Gretchen L; Desselle, Shane P; Draugalis, JoLaine R; Spies, Alan R; Davis, Tamra S; Bolino, Mark

2012-08-10

To identify pharmacy faculty members' perceptions of psychological contract breaches that can be used to guide improvements in faculty recruitment, retention, and development. A list of psychological contract breaches was developed using a Delphi procedure involving a panel of experts assembled through purposive sampling. The Delphi consisted of 4 rounds, the first of which elicited examples of psychological contract breaches in an open-ended format. The ensuing 3 rounds consisting of a survey and anonymous feedback on aggregated group responses. Usable responses were obtained from 11 of 12 faculty members who completed the Delphi procedure. The final list of psychological contract breaches included 27 items, after modifications based on participant feedback in subsequent rounds. The psychological contract breach items generated in this study provide guidance for colleges and schools of pharmacy regarding important aspects of faculty recruitment, retention, and development.

Hydrodynamic size-based separation and characterization of protein aggregates from total cell lysates

PubMed Central

Tanase, Maya; Zolla, Valerio; Clement, Cristina C; Borghi, Francesco; Urbanska, Aleksandra M; Rodriguez-Navarro, Jose Antonio; Roda, Barbara; Zattoni, Andrea; Reschiglian, Pierluigi; Cuervo, Ana Maria; Santambrogio, Laura

2016-01-01

Herein we describe a protocol that uses hollow-fiber flow field-flow fractionation (FFF) coupled with multiangle light scattering (MALS) for hydrodynamic size-based separation and characterization of complex protein aggregates. The fractionation method, which requires 1.5 h to run, was successfully modified from the analysis of protein aggregates, as found in simple protein mixtures, to complex aggregates, as found in total cell lysates. In contrast to other related methods (filter assay, analytical ultracentrifugation, gel electrophoresis and size-exclusion chromatography), hollow-fiber flow FFF coupled with MALS allows a flow-based fractionation of highly purified protein aggregates and simultaneous measurement of their molecular weight, r.m.s. radius and molecular conformation (e.g., round, rod-shaped, compact or relaxed). The polyethersulfone hollow fibers used, which have a 0.8-mm inner diameter, allow separation of as little as 20 μg of total cell lysates. In addition, the ability to run the samples in different denaturing and nondenaturing buffer allows defining true aggregates from artifacts, which can form during sample preparation. The protocol was set up using Paraquat-induced carbonylation, a model that induces protein aggregation in cultured cells. This technique will advance the biochemical, proteomic and biophysical characterization of molecular-weight aggregates associated with protein mutations, as found in many CNS degenerative diseases, or chronic oxidative stress, as found in aging, and chronic metabolic and inflammatory conditions. PMID:25521790

Acoustic telemetry reveals cryptic residency of whale sharks.

PubMed

Cagua, E Fernando; Cochran, Jesse E M; Rohner, Christoph A; Prebble, Clare E M; Sinclair-Taylor, Tane H; Pierce, Simon J; Berumen, Michael L

2015-04-01

Although whale sharks (Rhincodon typus) have been documented to move thousands of kilometres, they are most frequently observed at a few predictable seasonal aggregation sites. The absence of sharks at the surface during visual surveys has led to the assumption that sharks disperse to places unknown during the long 'off-seasons' at most of these locations. Here we compare 2 years of R. typus visual sighting records from Mafia Island in Tanzania to concurrent acoustic telemetry of tagged individuals. Sightings revealed a clear seasonal pattern with a peak between October and February and no sharks observed at other times. By contrast, acoustic telemetry demonstrated year-round residency of R. typus. The sharks use a different habitat in the off-season, swimming deeper and further away from shore, presumably in response to prey distributions. This behavioural change reduces the sharks' visibility, giving the false impression that they have left the area. We demonstrate, for the first time to our knowledge, year-round residency of unprovisioned, individual R. typus at an aggregation site, and highlight the importance of using multiple techniques to study the movement ecology of marine megafauna. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Biofilm architecture of Phanerozoic cryptic carbonate marine veneers

NASA Astrophysics Data System (ADS)

Riding, Robert

2002-01-01

Thin (<150 μm) micritic veneers lining crypts in Paleozoic and Mesozoic reef, microbial, and bioclastic carbonates have the dimensions and architecture of modern uncalcified bacterial biofilm. Morphologic attributes include rounded aggregate nanofabric, internal channels, external towers, mushrooms, and plumes. All can be interpreted as characteristics of attached bacterial communities, i.e., aggregates as microcolonies, originally embedded in a matrix of extracellular polymeric substances; channels as water conduits and/or uncolonized nutrient-poor spaces; external protuberances as localized growths; and plumes as surface streamers. Cryptic habitat favored pristine biofilm preservation by precluding disturbance and overgrowth, and suggests aphotic and anoxic conditions. These examples provide diagnostic morphologic criteria for wider recognition of biofilm in Phanerozoic and older carbonates.

Determining an Imaging Literacy Curriculum for Radiation Oncologists: An International Delphi Study

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

Giuliani, Meredith E., E-mail: Meredith.Giuliani@rmp.uhn.on.ca; Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Gillan, Caitlin

2014-03-15

Purpose: Rapid evolution of imaging technologies and their integration into radiation therapy practice demands that radiation oncology (RO) training curricula be updated. The purpose of this study was to develop an entry-to-practice image literacy competency profile. Methods and Materials: A list of 263 potential imaging competency items were assembled from international objectives of training. Expert panel eliminated redundant or irrelevant items to create a list of 97 unique potential competency items. An international 2-round Delphi process was conducted with experts in RO. In round 1, all experts scored, on a 9-point Likert scale, the degree to which they agreed anmore » item should be included in the competency profile. Items with a mean score ≥7 were included, those 4 to 6 were reviewed in round 2, and items scored <4 were excluded. In round 2, items were discussed and subsequently ranked for inclusion or exclusion in the competency profile. Items with >75% voting for inclusion were included in the final competency profile. Results: Forty-nine radiation oncologists were invited to participate in round 1, and 32 (65%) did so. Participants represented 24 centers in 6 countries. Of the 97 items ranked in round 1, 80 had a mean score ≥7, 1 item had a score <4, and 16 items with a mean score of 4 to 6 were reviewed and rescored in round 2. In round 2, 4 items had >75% of participants voting for inclusion and were included; the remaining 12 were excluded. The final list of 84 items formed the final competency profile. The 84 enabling competency items were aggregated into the following 4 thematic groups of key competencies: (1) imaging fundamentals (42 items); (2) clinical application (27 items); (3) clinical management (5 items); and (4) professional practice (10 items). Conclusions: We present an imaging literacy competency profile which could constitute the minimum training standards in radiation oncology residency programs.« less

Changes in particle morphology during illitization: An experimental study

USGS Publications Warehouse

Whitney, Gene; Velde, Bruce

1993-01-01

Smectite was reacted at several temperatures between 200°C and 500°C to produce interstratified illite/smectite (I/S) with different proportions of expandable layers. Dispersed and sedimented products were examined using a transmission electron microscope. Particle size and aspect ratio showed no systematic change as a function of reaction extent during R0 illitization. However, particles exhibited rounded edges during the early stages of the reaction, suggesting some dissolution of primary smectite. Additionally, increasing particle contrast in the electron beam suggests thickening of particles with increasing reaction extent. The thickening of particles is thought to be produced by the nucleation and precipitation of secondary illite layers on primary smectite layers. In the most extensively reacted I/S, particles have become aggregated into clumps or quasicrystals by lateral growth of illite layers. Internal uniformity of crystallographic alignment of individual growing crystals within each aggregate was reflected in the increasing frequency of 60° and 120° interfacial angles within each aggregate. In highly illitic I/S, these aggregates took on an overall euhedral form and became crystallographically contiguous, producing single crystal electron diffraction patterns.

COIN Project: Towards a zero-waste technology for concrete aggregate production in Norway

NASA Astrophysics Data System (ADS)

Cepuritis, Rolands; Willy Danielsen, Svein

2014-05-01

COIN Project: Towards a zero-waste technology for concrete aggregate production in Norway Rolands Cepuritis, Norcem/NTNU and Svein Willy Danielsen, SINTEF Aggregate production is a mining operation where no purification of the "ore" is necessary. Still it is extremely rare that an aggregate production plant is operating on the basis of zero-waste concept. This is since historically the fine crushed aggregate (particles with a size of less than 2, 4 or sometimes 8 mm) has been regarded as a by-product or waste of the more valuable coarse aggregate production. The reason is that the crushed coarse aggregates can easily replace coarse rounded natural stones in almost any concrete composition; while, the situation with the sand is different. The production of coarse aggregate normally yields fine fractions with rough surface texture, flaky or elongated particles an inadequate gradation. When such a material replaces smooth and rounded natural sand grains in a concrete mix, the result is usually poor and much more water and cement has to be used to achieve adequate concrete flow. The consequences are huge stockpiles of the crushed fine fractions that can't be sold (mass balance problems) for the aggregate producers, sustainability problems for the whole industry and environmental issues for society due to dumping and storing of the fine co-generated material. There have been attempts of utilising the material in concrete before; however, they have mostly ended up in failure. There have been attempts to adjust the crushed sand to the properties of the natural sand, which would still give a lot of waste, especially if the grading would have to be adjusted and the high amounts of fines abundantly present in the crushed sand would have to be removed. Another fundamental reason for failure has been that historically such attempts have mainly ended up in a research carried out by people (both industrial and academic) with aggregate background (= parties willing to find market for their crusher fines) providing only conclusions already well known by the engineers involved in concrete production. Due to the pressing situation with the left resources of the natural sand and gravel in Scandinavia, a new and different development approach has been recently attempted with the Concrete Innovation Center (COIN) in Norway. The centre is a research based innovation project that has brought together and served as a source of funding to facilitate the crucial interaction between the professionals from the different involved industries (quarrying machinery supplier, aggregate producers, concrete producers and concrete contractors) and the academic people from universities and research institutions, in order come up with a better crushed sand solution for the future. The concept under development has been a zero-waste technology for aggregate production, where instead of reducing the amount of the crushed fines their properties are rather engineered to crucially increase the overall performance of the sand in concrete. The project also involves collaboration with a state-of-the-art aggregate production plant where the new technology has already been implemented. The production process there is based on the new engineered sand concepts successfully supplying 100% all of the produced fractions to concrete and asphalt producers.

Rethinking Military Personnel Evaluations

DTIC Science & Technology

2011-03-23

review of references describing this effect, see Stephanie L. Wolfgeher, Inflation of USAF Officer Performance Reports: Analyzing the Organizational...Dennis P. Chapman, "It’s Time for a New Round of OER Reform," Military Review 86, no. 5 (September-October 2006), 100. 23 LTC Briggs is an Operations...Research Analyst who has an interesting, and award- winning, model for predicting promotion rates in the aggregate. David Briggs , "Modeling Army

Evaluation of sealing ability of Biodentine™ and mineral trioxide aggregate in primary molars using scanning electron microscope: A randomized controlled in vitro trial.

PubMed

Samuel, Allwyn; Asokan, Sharath; Geetha Priya, P R; Thomas, Seby

2016-01-01

The aim of this study was to compare the sealing ability of mineral trioxide aggregate (MTA) and Biodentine™ when used to repair the furcal perforations in primary molars using scanning electron microscope (SEM). The study sample comprised forty recently extracted primary molars. These teeth were placed in a 5.25% sodium hypochlorite solution for 24 h and washed with tap water. Access cavities were made using a round bur in high-speed handpiece. Perforations were made in the center of the floor of the pulpal chamber using a 0.5 mm round bur. The teeth were randomly assigned into two experimental groups based on the material used to seal the perforation: Group A - MTA and Group B - Biodentine™. The packed materials were allowed to set for 24 h. The samples were sectioned longitudinally and the extent of marginal adaptation was measured by SEM. Wilcoxon-signed rank test was used for statistical analysis using SPSS software. All teeth exhibited microleakage, but Biodentine™ showed significantly less leakage (0.149) compared to MTA (0.583). Based on the results of this study, Biodentine™ showed lesser microleakage compared to MTA and thus may be a good alternative to MTA.

Guidelines for Reporting Case Studies on Extracorporeal Treatments in Poisonings: Methodology

PubMed Central

Lavergne, Valéry; Ouellet, Georges; Bouchard, Josée; Galvao, Tais; Kielstein, Jan T; Roberts, Darren M; Kanji, Salmaan; Mowry, James B; Calello, Diane P; Hoffman, Robert S; Gosselin, Sophie; Nolin, Thomas D; Goldfarb, David S; Burdmann, Emmanuel A; Dargan, Paul I; Decker, Brian Scott; Hoegberg, Lotte C; Maclaren, Robert; Megarbane, Bruno; Sowinski, Kevin M; Yates, Christopher; Mactier, Robert; Wiegand, Timothy; Ghannoum, Marc

2014-01-01

A literature review performed by the EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup highlighted deficiencies in the existing literature, especially the reporting of case studies. Although general reporting guidelines exist for case studies, there are none in the specific field of extracorporeal treatments in toxicology. Our goal was to construct and propose a checklist that systematically outlines the minimum essential items to be reported in a case study of poisoned patients undergoing extracorporeal treatments. Through a modified two-round Delphi technique, panelists (mostly chosen from the EXTRIP workgroup) were asked to vote on the pertinence of a set of items to identify those considered minimally essential for reporting complete and accurate case reports. Furthermore, independent raters validated the clarity of each selected items between each round of voting. All case reports containing data on extracorporeal treatments in poisoning published in Medline in 2011 were reviewed during the external validation rounds. Twenty-one panelists (20 from the EXTRIP workgroup and an invited expert on pharmacology reporting guidelines) participated in the modified Delphi technique. This group included journal editors and experts in nephrology, clinical toxicology, critical care medicine, emergency medicine, and clinical pharmacology. Three independent raters participated in the validation rounds. Panelists voted on a total of 144 items in the first round and 137 items in the second round, with response rates of 96.3% and 98.3%, respectively. Twenty case reports were evaluated at each validation round and the independent raters' response rate was 99.6% and 98.8% per validation round. The final checklist consists of 114 items considered essential for case study reporting. This methodology of alternate voting and external validation rounds was useful in developing the first reporting guideline for case studies in the field of extracorporeal treatments in poisoning. We believe that this guideline will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports may provide early signals of effectiveness and/or harm, thereby improving healthcare decision-making. PMID:24890576

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

Landreh, Michael; Stukenborg, Jan-Bernd; Willander, Hanna

Highlights: Black-Right-Pointing-Pointer Insulin and C-peptide can interact under insulin fibril forming conditions. Black-Right-Pointing-Pointer C-peptide is incorporated into insulin aggregates and alters aggregation lag time. Black-Right-Pointing-Pointer C-peptide changes insulin fibril morphology and affects backbone accessibility. Black-Right-Pointing-Pointer C-peptide may be a regulator of fibril formation by {beta}-cell granule proteins. -- Abstract: Insulin aggregation can prevent rapid insulin uptake and cause localized amyloidosis in the treatment of type-1 diabetes. In this study, we investigated the effect of C-peptide, the 31-residue peptide cleaved from proinsulin, on insulin fibrillation at optimal conditions for fibrillation. This is at low pH and high concentration, when the fibrilsmore » formed are regular and extended. We report that C-peptide then modulates the insulin aggregation lag time and profoundly changes the fibril appearance, to rounded clumps of short fibrils, which, however, still are Thioflavine T-positive. Electrospray ionization mass spectrometry also indicates that C-peptide interacts with aggregating insulin and is incorporated into the aggregates. Hydrogen/deuterium exchange mass spectrometry further reveals reduced backbone accessibility in insulin aggregates formed in the presence of C-peptide. Combined, these effects are similar to those of C-peptide on islet amyloid polypeptide fibrillation and suggest that C-peptide has a general ability to interact with amyloidogenic proteins from pancreatic {beta}-cell granules. Considering the concentrations, these peptide interactions should be relevant also during physiological secretion, and even so at special sites post-secretory or under insulin treatment conditions in vivo.« less

Radiation damage to the microvasculature in the rabbit ear chamber. An electron microscope study. [X radiation

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

Yang, V.V.; Stearner, S.P.; Dimitrievich, G.S.

1977-04-01

Cell aggregates in increased numbers appear along blood vessel walls within a few days after local x irradiation of the tissue within rabbit ear chambers. At 7 days after irradiation with 400 or 700 rad of 250 kVp of x rays, electron microscopic studies of the microvasculature were carried out to determine the morphological characteristics of the cell types involved in the aggregates and the relation of these cells to vascular repair. The cell aggregates usually occur in the interstitial region subjacent to the endothelium. The cells that make up the aggregates show morphological characteristics of relatively undifferentiated mesenchymal cells;more » they have an irregularly rounded shape and contain large amounts of rough endoplasmic reticulum, Golgi vesicles, and mitochondria. In a few instances, cells of similar morphology also occur as part of the lining of the blood vessels. The perivascular cell aggregates may originate from the pericyte population or from undifferentiated mesenchymal cells that occur in the interstitial region surrounding blood vessels; it is improbable that they are dedifferentiated smooth muscle cells. It is suggested that the cells that make up these aggregates contribute to the repair of the microvasculation after radiation injury. The radiosensitivity of vascular endothelium reported by previous investigators seems to preclude endothelial proliferation as the principal repair mechanism at higher radiation doses.« less

An interlaboratory comparison programme on radio frequency electromagnetic field measurements: the second round of the scheme.

PubMed

Nicolopoulou, E P; Ztoupis, I N; Karabetsos, E; Gonos, I F; Stathopulos, I A

2015-04-01

The second round of an interlaboratory comparison scheme on radio frequency electromagnetic field measurements has been conducted in order to evaluate the overall performance of laboratories that perform measurements in the vicinity of mobile phone base stations and broadcast antenna facilities. The participants recorded the electric field strength produced by two high frequency signal generators inside an anechoic chamber in three measurement scenarios with the antennas transmitting each time different signals at the FM, VHF, UHF and GSM frequency bands. In each measurement scenario, the participants also used their measurements in order to calculate the relative exposure ratios. The results were evaluated in each test level calculating performance statistics (z-scores and En numbers). Subsequently, possible sources of errors for each participating laboratory were discussed, and the overall evaluation of their performances was determined by using an aggregated performance statistic. A comparison between the two rounds proves the necessity of the scheme. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reconnaissance of alluvial fans as potential sources of gravel aggregate, Santa Cruz River valley, Southeast Arizona

USGS Publications Warehouse

Lindsey, David A.; Melick, Roger

2002-01-01

This investigation was conducted to provide information on the aggregate potential of alluvial fan sediments in the Santa Cruz River valley. Pebble lithology, roundness, and particle size were determined in the field, and structures and textures of alluvial fan sediments were photographed and described. Additional measurements of particle size on digital photographs were made on a computer screen. Digital elevation models were acquired and compiled for viewing the areal extent of selected fans. Alluvial fan gravel in the Santa Cruz River valley reflects the lithology of its source. Gravel derived from granitic and gneissic terrane of the Tortolita, Santa Catalina, and Rincon Mountains weathers to grus and is generally inferior for use as aggregate. Gravel derived from the Tucson, Sierrita, and Tumacacori Mountains is composed mostly of angular particles of volcanic rock, much of it felsic in composition. This angular volcanic gravel should be suitable for use in asphalt but may require treatment for alkali-silica reaction prior to use in concrete. Gravel derived from the Santa Rita Mountains is of mixed plutonic (mostly granitic rocks), volcanic (mostly felsic rocks), and sedimentary (sandstone and carbonate rock) composition. The sedimentary component tends to make gravel derived from the Santa Rita Mountains slightly more rounded than other fan gravel. The coarsest (pebble, cobble, and boulder) gravel is found near the heads (proximal part) of alluvial fans. At the foot (distal part) of alluvial fans, most gravel is pebble-sized and interbedded with sand and silt. Some of the coarsest gravel was observed near the head of the Madera Canyon, Montosa Canyon, and Esperanza Wash fans. The large Cienega Creek fan, located immediately south and southeast of Tucson, consists entirely of distal-fan pebble gravel, sand, and silt.

Microstructure of the regions on a plane copper electrode surface affected by a spark discharge in air in the point-plane gap

NASA Astrophysics Data System (ADS)

Tren'kin, A. A.; Karelin, V. I.; Shibitov, Yu. M.; Blinova, O. M.; Yasnikov, I. S.

2017-09-01

The microstructure of the regions affected by spark discharge on the surface of a plane copper electrode in atmospheric air in the point-plane gap has been studied using a scanning electron microscope for both the positive and negative polarity of the point electrode. It has been found that the affected regions have the shape of round spots or groups of spots with diameters of individual spots varying in the range of 20-200 μm. It has been revealed that the spots have an internal spatial structure in the form of an aggregate of concentric rings. These rings are aggregates of a large number of microscopic craters with diameters of 0.1-1.0 μm.

Evaluation of Different Mineral Filler Aggregates for Asphalt Mixtures

NASA Astrophysics Data System (ADS)

Wasilewska, Marta; Małaszkiewicz, Dorota; Ignatiuk, Natalia

2017-10-01

Mineral filler aggregates play an important role in asphalt mixtures because they fill voids in paving mix and improve the cohesion of asphalt binder. Limestone powder containing over 90% of CaCO3 is the most frequently used type of filler. Waste material from the production of coarse aggregate can be successfully used as a mineral filler aggregate for hot asphalt concrete mixtures as the limestone powder replacement. This paper presents the experimental results of selected properties of filler aggregates which were obtained from rocks with different mineral composition and origin. Five types of rocks were used as a source of the mineral filler aggregate: granite, gabbro, trachybasalt, quartz sandstone and rocks from postglacial deposits. Limestone filler was used in this study as the reference material. The following tests were performed: grading (air jet sieving), quality of fines according to methylene blue test, water content by drying in a ventilated oven, particle density using pyknometer method, Delta ring and ball test, Bitumen Number, fineness determined as Blaine specific surface area. Mineral filler aggregates showed significant differences when they were mixed with bitumen and stiffening effect in Delta ring and ball test was evaluated. The highest values were achieved when gabbro and granite fillers were used. Additionally, Scanning Electron Microscopy (SEM) analysis of grain shape and size was carried out. Significant differences in grain size and shape were observed. The highest non-homogeneity in size was determined for quartz sandstone, gabbro and granite filler. Their Blaine specific surface area was lower than 2800 cm2/g, while for limestone and postglacial fillers with regular and round grains it exceeded 3000 cm2/g. All examined mineral filler aggregates met requirements of Polish National Specification WT-1: 2014 and could be used in asphalt mixtures.

Morphology of diesel soot residuals from supercooled water droplets and ice crystals: Implications for optical properties

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

China, Swarup; Kulkarni, Gourihar; Scarnato, Barbara V.

Freshly emitted soot particles are fractal-like aggregates, but atmospheric processing often transforms their morphology. Morphology of soot particles plays an important role in determining their optical properties, life cycle and hence their effect on Earth’s radiative balance. However, little is known about the morphology of soot particles that participated in cold cloud processes. Here we report results from laboratory experiments that simulate cold cloud processing of diesel soot particles by allowing them to form supercooled droplets and ice crystals at -20 and -40°C, respectively. Electron microscopy revealed that soot residuals from ice crystals were more compact (roundness~0.55) than those frommore » supercooled droplets (roundness ~0.45), while nascent soot particles were the least compact (roundness~0.41). Optical simulations using the discrete dipole approximation showed that the more compact structure enhances soot single scattering albedo by a factor up to 1.4, thereby reducing the top-of-the-atmosphere direct radiative forcing by ~63%. Lastly, these results underscore that climate models should consider the morphological evolution of soot particles due to cold cloud processing to improve the estimate of direct radiative forcing of soot.« less

Morphology of diesel soot residuals from supercooled water droplets and ice crystals: Implications for optical properties

DOE PAGES

China, Swarup; Kulkarni, Gourihar; Scarnato, Barbara V.; ...

2015-11-01

Freshly emitted soot particles are fractal-like aggregates, but atmospheric processing often transforms their morphology. Morphology of soot particles plays an important role in determining their optical properties, life cycle and hence their effect on Earth’s radiative balance. However, little is known about the morphology of soot particles that participated in cold cloud processes. Here we report results from laboratory experiments that simulate cold cloud processing of diesel soot particles by allowing them to form supercooled droplets and ice crystals at -20 and -40°C, respectively. Electron microscopy revealed that soot residuals from ice crystals were more compact (roundness~0.55) than those frommore » supercooled droplets (roundness ~0.45), while nascent soot particles were the least compact (roundness~0.41). Optical simulations using the discrete dipole approximation showed that the more compact structure enhances soot single scattering albedo by a factor up to 1.4, thereby reducing the top-of-the-atmosphere direct radiative forcing by ~63%. Lastly, these results underscore that climate models should consider the morphological evolution of soot particles due to cold cloud processing to improve the estimate of direct radiative forcing of soot.« less

In vitro differentiation of mouse embryonic stem (mES) cells using the hanging drop method.

PubMed

Wang, Xiang; Yang, Phillip

2008-07-23

Stem cells have the remarkable potential to develop into many different cell types. When a stem cell divides, each new cell has the potential to either remain a stem cell or become another type of cell with a more specialized function, This promising of science is leading scientists to investigate the possibility of cell-based therapies to treat disease. When culture in suspension without antidifferentiation factors, embryonic stem cells spontaneously differentiate and form three-dimensional multicellular aggregates. These cell aggregates are called embryoid bodies(EB). Hanging drop culture is a widely used EB formation induction method. The rounded bottom of hanging drop allows the aggregation of ES cells which can provide mES cells a good environment for forming EBs. The number of ES cells aggregatied in a hanging drop can be controlled by varying the number of cells in the initial cell suspension to be hung as a drop from the lid of Petri dish. Using this method we can reproducibly form homogeneous EBs from a predetermined number of ES cells.

Experimental aggregation of volcanic ash: the role of liquid bonding

NASA Astrophysics Data System (ADS)

Mueller, S.; Kueppers, U.; Jacob, M.; Ayris, P. M.; Dingwell, D. B.

2015-12-01

Explosive volcanic eruptions may release vast quantities of ash. Because of its size, it has the greatest dispersal potential and can be distributed globally. Ash may pose severe risks for 1) air traffic, 2) human and animal health, 3) agriculture and 4) infrastructure. Such ash particles can however cluster and form ash aggregates that range in size from millimeters to centimeters. During their growth, weight and aerodynamic properties change. This leads to significantly changed transport and settling behavior. The physico-chemical processes involved in aggregation are quantitatively poorly constrained. We have performed laboratory ash aggregation experiments using the ProCell Lab System® of Glatt Ingenieurtechnik GmbH. Solid particles are set into motion in a fluidized bed over a range of well-controlled boundary conditions (e.g., air flow rate, gas temperature, humidity, liquid composition). In this manner we simulate the variable gas-particle flow conditions expected in eruption plumes and pyroclastic density currents. We have used 1) soda-lime glass beads as an analogue material and 2) natural volcanic ash from Laacher See Volcano (Germany). In order to influence form, size, stability and the production rate of aggregates, a range of experimental conditions (e.g., particle concentration, degree of turbulence, temperature and moisture in the process chamber and the composition of the liquid phase) have been employed. We have successfully reproduced several features of natural ash aggregates, including round, internally structured ash pellets up to 3 mm in diameter. These experimental results help to constrain the boundary conditions required for the generation of spherical, internally-structured ash aggregates that survive deposition and are preserved in the volcanological record. These results should also serve as input parameters for models of ash transport and ash mass distribution.

Core Outcome Measures in Effectiveness Trials (COMET) initiative: protocol for an international Delphi study to achieve consensus on how to select outcome measurement instruments for outcomes included in a 'core outcome set'.

PubMed

Prinsen, Cecilia A C; Vohra, Sunita; Rose, Michael R; King-Jones, Susanne; Ishaque, Sana; Bhaloo, Zafira; Adams, Denise; Terwee, Caroline B

2014-06-25

The Core Outcome Measures in Effectiveness Trials (COMET) initiative aims to facilitate the development and application of 'core outcome sets' (COS). A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease or trial population. The overall aim of the Core Outcome Measurement Instrument Selection (COMIS) project is to develop a guideline on how to select outcome measurement instruments for outcomes included in a COS. As part of this project, we describe our current efforts to achieve a consensus on the methods for selecting outcome measurement instruments for outcomes to be included in a COS. A Delphi study is being performed by a panel of international experts representing diverse stakeholders with the intention that this will result in a guideline for outcome measurement instrument selection. Informed by a literature review, a Delphi questionnaire was developed to identify potentially relevant tasks on instrument selection. The Delphi study takes place in a series of rounds. In the first round, panelists were asked to rate the importance of different tasks in the selection of outcome measurement instruments. They were encouraged to justify their choices and to add other relevant tasks. Consensus was reached if at least 70% of the panelists considered a task 'highly recommended' or 'desirable' and if no opposing arguments were provided. These tasks will be included in the guideline. Tasks that at least 50% of the panelists considered 'not relevant' will be excluded from the guideline. Tasks that were indeterminate will be taken to the second round. All responses of the first round are currently being aggregated and will be fed back to panelists in the second round. A third round will only be performed if the results of the second round require it. Since the Delphi method allows a large group of international experts to participate, we consider it to be the preferred consensus-based method for our study. Based upon this consultation process, a guideline will be developed on instrument selection for outcomes to be included in a COS.

Effect of the slope and initial moisture content on soil loss, aggregate and particle size distribution

NASA Astrophysics Data System (ADS)

Szabó, Judit Alexandra; Jakab, Gergely; Szabó, Boglárka

2015-04-01

Soil structure degradation has effect through the soil water balance and nutrient supply on the agricultural potential of an area. The soil erosion process comprises two phases: detachment and transport by water. To study the transport phase nozzle type laboratory-scale rainfall simulator was used with constant 80 mmhr-1 intensity on an arable haplic Cambisol. Measuring the aggregate and particle size distribution of the soil loss gives a good approach the erosion process. The primary objective of this study was to examine the sediment concentration, and detect the quality and quantity change of the soil loss during a single precipitation under six treatment combinations (recently tilled and crusty soil surface on two different slope steepness, inland inundation and drought soil conditions). Soil loss were collected continually, and separated per aggregate size fractions with sieves in three rounds during a rain to measure the weights. The particle size distribution was measured with Horiba LA-950 particle size analyzer. In general the ratio of the macro aggregates decreases and the ratio of the micro aggregates and clay fraction increases in the sediment with time during the precipitation due to the raindrop impact. Sediment concentration depends on the slope steepness, as from steeper slopes the runoff can transport bigger amount of sediment, but from the tilled surface bigger aggregates were washing down. Micro aggregate fraction is one of the indicators of good soil structure. The degradation of micro aggregates occurs in steeper slopes and the most erosive time period depends on the micromorphology of the surface. And while the aggregate size distribution of the soil loss of the treatments shows high variety of distribution and differs from the original soil, the particle size distribution of each aggregate size fraction shows similar trends except the 50-250 µm fraction where the fine sand fraction is dominating instead of the loam. This anomaly may be connected with the TC content of this fraction, but more research is needed. In agricultural areas micro aggregate fraction plays important role in nutrient supply thus understanding the erosion process is necessary because of the better protection in the future.

Validity and reliability of exposure assessors' ratings of exposure intensity by type of occupational questionnaire and type of rater.

PubMed

Friesen, Melissa C; Coble, Joseph B; Katki, Hormuzd A; Ji, Bu-Tian; Xue, Shouzheng; Lu, Wei; Stewart, Patricia A

2011-07-01

In epidemiologic studies that rely on professional judgment to assess occupational exposures, the raters' accurate assessment is vital to detect associations. We examined the influence of the type of questionnaire, type of industry, and type of rater on the raters' ability to reliably and validly assess within-industry differences in exposure. Our aim was to identify areas where improvements in exposure assessment may be possible. Subjects from three foundries (n = 72) and three textile plants (n = 74) in Shanghai, China, completed an occupational history (OH) and an industry-specific questionnaire (IQ). Six total dust measurements were collected per subject and were used to calculate a subject-specific measurement mean, which was used as the gold standard. Six raters independently ranked the intensity of each subject's current job on an ordinal scale (1-4) based on the OH alone and on the OH and IQ together. Aggregate ratings were calculated for the group, for industrial hygienists, and for occupational physicians. We calculated intra-class correlation coefficients (ICCs) to evaluate the reliability of the raters. We calculated the correlation between the subject-specific measurement means and the ratings to evaluate the raters' validity. Analyses were stratified by industry, type of questionnaire, and type of rater. We also examined the agreement between the ratings by exposure category, where the subject-specific measurement means were categorized into two and four categories. The reliability and validity measures were higher for the aggregate ratings than for the ratings from the individual raters. The group's performance was maximized with three raters. Both the reliability and validity measures were higher for the foundry industry than for the textile industry. The ICCs were consistently lower in the OH/IQ round than in the OH round in both industries. In contrast, the correlations with the measurement means were higher in the OH/IQ round than in the OH round for the foundry industry (group rating, OH/IQ: Spearman rho = 0.77; OH: rho = 0.64). No pattern by questionnaire type was observed for the textile industry (group rating, Spearman rho = 0.50, both assessment rounds). For both industries, the agreement by exposure category was higher when the task was reduced to discriminating between two versus four exposure categories. Assessments based on professional judgment may reduce misclassification by using two or three raters, by using questionnaires that systematically collect task information, and by defining intensity categories that are distinguishable by the raters. However, few studies have the resources to use multiple raters and these additional efforts may not be adequate for obtaining valid subjective ratings. Thus, improving exposure assessment approaches for studies that rely on professional judgment remain an important research need.

Ecological role of bluefin tuna (Thunnus thynnus) fish farms for associated wild fish assemblages in the Mediterranean Sea.

PubMed

Stagličić, Nika; Šegvić-Bubić, Tanja; Ugarković, Pero; Talijančić, Igor; Žužul, Iva; Tičina, Vjekoslav; Grubišić, Leon

2017-12-01

The ecological effects of tuna fish farms are largely undocumented. This study confirmed their high capacity to attract surrounding wild fish. The aggregation effect persisted year round, without detectable seasonal differences. Farm impact was restricted to close proximity of the sea cages, and was more prominent over the bottom than in the water column strata. Tuna fish farms proved to be high energy trophic resources, as indicated by the enhanced fitness status of two focal species, bogue and seabream. Under abundant food supply, seabream appear to allocate the majority of energy reserves to gonad development. Farm associated bogue had greater parasite loads, with no detrimental effect on fitness status. Overall, tuna fish farms can be regarded as population sources for aggregated wild fish, and under the no fishing conditions within the leasehold areas, can serve as functional marine protected areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Partitioning-based mechanisms under personalized differential privacy.

PubMed

Li, Haoran; Xiong, Li; Ji, Zhanglong; Jiang, Xiaoqian

2017-05-01

Differential privacy has recently emerged in private statistical aggregate analysis as one of the strongest privacy guarantees. A limitation of the model is that it provides the same privacy protection for all individuals in the database. However, it is common that data owners may have different privacy preferences for their data. Consequently, a global differential privacy parameter may provide excessive privacy protection for some users, while insufficient for others. In this paper, we propose two partitioning-based mechanisms, privacy-aware and utility-based partitioning, to handle personalized differential privacy parameters for each individual in a dataset while maximizing utility of the differentially private computation. The privacy-aware partitioning is to minimize the privacy budget waste, while utility-based partitioning is to maximize the utility for a given aggregate analysis. We also develop a t -round partitioning to take full advantage of remaining privacy budgets. Extensive experiments using real datasets show the effectiveness of our partitioning mechanisms.

Comminution and sizing processes of concrete block waste as recycled aggregates.

PubMed

Gomes, P C C; Ulsen, C; Pereira, F A; Quattrone, M; Angulo, S C

2015-11-01

Due to the environmental impact of construction and demolition waste (CDW), recycling is mandatory. It is also important that recycled concrete aggregates (RCA) are used in concrete to meet market demands. In the literature, the influence of RCAs on concrete has been investigated, but very limited studies have been conducted on how the origin of concrete waste and comminution processes influence RCA characteristics. This paper aims to investigate the influence of three different comminution and sizing processes (simple screening, crushing and grinding) on the composition, shape and porosity characteristics of RCA obtained from concrete block waste. Crushing and grinding implies a reduction of RCA porosity. However, due to the presence of coarse quartz rounded river pebbles in the original concrete block mixtures, the shape characteristics deteriorated. A large amount of powder (<0.15 mm) without detectable anhydrous cement was also generated. Copyright © 2015 Elsevier Ltd. All rights reserved.

Partitioning-based mechanisms under personalized differential privacy

PubMed Central

Li, Haoran; Xiong, Li; Ji, Zhanglong; Jiang, Xiaoqian

2017-01-01

Differential privacy has recently emerged in private statistical aggregate analysis as one of the strongest privacy guarantees. A limitation of the model is that it provides the same privacy protection for all individuals in the database. However, it is common that data owners may have different privacy preferences for their data. Consequently, a global differential privacy parameter may provide excessive privacy protection for some users, while insufficient for others. In this paper, we propose two partitioning-based mechanisms, privacy-aware and utility-based partitioning, to handle personalized differential privacy parameters for each individual in a dataset while maximizing utility of the differentially private computation. The privacy-aware partitioning is to minimize the privacy budget waste, while utility-based partitioning is to maximize the utility for a given aggregate analysis. We also develop a t-round partitioning to take full advantage of remaining privacy budgets. Extensive experiments using real datasets show the effectiveness of our partitioning mechanisms. PMID:28932827

Volcanic ash aggregation in the lab - can we mimic natural processes?

NASA Astrophysics Data System (ADS)

Mueller, Sebastian B.; Kueppers, Ulrich; Jacob, Michael; Ayris, Paul; Cimarelli, Corrado; Dingwell, Donald B.; Guttzeit, Melanie; Hess, Kai-Uwe; Walter, Ulrich

2015-04-01

Explosive volcanic eruptions release large amounts of particles into the atmosphere. Volcanic ash, by definition pyroclasts smaller than 2 mm, can be distributed around the globe by prevailing winds. Ash poses hazards to aviation industry by melting in jet turbines, to human health by entering respiration systems and to society by damaging infrastructure. Under certain circumstances, ash particles can cluster together and build ash aggregates. Aggregates range in size from few mm to few cm and may exhibit complex internal stratigraphy. During growth, weight, density and aerodynamic properties change, leading to a significantly different settling behavior compared to individual ash particles. Although ash aggregation has been frequently observed in the geologic record, the physical and chemical mechanisms generating the aggregates remain poorly understood. During several field campaigns, we collected numerous ash aggregates and analyzed their textural, chemical and mechanical properties. Based on this knowledge, we have designed experiments using the ProCell Lab System® of Glatt Ingenieurtechnik GmbH, Germany. In this device, a continuous fluidized bed can be applied on solid particles and simulate gas-particle flow conditions as they would be expected in volcanic plumes or pyroclastic density currents. The geological record and direct observations have shown that both processes are capable of producing ash aggregates. As starting material we used Na-glass beads as an analogue and volcanic ash from Laacher See Volcano, Eifel Volcanic Field, Germany. We define parameters such as grainsize, specific surface area and concentration of the starting material, degree of turbulence, temperature and moisture in the process chamber and the composition of the liquid phase to influence form, size, stability and production rate of aggregates. We were able to experimentally produce round, unstructured ash pellets up to 5mm in diameter. A detailed textural description highlights the strongly different properties of single ash grains and ash aggregates. These experiments aim at experimentally constraining the boundary conditions required for the generation of strong ash aggregates. A better mechanistic understanding will serve for more adequate ash mass distribution modeling.

Assessing cooperativity in supramolecular systems.

PubMed

von Krbek, Larissa K S; Schalley, Christoph A; Thordarson, Pall

2017-05-09

This tutorial review summarises different aspects of cooperativity in supramolecular complexes. We propose a systematic categorisation of cooperativity into cooperative aggregation, intermolecular (allosteric) cooperativity, intramolecular (chelate) cooperativity and interannular cooperativity and discuss approaches to quantify them thermodynamically using cooperativity factors. A brief summary of methods to determine the necessary thermodynamic data is given with emphasis on isothermal titration calorimetry (ITC), a method still underrepresented in supramolecular chemistry, which however offers some advantages over others. Finally, a discussion of very few selected examples, which highlight different aspects to illustrate why such an analysis is useful, rounds up this review.

Diagnostic Exercise: Circling and Behavioral Changes in a Cat.

PubMed

Faller, K; Leach, J; Gutierrez-Quintana, R; Finck, M; Hammond, G; Penderis, J; Marchesi, F

2015-07-01

A 4-year old spayed male domestic shorthair cat was presented with a history of circling and behavioral changes. Neurologic examination showed mild proprioceptive deficits. The lesion was localized in the forebrain, and magnetic resonance imaging revealed the presence of a large midline intracranial mass extending from the frontal lobe to the tentorial region of the brain. Euthanasia was elected due to poor prognosis. Histopathologic evaluation confirmed the presence of a mass composed by sheets and aggregates of large round/polygonal cells and multinucleate cells associated with deposits of cholesterol clefts, scattered hemorrhages and hemosiderin-laden macrophages. Immunohistochemistry showed that the round/polygonal cells and multinucleate cells were strongly positive for major histocompatibility complex class II antigen, variably positive for CD18, and occasionally positive for S100. Subsets of spindle cells showing variable expression of vimentin, S100, and neuron-specific enolase were also present. The final diagnosis was cholesterol granuloma. Differential diagnosis with meningioma is discussed. © The Author(s) 2014.

Enhanced bacterial quorum aggregation on a zeolite capping layer for sustainable inhibition of ammonium release from contaminated sediment.

PubMed

Xu, Jinlan; Zhang, Haiyang; Zhao, Rong; Kong, Fanxing

2017-12-01

The main objective of this study was to investigate how signal molecules enhance bacterial quorum aggregation on a zeolite capping layer for sustainable inhibition of ammonium release from contaminated sediment. Sediment remediation experiments were carried out by using nitrifying bacteria (WGX10, WGX18), denitrifying bacteria (HF3, HF7) and two kinds of signal molecules (OHHL, C8-HSL). The results showed that nitrifying bacteria and denitrifying bacteria could significantly aggregate on zeolite after adding 1.0 μM OHHL at a C/N ratio of 7. The maximum ammonium removal of five times the amount of ammonium adsorbed was achieved when 1.0 μM OHHL was added at the C/N ratio of 7 (the bio-regeneration rate was up to 88.32%), which was 1.24-2.02 times the ammonium removal amount at C/N ratios of 3, 5, 9. The concentration of total nitrogen in the overlying water was no more than 0.8 mg/L during four rounds of sediment remediation experiments. In addition, the bio-regeneration rate was up to 71.20%, which achieved sustainable inhibition of ammonium release from contaminated sediment.

Replacement of Fine Aggregate by using Recyclable Materials in Paving Blocks

NASA Astrophysics Data System (ADS)

Koganti, Shyam Prakash; Hemanthraja, Kommineni; Sajja, Satish

2017-08-01

Cement concrete paving blocks are precast hard products complete out of cement concrete. The product is made in various sizes and shapes like square, round and rectangular blocks of different dimensions with designs for interlocking of adjacent tiles blocks. Several Research Works have been carried out in the past to study the possibility of utilizing waste materials and industrial byproducts in the manufacturing of paver blocks. Various industrial waste materials like quarry dust, glass powder, ceramic dust and coal dust are used as partial replacement of fine aggregate and assessed the strength parameters and compared the profit percentages after replacement with waste materials. Quarry dust can be replaced by 20% and beyond that the difference in strength is not much higher but considering cost we can replace upto 40% so that we can get a profit of almost 10%. Similarly we can replace glass powder and ceramic dust by 20% only beyond that there is decrement in strength and even with 20% replacement we can get 1.34 % and 2.42% of profit. Coal dust is not suitable for alternative material as fine aggregate as it reduces the strength.

Project PriMo: sharing principles and practices of bronchodilator therapy monitoring in COPD: a consensus initiative for optimizing therapeutic appropriateness among Italian specialists.

PubMed

Cazzola, Mario; Brusasco, Vito; Centanni, Stefano; Cerveri, Isa; De Michele, Fausto; Di Maria, Giuseppe; Palange, Paolo; Pellegrino, Riccardo; Polverino, Mario; Rossi, Andrea; Papi, Alberto

2013-04-01

Even after publication of the 2011 update of GOLD report, some fundamental questions in the management of COPD are still open and this may weaken the applicability of these guidelines in everyday clinical practice. To assess the level of consensus amongst Italian respirologists on different topics related to diagnosis, monitoring and role of bronchodilator therapy in COPD, by using the Delphi technique. A Delphi study was undertaken between July and November 2011, when two questionnaires were consecutively sent to a panel of experts to be answered anonymously. After each round, the data were aggregated at group level of question topics and structured feedback was given to the panel. A first-round questionnaire was sent to 208 pulmonologists randomly selected from different Italian regions. The 132 respondents (63% of those initially selected) were from northern (53%), central (19%) and southern (28%) Italy. A second-round questionnaire was sent to all the first-round respondents, and a response was received from 110 of them (83%). The main topics that reached the pre-defined cut off for consensus (67% or more) were: a) bronchodilator therapy with long-acting bronchodilators could be beneficial in patients with airflow limitation even in the absence of symptoms, b) in patients not fully controlled with one long-acting bronchodilator, maximizing bronchodilation (i.e. adding another bronchodilator with a different mechanism of action) is the preferable option; and c) the use of inhaled corticosteroids (ICSs) as add on therapy should be considered in severe patients with frequent exacerbations. Italian specialists agree on several aspects of the diagnosis and treatment of COPD and expert opinion could support everyday decision process in the management of COPD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Dynamic structural states of ClpB involved in its disaggregation function.

PubMed

Uchihashi, Takayuki; Watanabe, Yo-Hei; Nakazaki, Yosuke; Yamasaki, Takashi; Watanabe, Hiroki; Maruno, Takahiro; Ishii, Kentaro; Uchiyama, Susumu; Song, Chihong; Murata, Kazuyoshi; Iino, Ryota; Ando, Toshio

2018-06-01

The ATP-dependent bacterial protein disaggregation machine, ClpB belonging to the AAA+ superfamily, refolds toxic protein aggregates into the native state in cooperation with the cognate Hsp70 partner. The ring-shaped hexamers of ClpB unfold and thread its protein substrate through the central pore. However, their function-related structural dynamics has remained elusive. Here we directly visualize ClpB using high-speed atomic force microscopy (HS-AFM) to gain a mechanistic insight into its disaggregation function. The HS-AFM movies demonstrate massive conformational changes of the hexameric ring during ATP hydrolysis, from a round ring to a spiral and even to a pair of twisted half-spirals. HS-AFM observations of Walker-motif mutants unveil crucial roles of ATP binding and hydrolysis in the oligomer formation and structural dynamics. Furthermore, repressed and hyperactive mutations result in significantly different oligomeric forms. These results provide a comprehensive view for the ATP-driven oligomeric-state transitions that enable ClpB to disentangle protein aggregates.

Petrology of the Yamato nakhlites

NASA Astrophysics Data System (ADS)

Imae, N.; Ikeda, Y.; Kojima, H.

2005-11-01

The Yamato nakhlites, Y-000593, Y-000749, and Y-000802, were recovered in 2000 from the bare icefield around the Yamato mountains in Antarctica, consisting of three independent specimens with black fusion crusts. They are paired cumulate clinopyroxenites. We obtained the intercumulus melt composition of the Yamato nakhlites and here call it the Yamato intercumulus melt (YIM). The YIM crystallized to form the augite rims, the olivine rims and the mesostasis phases in the cumulates. The augite rims consist of two layers: inner and outer. The crystallization of the inner rim drove the interstitial melt into the plagioclase liquidus field. Subsequently, the residual melt crystallized pigeonites and plagioclase to form the outer rims and the mesostasis.Three types of inclusions were identified in olivine phenocrysts: rounded vitrophyric, angular vitrophyric, and monomineralic augite inclusions. The monomineralic augite inclusions are common and may have been captured by growing olivine phenocrysts. The rounded vitrophyric inclusions are rare and may represent the composition of middle-stage melts, whereas the angular vitrophyric inclusions seem to have been derived from fractionated late-stage melts. Glass inclusions occur in close association with titanomagnetite and ferroan augite halo in phenocryst core augites and the assemblages may be magmatic inclusions in augites. We compared the YIM with compositions of magmatic inclusions in olivine and augite. The composition of magmatic inclusions in augite is similar to the YIM.Phenocrystic olivines contain exsolution lamellae, augite-magnetite aggregates, and symplectites in the cores. The symplectites often occur at the boundaries between olivine and augite grains. The aggregates, symplectite and lamellae formed by exsolution from the host olivine at magmatic temperatures.We present a formational scenario for nakhlites as follows: (1) accumulation of augite, olivine, and titanomagnetite phenocrysts took place on the floor of a magma chamber; (2) olivine exsolved augite and magnetite as augite-magnetite aggregates, symplectites and lamellae; (3) the overgrowth on olivine phenocrysts formed their rims, and the inner rims crystallized on augite phenocryst cores; and finally, (4) the outer rim formed surrounding the inner rims of augite phenocrysts, and plagioclase and minor minerals crystallized to form mesostasis under a rapid cooling condition, probably in a lava flow or a sill.

Quantitative evaluation of morphological changes in activated platelets in vitro using digital holographic microscopy.

PubMed

Kitamura, Yutaka; Isobe, Kazushige; Kawabata, Hideo; Tsujino, Tetsuhiro; Watanabe, Taisuke; Nakamura, Masayuki; Toyoda, Toshihisa; Okudera, Hajime; Okuda, Kazuhiro; Nakata, Koh; Kawase, Tomoyuki

2018-06-18

Platelet activation and aggregation have been conventionally evaluated using an aggregometer. However, this method is suitable for short-term but not long-term quantitative evaluation of platelet aggregation, morphological changes, and/or adhesion to specific materials. The recently developed digital holographic microscopy (DHM) has enabled the quantitative evaluation of cell size and morphology without labeling or destruction. Thus, we aim to validate its applicability in quantitatively evaluating changes in cell morphology, especially in the aggregation and spreading of activated platelets, thus modifying typical image analysis procedures to suit aggregated platelets. Freshly prepared platelet-rich plasma was washed with phosphate-buffered saline and treated with 0.1% CaCl 2 . Platelets were then fixed and subjected to DHM, scanning electron microscopy (SEM), atomic force microscopy, optical microscopy, and flow cytometry (FCM). Tightly aggregated platelets were identified as single cells. Data obtained from time-course experiments were plotted two-dimensionally according to the average optical thickness versus attachment area and divided into four regions. The majority of the control platelets, which supposedly contained small and round platelets, were distributed in the lower left region. As activation time increased, however, this population dispersed toward the upper right region. The distribution shift demonstrated by DHM was essentially consistent with data obtained from SEM and FCM. Therefore, DHM was validated as a promising device for testing platelet function given that it allows for the quantitative evaluation of activation-dependent morphological changes in platelets. DHM technology will be applicable to the quality assurance of platelet concentrates, as well as diagnosis and drug discovery related to platelet functions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Load balancing prediction method of cloud storage based on analytic hierarchy process and hybrid hierarchical genetic algorithm.

PubMed

Zhou, Xiuze; Lin, Fan; Yang, Lvqing; Nie, Jing; Tan, Qian; Zeng, Wenhua; Zhang, Nian

2016-01-01

With the continuous expansion of the cloud computing platform scale and rapid growth of users and applications, how to efficiently use system resources to improve the overall performance of cloud computing has become a crucial issue. To address this issue, this paper proposes a method that uses an analytic hierarchy process group decision (AHPGD) to evaluate the load state of server nodes. Training was carried out by using a hybrid hierarchical genetic algorithm (HHGA) for optimizing a radial basis function neural network (RBFNN). The AHPGD makes the aggregative indicator of virtual machines in cloud, and become input parameters of predicted RBFNN. Also, this paper proposes a new dynamic load balancing scheduling algorithm combined with a weighted round-robin algorithm, which uses the predictive periodical load value of nodes based on AHPPGD and RBFNN optimized by HHGA, then calculates the corresponding weight values of nodes and makes constant updates. Meanwhile, it keeps the advantages and avoids the shortcomings of static weighted round-robin algorithm.

[Grape seed extract induces morphological changes of prostate cancer PC-3 cells].

PubMed

Shang, Xue-Jun; Yin, Hong-Lin; Ge, Jing-Ping; Sun, Yi; Teng, Wen-Hui; Huang, Yu-Feng

2008-12-01

To observe the morphological changes of prostate cancer PC-3 cells induced by grape seed extract (GSE). PC-3 cells were incubated with different concentrations of GSE (100, 200 and 300 microg/ml) for 24, 48 and 72 hours, and then observed for morphological changes by invert microscopy, HE staining and transmission electron microscopy. The incubated PC-3 cells appeared round, small, wrinkled and broken under the invert microscope and exhibited the classical morphological characteristics of cell death under the electron microscope, including cell atrophy, increased vacuoles, crumpled nuclear membrane, and chromosome aggregation. GSE can cause morphological changes and induce necrosis and apoptosis of PC-3 cells.

Standardised method for reporting exercise programmes: protocol for a modified Delphi study.

PubMed

Slade, Susan C; Dionne, Clermont E; Underwood, Martin; Buchbinder, Rachelle

2014-12-30

Exercise is integral to health across the lifespan and important for people with chronic health conditions. A systematic review of exercise trials for chronic conditions reported suboptimal descriptions of the evaluated interventions and concluded that this hinders interpretation and replication. The aim of this project is to develop a standardised method for reporting essential exercise programme details being evaluated in clinical trials. A modified Delphi technique will be used to gain consensus among international exercise experts. We will use three sequential rounds of anonymous online questionnaires to refine a standardised checklist. A draft checklist of potentially relevant items was developed based on the results of a systematic review of exercise systematic reviews. An international panel of experts was identified by exercise systematic review authorship, established international profile in exercise research and practice and by peer referral. In round 1, the international panel of experts will be asked to rate the importance of each draft item and provide additional suggestions for revisions or new items. Consensus will be considered reached if at least 70% of the panel strongly agree/disagree that an item should be included or excluded. Where agreement is not reached or there are suggestions for altered or new items, these will be taken to round 2 together with an aggregated summary of round 1 responses. Following the second round, a ranking of item importance will be made to rationalise the number of items. The final template will be distributed to panel members for approval. Ethics approval was received from The Cabrini Institute Ethics Committee, Melbourne, Australia (HREC 02-07-04-14). We plan to use a stepwise process to develop and refine a standardised and internationally agreed template for explicit reporting of exercise programmes. The template will be generalisable across all types of exercise interventions. The findings will be disseminated through peer-reviewed publications and conference presentations. 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.

Impacts of the Doha Round framework agreements on dairy policies.

PubMed

Suzuki, N; Kaiser, H M

2005-05-01

Dairy is highly regulated in many countries for several reasons. Perishability, seasonal imbalances, and inelastic supply and demand for milk can cause inherent market instability. Milk buyers typically have had more market power than dairy farmers. Comparative production advantages in some countries have led to regulations and policies to protect local dairy farmers by maintaining domestic prices higher than world prices. A worldwide consensus on reduction of border measures for protecting dairy products is unlikely, and dairy will probably be an exception in ongoing World Trade Organization (WTO) negotiations. Under the Doha Round framework agreements, countries may name some products such as dairy as "sensitive," thereby excluding them from further reforms. However, new Doha Round framework agreements depart from the current WTO rule and call for product-specific spending caps. Such caps will greatly affect the dairy sector because dairy accounts for much of the aggregate measure of support (AMS) in several countries, including the United States and Canada. Also, the amounts of dairy AMS in several countries may be recalculated relative to an international reference price. In addition, all export subsidies are targeted for elimination in the Doha Round, including export credit programs and state trading enterprises, which will limit options for disposing of surplus dairy products in foreign markets. Currently, with higher domestic prices, measures for cutting or disposing of surpluses have been used in many countries. Supply control, which is not regulated by WTO rules, remains as an option. Although explicit export subsidies are restricted by WTO rules, many countries use esoteric measures to promote dairy exports. If countries agree to eliminate "consumer financed" export subsidies using a theoretical definition and measurements proposed herein as Export Subsidy Equivalents (ESE), dairy exports in many countries may be affected. Although domestic supports and export subsidies will be reduced in the Doha Round, possible exclusion of "sensitive" products from tariff reduction will help some countries' dairy sectors survive after those final agreements. A key concern for those countries will be the simultaneous restriction of surplus-disposing measures. With fewer marketing options for surpluses, countries that continue border protection and high internal prices will likely be forced to use domestic supply control programs in the future.

In situ observation of D-rich carbonaceous globules embedded in NWA 801 CR2 chondrite

NASA Astrophysics Data System (ADS)

Hashiguchi, Minako; Kobayashi, Sachio; Yurimoto, Hisayoshi

2013-12-01

Eighty-five D-rich carbonaceous particles were identified in the matrix of the NWA 801 CR2 chondrite using isotope microscopy. The occurrence of 67 D-rich carbonaceous particles was characterized using secondary electron microscopy combined with X-ray elemental mapping. The close association of H and C, and D-enrichment suggests that the D-rich carbonaceous particles correspond to organic matter. The D-rich organic particles were scattered ubiquitously throughout the matrix at a concentration of approximately 660 ppm. The morphology of the D-rich carbonaceous particles is globular up to about 1 μm in diameter and is classified into four types: ring globules, round globules, irregular-shaped globules, and globule aggregates. The ring globules are ring-shaped organic matter containing silicate and/or oxide, with or without a void in the center. This is the first report of silicate and oxide grains surrounded by D-rich organic matter. The globule aggregates are composed of several D-rich organic globules mixed with silicates. Morphology of ring globules is very similar to core-mantle grain produced in the molecular cloud or in the outer solar nebula inferring by astronomy, suggesting that the organic globules have formed by UV photolysis in the ice mantle. Silicates or oxides attached to D-rich organic globules are the first observation among chondrites so far and may be unique nature of CR2 chondrites. The hydrogen isotopic compositions of the ring globules, round globules, irregular-shaped globules, and globule aggregates are δD = 3000-4800, 2900-8100, 2700-11,000, and 2500-11,000‰, respectively. Variations of D/H ratio of these organic globules seemed to be attributed to variations of D/H ratio of the organic radicals or differences of content of the D-rich organic radicals. There are no significant differences in the hydrogen isotopic compositions among the four types of D-rich carbonaceous matter. The D-enrichments suggest that these organic globules have formed in a cold molecular cloud and/or the outer protoplanetary disk of the early solar system. The oxygen isotopic compositions of the silicates and oxides attached to the ring globules and globule aggregates range from δ17O = -49 to 50‰ and δ18O = -46 to 64‰. The oxygen isotopic compositions are not distinct from those of solar system materials, which suggests that the organic globules were formed in the outer solar system rather than in the presolar environment. Therefore, it is possible that the ring globules and globule aggregates in NWA 801 may have formed in the outer protoplanetary disk of the early solar system. Organic globules that exhibit clear presolar origin were not identified in this study. The lack of clear presolar signatures might suggest that modifications of isotopic compositions or morphologies of the presolar organic matter occurred in the early solar nebula.

The making of a productivity hotspot in the coastal ocean.

PubMed

Wingfield, Dana K; Peckham, S Hoyt; Foley, David G; Palacios, Daniel M; Lavaniegos, Bertha E; Durazo, Reginaldo; Nichols, Wallace J; Croll, Donald A; Bograd, Steven J

2011-01-01

Highly productive hotspots in the ocean often occur where complex physical forcing mechanisms lead to aggregation of primary and secondary producers. Understanding how hotspots persist, however, requires combining knowledge of the spatio-temporal linkages between geomorphology, physical forcing, and biological responses with the physiological requirements and movement of top predators. Here we integrate remotely sensed oceanography, ship surveys, and satellite telemetry to show how local geomorphology interacts with physical forcing to create a region with locally enhanced upwelling and an adjacent upwelling shadow that promotes retentive circulation, enhanced year-round primary production, and prey aggregation. These conditions provide an area within the upwelling shadow where physiologically optimal water temperatures can be found adjacent to a region of enhanced prey availability, resulting in a foraging hotspot for loggerhead sea turtles (Caretta caretta) off the Baja California peninsula, Mexico. We have identified the set of conditions that lead to a persistent top predator hotspot, which increases our understanding of how highly migratory species exploit productive regions of the ocean. These results will aid in the development of spatially and environmentally explicit management strategies for marine species of conservation concern.

Regulation of cell-fate determination in Dictyostelium.

PubMed

Brown, J M; Firtel, R A

1999-12-15

A key step in the development of all multicellular organisms is the differentiation of specialized cell types. The eukaryotic microorganism Dictyostelium discoideum provides a unique experimental system for studying cell-type determination and spatial patterning in a developing multicellular organism. Unlike metazoans, which become multicellular by undergoing many rounds of cell division after fertilization of an egg, the social amoeba Dictyostelium achieves multicellularity by the aggregation of approximately 10(5) cells in response to nutrient depletion. Following aggregation, cell-type differentiation and morphogenesis result in a multicellular organism with only a few cell types that exhibit a defined patterning along the anterior-posterior axis of the organism. Analysis of the mechanisms that control these processes is facilitated by the relative simplicity of Dictyostelium development and the availability of molecular, genetic, and cell biological tools. Interestingly, analysis has shown that many molecules that play integral roles in the development of higher eukaryotes, such as PKA, STATs, and GSK-3, are also essential for cell-type differentiation and patterning in Dictyostelium. The role of these and other signaling pathways in the induction, maintenance, and patterning of cell types during Dictyostelium development is discussed.

Identifying and prioritising systematic review topics with public health stakeholders: A protocol for a modified Delphi study in Switzerland to inform future research agendas

PubMed Central

Mütsch, Margot; Kien, Christina; Gerhardus, Ansgar; Lhachimi, Stefan K

2017-01-01

Introduction The Cochrane Collaboration aims to produce relevant and top priority evidence that responds to existing evidence gaps. Hence, research priority setting (RPS) is important to identify which potential research gaps are deemed most important. Moreover, RPS supports future health research to conform both health and health evidence needs. However, studies that are prioritising systematic review topics in public health are surprisingly rare. Therefore, to inform the research agenda of Cochrane Public Health Europe (CPHE), we introduce the protocol of a priority setting study on systematic review topics in several European countries, which is conceptualised as pilot. Methods and analysis We will conduct a two-round modified Delphi study in Switzerland, incorporating an anonymous web-based questionnaire, to assess which topics should be prioritised for systematic reviews in public health. In the first Delphi round public health stakeholders will suggest relevant assessment criteria and potential priority topics. In the second Delphi round the participants indicate their (dis)agreement to the aggregated results of the first round and rate the potential review topics with the predetermined criteria on a four-point Likert scale. As we invite a wide variety of stakeholders we will compare the results between the different stakeholder groups. Ethics and dissemination We have received ethical approval from the ethical board of the University of Bremen, Germany (principal investigation is conducted at the University of Bremen) and a certificate of non-objection from the Canton of Zurich, Switzerland (fieldwork will be conducted in Switzerland). The results of this study will be further disseminated through peer reviewed publication and will support systematic review author groups (i.a. CPHE) to improve the relevance of the groups´ future review work. Finally, the proposed priority setting study can be used as a framework by other systematic review groups when conducting a priority setting study in a different context. PMID:28780546

Modelling Market Dynamics with a "Market Game"

NASA Astrophysics Data System (ADS)

Katahira, Kei; Chen, Yu

In the financial market, traders, especially speculators, typically behave as to yield capital gains by the difference between selling and buying prices. Making use of the structure of Minority Game, we build a novel market toy model which takes account of such the speculative mind involving a round-trip trade to analyze the market dynamics as a system. Even though the micro-level behavioral rules of players in this new model is quite simple, its macroscopic aggregational output has the reproducibility of the well-known stylized facts such as volatility clustering and heavy tails. The proposed model may become a new alternative bottom-up approach in order to study the emerging mechanism of those stylized qualitative properties of asset returns.

Core outcome domains for clinical trials in non-specific low back pain.

PubMed

Chiarotto, Alessandro; Deyo, Richard A; Terwee, Caroline B; Boers, Maarten; Buchbinder, Rachelle; Corbin, Terry P; Costa, Leonardo O P; Foster, Nadine E; Grotle, Margreth; Koes, Bart W; Kovacs, Francisco M; Lin, Chung-Wei Christine; Maher, Chris G; Pearson, Adam M; Peul, Wilco C; Schoene, Mark L; Turk, Dennis C; van Tulder, Maurits W; Ostelo, Raymond W

2015-06-01

Inconsistent reporting of outcomes in clinical trials of patients with non-specific low back pain (NSLBP) hinders comparison of findings and the reliability of systematic reviews. A core outcome set (COS) can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials. In 1998, Deyo et al. recommended a standardized set of outcomes for LBP clinical research. The aim of this study was to update these recommendations by determining which outcome domains should be included in a COS for clinical trials in NSLBP. An International Steering Committee established the methodology to develop this COS. The OMERACT Filter 2.0 framework was used to draw a list of potential core domains that were presented in a Delphi study. Researchers, care providers and patients were invited to participate in three Delphi rounds and were asked to judge which domains were core. A priori criteria for consensus were established before each round and were analysed together with arguments provided by panellists on importance, overlap, aggregation and/or addition of potential core domains. The Steering Committee discussed the final results and made final decisions. A set of 280 experts was invited to participate in the Delphi; response rates in the three rounds were 52, 50 and 45%. Of 41 potential core domains presented in the first round, 13 had sufficient support to be presented for rating in the third round. Overall consensus was reached for the inclusion of three domains in this COS: 'physical functioning', 'pain intensity' and 'health-related quality of life'. Consensus on 'physical functioning' and 'pain intensity' was consistent across all stakeholders, 'health-related quality of life' was not supported by the patients, and all the other domains were not supported by two or more groups of stakeholders. Weighting all possible argumentations, the Steering Committee decided to include in the COS the three domains that reached overall consensus and the domain 'number of deaths'. The following outcome domains were included in this updated COS: 'physical functioning', 'pain intensity', 'health-related quality of life' and 'number of deaths'. The next step for the development of this COS will be to determine which measurement instruments best measure these domains.

Nanoparticle conversion to biofilms: in vitro demonstration using serum-derived mineralo-organic nanoparticles.

PubMed

Wong, Tsui-Yin; Peng, Hsin-Hsin; Wu, Cheng-Yeu; Martel, Jan; Ojcius, David M; Hsu, Fu-Yung; Young, John D

2015-01-01

Mineralo-organic nanoparticles (NPs) detected in biological fluids have been described as precursors of physiological and pathological calcifications in the body. Our main objective was to examine the early stages of mineral NP formation in body fluids. A nanomaterial approach based on atomic force microscopy, dynamic light scattering, electron microscopy and spectroscopy was used. The mineral particles, which contain the serum proteins albumin and fetuin-A, initially precipitate in the form of round amorphous NPs that gradually grow in size, aggregate and coalesce to form crystalline mineral films similar to the structures observed in calcified human arteries. Our study reveals the early stages of particle formation and provides a platform to analyze the role(s) of mineralo-organic NPs in human tissues.

Nurse Reported Quality of Care: A Measure of Hospital Quality

PubMed Central

McHugh, Matthew D.; Stimpfel, Amy Witkoski

2013-01-01

As the primary providers of round-the-clock bedside care, nurses are well positioned to report on hospital quality of care. Researchers have not examined how nurses’ reports of quality correspond with standard process or outcomes measures of quality. We assess the validity of evaluating hospital quality by aggregating hospital nurses’ responses to a single item that asks them to report on quality of care. We found that a 10% increment in the proportion of nurses reporting excellent quality of care was associated with lower odds of mortality and failure to rescue; greater patient satisfaction; and higher composite process of care scores for acute myocardial infarction, pneumonia, and surgical patients. Nurse reported quality of care is a useful indicator of hospital performance. PMID:22911102

Squaring the circle. Social and environmental implications of pre-pottery neolithic building technology at Tell Qarassa (South Syria).

PubMed

Balbo, Andrea L; Iriarte, Eneko; Arranz, Amaia; Zapata, Lydia; Lancelotti, Carla; Madella, Marco; Teira, Luis; Jiménez, Miguel; Braemer, Frank; Ibáñez, Juan José

2012-01-01

We present the results of the microstratigraphic, phytolith and wood charcoal study of the remains of a 10.5 ka roof. The roof is part of a building excavated at Tell Qarassa (South Syria), assigned to the Pre-Pottery Neolithic B period (PPNB). The Pre-Pottery Neolithic (PPN) period in the Levant coincides with the emergence of farming. This fundamental change in subsistence strategy implied the shift from mobile to settled aggregated life, and from tents and huts to hard buildings. As settled life spread across the Levant, a generalised transition from round to square buildings occurred, that is a trademark of the PPNB period. The study of these buildings is fundamental for the understanding of the ever-stronger reciprocal socio-ecological relationship humans developed with the local environment since the introduction of sedentism and domestication. Descriptions of buildings in PPN archaeological contexts are usually restricted to the macroscopic observation of wooden elements (posts and beams) and mineral components (daub, plaster and stone elements). Reconstructions of microscopic and organic components are frequently based on ethnographic analogy. The direct study of macroscopic and microscopic, organic and mineral, building components performed at Tell Qarassa provides new insights on building conception, maintenance, use and destruction. These elements reflect new emerging paradigms in the relationship between Neolithic societies and the environment. A square building was possibly covered here with a radial roof, providing a glance into a topologic shift in the conception and understanding of volumes, from round-based to square-based geometries. Macroscopic and microscopic roof components indicate buildings were conceived for year-round residence rather than seasonal mobility. This implied performing maintenance and restoration of partially damaged buildings, as well as their adaptation to seasonal variability.

Squaring the Circle. Social and Environmental Implications of Pre-Pottery Neolithic Building Technology at Tell Qarassa (South Syria)

PubMed Central

Balbo, Andrea L.; Iriarte, Eneko; Arranz, Amaia; Zapata, Lydia; Lancelotti, Carla; Madella, Marco; Teira, Luis; Jiménez, Miguel; Braemer, Frank; Ibáñez, Juan José

2012-01-01

We present the results of the microstratigraphic, phytolith and wood charcoal study of the remains of a 10.5 ka roof. The roof is part of a building excavated at Tell Qarassa (South Syria), assigned to the Pre-Pottery Neolithic B period (PPNB). The Pre-Pottery Neolithic (PPN) period in the Levant coincides with the emergence of farming. This fundamental change in subsistence strategy implied the shift from mobile to settled aggregated life, and from tents and huts to hard buildings. As settled life spread across the Levant, a generalised transition from round to square buildings occurred, that is a trademark of the PPNB period. The study of these buildings is fundamental for the understanding of the ever-stronger reciprocal socio-ecological relationship humans developed with the local environment since the introduction of sedentism and domestication. Descriptions of buildings in PPN archaeological contexts are usually restricted to the macroscopic observation of wooden elements (posts and beams) and mineral components (daub, plaster and stone elements). Reconstructions of microscopic and organic components are frequently based on ethnographic analogy. The direct study of macroscopic and microscopic, organic and mineral, building components performed at Tell Qarassa provides new insights on building conception, maintenance, use and destruction. These elements reflect new emerging paradigms in the relationship between Neolithic societies and the environment. A square building was possibly covered here with a radial roof, providing a glance into a topologic shift in the conception and understanding of volumes, from round-based to square-based geometries. Macroscopic and microscopic roof components indicate buildings were conceived for year-round residence rather than seasonal mobility. This implied performing maintenance and restoration of partially damaged buildings, as well as their adaptation to seasonal variability. PMID:22848723

Mineralogy and chemistry of massive sulfide deposits from the Juan de Fuca Ridge.

USGS Publications Warehouse

Koski, R.A.; Clague, D.A.; Oudin, E.

1984-01-01

Two types of massive sulphide were dredged from one of the six vent sites located in the axial valley of the southern Juan de Fuca ridge. Type A samples are angular slabs of dark grey Zn-rich sulphide with interlayers and a thin, partly-oxidized crust of Fe-sulphide. These layered sulphide aggregates appear to be fragments of a sulphide wall enclosing an active hydrothermal vent. The outer sulphide wall is composed of colloform Fe sulphide and Fe-poor sphalerite deposited under low-T conditions when sea-water and hydrothermal fluid mix above the discharge point. Inside the wall the intensifying hydrothermal sytem deposits a higher-T assemblage of granular Fe-rich sphalerite, wurtzite, pyrite and minor Cu-Fe sulphide. Type B sulphide samples are sub-rounded, spongy-textured fragments composed almost entirely of dendritic aggregates of pale Fe-poor colloform sphalerite and opaline silica. This type of sulphide is deposited in settings peripheral to sites of focused discharge and in open spaces by moderate- to low-T fluid discharging at a slow but variable rate; the fluid becomes increasingly oxidizing, resulting in late-stage deposits of hematite, baryte and sulphur.-L.di H.

Effects of Weather on Caloric and Nutritive Intake in India

NASA Astrophysics Data System (ADS)

Zhang, J.; Babiarz, K.; Goldhaber-Fiebert, J.; Lobell, D. B.

2012-12-01

Many studies have investigated effects of weather on production of key food crops, largely motivated by a desire to anticipate impacts of climate change. However, health outcomes are most directly affected by food consumption, not production. Consumption changes will not necessarily follow production changes, primarily because people can adjust their diets away from foods that are most negatively affected. To more directly evaluate the effects of weather on nutrition, we analyzed reported household expenditure and consumption data from 20 rounds of the National Sample Survey (NSS) of India along with aggregated weather data of the two main agricultural seasons, kharif and rabi. Per capita intake of calories, protein, fats, and micronutrients were calculated from reported data at the household level, and then aggregated to district level for comparison with weather data. Regression analysis revealed significant negative effects of increased temperatures on calorie consumption in rural areas, with lower sensitivities in urban areas. We also found a higher sensitivity of protein and fat consumption to weather than for calories, which likely reflects the ability of households to switch to cheaper sources of calories in lean times. The results of this analysis will be useful for assessing the overall health burdens associated with climate change in India.

Communally Nesting Migratory Birds Create Ecological Hot-Spots in Tropical Australia.

PubMed

Natusch, Daniel J D; Lyons, Jessica A; Brown, Gregory; Shine, Richard

2016-01-01

Large numbers of metallic starlings (Aplonis metallica) migrate annually from New Guinea to the rainforests of tropical Australia, where they nest communally in single emergent trees (up to 1,000 birds). These aggregations create dense and species-rich faunal "hot-spots", attracting a diverse assemblage of local consumers that utilise this seasonal resource. The starlings nested primarily in poison-dart trees (Antiaris toxicaria) near the rainforest-woodland boundary. Surveys underneath these colonies revealed that bird-derived nutrients massively increased densities of soil invertebrates and mammals (primarily wild pigs) beneath trees, year-round. Flying invertebrates, nocturnal birds, reptiles, and amphibians congregated beneath the trees when starlings were nesting (the wet-season). Diurnal birds (primarily cockatoos and bush turkeys) aggregated beneath the trees during the dry-season to utilise residual nutrients when the starlings were not nesting. The abundance of several taxa was considerably higher (to > 1000-fold) under colony trees than under nearby trees. The system strikingly resembles utilisation of bird nesting colonies by predators in other parts of the world but this spectacular system has never been described, emphasizing the continuing need for detailed natural-history studies in tropical Australia.

Communally Nesting Migratory Birds Create Ecological Hot-Spots in Tropical Australia

PubMed Central

Natusch, Daniel J. D.; Lyons, Jessica A.; Brown, Gregory; Shine, Richard

2016-01-01

Large numbers of metallic starlings (Aplonis metallica) migrate annually from New Guinea to the rainforests of tropical Australia, where they nest communally in single emergent trees (up to 1,000 birds). These aggregations create dense and species-rich faunal “hot-spots”, attracting a diverse assemblage of local consumers that utilise this seasonal resource. The starlings nested primarily in poison-dart trees (Antiaris toxicaria) near the rainforest-woodland boundary. Surveys underneath these colonies revealed that bird-derived nutrients massively increased densities of soil invertebrates and mammals (primarily wild pigs) beneath trees, year-round. Flying invertebrates, nocturnal birds, reptiles, and amphibians congregated beneath the trees when starlings were nesting (the wet-season). Diurnal birds (primarily cockatoos and bush turkeys) aggregated beneath the trees during the dry-season to utilise residual nutrients when the starlings were not nesting. The abundance of several taxa was considerably higher (to > 1000-fold) under colony trees than under nearby trees. The system strikingly resembles utilisation of bird nesting colonies by predators in other parts of the world but this spectacular system has never been described, emphasizing the continuing need for detailed natural-history studies in tropical Australia. PMID:27706197

A decentralized fuzzy C-means-based energy-efficient routing protocol for wireless sensor networks.

PubMed

Alia, Osama Moh'd

2014-01-01

Energy conservation in wireless sensor networks (WSNs) is a vital consideration when designing wireless networking protocols. In this paper, we propose a Decentralized Fuzzy Clustering Protocol, named DCFP, which minimizes total network energy dissipation to promote maximum network lifetime. The process of constructing the infrastructure for a given WSN is performed only once at the beginning of the protocol at a base station, which remains unchanged throughout the network's lifetime. In this initial construction step, a fuzzy C-means algorithm is adopted to allocate sensor nodes into their most appropriate clusters. Subsequently, the protocol runs its rounds where each round is divided into a CH-Election phase and a Data Transmission phase. In the CH-Election phase, the election of new cluster heads is done locally in each cluster where a new multicriteria objective function is proposed to enhance the quality of elected cluster heads. In the Data Transmission phase, the sensing and data transmission from each sensor node to their respective cluster head is performed and cluster heads in turn aggregate and send the sensed data to the base station. Simulation results demonstrate that the proposed protocol improves network lifetime, data delivery, and energy consumption compared to other well-known energy-efficient protocols.

Feeding the world's largest fish: highly variable whale shark residency patterns at a provisioning site in the Philippines

PubMed Central

Araujo, Gonzalo; Labaja, Jessica; McCoy, Emer; Murray, Ryan; Ponzo, Alessandro

2017-01-01

Provisioning wildlife for tourism is a controversial yet widespread practice. We analysed the residency patterns of juvenile whale sharks (Rhincodon typus) in Oslob, Philippines, where provisioning has facilitated a large shark-watching operation since 2011. We identified 208 individual sharks over three years, with an average of 18.6 (s.d. = 7.8, range = 6–43) individuals sighted per week. Weekly shark abundance varied seasonally and peak-season abundance (approx. May–November) increased across years. Whale sharks displayed diverse individual site visitation patterns ranging from a single visit to sporadic visits, seasonal residency and year-round residency. Nine individuals became year-round residents, which represents a clear response to provisioning. The timing of the seasonal peak at Oslob did not align with known non-provisioned seasonal aggregations elsewhere in the Philippines, which could suggest that seasonal residents at Oslob exploit this food source when prey availability at alternative sites is low. Since prolonged residency equates to less time foraging naturally, provisioning could influence foraging success, alter distributions and lead to dependency in later life stages. Such impacts must be carefully weighed against the benefits of provisioning (i.e. tourism revenue in a remote community) to facilitate informed management decisions. PMID:28989750

Feeding the world's largest fish: highly variable whale shark residency patterns at a provisioning site in the Philippines.

PubMed

Thomson, Jordan A; Araujo, Gonzalo; Labaja, Jessica; McCoy, Emer; Murray, Ryan; Ponzo, Alessandro

2017-09-01

Provisioning wildlife for tourism is a controversial yet widespread practice. We analysed the residency patterns of juvenile whale sharks ( Rhincodon typus ) in Oslob, Philippines, where provisioning has facilitated a large shark-watching operation since 2011. We identified 208 individual sharks over three years, with an average of 18.6 (s.d. = 7.8, range = 6-43) individuals sighted per week. Weekly shark abundance varied seasonally and peak-season abundance (approx. May-November) increased across years. Whale sharks displayed diverse individual site visitation patterns ranging from a single visit to sporadic visits, seasonal residency and year-round residency. Nine individuals became year-round residents, which represents a clear response to provisioning. The timing of the seasonal peak at Oslob did not align with known non-provisioned seasonal aggregations elsewhere in the Philippines, which could suggest that seasonal residents at Oslob exploit this food source when prey availability at alternative sites is low. Since prolonged residency equates to less time foraging naturally, provisioning could influence foraging success, alter distributions and lead to dependency in later life stages. Such impacts must be carefully weighed against the benefits of provisioning (i.e. tourism revenue in a remote community) to facilitate informed management decisions.

A Decentralized Fuzzy C-Means-Based Energy-Efficient Routing Protocol for Wireless Sensor Networks

PubMed Central

2014-01-01

Energy conservation in wireless sensor networks (WSNs) is a vital consideration when designing wireless networking protocols. In this paper, we propose a Decentralized Fuzzy Clustering Protocol, named DCFP, which minimizes total network energy dissipation to promote maximum network lifetime. The process of constructing the infrastructure for a given WSN is performed only once at the beginning of the protocol at a base station, which remains unchanged throughout the network's lifetime. In this initial construction step, a fuzzy C-means algorithm is adopted to allocate sensor nodes into their most appropriate clusters. Subsequently, the protocol runs its rounds where each round is divided into a CH-Election phase and a Data Transmission phase. In the CH-Election phase, the election of new cluster heads is done locally in each cluster where a new multicriteria objective function is proposed to enhance the quality of elected cluster heads. In the Data Transmission phase, the sensing and data transmission from each sensor node to their respective cluster head is performed and cluster heads in turn aggregate and send the sensed data to the base station. Simulation results demonstrate that the proposed protocol improves network lifetime, data delivery, and energy consumption compared to other well-known energy-efficient protocols. PMID:25162060

The agencies method for coalition formation in experimental games

PubMed Central

Nash, John F.; Nagel, Rosemarie; Ockenfels, Axel; Selten, Reinhard

2012-01-01

In society, power is often transferred to another person or group. A previous work studied the evolution of cooperation among robot players through a coalition formation game with a non-cooperative procedure of acceptance of an agency of another player. Motivated by this previous work, we conduct a laboratory experiment on finitely repeated three-person coalition formation games. Human players with different strength according to the coalition payoffs can accept a transfer of power to another player, the agent, who then distributes the coalition payoffs. We find that the agencies method for coalition formation is quite successful in promoting efficiency. However, the agent faces a tension between short-term incentives of not equally distributing the coalition payoff and the long-term concern to keep cooperation going. In a given round, the strong player in our experiment often resolves this tension approximately in line with the Shapley value and the nucleolus. Yet aggregated over all rounds, the payoff differences between players are rather small, and the equal division of payoffs predicts about 80% of all groups best. One reason is that the voting procedure appears to induce a balance of power, independent of the individual player's strength: Selfish subjects tend to be voted out of their agency and are further disciplined by reciprocal behaviors. PMID:23175792

The agencies method for coalition formation in experimental games.

PubMed

Nash, John F; Nagel, Rosemarie; Ockenfels, Axel; Selten, Reinhard

2012-12-11

In society, power is often transferred to another person or group. A previous work studied the evolution of cooperation among robot players through a coalition formation game with a non-cooperative procedure of acceptance of an agency of another player. Motivated by this previous work, we conduct a laboratory experiment on finitely repeated three-person coalition formation games. Human players with different strength according to the coalition payoffs can accept a transfer of power to another player, the agent, who then distributes the coalition payoffs. We find that the agencies method for coalition formation is quite successful in promoting efficiency. However, the agent faces a tension between short-term incentives of not equally distributing the coalition payoff and the long-term concern to keep cooperation going. In a given round, the strong player in our experiment often resolves this tension approximately in line with the Shapley value and the nucleolus. Yet aggregated over all rounds, the payoff differences between players are rather small, and the equal division of payoffs predicts about 80% of all groups best. One reason is that the voting procedure appears to induce a balance of power, independent of the individual player's strength: Selfish subjects tend to be voted out of their agency and are further disciplined by reciprocal behaviors.

The emergence of superstructural order in insulin amyloid fibrils upon multiple rounds of self-seeding

NASA Astrophysics Data System (ADS)

Surmacz-Chwedoruk, Weronika; Babenko, Viktoria; Dec, Robert; Szymczak, Piotr; Dzwolak, Wojciech

2016-08-01

Typically, elongation of an amyloid fibril entails passing conformational details of the mother seed to daughter generations of fibrils with high fidelity. There are, however, several factors that can potentially prevent such transgenerational structural imprinting from perpetuating, for example heterogeneity of mother seeds or so-called conformational switching. Here, we examine phenotypic persistence of bovine insulin amyloid ([BI]) upon multiple rounds of self-seeding under quiescent conditions. According to infrared spectroscopy, with the following passages of homologous seeding, daughter fibrils gradually depart from the mother seed’s spectral characteristics. We note that this transgenerational structural drift in [BI] amyloid leads toward fibrils with infrared, chiroptical, and morphological traits similar to those of the superstructural variant of fibrils which normally forms upon strong agitation of insulin solutions. However, in contrast to agitation-induced insulin amyloid, the superstructural assemblies of daughter fibrils isolated through self-seeding are sonication-resistant. Our results suggest that formation of single amyloid fibrils is not a dead-end of the amyloidogenic self-assembly. Instead, the process appears to continue toward the self-assembly of higher-order structures although on longer time-scales. From this perspective, the fast agitation-induced aggregation of insulin appears to be a shortcut to amyloid superstructures whose formation under quiescent conditions is slow.

Identifying and prioritising systematic review topics with public health stakeholders: A protocol for a modified Delphi study in Switzerland to inform future research agendas.

PubMed

Hoekstra, Dyon; Mütsch, Margot; Kien, Christina; Gerhardus, Ansgar; Lhachimi, Stefan K

2017-08-04

The Cochrane Collaboration aims to produce relevant and top priority evidence that responds to existing evidence gaps. Hence, research priority setting (RPS) is important to identify which potential research gaps are deemed most important. Moreover, RPS supports future health research to conform both health and health evidence needs. However, studies that are prioritising systematic review topics in public health are surprisingly rare. Therefore, to inform the research agenda of Cochrane Public Health Europe (CPHE), we introduce the protocol of a priority setting study on systematic review topics in several European countries, which is conceptualised as pilot. We will conduct a two-round modified Delphi study in Switzerland, incorporating an anonymous web-based questionnaire, to assess which topics should be prioritised for systematic reviews in public health. In the first Delphi round public health stakeholders will suggest relevant assessment criteria and potential priority topics. In the second Delphi round the participants indicate their (dis)agreement to the aggregated results of the first round and rate the potential review topics with the predetermined criteria on a four-point Likert scale. As we invite a wide variety of stakeholders we will compare the results between the different stakeholder groups. We have received ethical approval from the ethical board of the University of Bremen, Germany (principal investigation is conducted at the University of Bremen) and a certificate of non-objection from the Canton of Zurich, Switzerland (fieldwork will be conducted in Switzerland). The results of this study will be further disseminated through peer reviewed publication and will support systematic review author groups (i.a. CPHE) to improve the relevance of the groups´ future review work. Finally, the proposed priority setting study can be used as a framework by other systematic review groups when conducting a priority setting study in a different context. © 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.

A Delphi study and ranking exercise to support commissioning services: future delivery of Thrombectomy services in England.

PubMed

Halvorsrud, Kristoffer; Flynn, Darren; Ford, Gary A; McMeekin, Peter; Bhalla, Ajay; Balami, Joyce; Craig, Dawn; White, Phil

2018-02-22

Intra-arterial thrombectomy is the gold standard treatment for large artery occlusive stroke. However, the evidence of its benefits is almost entirely based on trials delivered by experienced neurointerventionists working in established teams in neuroscience centres. Those responsible for the design and prospective reconfiguration of services need access to a comprehensive and complementary array of information on which to base their decisions. This will help to ensure the demonstrated effects from trials may be realised in practice and account for regional/local variations in resources and skill-sets. One approach to elucidate the implementation preferences and considerations of key experts is a Delphi survey. In order to support commissioning decisions, we aimed using an electronic Delphi survey to establish consensus on the options for future organisation of thrombectomy services among physicians with clinical experience in managing large artery occlusive stroke. A Delphi survey was developed with 12 options for future organisation of thrombectomy services in England. A purposive sampling strategy established an expert panel of stroke physicians from the British Association of Stroke Physicians (BASP) Clinical Standards and/or Executive Membership that deliver 24/7 intravenous thrombolysis. Options with aggregate scores falling within the lowest quartile were removed from the subsequent Delphi round. Options reaching consensus following the two Delphi rounds were then ranked in a final exercise by both the wider BASP membership and the British Society of Neuroradiologists (BSNR). Eleven stroke physicians from BASP completed the initial two Delphi rounds. Three options achieved consensus, with subsequently wider BASP (97%, n = 43) and BSNR members (86%, n = 21) assigning the highest approval rankings in the final exercise for transferring large artery occlusive stroke patients to nearest neuroscience centre for thrombectomy based on local CT/CT Angiography. The initial Delphi rounds ensured optimal reduction of options by an expert panel of stroke physicians, while subsequent ranking exercises allowed remaining options to be ranked by a wider group of experts within stroke to reach consensus. The preferred implementation option for thrombectomy is investigating suspected acute stroke patients by CT/CT Angiography and secondary transfer of large artery occlusive stroke patients to the nearest neuroscience (thrombectomy) centre.

Do antibody responses to the influenza vaccine persist year-round in the elderly? A systematic review and meta-analysis.

PubMed

Young, Barnaby; Zhao, Xiahong; Cook, Alex R; Parry, Christopher M; Wilder-Smith, Annelies; I-Cheng, Mark Chen

2017-01-05

The influenza vaccine is less immunogenic in older than younger adults, and the duration of protection is unclear. Determining if protection persists beyond a typical seasonal epidemic is important for climates where influenza virus activity is year-round. A systematic review protocol was developed and registered with PROSPERO [CRD42015023847]. Electronic databases were searched systematically for studies reporting haemagglutination-inhibition (HI) titres 180-360days following vaccination with inactivated trivalent seasonal influenza vaccine, in adults aged ⩾65years. Geometric mean titre (GMT) and seroprotection (HI titre ⩾1:40) at each time point was extracted. A Bayesian model was developed of titre trajectories from pre-vaccination to Day 360. In the meta-analysis, studies were aggregated using a random-effects model to compare pre-vaccination with post-vaccination HI titres at Day 21-42 ('seroconversion'), Day 180 and Day 360. Potential sources of bias were systematically assessed, and heterogeneity explored. 2864 articles were identified in the literature search, of which nineteen met study inclusion/exclusion criteria. Sixteen studies contained analysable data from 2565 subjects. In the Bayesian model, the proportion of subjects seroprotected increased from 41-51% pre-vaccination to 75-78% at seroconversion. Seroprotection subsequently fell below 60% for all serotypes by Day 360: A/H1 42% (95% CI 38-46), A/H3 59% (54-63), B 47% (42-52). The Bayesian model of GMT trajectories revealed a similar pattern. By Day 360, titres were similar to pre-vaccination levels. In the meta-analysis, no significant difference in proportion of subjects seroprotected, 0 (-0.11, 0.11) or in log 2 GMT 0.30 (-0.02, 0.63) was identified by Day 360 compared with pre-vaccination. The quality of this evidence was limited to moderate on account of significant participant dropout. The review found consistent evidence that HI antibody responses following influenza vaccination do not reliably persist year-round in older adults. Alternative vaccination strategies could provide clinical benefits in regions where year-round protection is important. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Multivariate Analysis of Mixed Lipid Aggregate Phase Transitions Monitored Using Raman Spectroscopy.

PubMed

Neal, Sharon L

2018-01-01

The phase behavior of aqueous 1,2-dimyristoyl-sn-glycero-3-phosphorylcholine (DMPC)/1,2-dihexanoyl-sn-glycero-3-phosphocholine (DHPC) mixtures between 8.0 ℃ and 41.0 ℃ were monitored using Raman spectroscopy. Temperature-dependent Raman matrices were assembled from series of spectra and subjected to multivariate analysis. The consensus of pseudo-rank estimation results is that seven to eight components account for the temperature-dependent changes observed in the spectra. The spectra and temperature response profiles of the mixture components were resolved by applying a variant of the non-negative matrix factorization (NMF) algorithm described by Lee and Seung (1999). The rotational ambiguity of the data matrix was reduced by augmenting the original temperature-dependent spectral matrix with its cumulative counterpart, i.e., the matrix formed by successive integration of the spectra across the temperature index (columns). Successive rounds of constrained NMF were used to isolate component spectra from a significant fluorescence background. Five major components exhibiting varying degrees of gel and liquid crystalline lipid character were resolved. Hydrogen-bonded water networks exhibiting varying degrees of organization are associated with the lipid components. Spectral parameters were computed to compare the chain conformation, packing, and hydration indicated by the resolved spectra. Based on spectral features and relative amounts of the components observed, four components reflect long chain lipid response. The fifth component could reflect the response of the short chain lipid, DHPC, but there were no definitive spectral features confirming this assignment. A minor component of uncertain assignment that exhibits a striking response to the DMPC pre-transition and chain melting transition also was recovered. While none of the spectra resolved exhibit features unequivocally attributable to a specific aggregate morphology or step in the gelation process, the results are consistent with the evolution of mixed phase bicelles (nanodisks) and small amounts of worm-like DMPC/DHPC aggregates, and perhaps DHPC micelles, at low temperature to suspensions of branched and entangled worm-like aggregates above the DMPC gel phase transition and perforated multi-lamellar aggregates at high temperature.

Environmentally-mediated ash aggregate formation: example from Tungurahua volcano, Ecuador

NASA Astrophysics Data System (ADS)

Kueppers, Ulrich; Ayris, Paul M.; Bernard, Benjamin; Delmelle, Pierre; Douillet, Guilhem A.; Lavallée, Yan; Mueller, Sebastian B.; Dingwell, Donald B.; Dobson, Kate J.

2016-04-01

Volcanic ash is generated during explosive eruptions through an array of different processes; it can be produced in large quantities and can, in some circumstances, have the potential for far-reaching impacts beyond the flanks of the volcano. Aggregation of ash particles can significantly impact the dispersal within the atmosphere, and its subsequent deposition into terrestrial or aquatic environments. However, our understanding of the complex interplay of the boundary conditions which permit aggregation to occur remain incomplete. Tungurahua volcano, Ecuador, has been intermittently active since 1999. In August 2006, a series of pyroclastic density currents (PDC) were generated during a series of dry, Vulcanian explosions and travelled down the western and northern flanks of the volcano. In some locations, the related PDC deposits temporarily dammed the Chambo river, and the residual heat within those deposits produced vigorous steam plumes. During several field campaigns (2009-2015), we mapped, sampled, and analysed the related deposits. At the base of the Rea ravine, a large delta fan of PDC deposits had dammed the river over a length of several hundred metres. In several outcrops adjacent to the river and in small erosional gullies we found a peculiar stratigraphic layer (up to ten centimetres thick) at the top of the PDC deposits. As this layer is capped by a thin fall unit of coarse ash that we also find elsewhere at the top of the August 2006 deposits, the primary nature is without doubt. In this unit, we observed abundant ash aggregates up to eight millimetres in diameter within a poorly sorted, ash-depleted lapilli tuff, primarily comprised of rounded pumiceous and scoriaceous clasts of similar size. Leaching experiments have shown that these aggregates contain several hundred ppm of soluble sulphate and chloride salts. Recent laboratory experiments (Mueller et al. 2015) have suggested that in order for accretionary lapilli to be preserved within ash deposits likely requires a combination of sufficient humidity and a pre-existing soluble salt load on aggregating ash particles. We suggest that steam pluming from the dammed Chambo river, coupled with soluble salts emplaced by gas-ash interactions between ejection and deposition, provided a unique opportunity for the formation of accretionary lapilli with sufficient mechanical strength to survive deposition, accounting for their presence in a deposit otherwise absent of such aggregates. This possibility provides an important reminder of the role played by external environmental triggers in shaping the properties volcanic ash deposits.

Using aggregated, de-identified electronic health record data for multivariate pharmacosurveillance: a case study of azathioprine.

PubMed

Patel, Vishal N; Kaelber, David C

2014-12-01

To demonstrate the use of aggregated and de-identified electronic health record (EHR) data for multivariate post-marketing pharmacosurveillance in a case study of azathioprine (AZA). Using aggregated, standardized, normalized, and de-identified, population-level data from the Explore platform (Explorys, Inc.) we searched over 10 million individuals, of which 14,580 were prescribed AZA based on RxNorm drug orders. Based on logical observation identifiers names and codes (LOINC) and vital sign data, we examined the following side effects: anemia, cell lysis, fever, hepatotoxicity, hypertension, nephrotoxicity, neutropenia, and neutrophilia. Patients prescribed AZA were compared to patients prescribed one of 11 other anti-rheumatologic drugs to determine the relative risk of side effect pairs. Compared to AZA case report trends, hepatotoxicity (marked by elevated transaminases or elevated bilirubin) did not occur as an isolated event more frequently in patients prescribed AZA than other anti-rheumatic agents. While neutropenia occurred in 24% of patients (RR 1.15, 95% CI 1.07-1.23), neutrophilia was also frequent (45%) and increased in patients prescribed AZA (RR 1.28, 95% CI 1.22-1.34). After constructing a pairwise side effect network, neutropenia had no dependencies. A reduced risk of neutropenia was found in patients with co-existing elevations in total bilirubin or liver transaminases, supporting classic clinical knowledge that agranulocytosis is a largely unpredictable phenomenon. Rounding errors propagated in the statistically de-identified datasets for cohorts as small as 40 patients only contributed marginally to the calculated risk. Our work demonstrates that aggregated, standardized, normalized and de-identified population level EHR data can provide both sufficient insight and statistical power to detect potential patterns of medication side effect associations, serving as a multivariate and generalizable approach to post-marketing drug surveillance. Copyright © 2013 Elsevier Inc. All rights reserved.

Virtual Breakthrough Series, Part 2: Improving Fall Prevention Practices in the Veterans Health Administration.

PubMed

Zubkoff, Lisa; Neily, Julia; Quigley, Pat; Soncrant, Christina; Young-Xu, Yinong; Boar, Shoshana; Mills, Peter D

2016-11-01

The Veterans Health Administration (VHA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help prevent falls and fall-related injuries. This project enabled teams to expand program infrastructure, redesign improvement strategies, and enhance program evaluation. A VBTS collaborative involves prework, action, and continuous improvement. Actions included educational calls, monthly reports, coaching, and feedback. Evaluation included assessment of interventions, team capacity and infrastructure changes, and rates of falls and fall-related major injuries. Fifty-nine teams completed the project. The majority submitted monthly reports. The average number of interventions per team was 6.66 (range, 1-12; mode = 6). The most frequently implemented changes were staff education; post-fall huddles; data tracking; and classifying falls, handoff communication, and intentional rounding. On a program questionnaire aggregated average summary scores improved from 136.54 (baseline) to 58.26 (follow-up; range, 0-189; p < 0.0001). The mean aggregated fall-related major injury rate for participants decreased from 6.8 to 4.8 per 100,000 bed-days of care (p = 0.02), or 5 major injuries avoided per month. No statistically significant changes occurred for nonparticipants. The mean aggregated fall rate did not change significantly from baseline to follow-up for participants (p = 0.42) or nonparticipants (p = 0.21). Teams submitted reports and implemented changes resulting in decreased major injuries related to falls for participating units. Teams also made changes in their fall prevention programs such as classifying how they analyze falls and implementing injury reduction strategies. The approaches used show promise for reducing fall-related harm for inpatients, as well as assisting teams in implementing changes. Copyright 2016 The Joint Commission.

Recyclable colorimetric sensor of Cr3 + and Pb2 + ions simultaneously using a zwitterionic amino acid modified gold nanoparticles

NASA Astrophysics Data System (ADS)

Sang, Fuming; Li, Xin; Zhang, Zhizhou; Liu, Jia; Chen, Guofu

2018-03-01

In this work, a rapid, simple and sensitive colorimetric sensor for simultaneous (or respective) detection of Cr3 + and Pb2 + using tyrosine functionalized gold nanoparticles (AuNPsTyr) has been developed. Tyrosine, a natural and zwitterionic amino acid, could be as a reducing and capping agent to synthesise AuNPs and allow for the simultaneous and selective detection of Cr3 + and Pb2 +. Upon the addition of Cr3 + or Pb2 + (a combination of them), the color of AuNPsTyr solution changes from red to blue grey and the characteristic surface plasmon resonance (SPR) band is red-shifted to 580 nm due to the aggregation of AuNPs. Interestingly, the aggregated AuNPsTyr can be regnerated and recycled by removing Pb2 + and Cr3 +. Even after 3 rounds, AuNPsTyr show almost the same A580 nm / A520 nm value for the assays of Pb2 + and Cr3 +, indicating the good recyclability of the colorimetric sensor. The responding time (within 1 min) and sensitivity of the colorimetric sensor are largely improved after the addition of 0.1 M NaCl. Moreover, the AuNPsTyr aggregated by Cr3 + or Pb2 + (a combination of them) show excellent selectivity compared to other metal ions (Cr3 +, Pb2 +, Fe2 +,Cu2 +,Zn2 +,Cr6 +,Ni2 +,Co2 +,Hg2 +,Mn2 +,Mg2 +,Ca2 +,Cd2 +). More importantly, the developed sensor manifests good stability at room temperature for 3 months, which has been successfully used to determine Cr3 + and Pb2 + in the real water samples with a high sensitivity.

Segregation or aggregation? Sex-specific patterns in the seasonal occurrence of white sharks Carcharodon carcharias at the Neptune Islands, South Australia.

PubMed

Bruce, B; Bradford, R

2015-12-01

The seasonal patterns of occurrence of male and female white sharks Carcharodon carcharias at the Neptune Islands in South Australia were reviewed. Analyses of a 14 year data series indicate that females seasonally aggregate in late autumn and winter coinciding with the maximum in-water availability of lactating female long-nose fur seals and seal pups. During this period, observed male:female sex ratios were similar; whereas during late spring and summer, males continued to visit, but females were rarely recorded. There was no evidence for segregation by sex or size at the Neptunes, but the highly focused seasonal pattern of occurrence of females compared with the year-round records of males suggests that there are likely to be differences between the sexes in overall distribution and movement patterns across southern Australia. It is suggested that foraging strategies and prey selection differ between sexes in C. carcharias across the life-history stages represented and that sex-specific foraging strategies may play an important role in structuring movement patterns and the sex ratios observed at such aggregation sites. Differences between sexes in distribution, movement patterns and foraging strategies are likely to have implications for modelling the consequences of fisheries by-catch between regions or jurisdictions and other spatially or temporally discrete anthropogenic effects on C. carcharias populations. Such differences urge for caution when estimating the size of C. carcharias populations based on observations at pinniped colonies due to the likelihood of sex-specific differences in movements and patterns of residency. These differences also suggest a need to account for sex-specific movement patterns and distribution in population and movement models as well as under conservation actions. © 2015 The Fisheries Society of the British Isles.

The return of bedside rounds: an educational intervention.

PubMed

Gonzalo, Jed D; Chuang, Cynthia H; Huang, Grace; Smith, Christopher

2010-08-01

Bedside rounds have decreased in frequency on teaching services. Perceived barriers toward bedside rounds are inefficiency and patient and house staff lack of preference for this mode of rounding. To evaluate the impact of a bedside rounding intervention on the frequency of bedside rounding, duration of patient encounters and rounding sessions, and patient and resident attitudes toward bedside rounds. A pre- and postintervention design, with a bedside rounding workshop midway through two consecutive internal medicine rotations, with daily resident interviews, patient surveys, and an end-of-the-year survey given to all Medicine house staff. Medicine house staff and medicine patients. Frequency of bedside rounds, duration of new patient encounters and rounding sessions, and patient and house staff attitudes regarding bedside rounds. Forty-four residents completed the bedside rounding workshop. Comparing the preintervention and postintervention phases, bedside rounds increased from <1% to 41% (p < 0.001). The average duration of walk rounding encounters was 16 min, and average duration of bedside rounding encounters was 15 min (p = 0.42). Duration of rounds was 95 and 98 min, respectively (p = 0.52). Patients receiving bedside rounds preferred bedside rounds (99% vs. 83%, p = 0.03) and perceived more time spent at the bedside by their team (p < 0.001). One hundred twelve house staff (71%) responded, with 73% reporting that bedside rounds are better for patient care. House staff performing bedside rounds were less likely to believe that bedside rounds were more educational (53% vs. 78%, p = 0.01). Bedside rounding increased after an educational intervention, and the time to complete bedside rounding encounters was similar to alternative forms of rounding. Patients preferred bedside rounds and perceived more time spent at the bedside when receiving bedside rounds. Medicine residents performing bedside rounds were less likely to believe bedside rounds were more educational, but all house staff valued the importance of bedside rounding for the delivery of patient care.

The Return of Bedside Rounds: An Educational Intervention

PubMed Central

Gonzalo, Jed D.; Chuang, Cynthia H.; Huang, Grace

2010-01-01

Background Bedside rounds have decreased in frequency on teaching services. Perceived barriers toward bedside rounds are inefficiency and patient and house staff lack of preference for this mode of rounding. Objectives To evaluate the impact of a bedside rounding intervention on the frequency of bedside rounding, duration of patient encounters and rounding sessions, and patient and resident attitudes toward bedside rounds. Design A pre- and postintervention design, with a bedside rounding workshop midway through two consecutive internal medicine rotations, with daily resident interviews, patient surveys, and an end-of-the-year survey given to all Medicine house staff. Participants Medicine house staff and medicine patients. Measures Frequency of bedside rounds, duration of new patient encounters and rounding sessions, and patient and house staff attitudes regarding bedside rounds. Results Forty-four residents completed the bedside rounding workshop. Comparing the preintervention and postintervention phases, bedside rounds increased from <1% to 41% (p < 0.001). The average duration of walk rounding encounters was 16 min, and average duration of bedside rounding encounters was 15 min (p = 0.42). Duration of rounds was 95 and 98 min, respectively (p = 0.52). Patients receiving bedside rounds preferred bedside rounds (99% vs. 83%, p = 0.03) and perceived more time spent at the bedside by their team (p < 0.001). One hundred twelve house staff (71%) responded, with 73% reporting that bedside rounds are better for patient care. House staff performing bedside rounds were less likely to believe that bedside rounds were more educational (53% vs. 78%, p = 0.01). Conclusions Bedside rounding increased after an educational intervention, and the time to complete bedside rounding encounters was similar to alternative forms of rounding. Patients preferred bedside rounds and perceived more time spent at the bedside when receiving bedside rounds. Medicine residents performing bedside rounds were less likely to believe bedside rounds were more educational, but all house staff valued the importance of bedside rounding for the delivery of patient care. PMID:20386997

The influence of chemical structure on thermal properties and surface morphology of polyurethane materials.

PubMed

Brzeska, Joanna; Morawska, Magda; Heimowska, Aleksandra; Sikorska, Wanda; Wałach, Wojciech; Hercog, Anna; Kowalczuk, Marek; Rutkowska, Maria

2018-01-01

The surface morphology and thermal properties of polyurethanes can be correlated to their chemical composition. The hydrophilicity, surface morphology, and thermal properties of polyurethanes (differed in soft segments and in linear/cross-linked structure) were investigated. The influence of poly([ R , S ]-3-hydroxybutyrate) presence in soft segments and blending of polyurethane with polylactide on surface topography were also estimated. The linear polyurethanes (partially crystalline) had the granular surface, whereas the surface of cross-linked polyurethanes (almost amorphous) was smooth. Round aggregates of polylactide un-uniformly distributed in matrix of polyurethane were clearly visible. It was concluded that some modification of soft segment (by mixing of poly([ R , S ]-3-hydroxybutyrate) with different polydiols and polytriol) and blending of polyurethanes with small amount of polylactide influence on crystallinity and surface topography of obtained polyurethanes.

Microengineering neocartilage scaffolds.

PubMed

Petersen, Erik F; Spencer, Richard G S; McFarland, Eric W

2002-06-30

Advances in micropatterning methodologies have made it possible to create structures with precise architecture on the surface of cell culture substrata. We applied these techniques to fabricate microfeatures (15-65 microm wide; 40 microm deep) on the surface of a flexible, biocompatible polysaccharide gel. The micropatterned polymer gels were subsequently applied as scaffolds for chondrocyte culture and proved effective in maintaining key aspects of the chondrogenic phenotype. These were rounded cell morphology and a positive and statistically significant (p < 0.0001) immunofluorescence assay for the production of type II collagen throughout the maximum culture time of 10 days after cell seeding. Further, cells housed within individual surface features were observed to proliferate, while serial application of chondrocytes resulted in the formation of cellular aggregates. These methods represent a novel approach to the problem of engineering reparative cartilage in vitro. Copyright 2002 Wiley Periodicals, Inc.

Development of a Chinese medicine assessment measure: an interdisciplinary approach using the delphi method.

PubMed

Schnyer, Rosa N; Conboy, Lisa A; Jacobson, Eric; McKnight, Patrick; Goddard, Thomas; Moscatelli, Francesca; Legedza, Anna T R; Kerr, Catherine; Kaptchuk, Ted J; Wayne, Peter M

2005-12-01

The diagnostic framework and clinical reasoning process in Chinese medicine emphasizes the contextual and qualitative nature of a patient's illness. Chinese medicine assessment data may help interpret clinical outcomes. As part of a study aimed at assessing the validity and improving the inter-rater reliability of the Chinese diagnostic process, a structured assessment instrument was developed for use in clinical trials of acupuncture and other Chinese medical therapies. To foster collaboration and maximize resources and information, an interdisciplinary advisory team was assembled. Under the guidance of two group process facilitators, and in order to establish whether the assessment instrument was consistent with accepted Chinese medicine diagnostic categories (face validity) and included the full range of each concept's meaning (content validity), a panel of Traditional Chinese Medicine (TCM) expert clinicians was convened and their responses were organized using the Delphi process, an iterative, anonymous, idea-generating and consensus-building process. An aggregate rating measure was obtained by taking the mean of mean ratings for each question across all 10 experts. Over three rounds, the overall rating increased from 7.4 (SD = 1.3) in Round 1 to 9.1 (SD = 0.5) in Round 3. The level of agreement among clinicians was measured by a decrease in SD. The final instrument TEAMSI-TCM (Traditional East Asian Medicine Structured Interview, TCM version) uses the pattern differentiation model characteristic of TCM. This modular, dynamic version was specifically designed to assess women, with a focus on gynecologic conditions; with modifications it can be adapted for use with other populations and conditions. TEAMSI-TCM is a prescriptive instrument that guides clinicians to use the proper indicators, combine them in a systematic manner, and generate conclusions. In conjunction with treatment manualization and training it may serve to increase inter-rater reliability and inter-trial reproducibility in Chinese medicine clinical trials. Testing of the validity and reliability of this instrument currently is underway.

Surviving High-temperature Components in CI Chondrites

NASA Technical Reports Server (NTRS)

Zolensky, M.; Frank, D.

2014-01-01

The CI1 chondrites, while having the most solar-like compo-sition of any astromaterial available for laboratory analysis, have also been considerably altered by asteroidal processes including aqueous alteration. It is of fundamental importance to determine their pre-alteration mineralogy, so that the state of matter in the early Solar System can be better determined. In the course of a re-examination of the compositional range of olivine and low-Ca pyroxene in CI chondrites Orgueil, Ivuna and Alais [1] we found the first reported complete CAI, as already reported [2], with at-tached rock consisting mainly of olivine and low-Ca pyroxene. The range of residual olivine major element compositions we have determined in the CIs (Fig. 1) may now be directly com-pared with those of other astromaterials, including Wild 2 grains. The abundance of olivine and low-Ca pyroxene in CIs is higher than is generally appreciated, and in fact much higher than for some CMs [1]. We also noted numerous rounded objects varying in shape from spheres to oblate spheroids, and ranging up to 100µm in size (Fig. 2), which have been previously noted [3] but have not been well documented or appreciated. We characterized the mineralogy by transmission electron microscopy and found that they consist mainly of rather fine-grained, flaky single phase to intergrown serpentine and saponite. These two materials in fact dominate the bulk of the host CI1 chondrites. With the exception of sparse spinels, the rounded phyllosilicate objects are remarka-bly free of other minerals, suggesting that the precursor from which the phyllosilicates were derived was a homogeneous mate-rial. We suggest that these round phyllosilicates aggregates in CI1 chondrites were cryptocrystalline to glassy microchondrules. If so then CI chondrites cannot be considered chondrule-free. Small though they are, the abundance of these putative microchondrules is the same as that of chondrules in the Tagish Lake meteorite.

Identification of Key Amino Acid Residues Modulating Intracellular and In vitro Microcin E492 Amyloid Formation

PubMed Central

Aguilera, Paulina; Marcoleta, Andrés; Lobos-Ruiz, Pablo; Arranz, Rocío; Valpuesta, José M.; Monasterio, Octavio; Lagos, Rosalba

2016-01-01

Microcin E492 (MccE492) is a pore-forming bacteriocin produced and exported by Klebsiella pneumoniae RYC492. Besides its antibacterial activity, excreted MccE492 can form amyloid fibrils in vivo as well as in vitro. It has been proposed that bacterial amyloids can be functional playing a biological role, and in the particular case of MccE492 it would control the antibacterial activity. MccE492 amyloid fibril’s morphology and formation kinetics in vitro have been well-characterized, however, it is not known which amino acid residues determine its amyloidogenic propensity, nor if it forms intracellular amyloid inclusions as has been reported for other bacterial amyloids. In this work we found the conditions in which MccE492 forms intracellular amyloids in Escherichia coli cells, that were visualized as round-shaped inclusion bodies recognized by two amyloidophilic probes, 2-4′-methylaminophenyl benzothiazole and thioflavin-S. We used this property to perform a flow cytometry-based assay to evaluate the aggregation propensity of MccE492 mutants, that were designed using an in silico prediction of putative aggregation hotspots. We established that the predicted amino acid residues 54–63, effectively act as a pro-amyloidogenic stretch. As in the case of other amyloidogenic proteins, this region presented two gatekeeper residues (P57 and P59), which disfavor both intracellular and in vitro MccE492 amyloid formation, preventing an uncontrolled aggregation. Mutants in each of these gatekeeper residues showed faster in vitro aggregation and bactericidal inactivation kinetics, and the two mutants were accumulated as dense amyloid inclusions in more than 80% of E. coli cells expressing these variants. In contrast, the MccE492 mutant lacking residues 54–63 showed a significantly lower intracellular aggregation propensity and slower in vitro polymerization kinetics. Electron microscopy analysis of the amyloids formed in vitro by these mutants revealed that, although with different efficiency, all formed fibrils morphologically similar to wild-type MccE492. The physiological implication of MccE492 intracellular amyloid formation is probably similar to the inactivation process observed for extracellular amyloids, and could be used as a mean of sequestering potentially toxic species inside the cell when this bacteriocin is produced in large amounts. PMID:26858708

Homozygosity for aquaporin 7 G264V in three unrelated children with hyperglyceroluria and a mild platelet secretion defect.

PubMed

Goubau, Christophe; Jaeken, Jaak; Levtchenko, Elena N; Thys, Chantal; Di Michele, Michela; Martens, Geert A; Gerlo, Erik; De Vos, Rita; Buyse, Gunnar M; Goemans, Nathalie; Van Geet, Chris; Freson, Kathleen

2013-01-01

Aquaporin 7 (AQP7) belongs to the aquaglyceroporin family, which transports glycerol and water. AQP7-deficient mice develop obesity, insulin resistance, and hyperglyceroluria. However, AQP7's pathophysiologic role in humans is not yet known. Three children with psychomotor retardation and hyperglyceroluria were screened for AQP7 mutations. The children were from unrelated families. Urine and plasma glycerol levels were measured using a three-step enzymatic approach. Platelet morphology and function were studied using electron microscopy, aggregations, and adenosine triphosphate (ATP) secretion tests. The index patients were homozygous for AQP7 G264V, which has previously been shown to inhibit transport of glycerol in Xenopus oocytes. We also detected a subclinical platelet secretion defect with reduced ATP secretion, and the absence of a secondary aggregation wave after epinephrine stimulation. Electron microscopy revealed round platelets with centrally located granules. Immunostaining showed AQP7 colocalization, with dense granules that seemed to be released after strong platelet activation. Healthy relatives of these patients, who were homozygous (not heterozygous) for G264V, also had hyperglyceroluria and platelet granule abnormalities. The discovery of an association between urine glycerol loss and a platelet secretion defect is a novel one, and our findings imply the involvement of AQPs in platelet secretion. Additional studies are needed to define whether AQP7 G264V is also a risk factor for mental disability.

Reproductive biology and seasonality of the Indo-Australasian mysid Mesopodopsis orientalis (Crustacea: Mysida) in a tropical mangrove estuary, Malaysia

NASA Astrophysics Data System (ADS)

Hanamura, Yukio; Siow, Ryon; Chee, Phaik-Ean

2008-04-01

A year-round survey of the tropical shallow-water mysid Mesopodopsis orientalis (Tattersall, 1908) (Crustacea, Mysidacea) was conducted in the Merbok mangrove estuary, northwestern Peninsular Malaysia. The mysid formed dense aggregations at the river's edge close to the mangrove forest during the daytime, but very few were captured elsewhere in the estuary system. The sampled population was found in a wide range of salinities from 16 to 32, demonstrating broad euryhalinity, and the number of the catch at the littoral zone ranged from 11.8 to 2273 ind m -2. The overall annual mean was 709.2 ind m -2. Females predominated over males in the entire population, and brooding females were present at every monthly sample, indicating that reproduction is continuous year round. The clutch size positively correlated with female body length. The diameter of eggs (Stage I embryos) was unaffected by the seasonality and independent of the maternal size within an observed size range. The life history pattern of the estuarine population of M. orientalis showed close similarity to that of the coastal counterpart. However, the former was found to produce fewer but larger eggs, and the specimens in this population were larger than those in the coastal population at the embryo, juvenile, and adult stages. This evidence indicates that the life history features of the estuarine population would differ to some degree from those of the coastal counterpart.

Using a Delphi Technique to Seek Consensus Regarding Definitions, Descriptions and Classification of Terms Related to Implicit and Explicit Forms of Motor Learning

PubMed Central

Kleynen, Melanie; Braun, Susy M.; Bleijlevens, Michel H.; Lexis, Monique A.; Rasquin, Sascha M.; Halfens, Jos; Wilson, Mark R.; Beurskens, Anna J.; Masters, Rich S. W.

2014-01-01

Background Motor learning is central to domains such as sports and rehabilitation; however, often terminologies are insufficiently uniform to allow effective sharing of experience or translation of knowledge. A study using a Delphi technique was conducted to ascertain level of agreement between experts from different motor learning domains (i.e., therapists, coaches, researchers) with respect to definitions and descriptions of a fundamental conceptual distinction within motor learning, namely implicit and explicit motor learning. Methods A Delphi technique was embedded in multiple rounds of a survey designed to collect and aggregate informed opinions of 49 international respondents with expertise related to motor learning. The survey was administered via an online survey program and accompanied by feedback after each round. Consensus was considered to be reached if ≥70% of the experts agreed on a topic. Results Consensus was reached with respect to definitions of implicit and explicit motor learning, and seven common primary intervention strategies were identified in the context of implicit and explicit motor learning. Consensus was not reached with respect to whether the strategies promote implicit or explicit forms of learning. Discussion The definitions and descriptions agreed upon may aid translation and transfer of knowledge between domains in the field of motor learning. Empirical and clinical research is required to confirm the accuracy of the definitions and to explore the feasibility of the strategies that were identified in research, everyday practice and education. PMID:24968228

The energetics of semicontact 3 x 2-min amateur boxing.

PubMed

Davis, Philip; Leithäuser, Renate M; Beneke, Ralph

2014-03-01

The energy expenditure of amateur boxing is unknown. Total metabolic cost (Wtot) as an aggregate of aerobic (Waer), anaerobic lactic (W[lactate]), and anaerobic alactic (WPCr) energy of a 3 × 2-min semicontact amateur boxing bout was analyzed. Ten boxers (mean ± SD [lower/upper 95% confidence intervals]) age 23.7 ± 4.1 (20.8/26.6) y, height 180.2 ± 7.0 (175.2/185.2) cm, body mass 70.6 ± 5.7 (66.5/74.7) kg performed a semicontact bout against handheld pads created from previously analyzed video footage of competitive bouts. Net metabolic energy was calculated using respiratory gases and blood [lactate]. Waer, 526.0 ± 57.1 (485.1/566.9) kJ, was higher (P < .001) than WPCr, 58.1 ± 13.6 (48.4/67.8) kJ. W[lactate], 26.2 ± 7.1 (21.1/31.3) kJ, was lower (P < .001) than Waer and WPCr. An ~70-kJ fraction of the aerobic energy expenditure reflects rephosphorylation of high-energy phosphates during the breaks between rounds, which elevated Wtot to ~680 kJ with relative contributions of 77% Waer, 19% WPCr, and 4% W[lactate]. The results indicate that the metabolic profile of amateur boxing is predominantly aerobic. They also highlight the importance of a highly developed aerobic capacity as a prerequisite of a high activity rate during rounds and recovery of the high-energy phosphate system during breaks as interrelated requirements of successful boxing.

Adenoviruses as a model in the study of the effect of space flight factors

NASA Astrophysics Data System (ADS)

Nosach, L. M.; Povnitsa, O. Yu.; Zhovnovata, V. L.

Simulated microgravity conditions, independently of multiplicity of infection, does not influence the reproduction of adenoviruses in cells which were clinorotated for 48 hours after adsorption of virus. The incubation of infected cells before clinorotation under static conditions at a temperature of 4 °C for three days (the conditions for keeping cells before the flight) does not change the number of infected cells relatively to control, but some changes of cell morphology are revealed, namely round off and aggregation of cells. The adenoviruses which were exposed in the medium keep infectivity under the conditions of clinorotation at 4 and 20-22 °C over prolonged periods (90 and 60 days, respectively). A model is elaborated for investigation of the influence of space flight factors on the interaction of the adenovirus and Epstein-Barr virus genomes at combined infection of limphoblastoid cells.

Assessing organizational change in multisector community health alliances.

PubMed

Alexander, Jeffrey A; Hearld, Larry R; Shi, Yunfeng

2015-02-01

The purpose of this article was to identify some common organizational features of multisector health care alliances (MHCAs) and the analytic challenges presented by those characteristics in assessing organizational change. Two rounds of an Internet-based survey of participants in 14 MHCAs. We highlight three analytic challenges that can arise when quantitatively studying the organizational characteristics of MHCAs-assessing change in MHCA organization, assessment of construct reliability, and aggregation of individual responses to reflect organizational characteristics. We illustrate these issues using a leadership effectiveness scale (12 items) validated in previous research and data from 14 MHCAs participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) program. High levels of instability and turnover in MHCA membership create challenges in using survey data to study changes in key organizational characteristics of MHCAs. We offer several recommendations to diagnose the source and extent of these problems. © Health Research and Educational Trust.

Ward rounds, participants, roles and perceptions: literature review.

PubMed

Walton, Victoria; Hogden, Anne; Johnson, Julie; Greenfield, David

2016-05-09

Purpose - The purpose of this paper is to classify and describe the purpose of ward rounds, who attends each round and their role, and participants' perception of each other's role during the respective ward rounds. Design/methodology/approach - A literature review of face-to-face ward rounds in medical wards was conducted. Peer reviewed journals and government publications published between 2000 and 2014 were searched. Articles were classified according to the type of round described in the study. Purposes were identified using keywords in the description of why the round was carried out. Descriptions of tasks and interactions with team members defined participant roles. Findings - Eight round classifications were identified. The most common were the generalised ward; multidisciplinary; and consultant rounds. Multidisciplinary rounds were the most collaborative round. Medical officers were the most likely discipline to attend any round. There was limited reference to allied health clinicians and patient involvement on rounds. Perceptions attendees held of each other reiterated the need to continue to investigate teamwork. Practical implications - A collaborative approach to care planning can occur by ensuring clinicians and patients are aware of different ward round processes and their role in them. Originality/value - Analysis fulfils a gap in the literature by identifying and analysing the different ward rounds being undertaken in acute medical wards. It identifies the complexities in the long established routine hospital processes of the ward round.

Family-centered rounds in Pakistani pediatric intensive care settings: non-randomized pre- and post-study design.

PubMed

Ladak, Laila Akbar; Premji, Shahirose Sadrudin; Amanullah, Muhammad Muneer; Haque, Anwarul; Ajani, Khairulnissa; Siddiqui, Fahad Javaid

2013-06-01

Involvement of family in bedside rounds is one strategy to implement family-centered care to help families get clear information about their child, and be actively involved in decision-making about care. However in developing countries such as Pakistan, daily bedside rounds include the physician, residents, medical students and a nurse/technician. Parents are not currently a part of these rounds. To assess whether family-centered rounds improve parents' and health care professionals' satisfaction, decrease patient length of stay, and improve time utilization when compared to traditional practice rounds in a population with a low literacy rate, socioeconomic status, and different cultural values and beliefs. A non-randomized before-after study design. A private hospital in Karachi, Pakistan. A convenience sample of 82 parents, whose children were hospitalized for a minimum of 48h, and 25 health care professionals able to attend two consecutive rounds. During the before phase, traditional bedside rounds were practiced; and during after phase, family-centered rounds were practiced. Parents and health care professionals completed a questionnaire on the second day of rounds. An observational form facilitated data collection on length of stay and time utilization during. Parents' ratings during the family-centered rounds were significantly higher for some parental satisfaction items: evidence of team work (p=0.007), use of simple language during the rounds (p=0.002), feeling of inclusion in discussion at rounds (p=0.03), decision making (p=0.01), and preference for family-centered rounds (p=<0.001). No significant differences were found in health care professionals' satisfaction between rounds. Patient length of stay was significantly reduced in the family-centered rounds group, while no significant difference was found in the duration of rounds. Family-centered rounds served as an opportunity for parents to correct/add to patient history or documentation. Parents were satisfied with both forms of rounds; however, they appeared to have a greater preference for family-centered rounds than health care professionals. Family-centered rounds were a resource for Pakistani parents, enabling direct communication with the medical team without impacting on the time required to complete rounds. Family-centered rounds may improve quality of care such as decreasing length of stay or preventing critical incidents. Copyright © 2012 Elsevier Ltd. All rights reserved.

Dark inclusions in CO3 chondrites: new indicators of parent-body processes

NASA Astrophysics Data System (ADS)

Itoh, Daisuke; Tomeoka, Kazushige

2003-01-01

A petrographic and scanning electron microscopic study of the four CO3 chondrites Kainsaz, Ornans, Lancé, and Warrenton reveals for the first time that dark inclusions (DIs) occur in all the meteorites. DIs are mostly smaller in size than those reported from CV3 chondrites. They show evidence suggesting that they were formed by aqueous alteration and subsequent dehydration of a chondritic precursor and so probably have a formation history similar to that of DIs in CV3 chondrites. DIs in the CO3 chondrites consist mostly of fine-grained, Fe-rich olivine and can be divided into two types on the basis of texture. Type I DIs contain rounded, porous aggregates of fine grains in a fine-grained matrix and have textures suggesting that they are fragments of chondrule pseudomorphs. Veins filled with Fe-rich olivine are common in type I DIs, providing evidence that they experienced aqueous alteration on the parent body. Type II DIs lack rounded porous aggregates and have a matrix-like, featureless texture. Bulk chemical compositions of DIs and mineralogical characteristics of olivine grains in DIs suggest that these two types of DIs have a close genetic relationship. The DIs are probably clasts that have undergone aqueous alteration and subsequent dehydration at a location different from the present location in the meteorites. The major element compositions, the mineralogy of metallic phases, and the widely dispersed nature of the DIs suggest that their precursor was CO chondrite material. The CO parent body has been commonly regarded to have been dry, homogeneous, and unprocessed. However, the DIs suggest that the CO parent body was a heterogeneous conglomerate consisting of water-bearing regions and water-free regions and that during asteroidal heating, the water-bearing regions were aqueously altered and subsequently dehydrated. Brecciation may also have been active in the parent body. The DIs and the matrices are similarly affected by thermal metamorphism in their own host CO3 chondrites (petrologic subtypes 3.1 to 3.6), but the degree of the secondary processing (aqueous alteration and subsequent dehydration) of the DIs has no apparent correlation with the petrologic grades of the host chondrites. These observations suggest that the DIs had been incorporated into the host chondrites before the thermal metamorphism took place and that the secondary processes that affected the DIs largely occurred before the thermal metamorphism.

A time-motion study of inpatient rounds using a family-centered rounds model.

PubMed

Bhansali, Priti; Birch, Sarah; Campbell, Joyce K; Agrawal, Dewesh; Hoffner, Wendy; Manicone, Paul; Shah, Kyle; Krieger, Evelina; Ottolini, Mary

2013-01-01

Family-centered rounds (FCR) have become increasingly prevalent in pediatric hospital settings. The objective of our study was to describe time use and discrete events during pediatric inpatient rounds by using a FCR model. We conducted a prospective observational study at Children's National Medical Center between September 2010 and February 2011. Investigators directly observed rounds on hospitalist and neurology services. Events were timed, and key features were recorded by using a Microsoft Access-based program. Associations with increased time spent during rounds were determined by using regression analyses. One hundred fifty-nine rounding encounters were observed. Rounds lasted 7.9 minutes on average per patient. An average of 1.3 minutes was spent between patients during rounds. Eighty-six (54%) encounters occurred outside the patient's room, 3% of the time because of the family's request. Infectious isolation was associated with rounds occurring outside the room (P<.0001). Participation of the parent, location of rounds inside or outside the patient's room, most teaching behaviors, and interruptions were not significantly associated with increased time spent during rounds. Teaching physical examination techniques by allowing multiple trainees to examine the patient was associated with increased rounding time (P= .02). The majority of rounds occurred outside the patient's room, yet rarely at the parent's request. Patients on infectious isolation were more likely to have rounds occur outside the patient's room. Neither parental participation nor most teaching behaviors were associated with increased time spent on rounds. These findings will enrich the evidence base needed to establish FCR best practices.

Differences by Ending Rounds and Other Rounds in Time-Motion Analysis of Mixed Martial Arts: Implications for Assessment and Training.

PubMed

Miarka, Bianca; Brito, Ciro J; Moreira, Danilo G; Amtmann, John

2018-02-01

Miarka, B, Brito, CJ, Moreira, DG, and Amtmann, J. Differences by ending rounds and other rounds in time-motion analysis of mixed martial arts: implications for assessment and training. J Strength Cond Res 32(2): 534-544, 2018-This study aimed to support training program development through the comparison of performance analysis of professionals mixed martial art (MMA) athletes in the bouts that were not finished by points. Using digital recordings of each bout, we analyzed 1,564 rounds (678 bouts) which were separated by ending and other rounds. Our results indicated that knockout/technical knockout is the main outcome that defines the ending round (≈60%); however, there is a higher frequency of ending by submission on the first and second rounds (>30%). Bouts ending during the first or second rounds had shorter total time and standing combat with low intensity than ending in the third round (91.5 ± 71.4, 93.4 ± 67.5, and 143.2 ± 87.4; for low intensity in the first, second, and third rounds, respectively; p ≤ 0.05), whereas standing combat time with high intensity was longer in the last round in comparison to bouts that finished in the first or second rounds (7.4 ± 9.2, 9.7 ± 18.0, and 17.7 ± 29.1 for high intensity in the first, second, and third rounds, respectively; p ≤ 0.05). The lower time dedicated to low-intensity stand-up combat actions, regardless of round, and forcefulness of the actions in groundwork in the first and second rounds seem to be elements that increase the probability of success in professional MMA bouts; these factors have essential implications related to training program design.

Nature-based care opportunities and barriers in oncology contexts: a modified international e-Delphi survey.

PubMed

Blaschke, Sarah; O'Callaghan, Clare C; Schofield, Penelope

2017-10-16

To develop recommendations regarding opportunities and barriers for nature-based care in oncology contexts using a structured knowledge generation process involving relevant healthcare and design experts. Four-round modified electronic Delphi study. Oncology patients' nature-based recommendations, uncovered in preceding qualitative investigation, were included in the first round for the expert participants' consideration. Key items (opportunities and barriers) were developed using data aggregation and synthesis, followed by item prioritisation and 10-point Likert scale ranking (1=not important, 10=very important). Descriptive statistics were calculated to assess items of highest importance representing expert recommendations. Online Delphi process constituting an electronic international survey. A purposive sample of 200 potential panellists (recruitment target n=40) comprising healthcare practitioners, managers, designers, architects and researchers were invited to participate; experts were identified via research networks, snowballing and systematic literature review. 38 experts across seven countries (Australia, USA, UK, New Zealand, Canada, Denmark and Sweden) returned questionnaire 1, which determined consent and acceptance for participation. Initial response rate was 19%, and subsequent response rates were 84%, 82% and 84% for rounds 2, 3 and 4, respectively. The Delphi panel developed recommendations consisting of 10 opportunities and 10 barriers. The following opportunities were rated to be of highest importance: window views from clinical areas onto nature; outdoor settings, gardens and courtyards with easy and effortless access; and nature-based physical exercise adapted to patient requirements. Highest-rated barriers for nature-based oncology care included lack of knowledge and awareness about benefits of nature engagement and inaccessibility, not considering access requirements for the very sick and frail. Experts suggested and agreed on a set of recommendations, which represent critical considerations for the safe adoption of nature-based oncology opportunities. These findings fill a gap in understanding about helpful nature-based oncology care and may translate into oncology design and innovation. © 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.

What Do Teachers Do When They Say They Are Doing Learning Rounds? Scotland's Experience of Instructional Rounds

ERIC Educational Resources Information Center

Philpott, Carey; Oates, Catriona

2015-01-01

This paper reports on research into the practice of learning rounds in Scotland. Learning rounds are a form of collaborative professional development for teachers based on the instructional rounds practice developed in the USA. In recent years learning rounds have gained high profile official support within education in Scotland. The research…

Temporal and spatial variability of pelagic wild fish assemblages around Atlantic bluefin tuna Thunnus thynnus farms in the eastern Adriatic Sea.

PubMed

Segvić Bubić, T; Grubišić, L; Tičina, V; Katavić, I

2011-01-01

The abundance and size structure of wild fishes aggregated around the sea-cages of two commercial Thunnus thynnus farms, including control locations, were assessed and compared over a 1 year period. The T. thynnus farms were located in the eastern Adriatic Sea, offshore of the islands of Ugljan and Brač. Fish assemblages were evaluated through visual census using scuba at 2 month intervals at two sites within each farm. The data suggest that wild fish assemblages at the study sites differed greatly; 20 species occurred at the Ugljan farm and 17 at the Brač farm, while only seven species were observed at the control locations. The abundance and diversity of wild fish assemblages were greater at the farms in comparison to control locations. The most abundant families were Sparidae and Belonidae (>80% of aggregated fishes). At both farms, the abundance and diversity of wild fishes were highest during summer, while diversity was lowest in winter and was mainly characterized by schools of bogue Boops boops and garfish Belone belone. Variability was also detected in spatial assemblages between farms; B. boops and B. belone were the most abundant species for the overall study at the Brač farm, while B. belone and saddled bream Oblada melanura were the most abundant at the Ugljan farm. The settlement also played a significant role in farm-associated fish assemblages, as both juveniles and advanced juveniles were common residents at farms. The majority of species which settled at the farms belonged to the sparids. Results indicate that aggregations of wild fishes at T. thynnus farms are persistent year-round, though the assemblage compositions and size structures of dominant species vary in respect to location and season. © 2011 The Authors. Journal of Fish Biology © 2011 The Fisheries Society of the British Isles.

Colorectal cancer in a second round after a negative faecal immunochemical test.

PubMed

Bujanda, Luis; Sarasqueta, Cristina; Castells, Antoni; Pellisé, María; Cubiella, Joaquín; Gil, Inés; Cosme, Angel; Arana-Arri, Eunate; Mar, Izaskun; Idigoras, Isabel; Portillo, Isabel

2015-07-01

The faecal immunochemical test is one of the tests recommended by scientific societies for colorectal cancer (CRC) screening in average-risk populations. Our aim was to evaluate the characteristics of CRC detected in a second round of screening after negative results in a first round. We studied patients in whom CRC was detected in a screening programme. This programme included asymptomatic individuals between 50 and 69 years old and offered tests every 2 years. A total of 363,792 individuals were invited to participate in the first round of faecal immunochemical test screening and 100,135 individuals in the second round after a first negative result. The screening strategy consisted of faecal testing of a single sample using an automated semiquantitative kit, with a cut-off of 20 μg haemoglobin (Hb)/g faeces. The rate of positive results was 6.9% (16,467/238,647) in the first round and 4.8% (3359/69,193) in the second round (P < 0.0005). Overall, 860 (0.36%) cases of CRC were detected in the first round and 100 (0.14%) in the second round (P < 0.005). The location of the cancer was proximal in 12.5 and 24% of cases detected in the first and second rounds, respectively (P = 0.008). Hb concentrations were higher in the first round (211 vs. 109 μg Hb/g faeces in the second round; P = 0.002). Multivariate analysis confirmed that, in the second round, CRC diagnosed was more often proximal (hazard ratio vs. first round, 2.4; 95% confidence interval, 1.3-4.4; P = 0.003) and the concentration of Hb/g faeces was lower (hazard ratio vs. first round, 2.1; 95% confidence interval, 1.3-3.5; P = 0.003). The CRC detection rate is lower in the second round of screening. Further, in the second round, CRC detected is more often in a proximal location and Hb concentrations are lower.

Evaluating the impact of computer-generated rounding reports on physician workflow in the nursing home: a feasibility time-motion study.

PubMed

Thorpe-Jamison, Patrice T; Culley, Colleen M; Perera, Subashan; Handler, Steven M

2013-05-01

To determine the feasibility and impact of a computer-generated rounding report on physician rounding time and perceived barriers to providing clinical care in the nursing home (NH) setting. Three NHs located in Pittsburgh, PA. Ten attending NH physicians. Time-motion method to record the time taken to gather data (pre-rounding), to evaluate patients (rounding), and document their findings/develop an assessment and plan (post-rounding). Additionally, surveys were used to determine the physicians' perception of barriers to providing optimal clinical care, as well as physician satisfaction before and after the use of a computer-generated rounding report. Ten physicians were observed during half-day sessions both before and 4 weeks after they were introduced to a computer-generated rounding report. A total of 69 distinct patients were evaluated during the 20 physician observation sessions. Each physician evaluated, on average, four patients before implementation and three patients after implementation. The observations showed a significant increase (P = .03) in the pre-rounding time, and no significant difference in the rounding (P = .09) or post-rounding times (P = .29). Physicians reported that information was more accessible (P = .03) following the implementation of the computer-generated rounding report. Most (80%) physicians stated that they would prefer to use the computer-generated rounding report rather than the paper-based process. The present study provides preliminary data suggesting that the use of a computer-generated rounding report can decrease some perceived barriers to providing optimal care in the NH. Although the rounding report did not improve rounding time efficiency, most NH physicians would prefer to use the computer-generated report rather than the current paper-based process. Improving the accuracy and harmonization of medication information with the electronic medication administration record and rounding reports, as well as improving facility network speeds might improve the effectiveness of this technology. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Effect of Blood Contamination on Marginal Adaptation and Surface Microstructure of Mineral Trioxide Aggregate: A SEM Study.

PubMed

Salem Milani, Amin; Rahimi, Saeed; Froughreyhani, Mohammad; Vahid Pakdel, Mahdi

2013-01-01

In various clinical situations, mineral trioxide aggregate (MTA) may come into direct contact or even be mixed with blood. The aim of the present study was to evaluate the effect of exposure to blood on marginal adaptation and surface microstructure of MTA. Thirty extracted human single-rooted teeth were used. Standard root canal treatment was carried out. Root-ends were resected, and retrocavities were prepared. The teeth were randomly divided into two groups (n = 15): in group 1, the internal surface of the cavities was coated with fresh blood. Then, the cavities were filled with MTA. The roots were immersed in molds containing fresh blood. In group 2, the aforementioned procedures were performed except that synthetic tissue fluid (STF) was used instead of blood. To assess the marginal adaptation, "gap perimeter" and "maximum gap width" were measured under scanning electron microscope. The surface microstructure was also examined. Independent samples t-test and Mann-Whitney U test were used to analyze the data. Maximum gap width and gap perimeter in the blood-exposed group were significantly larger than those in the STF-exposed group (p < 0.01). In the blood-exposed group, the crystals tended to be more rounded and less angular compared with the STF-exposed group, and there was a general lack of needle-like crystals. Exposure to blood during setting has a negative effect on marginal adaptation of MTA, and blood-exposed MTA has a different surface microstructure compared to STF-exposed MTA.

Evidence of specialized tissue in human interatrial septum: histological, immunohistochemical and ultrastructural findings.

PubMed

Mitrofanova, Lubov B; Gorshkov, Andrey N; Lebedev, Dmitry S; Mikhaylov, Evgeny N

2014-01-01

There is a paucity of information on structural organization of muscular bundles in the interatrial septum (IAS). The aim was to investigate histologic and ultrastructural organization of muscular bundles in human IAS, including fossa ovalis (FO) and flap valve. Macroscopic and light microscopy evaluations of IAS were performed from postmortem studies of 40 patients. Twenty three IAS specimens underwent serial transverse sectioning, and 17--longitudinal sectioning. The transverse sections from 10 patients were immunolabeled for HCN4, Caveolin3 and Connexin43. IAS specimens from 6 other patients underwent electron microscopy. In all IAS specimens sections the FO, its rims and the flap valve had muscle fibers consisting of working cardiac myocytes. Besides the typical cardiomyocytes there were unusual cells: tortuous and horseshoe-shaped intertangled myocytes, small and large rounded myocytes with pale cytoplasm. The cells were aggregated in a definite structure in 38 (95%) cases, which was surrounded by fibro-fatty tissue. The height of the structure on transverse sections positively correlated with age (P = 0.03) and AF history (P = 0.045). Immunohistochemistry showed positive staining of the cells for HCN4 and Caveolin3. Electron microscopy identified cells with characteristics similar to electrical conduction cells. Specialized conduction cells in human IAS have been identified, specifically in the FO and its flap valve. The cells are aggregated in a structure, which is surrounded by fibrous and fatty tissue. Further investigations are warranted to explore electrophysiological characteristics of this structure.

Differences in shoaling behavior in two species of freshwater fish (Danio rerio and Hyphessobrycon herbertaxelrodi).

PubMed

Gimeno, Elisabet; Quera, Vicenç; Beltran, Francesc S; Dolado, Ruth

2016-11-01

Fish can gain significant adaptive advantages when living in a group and they exhibit a wide variety of types of collective motion. The scientific literature recognizes 2 main patterns: shoals (aggregations of individuals that remain close to each other), and schools (aggregations of aligned, or polarized, individuals). We analyzed the collective motion of 2 social fish species, zebrafish (Danio rerio) and black neon tetra (Hyphessobrycon herbertaxelrodi), and compared their patterns of movement and the effect of group size and environmental constraints such as water column height and tank geometry on the collective motion of both species. We recorded the movement of groups of fish (n = 10 and n = 20) using 2 tank geometries: a rectangular shape and a rectangular shape with rounded corners; and we also manipulated the water column height (15 and 25 cm). We extracted the individual fish trajectories and calculated indices of cohesion, coordination, group density and group shape. The results showed that the 2 species had different types of collective motion: the zebrafish's global motion matched that of a shoal, while the black neon tetra's motion matched that of a school. Indirect evidence indicated that the 2 species tended to occupy the vertical space differently while swimming in a group. Finally, we found that tank geometry did not affect group polarization, whereas group size had an effect on black neon tetra density, which was higher in small group sizes than in large ones. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Purification of a factor from the granules of a rat natural killer cell line (RNK) that reduces tumor cell growth and changes tumor morphology. Molecular identity with a granule serine protease (RNKP-1).

PubMed

Sayers, T J; Wiltrout, T A; Sowder, R; Munger, W L; Smyth, M J; Henderson, L E

1992-01-01

We have purified a protein from the granules of the rat NK leukemia cell line (RNK) that is cytostatic to a variety of tumor cells. This protein shows no species specificity because certain tumor cell lines of mouse, rat, and human origin were equally sensitive to its growth inhibitory effects. Treatment of sensitive cells resulted in a rounding of the cells followed by homotypic aggregation into large aggregates. The granule protein was distinct from cytolysin, Na-Cbz-Lys-thiobenzylester-esterase, or leukolexin. It had a molecular mass of 29 to 31 kDa, bound strongly to heparin, was inactivated by heating at 70 degrees C for 5 min or reduction, but was stable to trypsin treatment. By using molecular sieve chromatography, heparin agarose chromatography, and reverse phase HPLC, this protein was purified to homogeneity. The first 33 amino acids of the N-terminal amino acid sequence showed complete identity to the sequence predicted from a rat serine protease gene recently cloned and designated RNKP-1. Therefore we have purified a novel serine protease and demonstrated that it has effects on the growth and morphology of certain tumor cells. Other serine proteases that were structurally related and have substantial homology with RNKP-1 at the amino acid level showed neither growth inhibitory properties nor affected the morphology of the tumor target cells we used.

Implementing iRound: A Computer-Based Auditing Tool.

PubMed

Brady, Darcie

Many hospitals use rounding or auditing as a tool to help identify gaps and needs in quality and process performance. Some hospitals are also using rounding to help improve patient experience. It is known that purposeful rounding helps improve Hospital Consumer Assessment of Healthcare Providers and Systems scores by helping manage patient expectations, provide service recovery, and recognize quality caregivers. Rounding works when a standard method is used across the facility, where data are comparable and trustworthy. This facility had a pen-and-paper process in place that made data reporting difficult, created a silo culture between departments, and most audits and rounds were completed differently on each unit. It was recognized that this facility needed to standardize the rounding and auditing process. The tool created by the Advisory Board called iRound was chosen as the tool this facility would use for patient experience rounds as well as process and quality rounding. The success of the iRound tool in this facility depended on several factors that started many months before implementation to current everyday usage.

Are family characteristics associated with attendance at family centered rounds in the PICU?.

PubMed

Drago, Matthew J; Aronson, Paul L; Madrigal, Vanessa; Yau, Jennifer; Morrison, Wynne

2013-02-01

The objective of this study was to identify if family characteristics or opinions affected participation in family centered rounds. Observational study of 431 patient encounters on daily work rounds, followed by 100 questionnaires completed by family members of patients in the unit during observation. PICU at a tertiary care, academic, free-standing children's hospital. Patients and families admitted to the PICU during the observation period. None. The most frequent family members present for rounds were mothers (40%). Race, educational level, age of the family member, age of the child, whether the admission was expected, and whether the family member was a medical professional had no association with whether the family member attended rounds. Both family members who were present and those who were not present felt being at rounds would improve the care of their child (87% vs. 100%, p = 0.57). A family's response that they preferred to attend rounds was the only factor associated with a higher likelihood of attending rounds (odds ratio 3.4, 95% confidence interval 1.1-10.8, p = 0.03). Families feel that participating in family centered rounds improves the care of their children. Those that like attending rounds are more likely to participate in family centered rounds, but family demographic characteristics were not associated with rounds attendance. Future studies are needed to identify barriers to family participation in family centered rounds.

Transient Three-Dimensional Side Load Analysis of Out-of-Round Film Cooled Nozzles

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Lin, Jeff; Ruf, Joe; Guidos, Mike

2010-01-01

The objective of this study is to investigate the effect of nozzle out-of-roundness on the transient startup side loads at a high altitude, with an anchored computational methodology. The out-of-roundness could be the result of asymmetric loads induced by hardware attached to the nozzle, asymmetric internal stresses induced by previous tests, and deformation, such as creep, from previous tests. The rocket engine studied encompasses a regeneratively cooled thrust chamber and a film cooled nozzle extension with film coolant distributed from a turbine exhaust manifold. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and a transient inlet history based on an engine system simulation. Transient startup computations were performed with the out-of-roundness achieved by four different degrees of ovalization: one perfectly round, one slightly out-of-round, one more out-of-round, and one significantly out-of-round. The results show that the separation-line-jump is the peak side load physics for the round, slightly our-of-round, and more out-of-round cases, and the peak side load increases as the degree of out-of-roundness increases. For the significantly out-of-round nozzle, however, the peak side load reduces to comparable to that of the round nozzle and the separation line jump is not the peak side load physics. The counter-intuitive result of the significantly out-of-round case is found to be related to a side force reduction mechanism that splits the effect of the separation-line-jump into two parts, not only in the circumferential direction and most importantly in time.

Introduction of a new ward round approach in a cardiothoracic critical care unit.

PubMed

Shaughnessy, Liz; Jackson, Jo

2015-07-01

Francis (2013) described inconsistent ward rounds and failures to conduct ward rounds properly as contributing factors to the poor care seen at the Mid Staffordshire Foundation Trust. He suggested that the absence of a nurse at the bedside had clear consequences for communication, ward round efficiency and patient safety. He recommended that nurses should be actively involved in ward rounds and linked this to high quality patient care. To share an experience of introducing a ward round checklist, a bedside nurse verbal summary and the development of standard operating procedure for Ward Rounds in cardiothoracic critical care unit to improve patient safety and care. Semi structured interviews of six registered nurses. A questionnaire to 69 registered nurses. An electronic questionnaire sent to 23 members of the MDT. An observational audit of seven ward rounds reviewing 69 patients. 97% of nurses agreed that verbal summarizing had improved clarity and 90% felt that it had improved patient care. 87% of the MDT respondents stated that they had noticed an improvement in the attendance of the bedside nurse at the ward round review. The ward round checklist reduced omissions. Communication with patients during ward rounds was an area which needed to be improved. The introduction of a new ward round approach and audit of its practice has enabled an improvement in the quality of patient care by: Giving more opportunity for the nurse to participate and feel part of the ward round. Reduction of omissions through the use of a ward round checklist. Improved clarity among the MDT by the use of bedside nurse verbal summarizing of the plan of care. Nurses' full participation in ward rounds is essential to ensure effective communication and enhance patient safety. © 2015 British Association of Critical Care Nurses.

PAs reduce rounding interruptions in the pediatric intensive care unit.

PubMed

Hascall, Rebecca L; Perkins, R Serene; Kmiecik, Lauren; Gupta, Priya R; Shelak, Carolyn F; Demirel, Shaban; Buchholz, Mark T

2018-06-01

We investigated the proportion of encounters that were interrupted during family-centered rounds in the pediatric intensive care unit (PICU) to determine whether the use of a physician assistant (PA) significantly affected the proportion of interrupted encounters. We evaluated 2,657 rounding encounters in our 24-bed regional referral unit. The duration of each rounding encounter and total rounding duration were recorded. The presence or absence of a PA during each rounding encounter, the occurrence of an interruption, and other potential predictors of interruptions were recorded. The presence of a PA during PICU rounds was significantly associated (P < .001) with a 35.4% lower likelihood of an interruption. Family-centered rounds in the PICU are less likely to be interrupted when a PA is present. PAs help physicians and improve rounding efficiency by safely and effectively handling certain interruptions.

An Evaluation of Family-Centered Rounds in the PICU: Room for Improvement Suggested by Families and Providers.

PubMed

Levin, Amanda B; Fisher, Kiondra R; Cato, Krista D; Zurca, Adrian D; October, Tessie W

2015-11-01

To identify areas for improvement in family-centered rounds from both the family and provider perspectives. Prospective, cross-sectional mixed-methods study, including an objective measure (direct observation of family-centered rounds) and subjective measures (surveys of English-speaking families and providers) of family-centered rounds. PICU in a single, tertiary children's hospital. Families of children admitted to the PICU, physicians, and nurses. None. Two hundred thirty-two family-centered round encounters were observed over a 10-week period. Family-centered round encounters averaged 10.5 minutes per child. Multivariable regression analysis revealed that family presence was independently associated with length of family-centered rounds (p < 0.002) despite family talk time accounting for an average of 25 seconds (4%) of the encounter. Non-English-speaking families were less likely to attend family-centered rounds compared with English-speaking families even when physically present at the patient's bedside (p < 0.001). Most commonly families and providers agreed that family-centered rounds keep the family informed and reported positive statements about family presence on family-centered rounds; however, PICU fellows did not agree that families provided pertinent information and nurses reported that family presence limited patient discussions. The primary advice families offered providers to improve family-centered rounds was to be more considerate and courteous, including accommodating family schedules, minimizing distractions, and limiting computer viewing. Family presence increased the length of family-centered rounds despite a small percentage of time spoken by families, suggesting longer rounds are due to changes in provider behavior when families are present. Also, non-English-speaking families may need more support to be able to attend and benefit from family-centered rounds. Lastly, in an era of full family-centered rounds acceptance, families and most providers, except fellows, report benefit from family presence during family-centered rounds. However, providers should be aware of the perception of their behaviors to optimize the experience for families.

In the Round: Supporting Teachers' Authentic Professional Learning

ERIC Educational Resources Information Center

Strand, Matt

2013-01-01

This is a study of teachers' authentic professional learning at a public school in Poudre School District in northern Colorado. At Polaris Expeditionary Learning School, teachers and administrators have developed a form of school-based instructional rounds referred to herein as PLC rounds (professional learning community rounds). In PLC rounds,…

Shot Group Statistics for Small Arms Applications

DTIC Science & Technology

2017-06-01

standard deviation. Analysis is presented as applied to one , n-round shot group and then is extended to treat multiple, n-round shot groups. A...dispersion measure for multiple, n-round shot groups can be constructed by selecting one of the dispersion measures listed above, measuring the dispersion of...as applied to one , n-round shot group and then is extended to treat multiple, n-round shot groups. A dispersion measure for multiple, n- round shot

Relationship between attack and pause in world Taekwondo championship contests: effects of gender and weight category.

PubMed

Santos, Victor Gustavo Ferreira; Pires, Flavio Oliveira; Bertuzzi, Romulo; Frachini, Emerson; da Silva-Cavalcante, Marcos David; Peduti Dal Molin Kiss, Maria Augusta; Lima-Silva, Adriano Eduardo

2014-04-01

The aim of this study was to compare between weight and gender categories the attack and pause times during the 2007 Taekwondo World Championship. A total of 88 rounds (47 male and 41 female contests) were analyzed. There was no difference in attack/balancing times ratio between genders (0.13 ± 0.06 vs 0.13 ± 0.06, P > 0.05). The attack number was significantly higher in round 3 than in round 1 for all categories and genders. The balancing time was lower during the round 3 than round 1 for low-weight male and high-weight female categories. The delta of change from round 1 to 3 (round 3 - round 1) for attack time and attack/balancing times ratio were lower in male than female. Female seems to intensify more the combat in the last round than male, and this seems be related to the weight division.

Assessment of parental presence during bedside pediatric intensive care unit rounds: effect on duration, teaching, and privacy.

PubMed

Phipps, Lorri M; Bartke, Cheryl N; Spear, Debra A; Jones, Linda F; Foerster, Carolyn P; Killian, Marie E; Hughes, Jennifer R; Hess, Joseph C; Johnson, David R; Thomas, Neal J

2007-05-01

There is a paucity of literature evaluating the effects of family member presence during bedside medical rounds in the pediatric intensive care unit. We hypothesized that, when compared with rounds without family members, parental presence during morning medical rounds would increase time spent on rounds, decrease medical team teaching/education, increase staff dissatisfaction, create more stress in family members, and violate patient privacy in our open unit. Prospective, blinded, observational study. Academic pediatric intensive care unit with 12 beds. A total of 105 admissions were studied, 81 family members completed a survey, and 187 medical team staff surveys were completed. Investigators documented parental presence and time allocated for presentation, teaching, and answering questions. Surveys related to perception of goals, teaching, and privacy of rounds were distributed to participants. Time spent on rounds, time spent teaching on rounds, and medical staff and family perception of the effects of parental presence on rounds. There was no significant difference between time spent on rounds in the presence or absence of family members (p = NS). There is no significant difference between the time spent teaching by the attending physician in the presence or absence of family members (p = NS). Overall, parents reported that the medical team spent an appropriate amount of time discussing their child and were not upset by this discussion. Parents did not perceive that their own or their child's privacy was violated during rounds. The majority of medical team members reported that the presence of family on rounds was beneficial. Parental presence on rounds does not seem to interfere with the educational and communication process. Parents report satisfaction with participation in rounds, and privacy violations do not seem to be a concern from their perspective.

A Computer Scientist’s Evaluation of Publically Available Hardware Trojan Benchmarks

DTIC Science & Technology

2015-09-01

in the Verilog file round.v. This module represents the tenth round of the AES encryption process. This round is similar to previous rounds. It...the round keys used during the AES encryption process. Note that the last two round keys are not leaked, but we assume that the attacker either...undermine the effectiveness of a 128-bit AES encryption circuit. These circuits are labelled AES -T100 through AES -T2100. The naming convention

The Effect of Family Presence on Rounding Duration in the PICU.

PubMed

Gupta, Priya R; Perkins, R Serene; Hascall, Rebecca L; Shelak, Carolyn F; Demirel, Shaban; Buchholz, Mark T

2017-02-01

The incorporation of family-centered rounds has become standard in PICUs across the United States. We compared rounding times in our institution, with and without family members present, to determine the effect on total rounding time and work flow. This observational study of a convenience sample was conducted over a 17-month period (May 2014-October 2015), accounting for typical seasonal variation in the PICU. The individual patient rounding times for 2657 encounters were recorded. The presence of family members, intubation status, physician assistant participation, interruptions during rounds, attending physician's full- or part-time status, and patient census were documented. The effect of family presence on per-patient rounding time was analyzed, while controlling for influential variables. Family members were present during 1743 of 2657 (66%) rounding encounters. The average per-patient rounding time with and without family members present was 8.6 minutes and 7.3 minutes, respectively, a difference of 1.3 minutes per patient. In statistical models that accounted for other influential variables, the presence of family members was associated with a highly significant (20.4%, P < .001) increase in the per-patient rounding time. The presence of family members increases per-patient rounding times in the PICU. Family presence on rounds may have benefits that outweigh the additional time required to complete each patient interaction. Copyright © 2017 by the American Academy of Pediatrics.

40 CFR 86.000-28 - Compliance with emission standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission limit, as appropriate), it shall be rounded to two significant figures in accordance with the... compared with the standard, it shall be rounded to two significant figures in accordance with the Rounding..., rounded to two significant figures in accordance with the Rounding-Off Method specified in ASTM E29-90...

40 CFR 86.000-28 - Compliance with emission standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission limit, as appropriate), it shall be rounded to two significant figures in accordance with the... compared with the standard, it shall be rounded to two significant figures in accordance with the Rounding..., rounded to two significant figures in accordance with the Rounding-Off Method specified in ASTM E29-90...

40 CFR 86.000-28 - Compliance with emission standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission limit, as appropriate), it shall be rounded to two significant figures in accordance with the... compared with the standard, it shall be rounded to two significant figures in accordance with the Rounding..., rounded to two significant figures in accordance with the Rounding-Off Method specified in ASTM E29-90...

40 CFR 86.000-28 - Compliance with emission standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission limit, as appropriate), it shall be rounded to two significant figures in accordance with the... compared with the standard, it shall be rounded to two significant figures in accordance with the Rounding..., rounded to two significant figures in accordance with the Rounding-Off Method specified in ASTM E29-90...

7 CFR 52.47 - Changing types of service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Changing types of service. If an applicant cancels a new year-round contract before a full year has elapsed, the applicant shall be charged the difference between the year-round rate and less than year-round rate for the full period the year-round contract was in effect. If an applicant cancels a year-round...

7 CFR 52.47 - Changing types of service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Changing types of service. If an applicant cancels a new year-round contract before a full year has elapsed, the applicant shall be charged the difference between the year-round rate and less than year-round rate for the full period the year-round contract was in effect. If an applicant cancels a year-round...

9 CFR 317.344 - Identification of major cuts of meat products.

Code of Federal Regulations, 2013 CFR

2013-01-01

... products. 317.344 Section 317.344 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... meat products are: Beef chuck blade roast, beef loin top loin steak, beef rib roast large end, beef round eye round steak, beef round top round steak, beef round tip roast, beef chuck arm pot roast, beef...

9 CFR 317.344 - Identification of major cuts of meat products.

Code of Federal Regulations, 2014 CFR

2014-01-01

... products. 317.344 Section 317.344 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... meat products are: Beef chuck blade roast, beef loin top loin steak, beef rib roast large end, beef round eye round steak, beef round top round steak, beef round tip roast, beef chuck arm pot roast, beef...

9 CFR 317.344 - Identification of major cuts of meat products.

Code of Federal Regulations, 2012 CFR

2012-01-01

... products. 317.344 Section 317.344 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... major cuts of single-ingredient, raw meat products are: Beef chuck blade roast, beef loin top loin steak, beef rib roast large end, beef round eye round steak, beef round top round steak, beef round tip roast...

9 CFR 317.344 - Identification of major cuts of meat products.

Code of Federal Regulations, 2010 CFR

2010-01-01

... products. 317.344 Section 317.344 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... meat products are: Beef chuck blade roast, beef loin top loin steak, beef rib roast large end, beef round eye round steak, beef round top round steak, beef round tip roast, beef chuck arm pot roast, beef...

[Prediction of round window visibility in cochlear implantation with temporal bone high resolution computed tomography].

PubMed

Sun, S P; Lu, W; Lei, Y B; Men, X M; Zuo, B; Ding, S G

2017-08-07

Objective: To discuss the prediction of round window(RW) visibility in cochlear implantation(CI) with temporal bone high resolution computed tomography(HRCT). Methods: From January 2013 to January 2017, 130 cases underwent both HRCT and CI in our hospital were analyzed. The distance from facial nerve to posterior canal wall(FWD), the angle between facial nerve and inner margin of round window(FRA), and the angle between facial nerve and tympanic anulus to inner margin of round window(FRAA) were detected at the level of round window on axial temporal bone HRCT. A line parallel to the posterior wall of ear canal was drawn from the anterior wall of facial nerve at the level of round window on axial temporal bone HRCT and its relationship with round window was detected (facial-round window line, FRL): type0-posterior to the round window, type1-between the round window, type2-anterior to the round window. Their(FWD, FRA, FRAA, FRL) relationships with intra-operative round window visibility were analyzed by SPSS 17.0 software. Results: FWD( F =18.76, P =0.00), FRA( F =34.57, P =0.00), FRAA ( F =14.24, P =0.00) could affect the intra-operative RW visibility significantly. RW could be exposed completely during CI when preoperative HRCT showing type0 FRL. RW might be partly exposed and not exposed when preoperative HRCT showing type1 and type2 FRL respectively. Conclusion: FWD, FRA, FRAA and FRL of temporal bone HRCT can predict intra-operative round window visibility effectively in CI surgery.

Lock-in of elastically mounted airfoils at a 90° angle of attack

NASA Astrophysics Data System (ADS)

Ehrmann, R. S.; Loftin, K. M.; Johnson, S.; White, E. B.

2014-01-01

Reducing vortex-induced vibration (VIV) of elastically mounted cylinders has applications to petroleum, nuclear, and civil engineering. One simple method is streamlining the cylinder into an airfoil shape. However, if flow direction changes, an elastic airfoil could experience similar oscillations with even more drag. To better understand a general airfoil's response, three elastically mounted airfoil shapes are tested at a 90° angle of attack in a 3 ft by 4 ft wind tunnel. The shapes are a NACA 0018, a sharp leading- and trailing-edge (sharp-sharp) model, and a round leading- and trailing-edge (round-round) model. Mass-damping ranges from 0.96 to 1.44. For comparison to canonical VIV research, a cylinder is also tested. Since lock-in occurs near Rec=125×103, the models are also tested with a trip strip. The NACA 0018 and sharp-sharp configuration show nearly identical responses. The cylinder and round-round airfoil have responses five to eight times larger. Thus, the existence of a single sharp edge is sufficient to greatly reduce VIV at 90° angle of attack. Whereas the cylinder and round-round maximum response amplitudes are similar, cylinder lock-in occurs over a velocity range three times larger than the round-round. The tripped cylinder and round-round models' response is attenuated by 70% compared to their respective clean configurations. Hysteresis is only observed in the circular cylinder and round-round models. Hotwire data indicates the clean cylinder has a unique vortex pattern compared to the other configurations.

Round Cell Tumors: Classification and Immunohistochemistry.

PubMed

Sharma, Shweta; Kamala, R; Nair, Divya; Ragavendra, T Raju; Mhatre, Swapnil; Sabharwal, Robin; Choudhury, Basanta Kumar; Rana, Vivek

2017-01-01

Round cell tumors as the name suggest are comprised round cells with increased nuclear-cytoplasmic ratio. This group of tumor includes entities such as peripheral neuroectodermal tumor, rhabdomyosarcoma, synovial sarcoma, non-Hodgkin's lymphoma, neuroblastoma, hepatoblastoma, Wilms' tumor, and desmoplastic small round cell tumor. These round cells tumors are characterized by typical histological pattern, immunohistochemical, and electron microscopic features that can help in differential diagnosis. The present article describes the classification and explains the histopathology and immunohistochemistry of some important round cell tumors.

Applied anatomy of round window and adjacent structures of tympanum related to cochlear implantation.

PubMed

Jain, Shraddha; Gaurkar, Sagar; Deshmukh, Prasad T; Khatri, Mohnish; Kalambe, Sanika; Lakhotia, Pooja; Chandravanshi, Deepshikha; Disawal, Ashish

2018-04-19

Various aspects of the round window anatomy and anatomy of posterior tympanum have relevant implications for designing cochlear implant electrodes and visualizing the round window through facial recess. Preoperative information about possible anatomical variations of the round window and its relationships to the adjacent neurovascular structures can help reduce complications in cochlear implant surgery. The present study was undertaken to assess the common variations in round window anatomy and the relationships to structures of the tympanum that may be relevant for cochlear implant surgery. Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of round window and its relation to facial nerve, carotid canal, jugular fossa and other structures of posterior tympanum. The dissected bones were photographed by a digital camera of 18 megapixels, which were then imported to a computer to determine various parameters using ScopyDoc 8.0.0.22 version software, after proper calibration and at 1× magnification. When the round window niche is placed posteriorly and inferiorly, the distance between round window and vertical facial nerve decreases, whereas that with horizontal facial nerve increases. In such cases, the distance between oval window and round window also increases. Maximum height of the round window in our study ranged from 0.51-1.27mm (mean of 0.69±0.25mm). Maximum width of round window ranged from 0.51 to 2.04mm (mean of 1.16±0.47mm). Average minimum distance between round window and carotid canal was 3.71±0.88mm (range of 2.79-5.34mm) and that between round window and jugular fossa was 2.47±0.9mm (range of 1.24-4.3mm). The distances from the round window to the oval window and facial nerve are important parameters in identifying a difficult round window niche. Modification of the electrode may be a better option than drilling off the round window margins for insertion of cochlear implant electrodes. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

7 CFR 52.47 - Changing types of service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Certification Fees and Charges § 52.47 Changing types of service. If an applicant cancels a new year-round...-round rate and less than year-round rate for the full period the year-round contract was in effect. If an applicant cancels a year-round contract after a full year or more of uninterrupted service, the...

7 CFR 52.47 - Changing types of service.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Certification Fees and Charges § 52.47 Changing types of service. If an applicant cancels a new year-round...-round rate and less than year-round rate for the full period the year-round contract was in effect. If an applicant cancels a year-round contract after a full year or more of uninterrupted service, the...

Playing Doctor with Education: Considerations in Using Medical Rounds as a Model for Instructional Rounds

ERIC Educational Resources Information Center

Roegman, Rachel; Riehl, Carolyn

2012-01-01

This article examines the literature on medical rounds to inform the recent move toward instructional rounds as a practice of districtwide improvement and professional learning for superintendents and administrators. Based on the practice of medical rounds as a method for creating shared norms and understandings about medicine and patient care,…

16 CFR 460.11 - Rounding off R-values.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Rounding off R-values. 460.11 Section 460.11... INSULATION § 460.11 Rounding off R-values. R-values shown in labels, fact sheets, ads, or other promotional materials must be rounded to the nearest tenth. However, R-values of 10 or more may be rounded to the...

What Happened Next? Making and Using an Interactive DVD Quiz Game

ERIC Educational Resources Information Center

Sluman, Jonny

2013-01-01

In this article Jonny Sluman describes how he adapted an interactive DVD quiz game at a Christmas family get-together into an exciting, creative science activity to teach his students. The rounds included: a "quick fire" question round, a "what happened next" round, a music round, and a "spot the difference" round.…

Magnetic properties of Japan Sea sediments in areas which host shallow gas hydrates and in relation to the the amount of gas hydrate

NASA Astrophysics Data System (ADS)

Shimono, T.; Matsumoto, R.

2016-12-01

Shallow gas hydrate is known to occur as massive nodular aggregates in subsurface and/or shallow marine sediments (e.g. Matsumoto et al. 2009). We conducted a rock magnetic study of marine core sediments to clarify the relationship between shallow gas hydrate and the surrounding sediments. The core samples were taken from around Oki area and offshore Joetsu, the eastern margin of Japan Sea, during PS15 cruise in 2015. We mainly report magnetic susceptibility measurement of whole-round core samples. From the onboard measurements, the magnetic susceptibilities of gas hydrates indicated diamagnetic mineral like water or ice ( -0.9 x 10-5 vol. SI). Moreover, we introduce a method to assess the amount of gas hydrate present within marine sediments using magnetic susceptibility and rock magnetic analyses. This study was conducted under the commission from AIST as a part of the methane hydrate research project of METI (the Ministry of Economy, Trade and Industry, Japan).

Melanogenesis in dermal melanocytes of Japanese Silky chicken embryos.

PubMed

Ortolani-Machado, C F; Freitas, P F; Faraco, C D

2009-08-01

The Japanese Silky chicken (SK) shows dermal and visceral hyperpigmentation. This study characterizes ultrastructurally the melanin granules developing in dermal melanocytes of the dorsal skin of SK, in an attempt to better understand the processes of melanogenesis in these permanently ectopic cells. The steps of melanogenesis are similar to those described for epidermal melanocytes, with melanosomes going from stage I to IV but, in SK, the maturation occurs in the cell body, as well as in the cytoplasmic processes. At stage III, the deposition of melanin is cumulative and can aggregate in rounded structures, which combine to turn into the mature granule. The final destiny of mature melanosomes is still unclear, although it was observed that dermal macrophages can accumulate melanin granules in their phagosomes. Even with the close proximity between melanocytes and other dermal cells, the transference of melanosomes was not observed. Our findings indicate that melanogenesis in dermal melanocytes in SK has the same morphological characteristics found in epidermal melanocytes, but the functional aspect still remains to be elucidated.

Transient Three-Dimensional Side Load Analysis of Out-of-Round Film Cooled Nozzles

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Lin, Jeff; Ruf, Joe; Guidos, Mike

2010-01-01

The objective of this study is to investigate the effect of nozzle out-of-roundness on the transient startup side loads. The out-of-roundness could be the result of asymmetric loads induced by hardware attached to the nozzle, asymmetric internal stresses induced by previous tests and/or deformation, such as creep, from previous tests. The rocket engine studied encompasses a regeneratively cooled thrust chamber and a film cooled nozzle extension with film coolant distributed from a turbine exhaust manifold. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and a transient inlet history based on an engine system simulation. Transient startup computations were performed with the out-of-roundness achieved by four degrees of ovalization of the nozzle: one perfectly round, one slightly out-of-round, one more out-of-round, and one significantly out-of-round. The computed side load physics caused by the nozzle out-of-roundness and its effect on nozzle side load are reported and discussed.

Relationship between attack and pause in world taekwondo championship contests: effects of gender and weight category

PubMed Central

Santos, Victor Gustavo Ferreira; de Oliveira Pires, Flavio; Bertuzzi, Romulo; Frachini, Emerson; da Silva-Cavalcante, Marcos David; Peduti Dal Molin Kiss, Maria Augusta; Lima-Silva, Adriano Eduardo

2014-01-01

Summary Background: the aim of this study was to compare between weight and gender categories the attack and pause times during the 2007 Taekwondo World Championship. Methods: a total of 88 rounds (47 male and 41 female contests) were analyzed. Results: there was no difference in attack/balancing times ratio between genders (0.13 ± 0.06 vs 0.13 ± 0.06, P > 0.05). The attack number was significantly higher in round 3 than in round 1 for all categories and genders. The balancing time was lower during the round 3 than round 1 for low-weight male and high-weight female categories. The delta of change from round 1 to 3 (round 3 - round 1) for attack time and attack/balancing times ratio were lower in male than female. Conclusions: female seems to intensify more the combat in the last round than male, and this seems be related to the weight division. PMID:25332922

Rounds Today: A Qualitative Study of Internal Medicine and Pediatrics Resident Perceptions.

PubMed

Rabinowitz, Raphael; Farnan, Jeanne; Hulland, Oliver; Kearns, Lisa; Long, Michele; Monash, Bradley; Bhansali, Priti; Fromme, H Barrett

2016-10-01

Attending rounds is a key component of patient care and education at teaching hospitals, yet there is an absence of studies addressing trainees' perceptions of rounds. To determine perceptions of pediatrics and internal medicine residents about the current and ideal purposes of inpatient rounds on hospitalist services. In this multi-institutional qualitative study, the authors conducted focus groups with a purposive sample of internal medicine and pediatrics residents at 4 teaching hospitals. The constant comparative method was used to identify themes and codes. The study identified 4 themes: patient care, clinical education, patient/family involvement, and evaluation. Patient care included references to activities on rounds that forwarded care of the patient. Clinical education pertained to teaching/learning on rounds. Patient/family involvement encompassed comments about incorporating patients and families on rounds. Evaluation described residents demonstrating skill for attendings. Resident perceptions of the purposes of rounds aligned with rounding activities described by prior observational studies of rounds. The influence of time pressures and the divergent needs of participants on today's rounds placed these identified purposes in tension, and led to resident dissatisfaction in the achievement of all of them. Suboptimal congruency exists between perceived resident clinical education and specialty-specific milestones. These findings suggest a need for education of multiple stakeholders by (1) enhancing faculty teaching strategies to maximize clinical education while minimizing inefficiencies; (2) informing residents about the value of patient interactions and family-centered rounds; and (3) educating program directors in proper alignment of inpatient rotational objectives to the milestones.

Ethics rounds: An appreciated form of ethics support.

PubMed

Silén, Marit; Ramklint, Mia; Hansson, Mats G; Haglund, Kristina

2016-03-01

Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection. The aim of this study was to gain a deeper understanding of how the ethics rounds were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff. An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews. A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed. The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards. The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work. A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care. By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. © The Author(s) 2014.

Hole-pin joining structure with fiber-round-hole distribution of lobster cuticle and biomimetic study.

PubMed

Chen, Bin; Fan, Jinghong; Gou, Jihua; Lin, Shiyun

2014-12-01

Observations of the cuticle of the Boston Spiny Lobster using scanning electron microscope (SEM) show that it is a natural biocomposite consisting of chitin fibers and sclerotic-protein matrix with hierarchical and helicoidal structure. The SEM images also indicate that there is a hole-pin joining structure in the cuticle. In this joining structure, the chitin fibers in the neighborhood of the joining holes continuously round the holes to form a fiber-round-hole distribution. The maximum pullout force of the fibers in the fiber-round-hole distribution, which is closely related to the fracture toughness of the cuticle, is investigated and compared with that of the fibers in non-fiber-round-hole distribution based on their representative models. It is revealed that the maximum pullout force of the fibers in the fiber-round-hole distribution is significantly larger than that of the fibers in the non-fiber-round-hole distribution, and that a larger diameter of the hole results in a larger difference in the maximum pullout forces of the fibers between the two kinds of the fiber distributions. Inspired by the fiber-round-hole distribution found in the cuticle, composite specimens with the fiber-round-hole distribution were fabricated with a special mold and process to mirror the fiber-round-hole distribution. The fracture toughness of the biomimetic composite specimens is tested and compared with that of the conventional composite specimens with the non-fiber-round-hole distribution. It is demonstrated that the fracture toughness of the biomimetic composite specimens with the fiber-round-hole distribution is significantly larger than that of the conventional composite specimens with the non-fiber-round-hole distribution. Copyright © 2014 Elsevier Ltd. All rights reserved.

ETV4 is a useful marker for the diagnosis of CIC-rearranged undifferentiated round-cell sarcomas: a study of 127 cases including mimicking lesions.

PubMed

Le Guellec, Sophie; Velasco, Valérie; Pérot, Gaëlle; Watson, Sarah; Tirode, Franck; Coindre, Jean-Michel

2016-12-01

Subsets of primitive round-cell sarcomas remain difficult to diagnose and classify. Among these is a rare round-cell sarcoma that harbors a CIC gene rearrangement known as CIC-rearranged undifferentiated round-cell sarcoma, which is most commonly fused to the DUX4 gene. Owing to its aggressive clinical behavior and potential therapeutic implications, accurate identification of this novel soft tissue sarcoma is necessary. Definitive diagnosis requires molecular confirmation, but only a few centers are as yet able to perform this test. Several studies have shown that PEA3 subfamily genes, notably ETV4 (belonging to the family of ETS transcription factors), are upregulated in CIC-rearranged undifferentiated round-cell sarcomas. We performed a detailed immunohistochemical analysis to investigate ETV4 expression in CIC-rearranged undifferentiated round-cell sarcomas and their potential mimics (especially Ewing sarcomas). The study cohort included 17 cases of CIC-rearranged undifferentiated round-cell sarcomas, and 110 tumors that morphologically mimic CIC-rearranged undifferentiated round-cell sarcomas: 43 Ewing sarcomas, 25 alveolar rhabdomyosarcomas, 20 poorly differentiated round-cell synovial sarcomas, 10 desmoplastic round-cell tumors, 5 BCOR-CCNB3 sarcomas, 5 lymphoblastic lymphomas, and 2 rhabdoid tumors. All CIC-rearranged undifferentiated round-cell sarcomas (on core needle biopsies and open biopsies) were ETV4-positive with a strong diffuse nuclear pattern. Among the other 110 tumors, only six cases (four Ewing sarcomas, one alveolar rhabdomyosarcoma, and one desmoplastic round-cell tumor) showed focal (<5% of tumor cells) and very weak nuclear expression of ETV4; all other tumors were completely negative for ETV4. We conclude that systematic immunohistochemical analysis of ETV4 makes it possible to diagnose undifferentiated round-cell sarcomas (with no molecular markers for sarcoma-associated translocation) such as CIC-rearranged undifferentiated round-cell sarcoma.

Quantum dots for a high-throughput Pfu polymerase based multi-round polymerase chain reaction (PCR).

PubMed

Sang, Fuming; Zhang, Zhizhou; Yuan, Lin; Liu, Deli

2018-02-26

Multi-round PCR is an important technique for obtaining enough target DNA from rare DNA resources, and is commonly used in many fields including forensic science, ancient DNA analysis and cancer research. However, multi-round PCR is often aborted, largely due to the accumulation of non-specific amplification during repeated amplifications. Here, we developed a Pfu polymerase based multi-round PCR technique assisted by quantum dots (QDs). Different PCR assays, DNA polymerases (Pfu and Taq), DNA sizes and GC amounts were compared in this study. In the presence of QDs, PCR specificity could be retained even in the ninth-round amplification. Moreover, the longer and more complex the targets were, the earlier the abortion happened in multi-round PCR. However, no obvious enhancement of specificity was found in multi-round PCR using Taq DNA polymerase. Significantly, the fidelity of Pfu polymerase based multi-round PCR was not sacrificed in the presence of QDs. Besides, pre-incubation at 50 °C for an hour had no impact on multi-round PCR performance, which further authenticated the hot start effect of QDs modulated in multi-round PCR. The findings of this study demonstrated that a cost-effective and promising multi-round PCR technique for large-scale and high-throughput sample analysis could be established with high specificity, sensibility and accuracy.

Impact of coupling techniques of an active middle ear device to the round window membrane for the backward stimulation of the cochlea.

PubMed

Gostian, Antoniu-Oreste; Pazen, David; Ortmann, Magdalene; Luers, Jan-Christoffer; Anagiotos, Andreas; Hüttenbrink, Karl-Bernd; Beutner, Dirk

2015-01-01

Interposed cartilage and the round window coupler (RWC) increase the efficiency of cochlea stimulation with the floating mass transducer (FMT) of a single active middle ear implant (AMEI) placed against the round window membrane. Treatment of mixed and conductive hearing loss with an AMEI attached to the round window is effective, yet the best placement technique of its FMT for the most efficient stimulation of the cochlea remains to be determined. Experimental study on human temporal bones with the FMT placed against firstly the unaltered round window niche and then subsequently against the fully exposed round window membrane with and without interposed cartilage and the RWC. Cochlea stimulation is measured by the volume velocities of the stapes footplate using LASER vibrometry. At the undrilled round window niche, placement of the FMT by itself and with the RWC resulted in similar volume velocities. The response was significantly raised by interposing cartilage into the undrilled round window niche. Complete exposure of the round window membrane allowed for significantly increased volume velocities. Among these, coupling of the FMT with interposed cartilage yielded responses of similar magnitude compared with the RWC but significantly higher compared with the FMT by itself. Good contact to the round window membrane is essential for efficient stimulation of the cochlea. Therefore, interposing cartilage into the undrilled round window niche is a viable option. At the drilled round window membrane, the FMT with interposed cartilage and attached to the RWC are similarly effective.

7 CFR 51.2285 - Tolerances for size.

Code of Federal Regulations, 2012 CFR

2012-01-01

... for size Smaller than three-fourths halves Will not pass through 24/64 inch round hole Pass through 24/64 inch round hole Pass through 16/64 inch round hole Pass through 8/64 inch round hole Halves 5 1...

7 CFR 51.2285 - Tolerances for size.

Code of Federal Regulations, 2011 CFR

2011-01-01

... for size Smaller than three-fourths halves Will not pass through 24/64 inch round hole Pass through 24/64 inch round hole Pass through 16/64 inch round hole Pass through 8/64 inch round hole Halves 5 1...

7 CFR 51.2285 - Tolerances for size.

Code of Federal Regulations, 2010 CFR

2010-01-01

... for size Smaller than three-fourths halves Will not pass through 24/64 inch round hole Pass through 24/64 inch round hole Pass through 16/64 inch round hole Pass through 8/64 inch round hole Halves 5 1...

Revealing and Resolving Patient Safety Defects: The Impact of Leadership WalkRounds on Frontline Caregiver Assessments of Patient Safety

PubMed Central

Frankel, Allan; Grillo, Sarah Pratt; Pittman, Mary; Thomas, Eric J; Horowitz, Lisa; Page, Martha; Sexton, Bryan

2008-01-01

Objective To evaluate the impact of rigorous WalkRounds on frontline caregiver assessments of safety climate, and to clarify the steps and implementation of rigorous WalkRounds. Data Sources/Study Setting Primary outcome variables were baseline and post WalkRounds safety climate scores from the Safety Attitudes Questionnaire (SAQ). Secondary outcomes were safety issues elicited through WalkRounds. Study period was August 2002 to April 2005; seven hospitals in Massachusetts agreed to participate; and the project was implemented in all patient care areas. Study Design Prospective study of the impact of rigorously applied WalkRounds on frontline caregivers assessments of safety climate in their patient care area. WalkRounds were conducted weekly and according to the seven-step WalkRounds Guide. The SAQ was administered at baseline and approximately 18 months post-WalkRounds implementation to all caregivers in patient care areas. Results Two of seven hospitals complied with the rigorous WalkRounds approach; hospital A was an academic teaching center and hospital B a community teaching hospital. Of 21 patient care areas, SAQ surveys were received from 62 percent of respondents at baseline and 60 percent post WalkRounds. At baseline, 10 of 21 care areas (48 percent) had safety climate scores below 60 percent, whereas post-WalkRounds three care areas (14 percent) had safety climate scores below 60 percent without improving by 10 points or more. Safety climate scale scores in hospital A were 62 percent at baseline and 77 percent post-WalkRounds (t=2.67, p=.03), and in hospital B were 46 percent at baseline and 56 percent post WalkRounds (t=2.06, p=.06). Main safety issues by category were equipment/facility (A [26 percent] and B [33 percent]) and communication (A [24 percent] and B [18 percent]). Conclusions WalkRounds implementation requires significant organizational will; sustainability requires outstanding project management and leadership engagement. In the patient care areas that rigorously implemented WalkRounds, frontline caregiver assessments of patient safety increased. SAQ results such as safety climate scores facilitate the triage of quality improvement efforts, and provide consensus assessments of frontline caregivers that identify themes for improvement. PMID:18671751

Diverse matrix metalloproteinase functions regulate cancer amoeboid migration

PubMed Central

Orgaz, Jose L.; Pandya, Pahini; Viros, Amaya; Albrengues, Jean; Nestle, Frank O.; Ridley, Anne J.; Gaggioli, Cedric; Marais, Richard; Karagiannis, Sophia N.; Sanz-Moreno, Victoria

2014-01-01

Rounded-amoeboid cancer cells use actomyosin contractility driven by Rho-ROCK and JAK-STAT3 to migrate efficiently. It has been suggested that rounded-amoeboid cancer cells do not require matrix metalloproteinases (MMPs) to invade. Here we compare MMP levels in rounded-amoeboid and elongated-mesenchymal melanoma cells. Surprisingly, we find that rounded-amoeboid melanoma cells secrete higher levels of several MMPs, including collagenase MMP-13 and gelatinase MMP-9. As a result, rounded-amoeboid melanoma cells degrade collagen I more efficiently than elongated-mesenchymal cells. Furthermore, using a non-catalytic mechanism, MMP-9 promotes rounded-amoeboid 3D migration through regulation of actomyosin contractility via CD44 receptor. MMP-9 is upregulated in a panel of rounded-amoeboid compared with elongated-mesenchymal melanoma cell lines and its levels are controlled by ROCK-JAK-STAT3 signalling. MMP-9 expression increases during melanoma progression and it is particularly prominent in the invasive fronts of lesions, correlating with cell roundness. Therefore, rounded-amoeboid cells use both catalytic and non-catalytic activities of MMPs for invasion. PMID:24963846

FACS selection of valuable mutant mouse round spermatids and strain rescue via round spermatid injection.

PubMed

Zhu, Lian; Zhou, Wei; Kong, Peng-Cheng; Wang, Mei-Shan; Zhu, Yan; Feng, Li-Xin; Chen, Xue-Jin; Jiang, Man-Xi

2015-06-01

Round spermatid injection (ROSI) into mammalian oocytes can result in the development of viable embryos and offspring. One current limitation to this technique is the identification of suitable round spermatids. In the current paper, round spermatids were selected from testicular cells with phase contrast microscopy (PCM) and fluorescence-activated cell sorting (FACS), and ROSI was performed in two strains of mice. The rates of fertilization, embryonic development and offspring achieved were the same in all strains. Significantly, round spermatids selected by PCM and FACS were effectively used to rescue the infertile Pten-null mouse. The current results indicate that FACS selection of round spermatids can not only provide high-purity and viable round spermatids for use in ROSI, but also has no harmful effects on the developmental capacity of subsequently fertilized embryos. It was concluded that round spermatids selected by FACS are useful for mouse strain rederivation and rescue of infertile males; ROSI should be considered as a powerful addition to the armamentarium of assisted reproduction techniques applicable in the mouse.

Public supply and domestic water use in the United States, 2015

USGS Publications Warehouse

Dieter, Cheryl A.; Maupin, Molly A.

2017-10-30

IntroductionThe U.S. Geological Survey (USGS) National Water Use Science Project (NWUSP), part of the USGS Water Availability and Use Science Program (WAUSP), has estimated water use in the United States every 5 years since 1950. This report provides an overview of total population, public-supply use, including the population that is served by public-supply systems and the domestic deliveries to those users, and self-supplied domestic water use in the United States for 2015, continuing the task of estimating water use in the United States every 5 years. In this report, estimates for the United States include the 50 States, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands (hereafter referred to as “states” for brevity).County-level data for total population, public-supply withdrawals and the population served by public-supply systems, and domestic withdrawals for 2015 were published in a data release in an effort to provide data to the public in a timely manner. Data in the current version (1.0) of Dieter and others (2017) contains county-level total withdrawals from groundwater and surface-water sources (both fresh and saline) for public-water supply, the deliveries from those suppliers to domestic users, and the quantities of water from groundwater and surface-water sources for self-supplied domestic users, and total population. Methods used to estimate the various data elements for the public-supply and domestic use categories at the county level are described by Bradley (2017).This Open-File Report is an interim report summarizing the data published in Dieter and others (2017) at the state and national level. This report includes discussions on the total population, totals for public-supply withdrawals and population served, total domestic withdrawals, and provides comparisons of the 2015 estimates to 2010 estimates (Maupin and others, 2014). Total domestic water use, as described in this report, represents the summation of deliveries from public-water supply to domestic users plus self-supplied domestic withdrawals.Values for 2010 are the best available data for 2010 from the USGS Aggregate Water-Use Data System (AWUDS). The 2010 values presented in this report may have been revised from 2010 values published in Maupin and others (2014), and therefore values for 2010 in this report may not exactly match values in Maupin and others (2014).Withdrawal and population values in this report are rounded to three significant figures. All values are rounded independently, so the sums of individually rounded numbers may not equal the totals. Percent change is calculated on unrounded data and is expressed as an integer. Differences between 2010 and 2015 values are calculated on unrounded data, then the differences are rounded.

The impact of a lean rounding process in a pediatric intensive care unit.

PubMed

Vats, Atul; Goin, Kristin H; Villarreal, Monica C; Yilmaz, Tuba; Fortenberry, James D; Keskinocak, Pinar

2012-02-01

Poor workflow associated with physician rounding can produce inefficiencies that decrease time for essential activities, delay clinical decisions, and reduce staff and patient satisfaction. Workflow and provider resources were not optimized when a pediatric intensive care unit increased by 22,000 square feet (to 33,000) and by nine beds (to 30). Lean methods (focusing on essential processes) and scenario analysis were used to develop and implement a patient-centric standardized rounding process, which we hypothesize would lead to improved rounding efficiency, decrease required physician resources, improve satisfaction, and enhance throughput. Human factors techniques and statistical tools were used to collect and analyze observational data for 11 rounding events before and 12 rounding events after process redesign. Actions included: 1) recording rounding events, times, and patient interactions and classifying them as essential, nonessential, or nonvalue added; 2) comparing rounding duration and time per patient to determine the impact on efficiency; 3) analyzing discharge orders for timeliness; 4) conducting staff surveys to assess improvements in communication and care coordination; and 5) analyzing customer satisfaction data to evaluate impact on patient experience. Thirty-bed pediatric intensive care unit in a children's hospital with academic affiliation. Eight attending pediatric intensivists and their physician rounding teams. Eight attending physician-led teams were observed for 11 rounding events before and 12 rounding events after implementation of a standardized lean rounding process focusing on essential processes. Total rounding time decreased significantly (157 ± 35 mins before vs. 121 ± 20 mins after), through a reduction in time spent on nonessential (53 ± 30 vs. 9 ± 6 mins) activities. The previous process required three attending physicians for an average of 157 mins (7.55 attending physician man-hours), while the new process required two attending physicians for an average of 121 mins (4.03 attending physician man-hours). Cumulative distribution of completed patient rounds by hour of day showed an improvement from 40% to 80% of patients rounded by 9:30 AM. Discharge data showed pediatric intensive care unit patients were discharged an average of 58.05 mins sooner (p < .05). Staff surveys showed a significant increase in satisfaction with the new process (including increased efficiency, improved physician identification, and clearer understanding of process). Customer satisfaction scores showed improvement after implementing the new process. Implementation of a lean-focused, patient-centric rounding structure stressing essential processes was associated with increased timeliness and efficiency of rounds, improved staff and customer satisfaction, improved throughput, and reduced attending physician man-hours.

7 CFR 51.2285 - Tolerances for size.

Code of Federal Regulations, 2013 CFR

2013-01-01

... inch round hole Pass through 24/64 inch round hole Pass through 16/64 inch round hole Pass through 8/64 inch round hole Halves 5 1 (included in 5 percent) Pieces and halves 1 18 3 (included in 18 percent) 1...

7 CFR 51.2285 - Tolerances for size.

Code of Federal Regulations, 2014 CFR

2014-01-01

... inch round hole Pass through 24/64 inch round hole Pass through 16/64 inch round hole Pass through 8/64 inch round hole Halves 5 1 (included in 5 percent) Pieces and halves 1 18 3 (included in 18 percent) 1...

Precision and Disclosure in Text and Voice Interviews on Smartphones

PubMed Central

Antoun, Christopher; Ehlen, Patrick; Fail, Stefanie; Hupp, Andrew L.; Johnston, Michael; Vickers, Lucas; Yan, H. Yanna; Zhang, Chan

2015-01-01

As people increasingly communicate via asynchronous non-spoken modes on mobile devices, particularly text messaging (e.g., SMS), longstanding assumptions and practices of social measurement via telephone survey interviewing are being challenged. In the study reported here, 634 people who had agreed to participate in an interview on their iPhone were randomly assigned to answer 32 questions from US social surveys via text messaging or speech, administered either by a human interviewer or by an automated interviewing system. 10 interviewers from the University of Michigan Survey Research Center administered voice and text interviews; automated systems launched parallel text and voice interviews at the same time as the human interviews were launched. The key question was how the interview mode affected the quality of the response data, in particular the precision of numerical answers (how many were not rounded), variation in answers to multiple questions with the same response scale (differentiation), and disclosure of socially undesirable information. Texting led to higher quality data—fewer rounded numerical answers, more differentiated answers to a battery of questions, and more disclosure of sensitive information—than voice interviews, both with human and automated interviewers. Text respondents also reported a strong preference for future interviews by text. The findings suggest that people interviewed on mobile devices at a time and place that is convenient for them, even when they are multitasking, can give more trustworthy and accurate answers than those in more traditional spoken interviews. The findings also suggest that answers from text interviews, when aggregated across a sample, can tell a different story about a population than answers from voice interviews, potentially altering the policy implications from a survey. PMID:26060991

Ultrastructure of germ cells, Sertoli cells and mitochondria during spermatogenesis in mature testis of the Chinese Taihang black goats (Capra hircus).

PubMed

Shi, Liguang; Xun, Wenjuan; Zhou, Hanlin; Hou, Guanyu; Yue, Wenbin; Zhang, Chunxiang; Ren, Youshe; Yang, Rujie

2013-07-01

The objective of this study was to describe the ultrastructure of germ cells, Sertoli cells and mitochondria in mature testis of the Chinese Taihang black goat. The characteristics of germ cell nucleus and mitochondria changing during spermatogenesis were investigated by transmission electron microscopy (TEM). The results showed that the spermatogonium was elliptical, and its nucleus was about 4-5 μm. The round mitochondria can be observed throughout the cytoplasm around the nucleus. Small patches of heterochromatin were distributed throughout the nucleus. Spermatocyte was oval-shaped with a nucleus of about 4-4.5 μm in diameter. The heterochromatin began to attach to the inner surface of the nuclear membrane. Spermatid was about 4 μm and oval in shape. Its nucleus was oval or round and approximately 2-3 μm in diameter. The borderline between nucleus membrane and karyoplasm was distinct. During spermiogenesis, spermatid nucleus was condensed and elongated, and chromatin reached the highest condensation in the mature spermatozoon. The mid-piece was surrounded by mitochondria at the neck region. The sperm tail showed the typical "9+2″ structure, contained axoneme and central singlet microtubules. The nuclei of the Sertoli cells were irregular shaped and showed indentations in the membrane. In the mature testes of goat bucks, abundant mitochondria were around the germ cells and Sertoli cells. The scattered mitochondria were aggregated around the base of the flagellum (axoneme) during the spermatid differentiation stage. In conclusion, the present study showed that the spermatogenic process of Taihang black goat followed the pattern of mammals with some specific. Copyright © 2013 Elsevier Ltd. All rights reserved.

Precision and Disclosure in Text and Voice Interviews on Smartphones.

PubMed

Schober, Michael F; Conrad, Frederick G; Antoun, Christopher; Ehlen, Patrick; Fail, Stefanie; Hupp, Andrew L; Johnston, Michael; Vickers, Lucas; Yan, H Yanna; Zhang, Chan

2015-01-01

As people increasingly communicate via asynchronous non-spoken modes on mobile devices, particularly text messaging (e.g., SMS), longstanding assumptions and practices of social measurement via telephone survey interviewing are being challenged. In the study reported here, 634 people who had agreed to participate in an interview on their iPhone were randomly assigned to answer 32 questions from US social surveys via text messaging or speech, administered either by a human interviewer or by an automated interviewing system. 10 interviewers from the University of Michigan Survey Research Center administered voice and text interviews; automated systems launched parallel text and voice interviews at the same time as the human interviews were launched. The key question was how the interview mode affected the quality of the response data, in particular the precision of numerical answers (how many were not rounded), variation in answers to multiple questions with the same response scale (differentiation), and disclosure of socially undesirable information. Texting led to higher quality data-fewer rounded numerical answers, more differentiated answers to a battery of questions, and more disclosure of sensitive information-than voice interviews, both with human and automated interviewers. Text respondents also reported a strong preference for future interviews by text. The findings suggest that people interviewed on mobile devices at a time and place that is convenient for them, even when they are multitasking, can give more trustworthy and accurate answers than those in more traditional spoken interviews. The findings also suggest that answers from text interviews, when aggregated across a sample, can tell a different story about a population than answers from voice interviews, potentially altering the policy implications from a survey.

Development of key indicators of hospital resilience: a modified Delphi study.

PubMed

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2015-04-01

Hospital resilience is an emerging concept, which can be defined as 'a hospital's ability to resist, absorb, and respond to the shock of disasters while maintaining its critical health care functions, and then recover to its original state or adapt to a new one'. Our aim was to develop a comprehensive framework of key indicators of hospital resilience. A panel of 33 Chinese experts was invited to participate in a three-round, modified Delphi study to develop a set of potential measures previously derived from a literature review. In the first round, these potential measures were modified to cover the comprehensive domains of hospital resilience. The importance of proposed measures was scored by experts on a five-point Likert scale. Subsequently, the experts reconsidered their voting in light of the previous aggregated results. Agreement on measures was defined as at least 70% of the responders agreeing or strongly agreeing to the inclusion of a measure. A large proportion of preliminary measures (89.5%) were identified as having good potential for assessing hospital resilience. These measures were categorized into eight domains, 17 subdomains, and 43 indicators. The highest rated indicators (mean score) were: equipment for on-site rescue (4.7), plan initiation (4.6), equipment for referral of patients with complex care needs (4.5), the plan execution (4.4), medication management strategies (4.4), emergency medical treatment conditions (4.4), disaster committee (4.4), stock types and quantities for essential medications (4.4), surge capacity of emergency beds (4.4), and mass-casualty triage protocols (4.4). This framework identifies a comprehensive set of indicators of hospital resilience. It can be used for hospital assessment, as well as informing priority practices to address future disasters better. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Changes in NHS organization of care and management of hospital admissions with COPD exacerbations between the national COPD audits of 2003 and 2008.

PubMed

George, P M; Stone, R A; Buckingham, R J; Pursey, N A; Lowe, D; Roberts, C M

2011-10-01

The 2003 UK Chronic Obstructive Pulmonary Disease (COPD) audit revealed wide variability between hospital units in care delivered. To assess whether processes of care, patient outcomes and organization of care have improved since 2003. A UK national audit was performed in 2008 to survey the organization and delivery of clinical care provided to patients admitted to hospital with COPD. All UK acute hospital Trusts (units) were invited to participate. Each unit completed cross-sectional resource and organization questionnaires and a prospective clinical audit comprising up to 60 consecutively admitted cases of COPD exacerbation. Comparison between 2003 and 2008 includes aggregated statistics for units participating in both audit rounds. A total of 192 units participated in both audit rounds (6197 admissions in 2003 and 8170 in 2008). In 2008, patients were older and of a poorer functional class. Overall mortality was unchanged but adjusting for age and performance status, inpatient mortality (P = 0.05) and 90-day mortality (P = 0.001) were both reduced in 2008. More patients were discharged under a respiratory specialist (P < 0.01), treated with non-invasive ventilation if acidotic (P < 0.001) and accepted onto early discharge schemes (P < 0.01) while median length of stay fell from 6 to 5 days (P < 0.001). Within these mean data, however, there remains considerable inter-unit variation in organization, resources and outcomes. Overall improvements in resources and organization are accompanied by reduced mortality, shorter admissions and greater access to specialist services. There remains, however, considerable variation in the quality of secondary care provided between units.

The Second SeaWiFS HPLC Analysis Round-Robin Experiment (SeaHARRE-2)

NASA Technical Reports Server (NTRS)

2005-01-01

Eight international laboratories specializing in the determination of marine pigment concentrations using high performance liquid chromatography (HPLC) were intercompared using in situ samples and a variety of laboratory standards. The field samples were collected primarily from eutrophic waters, although mesotrophic waters were also sampled to create a dynamic range in chlorophyll concentration spanning approximately two orders of magnitude (0.3 25.8 mg m-3). The intercomparisons were used to establish the following: a) the uncertainties in quantitating individual pigments and higher-order variables (sums, ratios, and indices); b) an evaluation of spectrophotometric versus HPLC uncertainties in the determination of total chlorophyll a; and c) the reduction in uncertainties as a result of applying quality assurance (QA) procedures associated with extraction, separation, injection, degradation, detection, calibration, and reporting (particularly limits of detection and quantitation). In addition, the remote sensing requirements for the in situ determination of total chlorophyll a were investigated to determine whether or not the average uncertainty for this measurement is being satisfied. The culmination of the activity was a validation of the round-robin methodology plus the development of the requirements for validating an individual HPLC method. The validation process includes the measurements required to initially demonstrate a pigment is validated, and the measurements that must be made during sample analysis to confirm a method remains validated. The so-called performance-based metrics developed here describe a set of thresholds for a variety of easily-measured parameters with a corresponding set of performance categories. The aggregate set of performance parameters and categories establish a) the overall performance capability of the method, and b) whether or not the capability is consistent with the required accuracy objectives.

Analysis of Historical Artillery Expenditures (AHART) Study - CY 87

DTIC Science & Technology

1987-06-30

Field ........ 2-20 Total Weight (TOTALWT) Field ................ 2-20 Round Cost (ROUNDCOST) Field ................ 2-20 Round Cost per Day (RDCOSTDAY...Field ........ 2-20 Total Cost (TOTALCOST) Field ................ 2-20 Round per Tube per Day (ROTUBEDAY,) Field and the Variable RTD...9999199l99l 9 TUBE CATLGORY: XXXXXXI TYPE ROUND: XXXXXX AVG 309 PER DAY: 99999999.9 TOTAL ROUNDS: 99999999999 COST PER RD($): 9999 AVG COST PER DAY

Supply and demand: application of Lean Six Sigma methods to improve drug round efficiency and release nursing time.

PubMed

Kieran, Maríosa; Cleary, Mary; De Brún, Aoife; Igoe, Aileen

2017-10-01

To improve efficiency, reduce interruptions and reduce the time taken to complete oral drug rounds. Lean Six Sigma methods were applied to improve drug round efficiency using a pre- and post-intervention design. A 20-bed orthopaedic ward in a large teaching hospital in Ireland. Pharmacy, nursing and quality improvement staff. A multifaceted intervention was designed which included changes in processes related to drug trolley organization and drug supply planning. A communications campaign aimed at reducing interruptions during nurse-led during rounds was also developed and implemented. Average number of interruptions, average drug round time and variation in time taken to complete drug round. At baseline, the oral drug round took an average of 125 min. Following application of Lean Six Sigma methods, the average drug round time decreased by 51 min. The average number of interruptions per drug round reduced from an average of 12 at baseline to 11 following intervention, with a 75% reduction in drug supply interruptions. Lean Six Sigma methodology was successfully employed to reduce interruptions and to reduce time taken to complete the oral drug round. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Requiem for the grand round.

PubMed

Stanyon, Maham; Khan, Shahid Anis

2015-02-01

The time-honoured tradition of Grand Round is firmly rooted in medical education, but has little evidence for its effectiveness or its impact on patient management. A mode of didactic teaching, Grand Round has lost its appeal in modern medical education with dwindling attendance at Grand Rounds worldwide. Once a platform for eminence-based medicine and a cross fertilisation of medical ideas, emphasis on sub-specialisation and clinical governance, combined with rota, trainee engagement and attendance failures has made Grand Round obsolete. To survive, Grand Round must have evidence for its effectiveness in medical education. It must be able to compete with other forms of teaching and adapt by using technology to reach trainees. Engaging the audience and encouraging participation needs to be woven into the fabric of the modern Grand Round, alongside learning clinical skills and developing clinical reasoning. Understanding the needs of today's trainees and their involvement in formulating the Grand Round programme is vital. Attendance at Grand Round is a recognised measure of its success and will be used in its evaluation. Questions still remain regarding the future of Grand Round. Its survival will depend upon its ability to change with time and reclaim its place as a credible tool to promote learning. © 2015 Royal College of Physicians.

Occurrence and food habits of the round goby in the profundal zone of southwestern Lake Ontario

USGS Publications Warehouse

Walsh, M.G.; Dittman, D.E.; O'Gorman, R.

2007-01-01

Little is known about the ecology of round goby (Neogobius melanostomus), an invasive benthic fish, in the profundal zone of the Great Lakes. In April 2002–2005 we caught increasing numbers of round gobies with a bottom trawl in the 45–150 m depth range of southwestern Lake Ontario. In 2005, we examined gut contents of 30 round gobies from each of three depths, 55, 95, and 130 m, and qualitatively compared gut contents with density of benthic invertebrates determined by Ponar grabs. Round goby guts contained mostly Dreissena spp. and opposum shrimp, Mysis relicta (Mysis); the frequency of occurrence of dreissenids in guts decreased with depth, whereas the frequency of occurrence of Mysis in guts increased with depth. Abundance of these invertebrates in the environment followed the same pattern, although dreissenids of optimum edible size (3–12 mm) were still abundant (1,373/m2) at 130 m, where round gobies primarily consumed Mysis, suggesting that round gobies may switch from dreissenids to more profitable prey when it is available. Other food items were ostracods and fish, with ostracods generally eaten by smaller round gobies and fish eaten by larger round gobies. Occurrence and increasing abundance of round gobies in the profundal zone and predation on Mysis by round goby could have far-reaching consequences for the Lake Ontario fish community.

Sulfur-inhibited Thermosphaera aggregans sp. nov., a new genus of hyperthermophilic archaea isolated after its prediction from environmentally derived 16S rRNA sequences.

PubMed

Huber, R; Dyba, D; Huber, H; Burggraf, S; Rachel, R

1998-01-01

Recently, a new procedure was developed which allowed for the first time the isolation of a hyperthermophilic archaeum tracked by 165 rRNA analysis from a terrestrial hot solfataric spring ('Obsidian Pool', Yellowstone National Park, WY, USA). This novel isolate is characterized here. Cells are round cocci with a diameter of 0.2-0.8 micron, occurring singly, in pairs, short chains and in grape-like aggregates. The aggregates exhibit a weak bluish-green fluorescence under UV radiation at 420 nm. The new isolate is an anaerobic obligate heterotroph, using preferentially yeast extract for growth. The metabolic products include CO2, H2, acetate and isovalerate. Growth is observed between 65 and 90 degrees C (optimum: 85 degrees C), from pH 5.0 to 7.0 (optimum: 6.5) and up to 0.7% NaCl. The apparent activation energy for growth is about 149 kJ mol-1. Elemental sulfur or hydrogen inhibits growth. The core lipids consist mainly of acyclic and cyclic glycerol diphytanyl tetraethers. The cell envelope contains a cytoplasmic membrane covered by an amorphous layer of unknown composition; there is no evidence for a regularly arrayed surface-layer protein. The G + C content is 46 mol%. On the basis of 165 rRNA sequence comparisons in combination with morphological, physiological and biochemical properties, the isolate represents a new genus within the Desulfurococcaceae, which has been named Thermosphaera. The type species is Thermosphaera aggregans, the type strain is isolate M11TLT (= DSM 11486T).

Tailoring of the titanium surface by immobilization of heparin/fibronectin complexes for improving blood compatibility and endothelialization: an in vitro study.

PubMed

Li, Guicai; Yang, Ping; Liao, Yuzhen; Huang, Nan

2011-04-11

To improve the blood compatibility and endothelialization simultaneously and to ensure the long-term effectiveness of the cardiovascular implants, we developed a surface modification method, enabling the coimmobilization of biomolecules to metal surfaces. In the present study, a heparin and fibronectin mixture (Hep/Fn) covalently immobilized on a titanium (Ti) substrate for biocompatibility was investigated. Different systems [N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide and N-hydroxysuccinimide, electrostatic] were used for the formation of Hep/Fn layers. Atomic force microscopy (AFM) showed that the roughness of the silanized Ti surface decreased after the immobilization of Hep/Fn. Fourier transform infrared spectroscopy (FTIR), Toluidine Blue O (TBO) test, and immunochemistry assay showed that Hep/Fn mixture was successfully immobilized on Ti surface. Blood compatibility tests (hemolysis rate, APTT, platelet adhesion, fibrinogen conformational change) showed that the coimmobilized films of Hep/Fn mixture reduced blood hemolysis rate, prolonged blood coagulation time, reduced platelets activation and aggregation, and induced less fibrinogen conformational change compared with a bare Ti surface. Endothelial cell (EC) seeding showed more EC with better morphology on pH 4 samples than on pH 7 and EDC/NHS samples, which showed rounded and aggregated cells. Systematic evaluation showed that the pH 4 samples also had much better blood compatibility. All results suggest that the coimmobilized films of Hep/Fn can confer excellent antithrombotic properties and with good endothelialization. We envisage that this method will provide a potential and effective solution for the surface modification of cardiovascular implant materials.

Comparing the information seeking strategies of residents, nurse practitioners, and physician assistants in critical care settings

PubMed Central

Kannampallil, Thomas G; Jones, Laura K; Patel, Vimla L; Buchman, Timothy G; Franklin, Amy

2014-01-01

Objective Critical care environments are information-intensive environments where effective decisions are predicated on successfully finding and using the ‘right information at the right time’. We characterize the differences in processes and strategies of information seeking between residents, nurse practitioners (NPs), and physician assistants (PAs). Method We conducted an exploratory study in the cardiothoracic intensive care units of two large academic hospitals within the same healthcare system. Clinicians (residents (n=5), NPs (n=5), and PAs (n=5)) were shadowed as they gathered information on patients in preparation for clinical rounds. Information seeking activities on 96 patients were collected over a period of 3 months (NRes=37, NNP=24, NPA=35 patients). The sources of information and time spent gathering the information at each source were recorded. Exploratory data analysis using probabilistic sequential approaches was used to analyze the data. Results Residents predominantly used a patient-based information seeking strategy in which all relevant information was aggregated for one patient at a time. In contrast, NPs and PAs primarily utilized a source-based information seeking strategy in which similar (or equivalent) information was aggregated for multiple patients at a time (eg, X-rays for all patients). Conclusions The differences in the information seeking strategies are potentially a result of the differences in clinical training, strategies of managing cognitive load, and the nature of the use of available health IT tools. Further research is needed to investigate the effects of these differences on clinical and process outcomes. PMID:24619926

Learning from Instructional Rounds

ERIC Educational Resources Information Center

City, Elizabeth A.

2011-01-01

Instructional rounds are a disciplined way for educators to work together to improve a school's instructional core. The practice combines three common elements of improvement: classroom observation, an improvement strategy, and a network. Instructional rounds differ from supervision and evaluation in that people doing rounds learn something…

Instructional Rounds in Action

ERIC Educational Resources Information Center

Roberts, John E.

2012-01-01

"Instructional Rounds in Action" is an invaluable guide for those involved in implementing instructional rounds as the foundation and framework for systemic improvement in schools. Over the past few years, districts across the United States, Canada, and Australia have begun implementing "instructional rounds," a set of ideas…

Ward round template: enhancing patient safety on ward rounds.

PubMed

Gilliland, Niall; Catherwood, Natalie; Chen, Shaouyn; Browne, Peter; Wilson, Jacob; Burden, Helena

2018-01-01

Concerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety. These parameters were based on Trust patient safety guidance and CQUIN targets. The quality improvement technique of plan-do-study-act (PDSA) was used in this project. We retrospectively reviewed ward round entries to record baseline measurements, based on the above described parameters, prior to making any changes. Following this, the change applied was the introduction of a ward round template to include the highlighted important baseline parameters. Monthly PDSA cycles are performed, and baseline measurements are re-examined, then relevant changes were made to the ward round template. Documentation of baseline measurements was poor prior to introduction of the ward round template; this improved significantly following introduction of a standardised ward round template. Following three cycles, documentation of VTE risk assessments increased from 14% to 92%. Antibiotic stewardship documentation went from 0% to 100%. Use of the TEP form went from 29% to 78%. Following introduction of the ward round template, compliance improved significantly in all safety parameters. Important safety measures being discussed on ward rounds will lead to enhanced patient safety and will improve compliance to Trust guidance and comissioning for quality and innovation (CQUIN) targets. Ongoing change implementation will focus on improving compliance with usage of the template on all urology ward rounds.

Evidence for predatory control of the invasive round goby

USGS Publications Warehouse

Madenjian, C.P.; Stapanian, M.A.; Witzel, L.D.; Einhouse, D.W.; Pothoven, S.A.; Whitford, H.L.

2011-01-01

We coupled bioenergetics modeling with bottom trawl survey results to evaluate the capacity of piscivorous fish in eastern Lake Erie to exert predatory control of the invading population of round goby Neogobius melanostomus. In the offshore (>20 m deep) waters of eastern Lake Erie, burbot Lota lota is a native top predator, feeding on a suite of prey fishes. The round goby invaded eastern Lake Erie during the late 1990s, and round goby population size increased dramatically during 1999–2004. According to annual bottom trawl survey results, round goby abundance in offshore waters peaked in 2004, but then declined during 2004–2008. Coincidentally, round goby became an important component of burbot diet beginning in 2003. Using bottom trawling and gill netting, we estimated adult burbot abundance and age structure in eastern Lake Erie during 2007. Diet composition and energy density of eastern Lake Erie burbot were also determined during 2007. This information, along with estimates of burbot growth, burbot mortality, burbot water temperature regime, and energy densities of prey fish from the literature, were incorporated into a bioenergetics model application to estimate annual consumption of round goby by the adult burbot population. Results indicated that the adult burbot population in eastern Lake Erie annually consumed 1,361 metric tons of round goby. Based on the results of bottom trawling, we estimated the biomass of yearling and older round goby in offshore waters eastern Lake Erie during 2007–2008 to be 2,232 metric tons. Thus, the adult burbot population was feeding on round goby at an annual rate equal to 61% of the estimated round goby standing stock. We concluded that the burbot population had high potential to exert predatory control on round goby in offshore waters of eastern Lake Erie.

Lipoma of round ligament on the intraperitoneal portion (abdominal site): a case report.

PubMed

Ozdemır, Ozhan; Sarı, Mustafa Erkan; Sakar, Vefa Selimova; Nebıoglu, Mehriban; Atalay, Cemal Resat

2017-09-01

Primary tumors of round ligament are rare, and when found are typically leiomyomas. Endometrioma, and mesothelial cysts are the benign lesions recognized as involving the round ligament. We report a case of lipoma of the round ligament in a 48-year-old premenopausal woman. Round ligament lipoma on the intraperitoneal portion (abdominal site) is very rare and it should be kept in the differential diagnosis of ovarian and abdominal masses.

THE DISTRIBUTION OF ROUNDS FIRED IN STOCHASTIC DUELS

DTIC Science & Technology

This paper continues the development of the theory of Stochastic Duels to include the distribution of the number of rounds fired. Most generally...the duel between two contestants who fire at each other with constant kill probabilities per round is considered. The time between rounds fired may be...at the beginning of the duel may be limited and is a discrete random variable. Besides the distribution of rounds fired, its first two moments and

Adherence to colorectal cancer screening: four rounds of faecal immunochemical test-based screening.

PubMed

van der Vlugt, Manon; Grobbee, Esmée J; Bossuyt, Patrick Mm; Bongers, Evelien; Spijker, Wolfert; Kuipers, Ernst J; Lansdorp-Vogelaar, Iris; Essink-Bot, Marie-Louise; Spaander, Manon C W; Dekker, Evelien

2017-01-03

The effectiveness of faecal immunochemical test (FIT)-based screening programs is highly dependent on consistent participation over multiple rounds. We evaluated adherence to FIT screening over four rounds and aimed to identify determinants of participation behaviour. A total of 23 339 randomly selected asymptomatic persons aged 50-74 years were invited for biennial FIT-based colorectal cancer screening between 2006 and 2014. All were invited for every consecutive round, except for those who had moved out of the area, passed the upper age limit, or had tested positive in a previous screening round. A reminder letter was sent to non-responders. We calculated participation rates per round, response rates to a reminder letter, and differences in participation between subgroups defined by age, sex, and socioeconomic status (SES). Over the four rounds, participation rates increased significantly, from 60% (95% CI 60-61), 60% (95% CI 59-60), 62% (95% CI 61-63) to 63% (95% CI 62-64; P for trend<0.001) with significantly higher participation rates in women in all rounds (P<0.001). Of the 17 312 invitees eligible for at least two rounds of FIT screening, 12 455 (72%) participated at least once, whereas 4857 (28%) never participated; 8271 (48%) attended all rounds when eligible. Consistent participation was associated with older age, female sex, and higher SES. Offering a reminder letter after the initial invite in the first round increased uptake with 12%; in subsequent screening rounds this resulted in an additional uptake of up to 10%. In four rounds of a pilot biennial FIT-screening program, we observed a consistently high and increasing participation rate, whereas sending reminders remain effective. The substantial proportion of inconsistent participants suggests the existence of incidental barriers to participation, which, if possible, should be identified and removed.

Establishment of performance standards and a cut-score for the Canadian Forces firefighter physical fitness maintenance evaluation (FF PFME).

PubMed

Todd Rogers, W; Docherty, David; Petersen, Stewart

2014-01-01

The bookmark method for setting cut-scores was used to re-set the cut-score for the Canadian Forces Firefighter Physical Fitness Maintenance Evaluation (FF PFME). The time required to complete 10 tasks that together simulate a first-response firefighting emergency was accepted as a measure of work capacity. A panel of 25 Canadian Forces firefighter supervisors set cut-scores in three rounds. Each round involved independent evaluation of nine video work samples, where the times systematically increased from 400 seconds to 560 seconds. Results for Round 1 were discussed before moving to Round 2 and results for Round 2 were discussed before moving to Round 3. Accounting for the variability among panel members at the end of Round 3, a cut-score of 481 seconds (mean Round 3 plus 2 SEM) was recommended. Firefighters who complete the FF PFME in 481 seconds or less have the physical capacity to complete first-response firefighting work.

Patient-Centered Bedside Rounds and the Clinical Examination.

PubMed

Lichstein, Peter R; Atkinson, Hal H

2018-05-01

Bedside hospital rounds promote patient-centered care in teaching and nonteaching settings. Patients and families prefer bedside rounds and provider acceptance is increasing. Efficient bedside rounds with an interprofessional team or with learners requires preparation of the patient and the rounding team. Bedside "choreography" provides structure and sets expectations for time spent in the room. By using relationship-centered communication, rounds can be both patient proximate and patient centered. The clinical examination can be integrated into the flow of the presentation and case discussion. Patient and provider experience can be enhanced through investing time at the bedside. Copyright © 2018 Elsevier Inc. All rights reserved.

Impact of near-peer teaching rounds on student satisfaction in the basic surgical clerkship.

PubMed

Lin, Joseph A; Farrow, Norma; Lindeman, Brenessa M; Lidor, Anne O

2017-06-01

Teaching rounds are rarely featured in the surgery clerkship. Senior students interested in surgery are suited to precept teaching rounds. Near-peer teaching can provide benefits to both learners and preceptors. Near-peer teaching rounds consisted of senior student-precetors leading groups of 3 clerkship students on teaching rounds once during the clerkship. We prospectively surveyed student satisfaction before and after instituting near-peer teaching rounds. We retrospectively gathered qualitative narratives from student-preceptors. The survey response rate was 93% before near-peer teaching rounds were instituted and 85% after. Satisfaction with the learning environment and the quality and amount of small-group teaching were significantly higher after the institution of near-peer teaching rounds (P ≤ .001 for all 3). Satisfaction with the overall clerkship and baseline interest in surgery were not significantly different. Student-preceptors reported gaining valuable experience for future roles in academia as residents and attending surgeons. Student satisfaction with small-group teaching and the learning environment increased after the institution of near-peer teaching rounds in the surgery clerkship. Student-preceptors gained early experience for careers in academic surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

A case study of healthcare providers' goals during interprofessional rounds.

PubMed

Prystajecky, Michael; Lee, Tiffany; Abonyi, Sylvia; Perry, Robert; Ward, Heather

2017-07-01

Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers' goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds. Focus group field notes and transcripts were analysed using thematic analysis. The data indicated that there was no consensus among healthcare providers regarding the goals of interprofessional rounds. Discharge planning and patient care delivery were perceived as competing priorities during rounds, which limited the participation of healthcare providers. Nevertheless, study participants identified goals of rounds that were relevant to most care providers: developing shared perspectives of patients through direct communication, promoting collaborative decision making, coordinating care, and strengthening interprofessional relationships. Challenges in achieving the goals of interprofessional rounds included inconsistent attendance, exchange of irrelevant information, variable participation by healthcare providers, and inconsistent leadership. The findings of this study underscore the importance of shared goals in the context of interprofessional rounding.

24 CFR 598.1 - Applicability and scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES: ROUND TWO AND THREE DESIGNATIONS General... the second and third rounds of designations of urban Empowerment Zones, authorized under Subchapter U... requirement of, Round II in this part is also a reference to, or requirement of, Round III. (b) This part...

24 CFR 598.1 - Applicability and scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES: ROUND TWO AND THREE DESIGNATIONS General... the second and third rounds of designations of urban Empowerment Zones, authorized under Subchapter U... requirement of, Round II in this part is also a reference to, or requirement of, Round III. (b) This part...

24 CFR 598.1 - Applicability and scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES: ROUND TWO AND THREE DESIGNATIONS General... the second and third rounds of designations of urban Empowerment Zones, authorized under Subchapter U... requirement of, Round II in this part is also a reference to, or requirement of, Round III. (b) This part...

Recommended Dollar Reductions to DoD’s Fiscal Year 1984 Ammunition Procurement and Production Base Programs.

DTIC Science & Technology

1983-09-28

No comment . Inventory will exceed requirements for blank NATO round. (See p. 10.) Inventory will exceed requirements for match round. (See p. 11.) No comment . Premature procurement. (See p. 17.) Inventory will exceed requirements for three types of rounds. (See p. 11.) Inventory will exceed requirements for both rounds. (See p. 13.) No comment . Inventory will exceed requirements for TP-T round. (See p. 13.) No comment . No comment . 38

[Academic origin of round magnetic needle and standardization operation].

PubMed

Cheng, Yan-Ting; Zhang, Tian-Sheng; Meng, Li-Qiang; Shi, Rui-Qi; Ji, Lai-Xi

2014-07-01

The origin and development of round magnetic needle was explored, and the structure of round magnetic needle was introduced in detail, including the handle, the body and the tip of the needle. The clinical opera tion of round magnetic needle were standardized from the aspects of the methods of holding needle, manipulation skill, tapping position, strength of manipulation, application scope and matters needing attention, which laid foundation for the popularization and application of round magnetic needle.

Use of electrical barriers to deter movement of round goby

USGS Publications Warehouse

Savino, Jacqueline F.; Jude, David J.; Kostich, Melissa J.; Coutant, Charles C.

2001-01-01

An electrical barrier was chosen as a possible means to deter movement of round goby Neogobius melanostomus. Feasibility studies in a 2.1-m donut-shaped tank determined the electrical parameters necessary to inhibit round goby from crossing the 1-m stretch of the benthic, electrical barrier. Increasing electrical pulse duration and voltage increased effectiveness of the barrier in deterring round goby movement through the barrier. Differences in activity of round goby during daytime and nocturnal tests did not change the effectiveness of the barrier. In field verification studies, an electrical barrier was placed between two blocking nets in the Shiawassee River, Michigan. The barrier consisted of a 6-m wide canvas on which were laid four cables carrying the electrical current. Seven experiments were conducted, wherein 25 latex paint-marked round goby were introduced upstream of the electrical barrier and recovered 24 h later upstream, on, and downstream of the barrier. During control studies, round goby moved across the barrier within 20 min from release upstream. With the barrier on and using the prescribed electrical settings shown to inhibit passage in the laboratory, the only marked round goby found below the barrier were dead. At reduced pulse durations, a few round goby (mean one/test) were found alive, but debilitated, below the barrier. The electrical barrier could be incorporated as part of a program in reducing movement of adult round goby through artificial connections between watersheds.

Addressing the workplace needs of Western Australian midwives: a Delphi study.

PubMed

Hauck, Yvonne L; Bayes, Sara J; Robertson, Jeanette M

2012-05-01

To determine the workplace needs of Western Australian midwives working in public metropolitan secondary hospitals. Using a three-round Delphi approach, Round 1 incorporated focus groups and a questionnaire. Fifteen focus groups were conducted with midwives also having the option of contributing through an open-ended questionnaire. During Round 2, 38 items reflecting seven themes were prioritised with a final ranking performed in Round 3. In total, 114 midwives participated in Round 1, 72 in Round 2 and 89 in Round 3. During Round 1, workplace needs identified as being met included: working across all areas of midwifery; ability to work in areas of interest; opportunity to work with low to moderate risk women; supportive colleagues; accessible parking; hospital close to home and friendly work atmosphere. Round 2 items revealed the five top unmet needs as: adequate midwifery staff coverage; access to maintained equipment; competitive pay scales; patient safety issues and opportunities to implement midwifery models. The top ranked needs from Round 3 included: recognising the unpredictable nature of midwifery services; provision of competent medical coverage, and adequate midwifery staff coverage. Demand for maternity services is unpredictable; however, in order to maintain a sustainable maternity workforce, WA midwives' prioritised needs would suggest health management focus upon expanding the availability of midwifery models of care, fostering flexible working conditions and ensuring collaboration between maternity health professionals occurs within clinically safe staffing levels.

Structure, development, and cytochemical properties of the nucleolus-associated "round body" in rat spermatocytes and early spermatids.

PubMed

Schultz, M C; Hermo, L; Leblond, C P

1984-09-01

The "round body," a spherical structure typically associated with a nucleolus in male germ cells of the rat, has been examined in the electron microscope using routine and cytochemical methods to determine its structure, composition, and mode of development. Cytochemical analysis indicates that the round body includes neither nucleic acid nor lipid, but is composed of nonhistone protein which appears in the form of 1.6-nm-wide fibrils. Development begins in late leptotene, when a single round body appears in each spermatocyte as an irregular spheroid located along the inner surface of the nuclear envelope. During subsequent stages of the meiotic prophase, the round body leaves the nuclear envelope, becomes a regular sphere, and gradually enlarges from a diameter of 0.4 micron in leptotene to 1.6 micron in diplotene. Concurrently, lacunae appear within its substance and enlarge. At each maturation division, the amount of round-body material is decreased by about half, presumably because the constituent proteins are dissociated at metaphase, distributed between the two daughter cells at telophase, and reconstituted into half-sized round bodies. As spermiogenesis proceeds, the round body shrinks gradually and disappears at step 8. Soon after its appearance at leptotene, the round body becomes associated with and is surrounded by the pars granulosa of one of the nucleoli. Moreover, 3H-uridine incorporation into nucleolar RNA is high as long as the size of the round body increases, but is low or absent when it decreases. It is possible, therefore, that the round body exerts some control on nucleolar activity in meiotic cells.

Generalised Pareto distribution: impact of rounding on parameter estimation

NASA Astrophysics Data System (ADS)

Pasarić, Z.; Cindrić, K.

2018-05-01

Problems that occur when common methods (e.g. maximum likelihood and L-moments) for fitting a generalised Pareto (GP) distribution are applied to discrete (rounded) data sets are revealed by analysing the real, dry spell duration series. The analysis is subsequently performed on generalised Pareto time series obtained by systematic Monte Carlo (MC) simulations. The solution depends on the following: (1) the actual amount of rounding, as determined by the actual data range (measured by the scale parameter, σ) vs. the rounding increment (Δx), combined with; (2) applying a certain (sufficiently high) threshold and considering the series of excesses instead of the original series. For a moderate amount of rounding (e.g. σ/Δx ≥ 4), which is commonly met in practice (at least regarding the dry spell data), and where no threshold is applied, the classical methods work reasonably well. If cutting at the threshold is applied to rounded data—which is actually essential when dealing with a GP distribution—then classical methods applied in a standard way can lead to erroneous estimates, even if the rounding itself is moderate. In this case, it is necessary to adjust the theoretical location parameter for the series of excesses. The other solution is to add an appropriate uniform noise to the rounded data ("so-called" jittering). This, in a sense, reverses the process of rounding; and thereafter, it is straightforward to apply the common methods. Finally, if the rounding is too coarse (e.g. σ/Δx 1), then none of the above recipes would work; and thus, specific methods for rounded data should be applied.

The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-centered communication, teamwork, and provider support.

PubMed

Lown, Beth A; Manning, Colleen F

2010-06-01

To assess the impact of Schwartz Center Rounds, an interdisciplinary forum where attendees discuss psychosocial and emotional aspects of patient care. The authors investigated changes in attendees' self-reported behaviors and beliefs about patient care, sense of teamwork, stress, and personal support. In 2006-2007, researchers conducted retrospective surveys of attendees at six sites offering Schwartz Center Rounds ("the Rounds") for > or =3 years and prospective surveys of attendees at 10 new Rounds sites that have held > or =7 Rounds. Most of the retrospective survey respondents indicated that attending Rounds enhanced their likelihood of attending to psychosocial and emotional aspects of care and enhanced their beliefs about the importance of empathy. Respondents reported better teamwork, including heightened appreciation of the roles and contributions of colleagues. There were significant decreases in perceived stress (P < .001) and improvements in the ability to cope with the psychosocial demands of care (P < .05). In the prospective study, after control for presurvey differences, the more Rounds one attended, the greater the impact on postsurvey insights into psychosocial aspects of care and teamwork (both: P < .05). Respondents to both retrospective and prospective surveys described changes in institutional culture and greater focus on patient-centered care and institution-specific initiatives. Schwartz Center Rounds may foster enhanced communication, teamwork, and provider support. The impact on measured outcomes increased with the number of Rounds attended. The Rounds represent an effective strategy for providing support to health care professionals and for enhancing relationships among them and with their patients.

Aesthetic phenomena as supernormal stimuli: the case of eye, lip, and lower-face size and roundness in artistic portraits.

PubMed

Costa, Marco; Corazza, Leonardo

2006-01-01

In the first study, eye and lip size and roundness, and lower-face roundness were compared between a control sample of 289 photographic portraits and an experimental sample of 776 artistic portraits covering the whole period of the history of art. Results showed that eye roundness, lip roundness, eye height, eye width, and lip height were significantly enhanced in artistic portraits compared to photographic ones. Lip width and lower-face roundness, on the contrary, were less prominent in artistic than in photographic portraits. In a second study, forty-two art academy students were requested to draw two self-portraits, one with a mirror and one without (from memory). Eye, lip, and lower-face roundness in artistic self-portraits was compared to the same features derived from photographic portraits of the participants. The results obtained confirmed those found in the first study. Eye and lip size and roundness were greater in artistic self-portraits, while lower-face roundness was significantly reduced. The same degree of modification was found also when a mirror was available to the subjects. In a third study the effect of lower-face roundness on the perception of attractiveness was assessed: fifty-three participants had to adjust the face width of 24 photographic portraits in order to achieve the highest level of attractiveness. Participants contracted the face width by a mean value of 5.26%, showing a preference for a reduced lower-face roundness. All results are discussed in terms of the importance of the 'supernormalisation' process as a means of assigning aesthetic value to perceptual stimuli.

Needed Research in Year-Round Education.

ERIC Educational Resources Information Center

Parks, David J.; Leffel, Linda G.

The current literature on year-round education is replete with feasibility studies; reports on operational programs; and thoughtful consideration of the potential effects of year-round education on the community, school, family, and child. Lay boards of education are frequently asked to make decisions on whether to implement year-round programs on…

The Year-Round School: Where Learning Never Stops. Fastback 259.

ERIC Educational Resources Information Center

Ballinger, Charles E.; And Others

This fastback examines the instructional and administrative benefits of year-round education and describes schools currently operating on a year-round schedule. Instructional benefits of year-round education for gifted, average, and remedial students are cited in a brief introductory article. Other benefits, discussed in more detail, include…

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 25.4 - Secretarial review and designation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... zones, enterprise communities and champion communities—(1) Round I. The Secretary may designate up to.... (2) Round II. The Secretary may, prior to January 1, 1999, designate up to five rural empowerment zones in addition to those designated in Round I. (3) Round IIS. The Secretary may designate up to 20...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

78 FR 53486 - Addition of Round-Trip Mailer Product to the Competitive Product List

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-29

... POSTAL SERVICE Addition of Round-Trip Mailer Product to the Competitive Product List AGENCY... request with the Postal Regulatory Commission to add a product called ``Round-Trip Mailer'' to the...] filed with the Postal Regulatory Commission (Commission) a request to add a ``Round-Trip Mailer...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 25.4 - Secretarial review and designation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... zones, enterprise communities and champion communities—(1) Round I. The Secretary may designate up to.... (2) Round II. The Secretary may, prior to January 1, 1999, designate up to five rural empowerment zones in addition to those designated in Round I. (3) Round IIS. The Secretary may designate up to 20...

7 CFR 25.602 - Eligible recipients.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Round II and Round IIS Grants § 25.602 Eligible recipients. (a) General. The grants made under this subpart shall be made to the lead managing entities on behalf of the Round II rural empowerment zones and Round IIS...

7 CFR 25.4 - Secretarial review and designation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... zones, enterprise communities and champion communities—(1) Round I. The Secretary may designate up to.... (2) Round II. The Secretary may, prior to January 1, 1999, designate up to five rural empowerment zones in addition to those designated in Round I. (3) Round IIS. The Secretary may designate up to 20...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 25.602 - Eligible recipients.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Round II and Round IIS Grants § 25.602 Eligible recipients. (a) General. The grants made under this subpart shall be made to the lead managing entities on behalf of the Round II rural empowerment zones and Round IIS...

Year-Round versus Traditional Schools

ERIC Educational Resources Information Center

Lyttle, LeighAnne

2011-01-01

This document serves as a literature review for the practicality and cost effectiveness of traditional versus year-round school systems. The differences in year-round and traditional schools are many, as the debate lingers on which type is best for students' learning. Generally conclusive, the literature indicates that year-round schools' benefits…

7 CFR 25.602 - Eligible recipients.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Round II and Round IIS Grants § 25.602 Eligible recipients. (a) General. The grants made under this subpart shall be made to the lead managing entities on behalf of the Round II rural empowerment zones and Round IIS...

Local quantum transformations requiring infinite rounds of classical communication.

PubMed

Chitambar, Eric

2011-11-04

In this Letter, we investigate the number of measurement and communication rounds needed to implement certain tasks by local quantum operations and classical communication (LOCC), a relatively unexplored topic. To demonstrate the possible strong dependence on the round number, we consider the problem of converting three-qubit entanglement into two-qubit form, specifically in the random distillation setting of [Phys. Rev. Lett. 98, 260501 (2007)]. We find that the number of LOCC rounds needed for a transformation can depend on the amount of entanglement distilled. In fact, for a wide range of transformations, the required number of rounds is infinite (unbounded). This represents the first concrete example of a task needing an infinite number of rounds to implement.

Firearm equipped with live round inhibiting means and method of making same

DOEpatents

Baehr, D.G.

1990-11-13

A firearm is disclosed having live round inhibiting means mounted in the barrel of the firearm which permits a blank cartridge to be loaded into a firearm and fired while preventing the loading and firing of a live round. The live round inhibiting means comprise shaft means mounted in the barrel of the firearm and which extends a sufficient length into the barrel at a point just beyond the chamber portion of the firearm to engage the bullet portion of a live round to prevent it from properly chambering, while permitting a blank cartridge to be loaded into the firearm and fired without engaging the live round-inhibiting shaft means. 9 figs.

Firearm equipped with live round inhibiting means and method of making same

DOEpatents

Baehr, Donald G.

1990-01-01

A firearm is disclosed having live round inhibiting means mounted in the barrel of the firearm which permits a blank cartridge to be loaded into a firearm and fired while preventing the loading and firing of a live round. The live round inhibiting means comprise shaft means mounted in the barrel of the firearm and which extends a sufficient length into the barrel at a point just beyond the chamber portion of the firearm to engage the bullet portion of a live round to prevent it from properly chambering, while permitting a blank cartridge to be loaded into the firearm and fired without engaging the live round-inhibiting shaft means.

Rounded atelectasis of the lung: A pictorial review

PubMed Central

Sobocińska, Magdalena; Sobociński, Bartosz; Jarzemska, Agnieszka; Serafin, Zbigniew

2014-01-01

Summary Rounded atelectasis of the lung is well described in medical literature, but still difficult to diagnose. Since lesions give no clinical symptoms in patients, radiologists are often the first to recognize the round lesion in an X-ray picture or a CT scan. Rounded atelectasis is an atypical form of lung collapse that usually occurs adjacent to scarred pleura and can be mistaken for lung cancer. Patients with rounded atelectasis have a history of asbestos exposure or pleural effusion due to various causes. When characteristic imaging findings are present, the diagnosis is rarely dubious and no further investigation is necessary. However, differential diagnosis of rounded atelectasis poses a challenge to pulmonary specialists and radiologists. PMID:25045412

Analysis of the Mean Absolute Error (MAE) and the Root Mean Square Error (RMSE) in Assessing Rounding Model

NASA Astrophysics Data System (ADS)

Wang, Weijie; Lu, Yanmin

2018-03-01

Most existing Collaborative Filtering (CF) algorithms predict a rating as the preference of an active user toward a given item, which is always a decimal fraction. Meanwhile, the actual ratings in most data sets are integers. In this paper, we discuss and demonstrate why rounding can bring different influences to these two metrics; prove that rounding is necessary in post-processing of the predicted ratings, eliminate of model prediction bias, improving the accuracy of the prediction. In addition, we also propose two new rounding approaches based on the predicted rating probability distribution, which can be used to round the predicted rating to an optimal integer rating, and get better prediction accuracy compared to the Basic Rounding approach. Extensive experiments on different data sets validate the correctness of our analysis and the effectiveness of our proposed rounding approaches.

The value of case-based teaching vignettes in clinical microbiology rounds.

PubMed

Spicer, Jennifer O; Kraft, Colleen S; Burd, Eileen M; Armstrong, Wendy S; Guarner, Jeannette

2014-03-01

To describe the implementation and evaluation of a case-based microbiology curriculum during daily microbiology rounds. Vignettes consist of short cases with images and questions that facilitate discussion among microbiologists, pathologists, infectious disease physicians, and trainees (residents and fellows). We performed a survey to assess the value of these vignettes to trainees. Motivation to come to rounds on time increased from 60% to 100%. Trainees attending rounds after implementation of the vignettes perceived the value of microbiology rounds to be significantly higher compared with those who attended rounds before implementation (P = .04). Pathology residents found that vignettes were helpful for retaining knowledge (8.3 of 10 points). The vignettes have enhanced the value of microbiology rounds by serving as a formalized curriculum exposing trainees from multiple specialties to various microbiology topics. Emphasis on interdisciplinary interactions between clinical and laboratory personnel was highlighted with this case-based curriculum.

[Ethic rounds in intensive care. Possible instrument for a clinical-ethical assessment in intensive care units].

PubMed

Scheffold, N; Paoli, A; Gross, J; Riemann, U; Hennersdorf, M

2012-10-01

Ethical problems, such as medical end-of-life decisions or withdrawing life-sustaining treatment are viewed as an essential task in intensive care units. This article presents the ethics rounds as an instrument for evaluation of ethical problems in intensive care medicine units. The benchmarks of ethical reflection during the ethics rounds are considerations of ethical theory of principle-oriented medical ethics. Besides organizational aspects and the institutional framework, the role of the ethicist is described. The essential evaluation steps, as a basis of the ethics rounds are presented. In contrast to the clinical ethics consultation, the ethicist in the ethics rounds model is integrated as a member of the ward round team. Therefore ethical problems may be identified and analyzed very early before the conflict escalates. This preventive strategy makes the ethics rounds a helpful instrument in intensive care units.

The Elusiveness of Equity: Evolution of Instructional Rounds in a Superintendent's Network

ERIC Educational Resources Information Center

Roegman, Rachel; Allen, David; Hatch, Thomas

2017-01-01

The practice of instructional rounds is a recent innovation in educational administration, intended to support administrators' understanding of instruction through the development of common language. This longitudinal study examines the rounds practice of a network of superintendents over 6 years to understand how rounds serves as a vehicle for…

The Wheels of Stress Go 'Round and 'Round

ERIC Educational Resources Information Center

Brey, Rebecca A.; Clark, Susan E.

2012-01-01

"The Wheels of Stress Go Round and Round" teaching idea uses three activity wheels to reinforce stress-related content and concepts. After presenting a definition of stress, the instructor assists students in identifying stressors, and aids in formulating a list of negative, reactive behaviors and a list of positive coping mechanisms. Using…

Language Identity and Multicultural Diversity in Botswana

ERIC Educational Resources Information Center

Boikhutso, Keene; Jotia, Agreement Lathi

2013-01-01

This study explored the common wisdom that sees Botswana as inherently ethnically homogenous. It used the existing Afrobarometer survey data drawn from Round 1 (1999), Round 2 (2003), Round 3 (2005) and Round 4 (2008). The findings of this study revealed that when using language spoken mostly at home, common wisdom is confirmed. However, it is…

Inquiry in the Round? Education Rounds in an Teacher Residency Program

ERIC Educational Resources Information Center

Reagan, Emilie Mitescu; Roegman, Rachel; Goodwin, A. Lin

2017-01-01

In education, the Rounds model provides opportunities for engaging educators as communities of learners who examine instructional issues for purposes of understanding and improving them. Over the past 10 years, Rounds have been implemented in school-based experiences in teacher preparation programs across the nation. Yet despite recent interest,…

School-Based Instructional Rounds: Improving Teaching and Learning across Classrooms

ERIC Educational Resources Information Center

Teitel, Lee

2013-01-01

In "School-Based Instructional Rounds," Teitel offers detailed case studies of five different models of school-based rounds and investigates critical learning from each. Instructional rounds--one of the most innovative and powerful approaches to improving teaching and learning--has been taken up by districts across the country and around…

9 CFR 317.344 - Identification of major cuts of meat products.

Code of Federal Regulations, 2011 CFR

2011-01-01

... products. 317.344 Section 317.344 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... 82165, Dec. 29, 2010. The major cuts of single-ingredient, raw meat products are: Beef chuck blade roast, beef loin top loin steak, beef rib roast large end, beef round eye round steak, beef round top round...

Leading Instructional Rounds in Education: A Facilitator?'s Guide. Instructional Rounds Series

ERIC Educational Resources Information Center

Fowler-Finn, Thomas

2013-01-01

Instructional rounds is a powerful form of professional learning aimed at helping schools and systems develop the capacity to educate all children to high levels. In this practical book, Thomas Fowler-Finn, an experienced consultant who has worked closely with the Harvard team that pioneered instructional rounds, discusses how facilitators can…

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

Brown, Geoffrey Wayne; Leonard, Philip; Hartline, Ernest Leon

High Explosives Science and Technology (M-7) completed all required formulation and testing of Remediated Nitrate Salt (RNS) surrogates on April 27, 2016 as specified in PLAN-TA9-2443 Rev B, "Remediated Nitrate Salt (RNS) Surrogate Formulation and Testing Standard Procedure", released February 16, 2016. This report summarizes the results of the work and also includes additional documentation required in that test plan. All formulation and testing was carried out according to PLAN-TA9-2443 Rev B. The work was carried out in three rounds, with the full matrix of samples formulated and tested in each round. Results from the first round of formulation andmore » testing were documented in memorandum M7-J6-6042, " Results from First Round of Remediated Nitrate Salt Surrogate Formulation and Testing." Results from the second round of formulation and testing were documented in M7-16-6053 , "Results from the Second Round of Remediated Nitrate Salt Surrogate Formulation and Testing." Initial results from the third round were documented in M7-16-6057, "Initial Results from the Third Round of Remediated Nitrate Salt Formulation and Testing."« less

Palliative medicine Death Rounds: small group learning on a vital subject.

PubMed

Kitzes, Judith A; Kalishman, Summers; Kingsley, Darra D; Mines, Jan; Lawrence, Elizabeth

The medical student's experience with patients' dying and death has profound impact on personal and professional development. Death Rounds at the University of New Mexico School of Medicine is a small group educational model that promotes student self-reflection, metacognition, professional growth, and collegial support. To describe the implementation and evaluation activities of a third year clerkship Death Rounds which are a structured, institutionally supported resource for helping students to understand the clinical, ethical, legal, professional, cultural, and spiritual aspects of death. Medical students attend 2 to 3 small group palliative medicine Death Rounds sessions, facilitated by the attending clerkship director, chief residents, and a palliative care physician. The students' assessment of their palliative medicine knowledge and skills in 5 categories before and after participation in Death Rounds rated their skills after Death Rounds higher with effect sizes ranging from 0.9 to 1.9. Evidence from both the Death Rounds Questionnaire and Facilitators' Logs demonstrates that multiple issues and topics were addressed and all associated with the School of Medicine's 6 core competencies. Death Rounds minimally affect on clerkship time and faculty resources.

Visual search, movement behaviour and boat control during the windward mark rounding in sailing.

PubMed

Pluijms, Joost P; Cañal-Bruland, Rouwen; Hoozemans, Marco J M; Savelsbergh, Geert J P

2015-01-01

In search of key-performance predictors in sailing, we examined to what degree visual search, movement behaviour and boat control contribute to skilled performance while rounding the windward mark. To this end, we analysed 62 windward mark roundings sailed without opponents and 40 windward mark roundings sailed with opponents while competing in small regattas. Across conditions, results revealed that better performances were related to gazing more to the tangent point during the actual rounding. More specifically, in the condition without opponents, skilled performance was associated with gazing more outside the dinghy during the actual rounding, while in the condition with opponents, superior performance was related to gazing less outside the dinghy. With respect to movement behaviour, superior performance was associated with the release of the trimming lines close to rounding the mark. In addition, better performances were related to approaching the mark with little heel, yet heeling the boat more to the windward side when being close to the mark. Potential implications for practice are suggested for each phase of the windward mark rounding.

Clarifying concepts of food parenting practices. A Delphi study with an application to snacking behavior.

PubMed

Gevers, D W M; Kremers, S P J; de Vries, N K; van Assema, P

2014-08-01

Inconsistencies in measurements of food parenting practices continue to exist. Fundamental to this problem is the lack of clarity about what is understood by different concepts of food parenting practices. The purpose of this study was to clarify food parenting practice concepts related to snacking. A three round Delphi study among an international group of experts (n = 63) was conducted. In the first round, an open-ended survey was used to collect food parenting practice descriptions and concept labels associated with those practices. In the second round, participants were asked to match up descriptions with the appropriate concept labels. The third and final round allowed participants to reconsider how descriptions and concept labels were matched, taking into account the opinions expressed in round two. Round one produced 408 descriptions of food parenting practices and 110 different concept names. Round two started with 116 descriptions of food parenting practices and 20 concept names. On 40 descriptions, consensus regarding the underlying concept name was reached in round two. Of the remaining 76 descriptions, consensus on 47 descriptions regarding the underlying concept name was reached in round three. The present study supports the essential process of consensus development with respect to food parenting practices concepts. Copyright © 2014 Elsevier Ltd. All rights reserved.

Medication communication during ward rounds on medical wards: Power relations and spatial practices.

PubMed

Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

2013-03-01

Communication plays a crucial role in the management of medications. Ward rounds are sites where health professionals from different disciplines and patients come together to exchange medication information and make treatment decisions. This article examines power relations and spatial practices surrounding medication communication between patients and health professionals including doctors, nurses and pharmacists during ward rounds. Data were collected in two medical wards of a metropolitan teaching hospital in Melbourne, Australia. Data collection methods involved participant observations, field interviews, video-recordings, together with individual and group reflexive interviews. A critical discourse analysis was undertaken to identify the location sites where power relations were reproduced or challenged in ward rounds. Findings demonstrated that traditional medical hierarchies constructed the ways in which doctors communicated about medications during ward rounds. Nurses and pharmacists ventured into the ward round space by using the discourse of preparation and occupying a peripheral physical position. Doctors privileged the discourse of medication rationalization in their ward round discussions, competing with the discourse of inquiry taken up by patients and families. Ward rounds need to be restructured to provide opportunities for nurses and pharmacists to speak at dedicated times and in strategic locations. By critically reflecting upon the complex process of medication communication during ward rounds, greater opportunities exist for enhanced team communication among health professionals.

Multi-scale computational study of the mechanical regulation of cell mitotic rounding in epithelia

PubMed Central

Xu, Zhiliang; Zartman, Jeremiah J.; Alber, Mark

2017-01-01

Mitotic rounding during cell division is critical for preventing daughter cells from inheriting an abnormal number of chromosomes, a condition that occurs frequently in cancer cells. Cells must significantly expand their apical area and transition from a polygonal to circular apical shape to achieve robust mitotic rounding in epithelial tissues, which is where most cancers initiate. However, how cells mechanically regulate robust mitotic rounding within packed tissues is unknown. Here, we analyze mitotic rounding using a newly developed multi-scale subcellular element computational model that is calibrated using experimental data. Novel biologically relevant features of the model include separate representations of the sub-cellular components including the apical membrane and cytoplasm of the cell at the tissue scale level as well as detailed description of cell properties during mitotic rounding. Regression analysis of predictive model simulation results reveals the relative contributions of osmotic pressure, cell-cell adhesion and cortical stiffness to mitotic rounding. Mitotic area expansion is largely driven by regulation of cytoplasmic pressure. Surprisingly, mitotic shape roundness within physiological ranges is most sensitive to variation in cell-cell adhesivity and stiffness. An understanding of how perturbed mechanical properties impact mitotic rounding has important potential implications on, amongst others, how tumors progressively become more genetically unstable due to increased chromosomal aneuploidy and more aggressive. PMID:28531187

Modified round block mastopexy versus traditional round block mastopexy.

PubMed

Sterodimas, A; Nicaretta, B; Boriani, F

2015-01-01

Breast ptosis may be caused by several factors, including significant weight loss, pregnancy, long breastfeeding periods, and involution of the postmenopausal breast tissue. The authors performed a prospective study to evaluate patient satisfaction and the rate of complications after modified round block mastopexy versus traditional round block mastopexy. Forty-four patients fulfilled the inclusion criteria for undergoing round block mastopexy in a prospective randomized controlled study performed from 2007 to 2008. All the patients received polyurethane silicone implants. Group A included patients who underwent the traditional round block technique described by Benelli. Group B included patients who underwent the traditional round block and 4 cardinal glando-glandular permanent sutures. The overall satisfaction with body appearance after breast mastopexy was rated on a scale of 1 (poor), 2 (fair), 3 (good), 4 (very good), and 5 (excellent). Group A patient ages ranged from 28 to 52 years and in Group B ranged from 29 to 49 years. The mean implant volume was 215 cc in both Groups. The complication and satisfaction rates for both Groups are reported. The combination of the cardinal glandulo-glandular sutures along with the traditional round block appears to be key to preventing the areolar enlargement and persistent breast ptosis. The satisfaction rates in patients who underwent the modified round mastopexy appear superior when compared to the traditional round block mastopexy. Furhter long-term follow-up need to be performed in order to confirm the favorable results seen in this series of cases.

Computed tomographic evaluation to determine efficacy of euthanasia of yearling feedlot cattle by use of various firearm-ammunition combinations.

PubMed

Thomson, Daniel U; Wileman, Benjamin W; Rezac, Darrel J; Miesner, Matt D; Johnson-Neitman, Jennifer L; Biller, David S

2013-11-01

To evaluate with CT the efficacy of various combinations of firearms and ammunitions to penetrate and disrupt the brain tissue of cadaveric heads of feedlot steers. 42 fresh cadaveric heads of 12- to 18-month-old Bos taurus steers. For each of 7 combinations of firearms and ammunitions (.22-caliber rifle firing a long rifle 30-grain plated lead solid- or hollow-point round, .223-caliber carbine firing a 50-grain ballistic-tip round, 9-mm pistol firing a 124-grain total metal jacket round, .45-caliber automatic Colt pistol [ACP] firing a 230-grain full metal jacket round, and 12-gauge shotgun firing a 2.75-inch 1.25-ounce No. 4 birdshot shell or a 1-ounce rifled slug), 6 cadaveric heads were shot at an identical distance (3 m), angle, and anatomic location. Heads were scanned with third-generation CT, and images were evaluated to determine extent of penetration, projectile fragmentation, cranial fracture, and likelihood of instantaneous death (≥ 30% destruction of brain tissue or a brainstem lesion). RESULTS-41 of 42 skulls were penetrated by the projectile. Instantaneous death was considered a likely consequence for 83% (25/30) of heads shot with a rifle-fired .22-caliber solid-point round, pistol-fired .45-caliber ACP round, carbine-fired .223-caliber round, and shotgun-fired birdshot and slug. Of the 18 heads shot with pistol-fired 9-mm and .45-caliber ACP rounds and rifle-fired .22-caliber hollow-point rounds, only 6 had brainstem lesions. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that gunshots delivered by all firearm-ammunition combinations except rifle-fired .22-caliber hollow-point rounds and pistol-fired 9-mm rounds were viable options for euthanasia of feedlot cattle.

Association Between ICU Admission During Morning Rounds and Mortality

PubMed Central

Gajic, Ognjen; Morales, Ian J.; Keegan, Mark T.; Peters, Steve G.; Hubmayr, Rolf D.

2009-01-01

Background: No previous study has evaluated the association between admission to ICUs during round time and patient outcome. The objective of this study was to determine the association between round-time ICU admission and patient outcome. Methods: This retrospective study included 49,844 patients admitted from October 1994 to December 2007 to four ICUs (two surgical, one medical, and one multispecialty) of an academic medical center. Of these patients, 3,580 were admitted to the ICU during round time (8:00 am to 10:59 am) and 46,264 were admitted during nonround time (from 1:00 pm to 6:00 am). The medical ICU had 24-h/7-day per week intensivist coverage during the last 2 years of the study. We compared the baseline characteristics and outcome of patients admitted to the ICU between the two groups. Data were abstracted from the acute physiology and chronic health evaluation (APACHE) III database. Results: The round-time and non-round-groups were similar in gender, ethnicity, and age. The predicted hospital mortality rate of the round time group was higher (17.4% vs 12.3% predicted, respectively; p < 0.001). The hospital length of stay was similar between the two groups. The round-time group had a higher hospital mortality rate (16.2% vs 8.8%, respectively; p < 0.001). Most of the round-time ICU admissions and deaths occurred in the medical ICU. Round-time admission was an independent risk factor for hospital death (odds ratio, 1.321; 95% CI, 1.178 to 1.481). This independent association was present for the whole study period except for the last 2 years. Conclusions: Patients admitted to the ICU during morning rounds have higher severity of illness and mortality rates. PMID:19505985

No difference in the graft shift between a round and a rounded rectangular femoral tunnel for anterior cruciate ligament reconstruction: an experimental study.

PubMed

Takata, Yasushi; Nakase, Junsuke; Oshima, Takeshi; Shimozaki, Kengo; Asai, Kazuki; Tsuchiya, Hiroyuki

2018-05-16

We developed a novel technique of creating a rounded rectangular femoral bone tunnel for anatomical, single-bundle, autologous hamstring tendon anterior cruciate ligament (ACL) reconstruction. Although this tunnel has many advantages, its non-circular shape has raised concerns regarding excessive graft shift within the bone tunnel. This study aimed to compare the graft shift between round and rounded rectangular tunnels using a graft diameter tester for simulating the femoral bone tunnel. Seven semitendinosus tendon grafts harvested from fresh-frozen cadavers were prepared by removing all excess soft tissue. The two ends of a double-fold hamstring tendon were sutured using a baseball stitch and then looped over a TightRope (Arthrex Co., Ltd., Naples, Florida, USA) to make a fourfold graft. The diameter of the graft was standardized to 8 mm using a round graft diameter tester. A round and an original rounded rectangular graft diameter tester were used for simulating the respective femoral bone tunnels. The graft was inserted into the tunnel, with the TightRope positioned on the outside of the tunnel. The distal end of the graft was tensioned to 40 N at an angle of 75° to reproduce the most severe graft bending angle. Digital photographs of the tunnel aperture taken at each simulated tunnel and the range of graft shift in the simulated tunnel were analyzed by ImageJ software. Statistical analyses were performed using the Tukey test. P < 0.05 was considered to be significant. There were no significant differences between the round and the rounded rectangular tunnel groups (P > 0.05) in terms of graft shift, gap area, and graft shift ratio. In a simulated ACL reconstruction, there is no difference in the graft shift between a round and a rounded rectangular bone tunnel.

Improving nurse-physician teamwork through interprofessional bedside rounding.

PubMed

Henkin, Stanislav; Chon, Tony Y; Christopherson, Marie L; Halvorsen, Andrew J; Worden, Lindsey M; Ratelle, John T

2016-01-01

Teamwork between physicians and nurses has a positive association with patient satisfaction and outcomes, but perceptions of physician-nurse teamwork are often suboptimal. To improve nurse-physician teamwork in a general medicine inpatient teaching unit by increasing face-to-face communication through interprofessional bedside rounds. From July 2013 through October 2013, physicians (attendings and residents) and nurses from four general medicine teams in a single nursing unit participated in bedside rounding, which involved the inclusion of nurses in morning rounds with the medicine teams at the patients' bedside. Based on stakeholder analysis and feedback, a checklist for key patient care issues was created and utilized during bedside rounds. To assess the effect of bedside rounding on nurse-physician teamwork, a survey of selected items from the Safety Attitudes Questionnaire (SAQ) was administered to participants before and after the implementation of bedside rounds. The number of pages to the general medicine teams was also measured as a marker of physician-nurse communication. Participation rate in bedside rounds across the four medicine teams was 58%. SAQ response rates for attendings, residents, and nurses were 36/36 (100%), 73/73 (100%), and 32/73 (44%) prior to implementation of bedside rounding and 36 attendings (100%), 72 residents (100%), and 14 (19%) nurses after the implementation of bedside rounding, respectively. Prior to bedside rounding, nurses provided lower teamwork ratings (percent agree) than residents and attendings on all SAQ items; but after the intervention, the difference remained significant only on SAQ item 2 ("In this clinical area, it is not difficult to speak up if I perceive a problem with patient care", 64% for nurses vs 79% for residents vs 94% for attendings, P=0.02). Also, resident responses improved on SAQ item 1 ("Nurse input is well received in this area", 62% vs 82%, P=0.01). Increasing face-to-face communication through interprofessional bedside rounding can improve the perceptions of nurse-physician teamwork, particularly among residents and nurses.

Validation of the Nurses' Perception of Patient Rounding Scale: An Exploratory Study of the Influence of Shift Work on Nurses' Perception of Patient Rounding.

PubMed

Neville, Kathleen; DiBona, Courtney; Mahler, Maureen

2016-01-01

Hourly rounds have re-emerged as standard practice among nurses in acute care settings, and there is the need to identify nurses' perceptions regarding this practice. Further use of the Nurses' Perception of Patient Rounding Scale (NPPRS) is needed to further validate this new instrument. In addition, there exists a dearth of literature that examines the impact of hours worked and shift on nurses' perceptions of patient rounding. The purpose of this descriptive study was to explore nurses' perception of the required practice of patient rounding, to examine the influence of nurses' shift on nurses' perception of rounding practice, and to provide additional psychometric support for the NPPRS. The NPPRS, a 42-item scale in 5-point Likert format, and a demographic information sheet were used in the study. The NPPRS yields three subscales: communication, patient benefits, and nurse benefits. Using a convenience sample of anonymous nurse participants, 76 nurses from five medical-surgical units at a medical center in the northeast corridor of the United States participated in the study. Further psychometric support for the NPPRS was demonstrated. Excellent reliability coefficients via Cronbach's alpha for the total scale (0.91) and each of the subscales were obtained. A statistically significant difference was noted among nurses working 8 hours versus 12 hours or combined 8- and 12-hour workloads. Perceptions of nurse benefits were statistically significantly higher for nurses working 8 hours. In addition, results indicated that nurses perceived rounding to be more beneficial to their own practice than to patients. Analyses revealed that leadership support was instrumental in successful rounding practice. Further support for the NPPRS was obtained through this study. Strong nursing leadership, supportive of rounding, is essential for successful rounding. Further research should examine the efficacy of nurse rounding-developed protocols specific to the shift and unit of nursing practice.

The Association Between Sensemaking During Physician Team Rounds and Hospitalized Patients' Outcomes.

PubMed

Leykum, Luci K; Chesser, Hannah; Lanham, Holly J; Carla, Pezzia; Palmer, Ray; Ratcliffe, Temple; Reisinger, Heather; Agar, Michael; Pugh, Jacqueline

2015-12-01

Sensemaking is the social act of assigning meaning to ambiguous events. It is recognized as a means to achieve high reliability. We sought to assess sensemaking in daily patient care through examining how inpatient teams round and discuss patients. Our purpose was to assess the association between inpatient physician team sensemaking and hospitalized patients' outcomes, including length of stay (LOS), unnecessary length of stay (ULOS), and complication rates. Eleven inpatient medicine teams' daily rounds were observed for 2 to 4 weeks. Rounds were audiotaped, and field notes taken. Four patient discussions per team were assessed using a standardized Situation, Task, Intent, Concern, Calibrate (STICC) framework. Inpatient physician teams at the teaching hospitals affiliated with the University of Texas Health Science Center at San Antonio participated in the study. Outcomes of patients admitted to the teams were included. Sensemaking was assessed based on the order in which patients were seen, purposeful rounding, patient-driven rounding, and individual patient discussions. We assigned teams a score based on the number of STICC elements used in the four patient discussions sampled. The association between sensemaking and outcomes was assessed using Kruskal-Wallis sum rank and Dunn's tests. Teams rounded in several different ways. Five teams rounded purposefully, and four based rounds on patient-driven needs. Purposeful and patient-driven rounds were significantly associated with lower complication rates. Varying the order in which patients were seen and purposefully rounding were significantly associated with lower LOS, and purposeful and patient-driven rounds associated with lower ULOS. Use of a greater number of STICC elements was associated with significantly lower LOS (4.6 vs. 5.7, p = 0.01), ULOS (0.3 vs. 0.6, p = 0.02), and complications (0.2 vs. 0.5, p = 0.0001). Improving sensemaking may be a strategy for improving patient outcomes, fostering a shared understanding of a patient's clinical trajectory, and enabling high reliability.

Temporal and spatial variation of morphological descriptors for atmospheric aerosols collected in Mexico City

NASA Astrophysics Data System (ADS)

China, S.; Mazzoleni, C.; Dubey, M. K.; Chakrabarty, R. K.; Moosmuller, H.; Onasch, T. B.; Herndon, S. C.

2010-12-01

We present an analysis of morphological characteristics of atmospheric aerosol collected during the MILAGRO (Megacity Initiative: Local and Global Research Observations) field campaign that took place in Mexico City in March 2006. The sampler was installed on the Aerodyne mobile laboratory. The aerosol samples were collected on nuclepore clear polycarbonate filters mounted in Costar pop-top membrane holders. More than one hundred filters were collected at different ground sites with different atmospheric and geographical characteristics (urban, sub-urban, mountain-top, industrial, etc.) over a month period. Selected subsets of these filters were analyzed for aerosol morphology using a scanning electron microscope and image analysis techniques. In this study we investigate spatial and temporal variations of aerosol shape descriptors, morphological parameters, and fractal dimension. We also compare the morphological results with other aerosol measurements such as aerosol optical properties(scattering and absorption) and size distribution data. Atmospheric aerosols have different morphological characteristics depending on many parameters such as emission sources, atmospheric formation pathways, aging processes, and aerosol mixing state. The aerosol morphology influences aerosol chemical and mechanical interactions with the environment, physical properties, and radiative effects. In this study, ambient aerosol particles have been classified in different shape groups as spherical, irregularly shaped, and fractal-like aggregates. Different morphological parameters such as aspect ratio, roundness, feret diameter, etc. have been estimated for irregular shaped and spherical particles and for different kinds of soot particles including fresh soot, collapsed and coated soot. Fractal geometry and image processing have been used to obtain morphological characteristics of different soot particles. The number of monomers constituting each aggregate and their diameters were measured and used to estimate an ensemble three-dimensional (3-d) fractal dimension. One-dimensional (1-d) and two-dimensional (2-d) fractal geometries have been measured using a power-law scaling relationship between 1-d and 2-d properties of projected images. Temporal variations in fractal dimension of soot-like aggregates have been observed at the mountaintop site and spatial variation of fractal dimension and other morphological descriptors of different shaped particles have been investigated for the different ground sites.

31 CFR 593.510 - Transactions related to the importation of any round log or timber product originating in Liberia...

Code of Federal Regulations, 2010 CFR

2010-07-01

... importation of any round log or timber product originating in Liberia authorized. 593.510 Section 593.510... importation of any round log or timber product originating in Liberia authorized. Except as otherwise... into the United States of any round log or timber product originating in Liberia are authorized. ...

75 FR 21343 - Notice of Availability of the Final Environmental Impact Statement for the Round Mountain...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... INFORMATION: The Round Mountain Gold Corporation, which is a joint venture of Kinross Gold Corporation and Barrick Gold Corporation, proposes to expand its Round Mountain Mine, an existing open-pit gold mining and... about 66.2 acres between the Round Mountain area and the Gold Hill area. The primary method of...

ASBESTOS-CONTAINING MATERIALS IN SCHOOL BUILDINGS: BULK SAMPLE ANALYSIS QUALITY ASSURANCE PROGRAM-BULK SAMPLE ROUNDS 9, 10, 11 AND BLIND ROUND 2

EPA Science Inventory

The report presents the results of laboratories participating in the nineth, tenth, eleventh and second blind round(s) of the bulk sample analysis quality assurance program sponsored by the U.S. Environmental Protection Agency. Two hundred fifty-four, 320, 318, and 50 laboratorie...

Strength of small-diameter round and tapered bending members

Treesearch

Ron Wolfe; Joe Murphy

2005-01-01

An early focus on structural use of processed rather than round timber resulted in an underestimation of the structural advantages of retaining the natural form of small-diameter round timber. In the round and tapered form, timbers are not susceptible to the strength-reducing effects of diving grain and exposed juvenile wood. Fiber continuity around knots on the...

31 CFR 593.205 - Prohibition on the importation of any round log or timber product originating in Liberia.

Code of Federal Regulations, 2012 CFR

2012-07-01

... round log or timber product originating in Liberia. 593.205 Section 593.205 Money and Finance: Treasury... on the importation of any round log or timber product originating in Liberia. Except as otherwise... section, the importation into the United States, directly or indirectly, of any round log or timber...

26 CFR 49.4264(e)-1 - Round trips.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Round trips. 49.4264(e)-1 Section 49.4264(e)-1... TAXES FACILITIES AND SERVICES EXCISE TAXES Transportation of Persons § 49.4264(e)-1 Round trips. (a) In general. For purposes of the regulations in this subpart, a round trip shall be considered to consist of...

31 CFR 593.205 - Prohibition on the importation of any round log or timber product originating in Liberia.

Code of Federal Regulations, 2013 CFR

2013-07-01

... round log or timber product originating in Liberia. 593.205 Section 593.205 Money and Finance: Treasury... on the importation of any round log or timber product originating in Liberia. Except as otherwise... section, the importation into the United States, directly or indirectly, of any round log or timber...

31 CFR 593.205 - Prohibition on the importation of any round log or timber product originating in Liberia.

Code of Federal Regulations, 2014 CFR

2014-07-01

... round log or timber product originating in Liberia. 593.205 Section 593.205 Money and Finance: Treasury... on the importation of any round log or timber product originating in Liberia. Except as otherwise... section, the importation into the United States, directly or indirectly, of any round log or timber...

31 CFR 593.205 - Prohibition on the importation of any round log or timber product originating in Liberia.

Code of Federal Regulations, 2011 CFR

2011-07-01

... round log or timber product originating in Liberia. 593.205 Section 593.205 Money and Finance: Treasury... on the importation of any round log or timber product originating in Liberia. Except as otherwise... section, the importation into the United States, directly or indirectly, of any round log or timber...

50 CFR 679.54 - Release of observer data to the public.

Code of Federal Regulations, 2013 CFR

2013-10-01

... round weight of incidentally caught halibut or Pacific herring to the total round weight of groundfish in sampled catch. (4) The ratio of number of king crab or C. bairdi Tanner crab to the total round... of Chinook salmon to the total round weight of groundfish. (vii) The ratio of the number of other...

26 CFR 49.4264(e)-1 - Round trips.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Round trips. 49.4264(e)-1 Section 49.4264(e)-1... TAXES FACILITIES AND SERVICES EXCISE TAXES Transportation of Persons § 49.4264(e)-1 Round trips. (a) In general. For purposes of the regulations in this subpart, a round trip shall be considered to consist of...

31 CFR 593.510 - Transactions related to the importation of any round log or timber product originating in Liberia...

Code of Federal Regulations, 2012 CFR

2012-07-01

... importation of any round log or timber product originating in Liberia authorized. 593.510 Section 593.510... importation of any round log or timber product originating in Liberia authorized. Except as otherwise... into the United States of any round log or timber product originating in Liberia are authorized. ...

26 CFR 49.4264(e)-1 - Round trips.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Round trips. 49.4264(e)-1 Section 49.4264(e)-1... TAXES FACILITIES AND SERVICES EXCISE TAXES Transportation of Persons § 49.4264(e)-1 Round trips. (a) In general. For purposes of the regulations in this subpart, a round trip shall be considered to consist of...

50 CFR 679.54 - Release of observer data to the public.

Code of Federal Regulations, 2014 CFR

2014-10-01

... round weight of incidentally caught halibut or Pacific herring to the total round weight of groundfish in sampled catch. (4) The ratio of number of king crab or C. bairdi Tanner crab to the total round... of Chinook salmon to the total round weight of groundfish. (vii) The ratio of the number of other...

Summary of Round Table Session and Appendixes

Treesearch

1992-01-01

The round table session was designed for interaction between the presenters and other round table participants. Twelve round tables, each capable of holding 10 participants were set up in one room. Presenters for the sessions were encouraged to lead discussions on one of many topics in these areas: a research idea that the presenter was just formulating; an unpublished...

Rounding the Regression

ERIC Educational Resources Information Center

Marland, Eric; Bossé, Michael J.; Rhoads, Gregory

2018-01-01

Rounding is a necessary step in many mathematical processes. We are taught early in our education about significant figures and how to properly round a number. So when we are given a data set and asked to find a regression line, we are inclined to offer the line with rounded coefficients to reflect our model. However, the effects are not as…

Mesothelial cell proliferation in the scala tympani: a reaction to the rupture of the round window membrane.

PubMed

Sone, M

1998-10-01

The inner layer of the round window membrane is composed of mesothelial cells and this mesothelial cell layer extends to the scala tympani. This study describes the histopathologic findings of temporal bone analysis from a patient with bilateral perilymphatic fistula of the round window membrane. The left ear showed proliferation of mesothelial cells in the scala tympani of the basal turn adjoining the round window membrane. This cell proliferation is thought to be a reaction to the rupture of the round window membrane.

IFLA General Conference, 1990. Division of Education and Research: Section of Education and Training; Section of Library Theory and Research; Library History, Round Table; Research in Reading, Round Table; Editors of Library Journals, Round Table; and Continuing Professional Education, Round Table; Joint Workshop Papers. Booklet 7.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

The 21 papers in this collection were presented at the meetings of two sections and three round tables of the Division of Education and Research: (1) "Library and Information Services in Culturally Diverse Communities" (Cheryl Metoyer-Duran); (2) "Library Education in a Pluralistic Society" (Shmuel Sever); (3) "Each One an Individual:…

1988 Delphi survey of nursing research priorities for New York State.

PubMed

Shortridge, L; Doswell, W; Evans, M E; Levin, R F; Millor, G K; Carter, E

1989-09-01

In order to inform decisions about nursing research and health care policy, the Council on Nursing Research of the New York State Nurses Association (NYSNA) conducted a Delphi survey to identify the priorities for nursing research in New York state. The Delphi technique is a method of eliciting judgements from experts for the purpose of short-term forecasting and planning. The survey was conducted by mail in three rounds during 1988. Round I required participants to identify three primary research priorities for the nursing profession. In Round II participants ranked the 37 most frequently identified categories from Round I. The highest 16 categories from Round II were ranked by participants in Round III to provide the final 10 nursing research priority categories for New York state. All members of the New York State Nurses Association holding a minimum of a master's degree in nursing were invited to participate. The response rates were: Round I, 34% (N = 872); Round II, 38% (N = 985); Round III 37% (N = 974). Of the 10 nursing research priority categories identified in the final round, 5 relate to nurses, 2 relate to nursing, and 3 relate to clients. None of the high-risk conditions or populations with whom nurses work appear in the top 10, and only 2 of these are ranked in the top 15 priority categories. These priority categories will be used by the NYSNA Council on Nursing Research to influence its future agenda and activities. They can be used by the nursing profession and others for planning, policy making, and establishing nursing research funding priorities.(ABSTRACT TRUNCATED AT 250 WORDS)

Interactions between invasive round gobies (Neogobius melanostomous) and fantail darters (Etheostoma flabellare) in a tributary of the St. Lawrence River, New York, USA

USGS Publications Warehouse

Abbett, Ross; Waldt, Emily M.; Johnson, James H.; McKenna, James E.; Dittman, Dawn E.

2013-01-01

The initial, rapid expansion of the invasive round goby (Neogobius melanostomus) throughout the Great Lakes drainage was largely confined to lentic systems. We recently observed round gobies ascending two tributaries of the St. Lawrence River. The expansion of gobies into small lotic environments may place ecologically similar species at risk. Fantail darter (Etheostoma flabellare) is one of the several benthic species of the New York Great Lakes drainages that are threatened by round goby invasion. We examined the habitat use and diet composition of fantail darters and round gobies in Mullet Creek, a third-order tributary of the St. Lawrence River, NY, USA. The objectives of this study were to determine the degree of habitat and diet overlap between fantail darters and round gobies in a tributary of the St. Lawrence River. Gobies and darters co-occurred at 22% of capture sites. Of the four habitat variables examined (cover, depth, substrate and velocity), only depth use was significantly different with gobies using deeper habitats than darters. Among the two species and size classes sampled (large vs. small), large darters had the most restricted habitat use requirements. There was variation in round goby and darter diet composition, but only moderate diet overlap occurred between fantail darters and round gobies (Cλ = 0.43). Conditions in Mullet Creek were appropriate for the evaluation of possible spatial and dietary competition between round goby and native darters. Early detection and management of round goby invasions is critical to maintaining ecological integrity of lotic ecosystems in the St. Lawrence Valley.

Accuracy of Laboratory Data Communication on ICU Daily Rounds Using an Electronic Health Record.

PubMed

Artis, Kathryn A; Dyer, Edward; Mohan, Vishnu; Gold, Jeffrey A

2017-02-01

Accurately communicating patient data during daily ICU rounds is critically important since data provide the basis for clinical decision making. Despite its importance, high fidelity data communication during interprofessional ICU rounds is assumed, yet unproven. We created a robust but simple methodology to measure the prevalence of inaccurately communicated (misrepresented) data and to characterize data communication failures by type. We also assessed how commonly the rounding team detected data misrepresentation and whether data communication was impacted by environmental, human, and workflow factors. Direct observation of verbalized laboratory data during daily ICU rounds compared with data within the electronic health record and on presenters' paper prerounding notes. Twenty-six-bed academic medical ICU with a well-established electronic health record. ICU rounds presenter (medical student or resident physician), interprofessional rounding team. None. During 301 observed patient presentations including 4,945 audited laboratory results, presenters used a paper prerounding tool for 94.3% of presentations but tools contained only 78% of available electronic health record laboratory data. Ninty-six percent of patient presentations included at least one laboratory misrepresentation (mean, 6.3 per patient) and 38.9% of all audited laboratory data were inaccurately communicated. Most misrepresentation events were omissions. Only 7.8% of all laboratory misrepresentations were detected. Despite a structured interprofessional rounding script and a well-established electronic health record, clinician laboratory data retrieval and communication during ICU rounds at our institution was poor, prone to omissions and inaccuracies, yet largely unrecognized by the rounding team. This highlights an important patient safety issue that is likely widely prevalent, yet underrecognized.

Diets and diet overlap of nonindigenous gobies and small benthic native fishes co-inhabiting the St. Clair River, Michigan

USGS Publications Warehouse

French, John R. P.; Jude, David J.

2001-01-01

Round gobies (Neogobius melanostomus), after successfully reproducing in the early 1990s, decimated populations of mottled sculpins (Cottus bairdi) and possibly logperch (Percina caprodes) in the St. Clair River. Studies were conducted during 1994 to determine whether diets of round and tubenose (Proterorhinus marmoratus) gobies overlapped with those of native forage fishes. In the nearshore zone (depth ≤ 1 m), round and tubenose gobies, logperch, and rainbow darters (Etheostoma caeruleum) of similar sizes (total lengths < 75 mm) consumed mainly small-sized macroinvertebrates (dipterans, Caenis, and amphipods) during June 1994. Logperch and rainbow darters were present in the nearshore zone only during this month. At the crest of the channel slope (depth = 3 m), round gobies and northern madtoms (Noturus stigmosus) ate mostly ephemeropteran nymphs (Hexagenia and Baetisca), while predation on zebra mussels (Dreissena polymorpha) and other mollusks by round gobies was minimal. Northern madtoms did not feed on mollusks. Diet overlap between round gobies and native fishes was not observed at the channel slope (depth = 5 m and 7 m) due to heavy predation on mollusks by round gobies. Young-of-the-year (YOY) round gobies migrated to deeper water in autumn and became prey of mottled sculpins and northern madtoms. Eggs and YOY of mottled sculpins may have become vulnerable to predation by both round gobies and native fishes in deeper water, since adult mottled sculpins were apparently confined to the channel with limited home range because aggressive round gobies occupied preferred shallow habitat, including spawning sites.

Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.

PubMed

Katz-Sidlow, Rachel J; Ludwig, Allison; Miller, Scott; Sidlow, Robert

2012-10-01

While there are numerous benefits of smartphone use for physicians, little is known about the negative effects of using these devices in the context of patient care. To assess resident and faculty smartphone use during inpatient attending rounds and its potential as a source of distraction during transfer of clinical information. Cross-sectional survey. University-affiliated public teaching hospital. All housestaff and inpatient faculty in the departments of Medicine and Pediatrics. Participants were asked about smartphone ownership, usage patterns during attending rounds, and whether team members had ever missed important data during rounds due to distraction from smartphones. Attendings were asked whether policies should be established for smartphone use during rounds. The overall response rate was 73%. Device ownership was prevalent (89% residents, 98% faculty), as was use of smartphones during inpatient rounds (57% residents, 28% attendings). According to self-reports, smartphones were used during rounds for patient care (85% residents, 48% faculty), reading/responding to personal texts/e-mails (37% residents, 12% faculty), and other non-patient care uses (15% residents, 0% faculty). Nineteen percent of residents and 12% of attendings believed they had missed important information because of distraction from smartphones. Residents and faculty agreed that smartphones "can be a serious distraction during attending rounds," and nearly 80% of faculty believed that smartphone policies should be established. Smartphone use during attending rounds is prevalent and can distract users during important information transfer. Attendings strongly favored the institution of formal policies governing appropriate smartphone use during inpatient rounds. Copyright © 2012 Society of Hospital Medicine.

Perceptions of Family Participation in Intensive Care Unit Rounds and Telemedicine: A Qualitative Assessment.

PubMed

Stelson, Elisabeth A; Carr, Brendan G; Golden, Kate E; Martin, Niels; Richmond, Therese S; Delgado, M Kit; Holena, Daniel N

2016-09-01

Family-centered rounds involve purposeful interactions between patients' families and care providers to refocus the delivery of care on patients' needs. To examine perspectives of patients' family members and health care providers on family participation in rounds in the surgical intensive care unit (ICU) and the potential use of telemedicine to facilitate this process. Patients' family members and surgical ICU care providers were recruited for semistructured interviews exploring stakeholders' perspectives on family participation in ICU rounds and the potential role of telemedicine. Thirty-two interviews were conducted, audio recorded, and transcribed verbatim. Common coding methods were facilitated by using NVivo 10. A mean coding agreement of 97.3% was calculated for 22% of transcripts. Both patients' family members and health care providers described inconsistent practices surrounding family participation in ICU rounds as well as barriers to and facilitators of family participation. Family members identified 3 primary logistical challenges to participation in ICU rounds: distance to hospitals, work/family obligations, and the rounding schedule. Both family members and providers reported receptivity to virtual participation as a potential solution to these challenges. Understanding the barriers to and facilitators of family participation in ICU rounds is key to encouraging adoption of family-centered rounds. For families that live far away or have competing demands, telemedical options may facilitate participation. ©2016 American Association of Critical-Care Nurses.

7 CFR 810.402 - Definition of other terms.

Code of Federal Regulations, 2014 CFR

2014-01-01

... corn. All matter that passes readily through a 12/64 round-hole sieve and over a 6/64 round-hole sieve... matter that passes readily through a 12/64 round-hole sieve and all matter other than corn that remains... sieve and all matter other than corn that remains on top of the 12/64 round-hole sieve according to...

7 CFR 810.402 - Definition of other terms.

Code of Federal Regulations, 2012 CFR

2012-01-01

... corn. All matter that passes readily through a 12/64 round-hole sieve and over a 6/64 round-hole sieve... matter that passes readily through a 12/64 round-hole sieve and all matter other than corn that remains... sieve and all matter other than corn that remains on top of the 12/64 round-hole sieve according to...

7 CFR 810.402 - Definition of other terms.

Code of Federal Regulations, 2010 CFR

2010-01-01

... corn. All matter that passes readily through a 12/64 round-hole sieve and over a 6/64 round-hole sieve... matter that passes readily through a 12/64 round-hole sieve and all matter other than corn that remains... sieve and all matter other than corn that remains on top of the 12/64 round-hole sieve according to...

7 CFR 810.402 - Definition of other terms.

Code of Federal Regulations, 2011 CFR

2011-01-01

... corn. All matter that passes readily through a 12/64 round-hole sieve and over a 6/64 round-hole sieve... matter that passes readily through a 12/64 round-hole sieve and all matter other than corn that remains... sieve and all matter other than corn that remains on top of the 12/64 round-hole sieve according to...

7 CFR 810.402 - Definition of other terms.

Code of Federal Regulations, 2013 CFR

2013-01-01

... corn. All matter that passes readily through a 12/64 round-hole sieve and over a 6/64 round-hole sieve... matter that passes readily through a 12/64 round-hole sieve and all matter other than corn that remains... sieve and all matter other than corn that remains on top of the 12/64 round-hole sieve according to...

40 CFR 80.9 - Rounding a test result for determining conformance with a fuels standard.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Rounding a test result for determining conformance with a fuels standard. (a) For purposes of determining compliance with the fuel standards of 40 CFR part 80, a test result will be rounded to the nearest unit of... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Rounding a test result for determining...

40 CFR 80.9 - Rounding a test result for determining conformance with a fuels standard.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Rounding a test result for determining conformance with a fuels standard. (a) For purposes of determining compliance with the fuel standards of 40 CFR part 80, a test result will be rounded to the nearest unit of... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Rounding a test result for determining...

40 CFR 80.9 - Rounding a test result for determining conformance with a fuels standard.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Rounding a test result for determining conformance with a fuels standard. (a) For purposes of determining compliance with the fuel standards of 40 CFR part 80, a test result will be rounded to the nearest unit of... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Rounding a test result for determining...

40 CFR 80.9 - Rounding a test result for determining conformance with a fuels standard.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Rounding a test result for determining conformance with a fuels standard. (a) For purposes of determining compliance with the fuel standards of 40 CFR part 80, a test result will be rounded to the nearest unit of... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Rounding a test result for determining...

Mechanical grading of round timber beams

Treesearch

David W. Green; Thomas M. Gorman; James W. Evans; Joseph F. Murphy

2006-01-01

Current procedures used to sort round timber beams into structural grades rely on visual grading methods and property assignments based on modification of clear wood properties. This study provides the technical basis for mechanical grading of 228 mm (9 in.) diameter round timbers. Test results on 225 round Engelmann spruce–alpine fir–lodgepole pine beams demonstrate...

37 CFR 1.701 - Extension of patent term due to examination delay under the Uruguay Round Agreements Act...

Code of Federal Regulations, 2013 CFR

2013-07-01

... to examination delay under the Uruguay Round Agreements Act (original applications, other than... Examination Delay § 1.701 Extension of patent term due to examination delay under the Uruguay Round Agreements....C. 154(b)(2) as amended by section 532(a) of the Uruguay Round Agreements Act, Public Law 103-465...

37 CFR 1.701 - Extension of patent term due to examination delay under the Uruguay Round Agreements Act...

Code of Federal Regulations, 2014 CFR

2014-07-01

... to examination delay under the Uruguay Round Agreements Act (original applications, other than... Examination Delay § 1.701 Extension of patent term due to examination delay under the Uruguay Round Agreements....C. 154(b)(2) as amended by section 532(a) of the Uruguay Round Agreements Act, Public Law 103-465...

15 CFR 712.1 - Round to zero rule that applies to activities involving Schedule 1 chemicals.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 2 2013-01-01 2013-01-01 false Round to zero rule that applies to... CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 1 CHEMICALS § 712.1 Round to zero.... 1 to this part) as unavoidable by-products or impurities may round to zero and are not subject to...

15 CFR 712.1 - Round to zero rule that applies to activities involving Schedule 1 chemicals.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 2 2012-01-01 2012-01-01 false Round to zero rule that applies to... CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 1 CHEMICALS § 712.1 Round to zero.... 1 to this part) as unavoidable by-products or impurities may round to zero and are not subject to...

15 CFR 712.1 - Round to zero rule that applies to activities involving Schedule 1 chemicals.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 2 2014-01-01 2014-01-01 false Round to zero rule that applies to... CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 1 CHEMICALS § 712.1 Round to zero.... 1 to this part) as unavoidable by-products or impurities may round to zero and are not subject to...

Policy Considerations in Conversion to Year-Round Schools. Policy Briefs of the Education Policy Studies Laboratory, No. 92-01.

ERIC Educational Resources Information Center

Glass, Gene V.

Increasing enrollments and budget problems have prompted many school districts nationwide to experiment with year-round school schedules. Year-round school schedules allow districts to serve more students without constructing more buildings. As in traditional 9-month schools, students in year-round schools attend classes about 180 days a year. The…

Measuring ward round quality in urology.

PubMed

Darbyshire, Daniel; Barrett, Charlotte; Ross, David; Shackley, David

2015-01-01

Ward rounds are the traditional process by which clinical information is interpreted and management plans made in the inpatient setting and the only time during which patient-doctor interaction can reliably occur. Efforts to improve quality and safety have started looking at the ward round but this has mainly been in the acute medical setting. To begin the quality improvement process for Urological ward rounds. Twenty indicators thought to relate to quality were recorded for every weekday ward round by the Urology team for one month. Twenty ward rounds, 93 patient encounters, were reviewed. A consultant was present for 37% of the patient encounters. 84% of observation charts were reviewed; drug charts 28% and antibiotics 70%. Plans were communicated to the doctors, patient and nursing staff. All notes were typed directly onto the electronic system, 20% of notes were checked by the lead clinician. Mean time per patient was 6 minutes. By starting a discussion about ward rounds we aim to align the process with the broader values of the organisation. Ward rounds can be the cornerstone of delivering safe, clean and personal care and measuring this process is vital to understanding efforts to improve them.

Influence of blade tip rounding on tip leakage vortex cavitation of axial flow pump

NASA Astrophysics Data System (ADS)

Wu, S. Q.; Shi, W. D.; Zhang, D. S.; Yao, J.; Cheng, C.

2013-12-01

Tip leakage flow in axial flow pumps is mainly caused by the tip clearance, which is the main cause of tip leakage vortex cavitation and blade tip cavitation erosion. In order to improve tip clearance flow and reduce TLV cavitation, four schemes were adopted to the round blade tip. These are: no tip rounding, one time tip clearance tip rounding, two times tip clearance tip rounding, four times tip clearance tip rounding. Using SST k-ω turbulence model and Zwart cavitation model in CFX software, this simulation obtained four kinds of inner flow field results. The numerical results indicated that with the increase of r*, NPSHc gradually increased and the cavitation performance reduced. However, corner vortex was eliminated so that cavitation in gap was restrained. But TLV vorticity increased and cavitation's range here had a little expansion. Combined with the research of this paper and the different analyses of four schemes, we recommend adopting the two times of the tip clearance rounding.

Clinical librarian attendance at general surgery quality of care rounds (Morbidity and Mortality Conference).

PubMed

Greco, Elisa; Englesakis, Marina; Faulkner, Amy; Trojan, Boguslawa; Rotstein, Lorne E; Urbach, David R

2009-09-01

Quality of Care rounds, also known as Mortality and Morbidity conferences, are an important and time-honored forum for quality audit in clinical surgery services. The authors created a modification to their hospital's Quality of Care rounds by incorporating a clinical librarian, who assisted residents in conducting literature reviews related to clinical topics discussed during the rounds. The objective of this article is to describe the authors' experience with this intervention. The clinical librarian program has greatly improved the Quality of Care rounds by aiding in literature searches and quality of up-to-date, evidence-based presentations.

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

37 CFR 1.701 - Extension of patent term due to examination delay under the Uruguay Round Agreements Act...

Code of Federal Regulations, 2012 CFR

2012-07-01

... to examination delay under the Uruguay Round Agreements Act (original applications, other than... Examination Delay § 1.701 Extension of patent term due to examination delay under the Uruguay Round Agreements... phrase is used in 35 U.S.C. 154(b)(2) as amended by section 532(a) of the Uruguay Round Agreements Act...

17 CFR 249.11 - Form R31 for reporting covered sales and covered round turn transactions under section 31 of the...

Code of Federal Regulations, 2013 CFR

2013-04-01

... sales and covered round turn transactions under section 31 of the Act. 249.11 Section 249.11 Commodity... Securities Exchanges § 249.11 Form R31 for reporting covered sales and covered round turn transactions under... number of round turn transactions in security futures that occurred on the exchange, had a charge date in...

17 CFR 249.11 - Form R31 for reporting covered sales and covered round turn transactions under section 31 of the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... sales and covered round turn transactions under section 31 of the Act. 249.11 Section 249.11 Commodity... Securities Exchanges § 249.11 Form R31 for reporting covered sales and covered round turn transactions under... number of round turn transactions in security futures that occurred on the exchange, had a charge date in...

37 CFR 1.701 - Extension of patent term due to examination delay under the Uruguay Round Agreements Act...

Code of Federal Regulations, 2011 CFR

2011-07-01

... to examination delay under the Uruguay Round Agreements Act (original applications, other than... Examination Delay § 1.701 Extension of patent term due to examination delay under the Uruguay Round Agreements... phrase is used in 35 U.S.C. 154(b)(2) as amended by section 532(a) of the Uruguay Round Agreements Act...

17 CFR 249.11 - Form R31 for reporting covered sales and covered round turn transactions under section 31 of the...

Code of Federal Regulations, 2012 CFR

2012-04-01

... sales and covered round turn transactions under section 31 of the Act. 249.11 Section 249.11 Commodity... Securities Exchanges § 249.11 Form R31 for reporting covered sales and covered round turn transactions under... number of round turn transactions in security futures that occurred on the exchange, had a charge date in...

17 CFR 249.11 - Form R31 for reporting covered sales and covered round turn transactions under section 31 of the...

Code of Federal Regulations, 2011 CFR

2011-04-01

... sales and covered round turn transactions under section 31 of the Act. 249.11 Section 249.11 Commodity... Securities Exchanges § 249.11 Form R31 for reporting covered sales and covered round turn transactions under... number of round turn transactions in security futures that occurred on the exchange, had a charge date in...

17 CFR 249.11 - Form R31 for reporting covered sales and covered round turn transactions under section 31 of the...

Code of Federal Regulations, 2014 CFR

2014-04-01

... sales and covered round turn transactions under section 31 of the Act. 249.11 Section 249.11 Commodity... Securities Exchanges § 249.11 Form R31 for reporting covered sales and covered round turn transactions under... number of round turn transactions in security futures that occurred on the exchange, had a charge date in...

37 CFR 1.701 - Extension of patent term due to examination delay under the Uruguay Round Agreements Act...

Code of Federal Regulations, 2010 CFR

2010-07-01

... to examination delay under the Uruguay Round Agreements Act (original applications, other than... Examination Delay § 1.701 Extension of patent term due to examination delay under the Uruguay Round Agreements... phrase is used in 35 U.S.C. 154(b)(2) as amended by section 532(a) of the Uruguay Round Agreements Act...

Preparing staff for intentional rounding: a process yielding success on a general surgical unit.

PubMed

Patterson, Lisa M

2014-01-01

Intentional rounding is a strategicway to improve patient care through decreasing falls and hospital-acquired pressure ulcers, while increasing patient satisfaction. On the basis of literature reviews and discussions with nurses on units that pilot-tested intentional rounding, useful strategies emerged. This article will provide information about intentional rounding, a means for planning implementation, and the results of evaluating its implementation.

Final screening round of the NELSON lung cancer screening trial: the effect of a 2.5-year screening interval.

PubMed

Yousaf-Khan, Uraujh; van der Aalst, Carlijn; de Jong, Pim A; Heuvelmans, Marjolein; Scholten, Ernst; Lammers, Jan-Willem; van Ooijen, Peter; Nackaerts, Kristiaan; Weenink, Carla; Groen, Harry; Vliegenthart, Rozemarijn; Ten Haaf, Kevin; Oudkerk, Matthijs; de Koning, Harry

2017-01-01

In the USA annual lung cancer screening is recommended. However, the optimal screening strategy (eg, screening interval, screening rounds) is unknown. This study provides results of the fourth screening round after a 2.5-year interval in the Dutch-Belgian Lung Cancer Screening trial (NELSON). Europe's largest, sufficiently powered randomised lung cancer screening trial was designed to determine whether low-dose CT screening reduces lung cancer mortality by ≥25% compared with no screening after 10 years of follow-up. The screening arm (n=7915) received screening at baseline, after 1 year, 2 years and 2.5 years. Performance of the NELSON screening strategy in the final fourth round was evaluated. Comparisons were made between lung cancers detected in the first three rounds, in the final round and during the 2.5-year interval. In round 4, 46 cancers were screen-detected and there were 28 interval cancers between the third and fourth screenings. Compared with the second round screening (1-year interval), in round 4 a higher proportion of stage IIIb/IV cancers (17.3% vs 6.8%, p=0.02) and higher proportions of squamous-cell, bronchoalveolar and small-cell carcinomas (p=0.001) were detected. Compared with a 2-year interval, the 2.5-year interval showed a higher non-significant stage distribution (stage IIIb/IV 17.3% vs 5.2%, p=0.10). Additionally, more interval cancers manifested in the 2.5-year interval than in the intervals of previous rounds (28 vs 5 and 28 vs 19). A 2.5-year interval reduced the effect of screening: the interval cancer rate was higher compared with the 1-year and 2-year intervals, and proportion of advanced disease stage in the final round was higher compared with the previous rounds. ISRCTN63545820. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Patterns of interaction during rounds: implications for work-based learning.

PubMed

Walton, Jennifer M; Steinert, Yvonne

2010-06-01

OBJECTIVES In-patient rounds are a major educational and patient care-related activity in teaching hospitals. This exploratory study was conducted to gain better understanding of team interactions during rounds and to assess student and resident perceptions of the utility of this activity. METHODS Data were collected by a non-participant observer using a novel, personal digital assistant (PDA)-based data collection system. Medical students and residents completed surveys related to the utility of rounds for patient care, education and ward administration. Analyses included descriptive and correlational statistics and the use of social network analysis to describe and measure patterns of interaction. RESULTS Eighteen different rounds were observed. On average, rounds were 106 minutes long and included discussion of 22.1 patients. Three different patterns of verbal interaction were observed. In most cases, the attending physician was most talkative and many students and residents spoke infrequently. More time was devoted to patients discussed earlier in the round, regardless of diagnosis. Observed teaching was primarily factual and teacher-centred. Attending physician-dominated sessions were rated more highly for educational utility than those that were more interactive. CONCLUSIONS In-patient rounds are an example of an opportunity for powerful work-based learning. In this study, we used a novel method of observational data collection and analysis to examine this activity and found that it may not always live up to its educational potential. Rounds are time-consuming and are generally dominated by the attending physician. Individuals who are not directly involved in a case are often minimally involved. Participants felt that rounds were most useful for patient care and, contrary to expectations, students and residents viewed attending physician-dominated sessions as more educational. To improve the educational impact of rounds, the order of patient discussion should be planned to highlight specific teaching points, preceptors (teaching staff) should ensure that all team members are actively engaged in the process and learning should be made explicit.

Does Robotic Telerounding Enhance Nurse-Physician Collaboration Satisfaction About Care Decisions?

PubMed

Bettinelli, Michele; Lei, Yuxiu; Beane, Matt; Mackey, Caleb; Liesching, Timothy N

2015-08-01

Delivering healthcare using remote robotic telepresence is an evolving practice in medical and surgical intensive critical care units and will likely have varied implications for work practices and working relationships in intensive care units. Our study assessed the nurse-physician collaboration satisfaction about care decisions from surgical intensive critical care nurses during remote robotic telepresence night rounds in comparison with conventional telephone night rounds. This study used a randomized trial to test whether robotic telerounding enhances the nurse-physician collaboration satisfaction about care decisions. A physician randomly used either the conventional telephone or the RP-7 robot (InTouch(®) Health, Santa Barbara, CA) to perform nighttime rounding in a surgical intensive care unit. The Collaboration and Satisfaction About Care Decisions (CSACD) survey instrument was used to measure the nurse-physician collaboration. The CSACD scores were compared using the signed-rank test with a significant p value of ≤0.05. From December 1, 2011 to December 13, 2012, 20 off-shift nurses submitted 106 surveys during telephone rounds and 108 surveys during robot rounds. The median score of surveys during robot rounds was slightly but not significantly higher than telephone rounds (51.3 versus 50.5; p=0.3). However, the CSACD score was significantly increased from baseline with robot rounds (51.3 versus 43.0; p=0.01), in comparison with telephone rounds (50.5 versus 43.0; p=0.09). The mediators, including age, working experience, and robot acceptance, were not significantly (p>0.1) correlated with the CSACD score difference (robot versus telephone). Robot rounding in the intensive care unit was comparable but not superior to the telephone in regard to the nurse-physician collaboration and satisfaction about care decision. The working experience and technology acceptance of intensive care nurses did not contribute to the preference of night shift rounding method from the aspect of collaboration with the physician about care decision-making.

Effects of efforts to optimise morbidity and mortality rounds to serve contemporary quality improvement and educational goals: a systematic review.

PubMed

Smaggus, Andrew; Mrkobrada, Marko; Marson, Alanna; Appleton, Andrew

2018-01-01

The quality and safety movement has reinvigorated interest in optimising morbidity and mortality (M&M) rounds. We performed a systematic review to identify effective means of updating M&M rounds to (1) identify and address quality and safety issues, and (2) address contemporary educational goals. Relevant databases (Medline, Embase, PubMed, Education Resource Information Centre, Cumulative Index to Nursing and Allied Health Literature, Healthstar, and Global Health) were searched to identify primary sources. Studies were included if they (1) investigated an intervention applied to M&M rounds, (2) reported outcomes relevant to the identification of quality and safety issues, or educational outcomes relevant to quality improvement (QI), patient safety or general medical education and (3) included a control group. Study quality was assessed using the Medical Education Research Study Quality Instrument and Newcastle-Ottawa Scale-Education instruments. Given the heterogeneity of interventions and outcome measures, results were analysed thematically. The final analysis included 19 studies. We identified multiple effective strategies (updating objectives, standardising elements of rounds and attaching rounds to a formal quality committee) to optimise M&M rounds for a QI/safety purpose. These efforts were associated with successful integration of quality and safety content into rounds, and increased implementation of QI interventions. Consistent effects on educational outcomes were difficult to identify, likely due to the use of methodologies ill-fitted for educational research. These results are encouraging for those seeking to optimise the quality and safety mission of M&M rounds. However, the inability to identify consistent educational effects suggests the investigation of M&M rounds could benefit from additional methodologies (qualitative, mixed methods) in order to understand the complex mechanisms driving learning at M&M rounds. © 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.

The U. S. transportation sector in the year 2030: results of a two-part Delphi survey.

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

Morrison, G.; Stephens, T.S.; Univ. of California at Davis)

2011-10-11

A two-part Delphi Survey was given to transportation experts attending the Asilomar Conference on Transportation and Energy in August, 2011. The survey asked respondents about trends in the US transportation sector in 2030. Topics included: alternative vehicles, high speed rail construction, rail freight transportation, average vehicle miles traveled, truck versus passenger car shares, vehicle fuel economy, and biofuels in different modes. The survey consisted of two rounds -- both asked the same set of seven questions. In the first round, respondents were given a short introductory paragraph about the topic and asked to use their own judgment in their responses.more » In the second round, the respondents were asked the same questions, but were also given results from the first round as guidance. The survey was sponsored by Argonne National Lab (ANL), the National Renewable Energy Lab (NREL), and implemented by University of California at Davis, Institute of Transportation Studies. The survey was part of the larger Transportation Energy Futures (TEF) project run by the Department of Energy, Office of Energy Efficiency and Renewable Energy. Of the 206 invitation letters sent, 94 answered all questions in the first round (105 answered at least one question), and 23 of those answered all questions in the second round. 10 of the 23 second round responses were at a discussion section at Asilomar, while the remaining were online. Means and standard deviations of responses from Round One and Two are given in Table 1 below. One main purpose of Delphi surveys is to reduce the variance in opinions through successive rounds of questioning. As shown in Table 1, the standard deviations of 25 of the 30 individual sub-questions decreased between Round One and Round Two, but the decrease was slight in most cases.« less

Microbial shaping of sedimentary wrinkle structures

NASA Astrophysics Data System (ADS)

Mariotti, G.; Pruss, S. B.; Perron, J. T.; Bosak, T.

2014-10-01

Wrinkle structures on sandy bed surfaces were present in some of the earliest sedimentary environments, but are rare in modern environments. These enigmatic millimetre- to centimetre-scale ridges or pits are particularly common in sediments that harbour trace fossils and imprints of early animals, and appeared in the aftermath of some large mass extinctions. Wrinkle structures have been interpreted as possible remnants of microbial mats, but the formation mechanism and associated palaeoenvironmental and palaeoecological implications of these structures remain debated. Here we show that microbial aggregates can form wrinkle structures on a bed of bare sand in wave tank experiments. Waves with a small orbital amplitude at the bed surface do not move sand grains directly. However, they move millimetre-size, light microbial fragments and thereby produce linear sand ridges and rounded scour pits at the wavelengths observed in nature within hours. We conclude that wrinkle structures are morphological biosignatures that form at the sediment-water interface in wave-dominated environments, and not beneath microbial mats as previously thought. During early animal evolution, grazing by eukaryotic organisms may have temporarily increased the abundance of microbial fragments and thus the production of wrinkle structures.

Methanogenic degradation of acetone by an enrichment culture.

PubMed

Platen, H; Schink, B

1987-01-01

An anaerobic enrichment culture degraded 1 mol of acetone to 2 mol of methane and 1 mol of carbon dioxide. Two microorganisms were involved in this process, a filament-forming rod similar to Methanothrix sp. and an unknown rod with round to slightly pointed ends. Both organisms formed aggregates up to 300 micron in diameter. No fluorescing bacteria were observed indicating that hydrogen or formate-utilizing methanogens are not involved in this process. Acetate was utilized in this culture by the Methanothrix sp. Inhibition of methanogenesis by bromoethanesulfonic acid or acetylene decreased the acetone degradation rate drastically and led to the formation of 2 mol acetate per mol of acetone. Streptomycin completely inhibited acetone degradation, and neither acetate nor methane was formed. 14CO2 was incorporated exclusively into the C-1 atom of acetate indicating that acetone is degraded via carboxylation to an acetoacetate residue. It is concluded that acetone is degraded by a coculture of an eubacterium and an acetate-utilizing methanogen and that acetate is the only intermediate transferred between both. The energetical problems of the eubacterium converting acetone to acetate are discussed.

Parkinson-causing α-synuclein missense mutations shift native tetramers to monomers as a mechanism for disease initiation

PubMed Central

Dettmer, Ulf; Newman, Andrew J.; Soldner, Frank; Luth, Eric S.; Kim, Nora C.; von Saucken, Victoria E.; Sanderson, John B.; Jaenisch, Rudolf; Bartels, Tim; Selkoe, Dennis

2015-01-01

β-Sheet-rich α-synuclein (αS) aggregates characterize Parkinson's disease (PD). αS was long believed to be a natively unfolded monomer, but recent work suggests it also occurs in α-helix-rich tetramers. Crosslinking traps principally tetrameric αS in intact normal neurons, but not after cell lysis, suggesting a dynamic equilibrium. Here we show that freshly biopsied normal human brain contains abundant αS tetramers. The PD-causing mutation A53T decreases tetramers in mouse brain. Neurons derived from an A53T patient have decreased tetramers. Neurons expressing E46K do also, and adding 1-2 E46K-like mutations into the canonical αS repeat motifs (KTKEGV) further reduces tetramers, decreases αS solubility and induces neurotoxicity and round inclusions. The other three fPD missense mutations likewise decrease tetramer:monomer ratios. The destabilization of physiological tetramers by PD-causing missense mutations and the neurotoxicity and inclusions induced by markedly decreasing tetramers suggest that decreased α-helical tetramers and increased unfolded monomers initiate pathogenesis. Tetramer-stabilizing compounds should prevent this. PMID:26076669

Insight into the geology of the East Antarctic hinterland: a study of sediment inclusions from ice cores of the Lake Vostok borehole

USGS Publications Warehouse

Leitchenkov, G.L.; Belyatsky, B.V.; Rodionov, N.V.; Sergeev, S.A.

2007-01-01

refrozen from the lake water. This ice layer contains random sediment inclusions, eight of which have been studied using state-of the-art analytical techniques. Six inclusions comprise soft aggregates consisting mainly of clay-mica minerals and micron-sized quartz grains while two others are solid clasts of fine-grained cemented rocks. The largest rock clast consists of poorly-rounded quartz and minor amounts of accessory minerals and is classified as quartzose siltstone. More than twenty grains of zircon and monazite have been identified in this siltstone and dated by SIMS SHRIMP-II. Two age clusters have been recognized for these detrital grains, in the ranges 0.8−1.2 Ga and 1.6−1.8 Ga. The compositions of the rock clasts suggest that the bedrock situated to the west of Lake Vostok is sedimentary. The age data on the detrital accessory minerals suggest that the provenance of these sedimentary rocks − the Gamburtsev Mountains and Vostok Subglacial Highlands, is mainly represented by Paleoproterozoic and MesoproterozoicNeoproterozoic crustal provinces

The Pathogenesis of Human Cervical Epithelium Cells Induced by Interacting with Trichomonas vaginalis

PubMed Central

Lin, Wei-Chen; Chang, Wei-Ting; Chang, Tsuey-Yu; Shin, Jyh-Wei

2015-01-01

Background Trichomonas vaginalis is a protozoan parasite that occurs in the urogenital-vaginal tract and is the primary causative agent of trichomoniasis, a common sexually transmitted disease in humans. The aggregation of this protozoan tends to destroy epithelial cells and induce pathogenesis. Principal Findings This study cultured T. vaginalis and human cervical epithelial cells (Z172) under the same conditions in the experiments. Following co-culturing for ten hours, the protozoans became attached to Z172, such that the cells presented a round shape and underwent shrinkage. Time-lapse recording and flow cytometry on interacted Z172 revealed that 70% had been disrupted, 18% presented a necrosis-like morphology and 8% showed signs of apoptosis. Gene expression profiling revealed in the seven inflammatory Z172 genes as well as in T. vaginalis genes that code for adhesion proteins 65 and 65-1. Significance These results suggest that cytopathogenic effects progress while Z172 is in contact with T. vaginalis, and the resulting morphological changes can be categorized as disruption. PMID:25901354

An Energy Centric Cluster-Based Routing Protocol for Wireless Sensor Networks.

PubMed

Hosen, A S M Sanwar; Cho, Gi Hwan

2018-05-11

Clustering is an effective way to prolong the lifetime of a wireless sensor network (WSN). The common approach is to elect cluster heads to take routing and controlling duty, and to periodically rotate each cluster head's role to distribute energy consumption among nodes. However, a significant amount of energy dissipates due to control messages overhead, which results in a shorter network lifetime. This paper proposes an energy-centric cluster-based routing mechanism in WSNs. To begin with, cluster heads are elected based on the higher ranks of the nodes. The rank is defined by residual energy and average distance from the member nodes. With the role of data aggregation and data forwarding, a cluster head acts as a caretaker for cluster-head election in the next round, where the ranks' information are piggybacked along with the local data sending during intra-cluster communication. This reduces the number of control messages for the cluster-head election as well as the cluster formation in detail. Simulation results show that our proposed protocol saves the energy consumption among nodes and achieves a significant improvement in the network lifetime.

An Energy Centric Cluster-Based Routing Protocol for Wireless Sensor Networks

PubMed Central

Hosen, A. S. M. Sanwar; Cho, Gi Hwan

2018-01-01

Clustering is an effective way to prolong the lifetime of a wireless sensor network (WSN). The common approach is to elect cluster heads to take routing and controlling duty, and to periodically rotate each cluster head’s role to distribute energy consumption among nodes. However, a significant amount of energy dissipates due to control messages overhead, which results in a shorter network lifetime. This paper proposes an energy-centric cluster-based routing mechanism in WSNs. To begin with, cluster heads are elected based on the higher ranks of the nodes. The rank is defined by residual energy and average distance from the member nodes. With the role of data aggregation and data forwarding, a cluster head acts as a caretaker for cluster-head election in the next round, where the ranks’ information are piggybacked along with the local data sending during intra-cluster communication. This reduces the number of control messages for the cluster-head election as well as the cluster formation in detail. Simulation results show that our proposed protocol saves the energy consumption among nodes and achieves a significant improvement in the network lifetime. PMID:29751663

Characterisation of Suspension Precipitated Nanocrystalline Hydroxyapatite Powders

NASA Astrophysics Data System (ADS)

Mallik, P. K.; Swain, P. K.; Patnaik, S. C.

2016-02-01

Hydroxyapatite (HA) is a well-known biomaterial for coating on femoral implants, filling of dental cavity and scaffold for tissue replacement. Hydroxyapatite possess limited load bearing capacity due to their brittleness. In this paper, the synthesis of nanocrystalline hydroxyapatite powders was prepared by dissolving calcium oxide in phosphoric acid, followed by addition of ammonia liquor in a beaker. The prepared solution was stirred by using magnetic stirrer operated at temperature of 80°C for an hour. This leads to the formation of hydroxyapatite precipitate. The precipitate was dried in oven for overnight at 100°C. The dried agglomerated precipitate was calcined at 800°C in conventional furnace for an hour. The influence of calcium oxide concentration and pH on the resulting precipitates was studied using BET, XRD and SEM. As result, a well-defined sub-rounded morphology of powders size of ∼41 nm was obtained with a salt concentration of 0.02 M. Finally, it can be concluded that small changes in the reaction conditions led to large changes in final size, shape and degree of aggregation of the hydroxyapatite particles.

Coastal leatherback turtles reveal conservation hotspot

PubMed Central

Robinson, Nathan J.; Morreale, Stephen J.; Nel, Ronel; Paladino, Frank V.

2016-01-01

Previous studies have shown that the world’s largest reptile – the leatherback turtle Dermochelys coriacea – conducts flexible foraging migrations that can cover thousands of kilometres between nesting sites and distant foraging areas. The vast distances that may be travelled by migrating leatherback turtles have greatly complicated conservation efforts for this species worldwide. However, we demonstrate, using a combination of satellite telemetry and stable isotope analysis, that approximately half of the nesting leatherbacks from an important rookery in South Africa do not migrate to distant foraging areas, but rather, forage in the coastal waters of the nearby Mozambique Channel. Moreover, this coastal cohort appears to remain resident year-round in shallow waters (<50 m depth) in a relatively fixed area. Stable isotope analyses further indicate that the Mozambique Channel also hosts large numbers of loggerhead turtles Caretta caretta. The rare presence of a resident coastal aggregation of leatherback turtles not only presents a unique opportunity for conservation, but alongside the presence of loggerhead turtles and other endangered marine megafauna in the Mozambique Channel, highlights the importance of this area as a marine biodiversity hotspot. PMID:27886262

Atmospheric pulsed laser deposition of plasmonic nanoparticle films of silver with flowing gas and flowing atmospheric plasma

NASA Astrophysics Data System (ADS)

Khan, T. M.; Pokle, A.; Lunney, J. G.

2018-04-01

Two methods of atmospheric pulsed laser deposition of plasmonic nanoparticle films of silver are described. In both methods the ablation plume, produced by a 248 nm, 20 ns excimer laser in gas, is strongly confined near the target and forms a nanoparticle aerosol. For both the flowing gas, and the atmospheric plasma from a dielectric barrier discharge plasma source, the aerosol is entrained in the flow and carried to a substrate for deposition. The nanoparticle films produced by both methods were examined by electron microscopy and optical absorption spectroscopy. With plasma assistance, the deposition rate was significantly enhanced and the film morphology altered. With argon gas, isolated nanoparticles of 20 nm size were obtained, whereas in argon plasma, the nanoparticles are aggregated in clusters of 90 nm size. Helium gas also leads to the deposition of isolated nanoparticles, but with helium plasma, two populations of nanoparticles are observed: one of rounded particles with a mean size of 26 nm and the other of faceted particles with a mean size 165 nm.

Developing non-technical ward-round skills.

PubMed

Harvey, Rachel; Mellanby, Edward; Dearden, Effie; Medjoub, Karima; Edgar, Simon

2015-10-01

Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform. There is evidence that newly qualified doctors are not adequately prepared by their undergraduate experiences for this task. The aim of this study was to analyse the challenges pertaining to non-technical skills that students would face during ward rounds, and to create a model that facilitates the transition from medical student to doctor. A total of 217 final-year medical students completed a simulated ward round. Free-text responses were analysed using template analysis applying an a priori template developed from the literature by the research team. This drew on the generic categories of non-technical skills suggested by Flin et al. Ninety-seven per cent of students agreed or strongly agreed that the simulated ward round improved their insight into the challenges of ward rounds and their perceived ability to work efficiently as an active member of the ward round. The responding students (206) submitted written feedback describing the learning that they planned to use: 800 learning points were recorded, and all could be categorised into one of seven non-technical skills. Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform We believe that improved task efficiency and insight into the challenges of the ward round gained by medical students will lead to an enhancement in performance during clinical rounds, and will have a positive impact on patient safety. We would suggest that undergraduate medical schools consider this model in the preparation for the clinical practice element of the curriculum. © 2015 John Wiley & Sons Ltd.

Medical Student Self-Efficacy with Family-Centered Care during Bedside Rounds

PubMed Central

Young, Henry N.; Schumacher, Jayna B.; Moreno, Megan A.; Brown, Roger L.; Sigrest, Ted D.; McIntosh, Gwen K.; Schumacher, Daniel J.; Kelly, Michelle M.; Cox, Elizabeth D.

2012-01-01

Purpose Factors that support self-efficacy must be understood in order to foster family-centered care (FCC) during rounds. Based on social cognitive theory, this study examined (1) how 3 supportive experiences (observing role models, having mastery experiences, and receiving feedback) influence self-efficacy with FCC during rounds and (2) whether the influence of these supportive experiences was mediated by self-efficacy with 3 key FCC tasks (relationship building, exchanging information, and decision making). Method Researchers surveyed 184 students during pediatric clerkship rotations during the 2008–2011 academic years. Surveys assessed supportive experiences and students’ self-efficacy with FCC during rounds and with key FCC tasks. Measurement models were constructed via exploratory and confirmatory factor analyses. Composite indicator structural equation (CISE) models evaluated whether supportive experiences influenced self-efficacy with FCC during rounds and whether self-efficacy with key FCC tasks mediated any such influences. Results Researchers obtained surveys from 172 eligible students who were 76% (130) White and 53% (91) female. Observing role models and having mastery experiences supported self-efficacy with FCC during rounds (each p<0.01), while receiving feedback did not. Self-efficacy with two specific FCC tasks, relationship building and decision making (each p < 0.05), mediated the effects of these two supportive experiences on self-efficacy with FCC during rounds. Conclusions Observing role models and having mastery experiences foster students’ self-efficacy with FCC during rounds, operating through self-efficacy with key FCC tasks. Results suggest the importance of helping students gain self-efficacy in key FCC tasks before the rounds experience and helping educators implement supportive experiences during rounds. PMID:22534602

Medical ward round competence in internal medicine - an interview study towards an interprofessional development of an Entrustable Professional Activity (EPA).

PubMed

Wölfel, Teresa; Beltermann, Esther; Lottspeich, Christian; Vietz, Elisa; Fischer, Martin R; Schmidmaier, Ralf

2016-07-11

The medical ward round is a central but complex activity that is of relevance from the first day of work. However, difficulties for young doctors have been reported. Instruction of ward round competence in medical curricula is hampered by the lack of a standardized description of the procedure. This paper aims to identify and describe physicians' tasks and relevant competences for conducting a medical ward round on the first day of professional work. A review of recent literature revealed known important aspects of medical ward rounds. These were used for the development of a semi-structured interview schedule. Medical ward round experts working at different hospitals were interviewed. The sample consisted of 14 ward physicians (M = 8.82 years of work experience) and 12 nurses (M = 14.55 years of work experience) working in different specializations of internal medicine. All interviews were audiotaped, fully transcribed, and analyzed using an inductive-deductive coding scheme. Nine fields of competences with 18 related sub-competences and 62 observable tasks were identified as relevant for conducting a medical ward round. Over 70 % of the experts named communication, collaborative clinical reasoning and organization as essential competences. Deeper analysis further unveiled the importance of self-management, management of difficult situations, error management and teamwork. The study is the first to picture ward round competences and related tasks in detail and to define an EPA "Conducting an internal medicine ward round" based on systematic interprofessional expert interviews. It thus provides a basis for integration of ward round competences in the medical curricula in an evidence based manner and gives a framework for the development of instructional intervention studies and comparative studies in other medical fields.

DUX4 Immunohistochemistry Is a Highly Sensitive and Specific Marker for CIC-DUX4 Fusion-positive Round Cell Tumor.

PubMed

Siegele, Bradford; Roberts, Jon; Black, Jennifer O; Rudzinski, Erin; Vargas, Sara O; Galambos, Csaba

2017-03-01

The histologic differential diagnosis of pediatric and adult round cell tumors is vast and includes the recently recognized entity CIC-DUX4 fusion-positive round cell tumor. The diagnosis of CIC-DUX4 tumor can be suggested by light microscopic and immunohistochemical features, but currently, definitive diagnosis requires ancillary genetic testing such as conventional karyotyping, fluorescence in situ hybridization, or molecular methods. We sought to determine whether DUX4 expression would serve as a fusion-specific immunohistochemical marker distinguishing CIC-DUX4 tumor from potential histologic mimics. A cohort of CIC-DUX4 fusion-positive round cell tumors harboring t(4;19)(q35;q13) and t(10;19)(q26;q13) translocations was designed, with additional inclusion of a case with a translocation confirmed to involve the CIC gene without delineation of the partner. Round cell tumors with potentially overlapping histologic features were also collected. Staining with a monoclonal antibody raised against the C-terminus of the DUX4 protein was applied to all cases. DUX4 immunohistochemistry exhibited diffuse, crisp, strong nuclear staining in all CIC-DUX4 fusion-positive round cell tumors (5/5, 100% sensitivity), and exhibited negative staining in nuclei of all of the other tested round cell tumors, including 20 Ewing sarcomas, 1 Ewing-like sarcoma, 11 alveolar rhabdomyosarcomas, 9 embryonal rhabdomyosarcomas, 12 synovial sarcomas, 7 desmoplastic small round cell tumors, 3 malignant rhabdoid tumors, 9 neuroblastomas, and 4 clear cell sarcomas (0/76, 100% specificity). Thus, in our experience, DUX4 immunostaining distinguishes CIC-DUX4 tumors from other round cell mimics. We recommend its use when CIC-DUX4 fusion-positive round cell tumor enters the histologic differential diagnosis.

The cross-sectional shape of the fourfold semitendinosus tendon is oval, not round.

PubMed

Oshima, Takeshi; Nakase, Junsuke; Numata, Hitoaki; Takata, Yasushi; Tsuchiya, Hiroyuki

2016-12-01

The looped side of the semitendinosus tendon (ST) graft (i.e., the side inserted into the femoral tunnel during anterior cruciate ligament reconstruction) appears to be oval rather than round. The purpose of this study was to investigate the cross section of the fourfold semitendinosus tendon graft and, more specifically, the differences in pressure exerted by a rounded rectangular tunnel versus a round femoral tunnel. Seven STs were harvested from cadaveric knees and a fourfold ST graft was made. Aluminum cubes with round or rectangular tunnels containing four-way pressure-sensitive conductive sensors (vertically and bilaterally) were used. The area of both cubes was the same. The graft was inserted into the tunnels 15 mm from the looped edge. After measuring pressure, the graft was fixed using ultraviolet-curing acrylic resin and was cut at 7.5 mm and 15 mm from the lapel edge. The area, axes for the best fitting ellipse of the cross-section, and ellipticity of the axes were measured. In the round tunnel, the mean contact pressure was 287.0 ± 136.7 gf at the bilateral sensor; there was no contact pressure detected by the vertical sensor. In the rounded rectangular tunnel, the mean contact pressure was 260.9 ± 186.4 gf at the bilateral sensor and 352.9 ± 49.5 gf at the vertical sensor. Ellipticity was 1.25 ± 0.13 at 7.5 mm, and 1.17 ± 0.07 at 15 mm from the lapel edge of the graft. The cross-sectional shape of the fourfold ST graft was not round, but oval. Moreover, the rounded rectangular tunnel was more fitted to the graft than the round tunnel.

Lifestyle predictors for non-participation and outcome in the second round of faecal immunochemical test in colorectal cancer screening.

PubMed

Knudsen, Markus Dines; Berstad, Paula; Hjartåker, Anette; Gulichsen, Elisabeth Haagensen; Hoff, Geir; de Lange, Thomas; Bernklev, Tomm; Botteri, Edoardo

2017-08-08

To reduce colorectal cancer (CRC) mortality through population-based screening programmes using faecal tests, it is important that individuals continue to participate in the repeated rounds of screening. We aimed to identify lifestyle predictors for discontinuation of faecal immunochemical test (FIT) screening after the first round, as well as lifestyle predictors for colorectal neoplasia detected in the second-round FIT screening. In this longitudinal study, we invited 6959 individuals aged 50-74 years from south-east Norway for a first round of FIT screening and to complete a self-reported lifestyle questionnaire on demographic factors, body mass index (BMI, kg m -2 ), smoking habits, physical activity, consumption of alcohol and dietary items. Two years later, we estimated the associations between these factors, non-participation and screening results in the second round of FIT screening using adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Of the 3114 responders to the questionnaire who completed the first-round FIT and who were invited to participate in second-round FIT screening, 540 (17%) did not participate. The OR and (95% CI) for discontinuation of FIT screening after the first round was 1.61 (1.24-2.10) for current smoking compared with non-smoking; 2.01 (1.25-3.24) for BMI⩾35 kg m -2 compared with BMI 16.9-24.9 kg m -2 and 0.70 (0.52-0.94) for physical activity in the third quartile vs the first. Among participants, smoking, high BMI and high alcohol consumption were associated with an increased odds of detecting colorectal neoplasia (n=107). These results may indicate that Norwegian FIT screening participants who discontinue after the first round have lifestyle behaviours associated with increased risk of CRC.

Spatial anatomy of the round ligament, gallbladder, and intrahepatic vessels in patients with right-sided round ligament of the liver.

PubMed

Ibukuro, Kenji; Takeguchi, Takaya; Fukuda, Hozumi; Abe, Shoko; Tobe, Kimiko

2016-11-01

To analyze the vascular structure of the liver in patients with a right-sided round ligament. We reviewed 16 patients with a right-sided round ligament and 3 polysplenia and situs inversus patients with a left-sided round ligament who underwent multidetector row CT with contrast media. The patient population consisted of 13 men and 6 women (mean 62 years). We analyzed the axial and volume-rendered images for the location of the round ligament, gallbladder, portal veins, hepatic veins, and hepatic artery. The following imaging findings for the patients with polysplenia and situs inversus were horizontally reversed. The prevalence of a right-sided round ligament with and without polysplenia was 75 and 0.11 %, respectively. The gallbladder was located to the right, below, and left of the round ligament in 27.7, 38.8 and 33.3 %, respectively. Independent branching of the right posterior portal vein was noted in 57.8 %. PV4 was difficult to identify in 36.8 %. The middle hepatic vein was located to the left of the round ligament. Two branching patterns for the lateral and medial branches of the right anterior hepatic artery were noted: the common (44.4 %) and separated types (55.5 %). Both of the right anterior hepatic artery and portal vein ramified into two segments; the lateral segment with many branches and the medial segment with a few branches. The right-sided round ligament divided the right anterior section into the lateral and medial segments based on the portal vein and hepatic artery anatomy.

Shaped versus Round Implants in Breast Reconstruction: A Multi-Institutional Comparison of Surgical and Patient-Reported Outcomes.

PubMed

Khavanin, Nima; Clemens, Mark W; Pusic, Andrea L; Fine, Neil A; Hamill, Jennifer B; Kim, H Myra; Qi, Ji; Wilkins, Edwin G; Kim, John Y S

2017-05-01

Since the 2012 approval of shaped implants, their use in breast reconstruction has increased in the United States. However, large-scale comparisons of complications and patient-reported outcomes are lacking. The authors endeavored to compare surgical and patient-reported outcomes across implant types. The Mastectomy Reconstruction Outcomes Consortium database was queried for expander/implant reconstructions with at least 1-year postexchange follow-up (mean, 18.5 months). Outcomes of interest included postoperative complications, 1-year revisions, and patient-reported outcomes. Bivariate and mixed-effects regression analyses evaluated the effect of implant type on patient outcomes. Overall, 822 patients (73.5 percent) received round and 297 patients (26.5 percent) received shaped implants. Patients undergoing unilateral reconstructions with round implants underwent more contralateral symmetry procedures, including augmentations (round, 18.7 percent; shaped, 6.8 percent; p = 0.003) and reductions (round, 32.2 percent; shaped, 20.5 percent; p = 0.019). Shaped implants were associated with higher rates of infection (shaped, 6.1 percent; round, 2.3 percent; p = 0.002), that remained significant after multivariable adjustment. Other complication rates did not differ significantly between cohorts. Round and shaped implants experienced similar 2-year patient-reported outcome scores. This prospective, multicenter study is the largest evaluating outcomes of shaped versus round implants in breast reconstruction. Although recipients of round implants demonstrated lower infection rates compared with shaped implants, these patients were more likely to undergo contralateral symmetry procedures. Both implant types yielded comparable patient-reported outcome scores. With appropriate patient selection, both shaped and round implants can provide acceptable outcomes in breast reconstruction. Therapeutic, III.

Properties of Cement Mortar by Use of Hot-Melt Polyamides as Substitute for Fine Aggregate

PubMed Central

Yuan, Xiongzhou; Xu, Weiting; Sun, Wei; Xing, Feng; Wang, Weilun

2015-01-01

This paper presents an experimental study on use of hot-melt polyamide (HMP) to prepare mortar specimens with improved crack healing and engineering properties. The role of HMP in the crack repairing of cement mortar subjected to several rounds of heat treatment was investigated. Compatibility between HMP and hydraulic cement was investigated through X-ray diffraction (XRD) and Fourier transform infrared spectra (FTIR) technology. Mortar specimens were prepared using standard cement mortar mixes with HMP at 1%, 3% and 5% (by volume) for fine aggregate substitute. After curing for 28 days, HMP specimens were subjected to heating at temperature of 160 °C for one, two, and three days and then natural cooling down to ambient temperature. Mechanical and durability properties of the heated HMP mortars were evaluated and compared with those of the corresponding mortars without heating. The microscopic observation of the interfacial transition zone (ITZ) of HMP mortar was conducted through environmental scanning electron microscopy (ESEM). Results reveal that incorporation of HMP improves the workability of the HMP/cement binder while leading to decrease in compressive strength and durability. The heated HMP mortars after exposure to heating for one, two, and three days exhibit no obvious change in compressive strength while presenting notable increase in flexural strength and durability compared with the corresponding mortars without heating. The XRD, FTIR and ESEM analyses indicate that no obvious chemical reaction occurs between HMP and hydraulic cement, and thus the self-repairing for interfacial micro-crack in HMP/cement composite system is ascribed to the physical adhesion of HMP to cement matrix rather than the chemical bonding between them.

Regional patterns of genetic diversity in swine influenza A viruses in the United States from 2010 to 2016.

PubMed

Walia, Rasna R; Anderson, Tavis K; Vincent, Amy L

2018-04-06

Regular spatial and temporal analyses of the genetic diversity and evolutionary patterns of influenza A virus (IAV) in swine informs control efforts and improves animal health. Initiated in 2009, the USDA passively surveils IAV in U.S. swine, with a focus on subtyping clinical respiratory submissions, sequencing at minimum the hemagglutinin (HA) and neuraminidase (NA) genes, and sharing these data publicly. In this study, our goal was to quantify and describe regional and national patterns in the genetic diversity and evolution of IAV in U.S. swine from 2010 to 2016. A comprehensive phylogenetic and epidemiological analysis of publicly available HA and NA genes generated by the USDA surveillance system collected from January 2010 to December 2016 was conducted. The dominant subtypes and genetic clades detected during the study period were H1N1 (H1-γ/1A.3.3.3, N1-classical, 29%), H1N2 (H1-δ1/1B.2.2, N2-2002, 27%), and H3N2 (H3-IV-A, N2-2002, 15%), but many other minor clades were also maintained. Year-round circulation was observed, with a primary epidemic peak in October-November and a secondary epidemic peak in March-April. Partitioning these data into 5 spatial zones revealed that genetic diversity varied regionally and was not correlated with aggregated national patterns of HA/NA diversity. These data suggest that vaccine composition and control efforts should consider IAV diversity within swine production regions in addition to aggregated national patterns. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Ball mounting fixture for a roundness gage

DOEpatents

Gauler, Allen L.; Pasieka, Donald F.

1983-01-01

A ball mounting fixture for a roundness gage is disclosed. The fixture includes a pair of chuck assemblies oriented substantially transversely with respect to one another and mounted on a common base. Each chuck assembly preferably includes a rotary stage and a wobble plate affixed thereto. A ball chuck affixed to each wobble plate is operable to selectively support a ball to be measured for roundness, with the wobble plate permitting the ball chuck to be tilted to center the ball on the axis of rotation of the rotary stage. In a preferred embodiment, each chuck assembly includes a vacuum chuck operable to selectively support the ball to be measured for roundness. The mounting fixture enables a series of roundness measurements to be taken with a conventional rotating gagehead roundness instrument, which measurements can be utilized to determine the sphericity of the ball.

An unusual abdominal cystic mass in the round ligament of the uterus: a case report.

PubMed

Açmaz, Gökhan; Aksoy, Hüseyin; Aksoy, Ülkü; Özyurt, Sezin; Esin, Erkan; Gökahmetoğlu, Günhan

2014-10-01

Cystic tumor of the round ligament is extremely rare. To our knowledge, this is the first case reported in the literature of a round ligament giant serous cystadenoma. A 17-year-old adolescent who presented with massive abdominal swelling and was later identified as a serous cystadenomas of the round ligament with a size of approximately 50 cm. A multidisciplinary team including gynecologist, surgeon, and urologist performed the surgical cyst excision and she has recovered well without any complications. Round ligament serous cystadenomas could grow to any size when there is a diagnosis. In addition, even in unusual locations, round ligament serous cysts should be kept in the differential diagnosis of abdominal masses. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Surgical anatomy of the round window-Implications for cochlear implantation.

PubMed

Luers, J C; Hüttenbrink, K B; Beutner, D

2018-04-01

The round window is an important portal for the application of active hearing aids and cochlear implants. The anatomical and topographical knowledge about the round window region is a prerequisite for successful insertion for a cochlear implant electrode. To sum up current knowledge about the round window anatomy and to give advice to the cochlear implant surgeon for optimal placement of an electrode. Systematic Medline search. Search term "round window[Title]" with no date restriction. Only publications in the English Language were included. All abstracts were screened for relevance, that is a focus on surgical anatomy of the round window. The search results were supplemented with hand searching of selected reviews and reference lists from included studies. Subjective assessment. There is substantial variability in size and shape of the round window. The round window is regarded as the most reliable surgical landmark to safely locate the scala tympani. Factors affecting the optimal trajectory line for atraumatic electrode insertion are anatomy of the round window, the anatomy of the intracochlear hook region and the variable orientation and size of the cochlea's basal turn. The very close relation to the sensitive inner ear structures necessitates a thorough anatomic knowledge and careful insertion technique, especially when implanting patients with residual hearing. In order to avoid electrode migration between the scalae and to achieve protect the modiolus and the basilar membrane, it is recommended to aim for an electrode insertion vector from postero-superior to antero-inferior. © 2017 John Wiley & Sons Ltd.

Parental responses to involvement in rounds on a pediatric inpatient unit at a teaching hospital: a qualitative study.

PubMed

Latta, Linda C; Dick, Ronald; Parry, Carol; Tamura, Glen S

2008-03-01

In pediatric teaching hospitals, medical decisions are traditionally made by the attending and resident physicians during rounds that do not include parents. This structure limits the ability of the medical team to provide "family-centered care" and the attending physician to model communication skills. The authors thus set out to identify how parents responded to participation in interdisciplinary teaching rounds conducted in a large tertiary care children's teaching hospital. A qualitative descriptive study was conducted using data from semistructured interviews of parents who had participated in rounds on the inpatient medical unit of a large academic children's hospital. From December 2004 to April 2005, 18 parents were interviewed after their participation in rounds. Questions assessed their experiences, expectations, preferred communication styles, and suggestions for improvement. Transcripts of the interviews were analyzed using qualitative content analysis. Being able to communicate, understand the plan, and participate with the team in decision making about their child's care were the most frequently cited outcomes of importance to parents. All 18 participants described the overall experience as positive, and 17 of 18 described themselves as "comfortable" with inclusion in rounds. Use of lay terminology and inclusion of nurses in rounds were preferred. Including parents on ward rounds at a teaching hospital was viewed positively by parents. Specific themes of particular importance to parents were identified. Further study is needed to assess the impact of inclusion of parents on rounds on patient outcomes and the resident experience.

7 CFR 996.31 - Outgoing quality standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... materials(percent) Moisture(percent) Excluding Lots of “splits” Runner 1.50 2.50 6.00%; 17/64 inch round screen .20 9.00 Virginia (except No. 2) 1.50 2.50 6.00%; 17/64 inch round screen .20 9.00 Spanish and Valencia 1.50 2.50 6.00%; 16/64 inch round screen .20 9.00 No. 2 Virginia 1.50 3.00 6.00%; 17/64 inch round...

31 CFR 593.412 - Release of any round log or timber product originating in Liberia from a bonded warehouse or...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Release of any round log or timber... Interpretations § 593.412 Release of any round log or timber product originating in Liberia from a bonded... from a bonded warehouse or foreign trade zone of any round log or timber product originating in Liberia...

7 CFR 996.31 - Outgoing quality standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... materials(percent) Moisture(percent) Excluding Lots of “splits” Runner 1.50 2.50 6.00%; 17/64 inch round screen .20 9.00 Virginia (except No. 2) 1.50 2.50 6.00%; 17/64 inch round screen .20 9.00 Spanish and Valencia 1.50 2.50 6.00%; 16/64 inch round screen .20 9.00 No. 2 Virginia 1.50 3.00 6.00%; 17/64 inch round...

31 CFR 593.412 - Release of any round log or timber product originating in Liberia from a bonded warehouse or...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Release of any round log or timber... Interpretations § 593.412 Release of any round log or timber product originating in Liberia from a bonded... from a bonded warehouse or foreign trade zone of any round log or timber product originating in Liberia...

7 CFR 996.31 - Outgoing quality standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... materials(percent) Moisture(percent) Excluding Lots of “splits” Runner 1.50 2.50 6.00%; 17/64 inch round screen .20 9.00 Virginia (except No. 2) 1.50 2.50 6.00%; 17/64 inch round screen .20 9.00 Spanish and Valencia 1.50 2.50 6.00%; 16/64 inch round screen .20 9.00 No. 2 Virginia 1.50 3.00 6.00%; 17/64 inch round...

Students' Perceptions on an Interprofessional Ward Round Training - A Qualitative Pilot Study.

PubMed

Nikendei, C; Huhn, D; Pittius, G; Trost, Y; Bugaj, T J; Koechel, A; Schultz, J-H

2016-01-01

Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students', nurses' as well as physiotherapists' views on a simulation-based interprofessional ward round training. In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second) volunteered to participate in two standardized patient ward round scenarios: (1) patient with myocardial infarction, and (2) patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups. Focus group based feedback contained two main categories (A) ward round training benefits and (B) difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups. The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

Optimisation of the round window opening in cochlear implant surgery in wet and dry conditions: impact on intracochlear pressure changes.

PubMed

Mittmann, Philipp; Ernst, A; Mittmann, M; Todt, I

2016-11-01

To preserve residual hearing in cochlear implant candidates, the atraumatic insertion of the cochlea electrode has become a focus of cochlea implant research. In a previous study, intracochlear pressure changes during the opening of the round window membrane were investigated. In the current study, intracochlear pressure changes during opening of the round window membrane under dry and transfluid conditions were investigated. Round window openings were performed in an artificial cochlear model. Intracochlear pressure changes were measured using a micro-optical pressure sensor, which was placed in the apex. Openings of the round window membrane were performed under dry and wet conditions using a cannula and a diode laser. Statistically significant differences in the intracochlear pressure changes were seen between the different methods used for opening of the round window membrane. Lower pressure changes were seen by opening the round window membrane with the diode laser than with the cannula. A significant difference was seen between the dry and wet conditions. The atraumatic approach to the cochlea is assumed to be essential for the preservation of residual hearing. Opening of the round window under wet conditions produce a significant advantage on intracochlear pressure changes in comparison to dry conditions by limiting negative outward pressure.

Development of post-disaster psychosocial evaluation and intervention for children: Results of a South Korean delphi panel survey

PubMed Central

Lee, Mi-Sun; Hwang, Jun-Won; Lee, Cheol-Soon; Kim, Ji-Youn; Lee, Ju-Hyun; Kim, Eunji; Chang, Hyoung Yoon; Bae, SeungMin; Park, Jang-Ho

2018-01-01

Objective This study aimed to administer a Delphi panel survey and provide evidence for the development of a psychological intervention protocol for use after disasters in South Korea. Method A three-round Delphi survey was conducted. In all rounds, respondents answered open- or closed-ended questions regarding their views on i) the concept of disaster, ii) evaluation, iii) intervention, and iv) considerations in a disaster. Data from Round 1 were subjected to content analysis. In Round 2, items with content validity ratios (CVRs) greater than 0.49 were included, and in Round 3, items with a CVR≥0.38 were accepted. Results The response rates for the Delphi survey were high: 83% (n = 15, Round 1), 80% (n = 16, Round 2), and 86% (n = 24, Round 3). The data collected during this survey showed a need for a support system for children; for preventive strategies, including disaster readiness plans; for the protection of children's safety; and for the development of post-disaster psychosocial care. Conclusions The panel experts reached a consensus regarding the steps they considered critical in post-disaster evaluation and intervention. The findings suggest a unified model for advancing the development of the Korean version of an intervention protocol for children and adolescents exposed to traumatic events. PMID:29596483

International Round-Robin Study on Thermoelectric Transport Properties of n-type Half-Heusler from 300 K to 773 K

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

Wang, Hsin; Bai, Shengqiang; Chen, Lidong

2015-09-03

International transport property measurement round-robins have been conducted by the Thermoelectric Annex under the International Energy Agency (IEA) Implementing Agreement on Advanced Materials for Transportation (AMT). The previous round-robins used commercially available bismuth telluride as the testing material, with the goals of understanding measurement issues and developing standard testing procedures. The current round-robin extended the measurement temperature range to 773 K. It was designed to meet the increasing demands for reliable transport data of thermoelectric materials for power generation applications. Eleven laboratories from six IEA-AMT member countries participated in this study. Half-Heusler (n-type) material prepared by GMZ Energy was selectedmore » for the round-robin. The measured transport properties showed narrower distribution on uncertainties compared to previous round-robin efforts. The study intentionally included multiple testing methods and instrument types. Over the full temperature range, the measurement discrepancies on the figure of merit, ZT, in this round-robin were ±1.5 to ±16.4% from the averages.« less

Anesthesiology leadership rounding: identifying opportunities for improvement.

PubMed

Gravenstein, Dietrich; Ford, Susan; Enneking, F Kayser

2012-01-01

Rounding that includes participation of individuals with authority to implement changes has been advocated as important to the transformation of an institution into a high-quality and safe organization. We describe a Department of Anesthesiology's experience with leadership rounding. The Department Chair or other senior faculty designate, a quality coordinator, up to four residents, the ward charge nurse, and patient nurses participated in rounds at bedsides. During a 23-month period, 14 significant opportunities to improve care were identified. Nurses identified 5 of these opportunities, primary team physicians 2, the rounding team 4, and patients or their family members another 3. The anesthesiology service had sole or shared responsibility for 10 improvements. A variety of organizations track specific measures across all phases of the patient experience to gauge quality of care. Chart auditing tools for detecting threats to safety are often used. These measures and tools missed opportunities for improvement that were discovered only through rounding. We conclude that the introduction of leadership rounding by an anesthesiology service can identify opportunities for improving quality that are not captured by conventional efforts.

Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff.

PubMed

Morrison, Cecily; Jones, Matthew; Blackwell, Alan; Vuylsteke, Alain

2008-01-01

Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record. A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews. Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions. We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round.

Measurement of stapes vibration in Human temporal bones by round window stimulation using a 3-coil transducer.

PubMed

Shin, Dong Ho; Kim, Dong Wook; Lim, Hyung Gyu; Jung, Eui Sung; Seong, Ki Woong; Lee, Jyung Hyun; Kim, Myoung Nam; Cho, Jin Ho

2014-01-01

Round window placement of a 3-coil transducer offers a new approach for coupling an implantable hearing aid to the inner ear. The transducer exhibits high performance at low-frequencies. One remarkable feature of the 3-coil transducer is that it minimizes leakage flux. Thus, the transducer, which consists of two permanent magnets and three coils, can enhance vibrational displacement. In human temporal bones, stapes vibration was observed by laser Doppler vibrometer in response to round window stimulation using the 3-coil transducer. Coupling between the 3-coil transducer and the round window was connected by a wire-rod. The stimulation created stapes velocity when the round window stimulated. Performance evaluation was conducted by measuring stapes velocity. To verify the performance of the 3-coil transducer, stapes velocity for round window and tympanic membrane stimulation were compared, respectively. Stapes velocity by round window stimulation using the 3-coil transducer was approximately 14 dB higher than that achieved by tympanic membrane stimulation. The study shows that 3-coil transducer is suitable for implantable hearing aids.

Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff

PubMed Central

Morrison, Cecily; Jones, Matthew; Blackwell, Alan; Vuylsteke, Alain

2008-01-01

Introduction Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record. Methods A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews. Results Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions. Conclusions We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round. PMID:19025662

Use of foreslope rounding by departments of transportation.

DOT National Transportation Integrated Search

2011-09-11

"To enhance driver safety, departments of transportation sometimes round the foreslopes of highway shoulders at the : intersection of the shoulder and its side slope. WisDOT was interested in learning about foreslope rounding practices : used by othe...

1. HISTORIC PHOTOGRAPH, VIEW OF ROUND HILL ROAD BRIDGE, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. HISTORIC PHOTOGRAPH, VIEW OF ROUND HILL ROAD BRIDGE, LOOKING WEST, CA. 1940. CONNECTICUT DEPARTMENT OF TRANSPORTATION. - Merritt Parkway, Round Hill Road Bridge, Spanning Merritt Parkway at 3.5 mile mark, Greenwich, Fairfield County, CT

Artillery Survivability Model

DTIC Science & Technology

2016-06-01

effectiveness of possible guns of the future. Different than this project, this thesis seeks to optimize the survival time of the artillery units and to find...one SME mentioned that the gun they were shot by provides more clues about subsequent shots. If we are taking mortar fire, falling rounds are...just be reloading their guns . If two rounds are necessary, two howitzers with a higher amount of the specified rounds are fired. After rounds have been

Ball mounting fixture for a roundness gage

DOEpatents

Gauler, A.L.; Pasieka, D.F.

1983-11-15

A ball mounting fixture for a roundness gage is disclosed. The fixture includes a pair of chuck assemblies oriented substantially transversely with respect to one another and mounted on a common base. Each chuck assembly preferably includes a rotary stage and a wobble plate affixed thereto. A ball chuck affixed to each wobble plate is operable to selectively support a ball to be measured for roundness, with the wobble plate permitting the ball chuck to be tilted to center the ball on the axis of rotation of the rotary stage. In a preferred embodiment, each chuck assembly includes a vacuum chuck operable to selectively support the ball to be measured for roundness. The mounting fixture enables a series of roundness measurements to be taken with a conventional rotating gagehead roundness instrument, which measurements can be utilized to determine the sphericity of the ball. 6 figs.

Mitotic cells contract actomyosin cortex and generate pressure to round against or escape epithelial confinement

PubMed Central

Sorce, Barbara; Escobedo, Carlos; Toyoda, Yusuke; Stewart, Martin P.; Cattin, Cedric J.; Newton, Richard; Banerjee, Indranil; Stettler, Alexander; Roska, Botond; Eaton, Suzanne; Hyman, Anthony A.; Hierlemann, Andreas; Müller, Daniel J.

2015-01-01

Little is known about how mitotic cells round against epithelial confinement. Here, we engineer micropillar arrays that subject cells to lateral mechanical confinement similar to that experienced in epithelia. If generating sufficient force to deform the pillars, rounding epithelial (MDCK) cells can create space to divide. However, if mitotic cells cannot create sufficient space, their rounding force, which is generated by actomyosin contraction and hydrostatic pressure, pushes the cell out of confinement. After conducting mitosis in an unperturbed manner, both daughter cells return to the confinement of the pillars. Cells that cannot round against nor escape confinement cannot orient their mitotic spindles and more likely undergo apoptosis. The results highlight how spatially constrained epithelial cells prepare for mitosis: either they are strong enough to round up or they must escape. The ability to escape from confinement and reintegrate after mitosis appears to be a basic property of epithelial cells. PMID:26602832

Attitudes of nursing staff toward interprofessional in-patient-centered rounding.

PubMed

Sharma, Umesh; Klocke, David

2014-09-01

Historically, medicine and nursing has had a hierarchical and patriarchal relationship, with physicians holding monopoly over knowledge-based practice of medical care, thus impeding interprofessional collaboration. Power gradient prevents nurses from demanding cooperative patient rounding. We surveyed attitudes of nursing staff at our tertiary care community hospital, before and after implementation of a patient-centered interprofessional (hospitalist-nurse) rounding process for patients. There was a substantial improvement in nursing staff satisfaction related to the improved communication (7%-54%, p < 0.001) and rounding (3%-49%, p < 0.001) by hospitalist providers. Patient-centered rounding also positively impacted nursing workflow (5%-56%, p < 0.001), nurses' perceptions of value as a team member (26%-56%, p = 0.018) and their job satisfaction (43%-59%, p = 0.010). Patient-centered rounding positively contributed to transforming the hospitalist-nurse hierarchical model to a team-based collaborative model, thus enhancing interprofessional relationships.

Mitotic cells contract actomyosin cortex and generate pressure to round against or escape epithelial confinement

NASA Astrophysics Data System (ADS)

Sorce, Barbara; Escobedo, Carlos; Toyoda, Yusuke; Stewart, Martin P.; Cattin, Cedric J.; Newton, Richard; Banerjee, Indranil; Stettler, Alexander; Roska, Botond; Eaton, Suzanne; Hyman, Anthony A.; Hierlemann, Andreas; Müller, Daniel J.

2015-11-01

Little is known about how mitotic cells round against epithelial confinement. Here, we engineer micropillar arrays that subject cells to lateral mechanical confinement similar to that experienced in epithelia. If generating sufficient force to deform the pillars, rounding epithelial (MDCK) cells can create space to divide. However, if mitotic cells cannot create sufficient space, their rounding force, which is generated by actomyosin contraction and hydrostatic pressure, pushes the cell out of confinement. After conducting mitosis in an unperturbed manner, both daughter cells return to the confinement of the pillars. Cells that cannot round against nor escape confinement cannot orient their mitotic spindles and more likely undergo apoptosis. The results highlight how spatially constrained epithelial cells prepare for mitosis: either they are strong enough to round up or they must escape. The ability to escape from confinement and reintegrate after mitosis appears to be a basic property of epithelial cells.

Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial.

PubMed

Hidalgo, David A; Weinstein, Andrew L

2017-03-01

The purpose of this randomized controlled trial was to determine whether anatomical implants are aesthetically superior to round implants in breast augmentation. Seventy-five patients undergoing primary breast augmentation had a round silicone implant of optimal volume, projection, and diameter placed in one breast and an anatomical silicone device of similar volume and optimal shape placed in the other. After intraoperative photographs were taken, the anatomical device was replaced by a round implant to complete the procedure. A survey designed to measure breast aesthetics was administered to 10 plastic surgeon and 10 lay reviewers for blind evaluation of the 75 cases. No observable difference in breast aesthetics between anatomical and round implants was reported by plastic surgeons in 43.6 percent or by lay individuals in 29.2 percent of cases. When a difference was perceived, neither plastic surgeons nor lay individuals preferred the anatomical side more often than the round side. Plastic surgeons judged the anatomical side superior in 51.1 percent of cases and the round side superior in 48.9 percent of cases (p = 0.496). Lay individuals judged the anatomical side superior in 46.7 percent of cases and the round side superior in 53.3 percent (p = 0.140). Plastic surgeons identified implant shape correctly in only 26.5 percent of cases. This study provides high-level evidence supporting no aesthetic superiority of anatomical over round implants. Given that anatomical implants have important and unique disadvantages, a lack of proven aesthetic superiority argues against their continued use in breast augmentation. Therapeutic, I.

Strategies for improving family engagement during family-centered rounds.

PubMed

Kelly, Michelle M; Xie, Anping; Carayon, Pascale; DuBenske, Lori L; Ehlenbach, Mary L; Cox, Elizabeth D

2013-04-01

Family-centered rounds (FCR) are recommended as standard practice in the pediatric inpatient setting; however, limited data exist on best practices promoting family engagement during rounds. To identify strategies to enhance family engagement during FCR using a recognized systems engineering approach. In this qualitative study, stimulated recall interviews using video-recorded rounding sessions were conducted with participants representing the various stakeholders on rounds (15 parents/children and 22 healthcare team [HCT] members) from 4 inpatient services at a children's hospital in Wisconsin. On video review, participants were asked to provide strategies that would increase family engagement on FCR. Qualitative content analysis of interview transcripts was performed in an iterative process. We identified 21 categories of strategies corresponding to 2 themes related to the structure and process of FCR. Strategies related to the structure of FCR were associated with all five recognized work system elements: people (HCT composition), tasks (HCT roles), organization (scheduling of rounds and HCT training), environment (location of rounds and HCT positioning), and tools and technologies (computer use). Strategies related to the FCR process were associated with three rounding phases: before (HCT and family preparation), during (eg, introductions, presentation content, communication style), and after (follow-up) FCR. We identified a range of strategies to enhance family engagement during FCR. These strategies both confirm prior work on the importance of the content and style of communication on rounds and highlight other factors within the hospital work system, like scheduling and computer use, which may affect family engagement in care. Copyright © 2013 Society of Hospital Medicine.

Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

PubMed

Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

2014-04-01

The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

Activity, aggression, and habitat use of ruffe (Gymnocephalus cernuus) and round goby (Apollonia melanostoma) under laboratory conditions

USGS Publications Warehouse

Savino, J.F.; Riley, S.C.; Holuszko, M.J.

2007-01-01

Potential negative ecological interactions between ruffe Gymnocephalus cernuus and round gobyApollonia melanostoma (formerly Neogobius melanostomus) might affect the colonization dynamics of these invasive species where they are sympatric in the Great Lakes. In order to determine the potential for ecological interactions between these species, we examined the activity, aggression, and habitat use of round gobies and ruffe in single species and mixed species laboratory experiments. Trials included conditions in which food was concentrated (in light or darkness) or scattered. Results showed that ruffe were more active than gobies, particularly when food was scattered. Activity of both species was significantly lower during darkness. Round gobies were significantly more aggressive than ruffe, and total aggression was lower in mixed species trials. Habitat use by ruffe and round gobies overlapped considerably, but we observed significant differences between species in their use of specific habitats that depended on experimental conditions. Overall, ruffe used open habitats more often than did round gobies, primarily when food was scattered. Round gobies used rocks significantly more frequently than did ruffe, but their use of rock habitat decreased during dark conditions. Ruffe were found more often in plant habitats and less often near the wall of the pool in trials during daylight with concentrated food. Activity and habitat use of ruffe and round goby did not significantly differ between single and mixed species trials. Overall, we found little evidence for negative ecological interactions between ruffe and round goby in these laboratory experiments.

Transient Side Load Analysis of Out-of-Round Film-Cooled Nozzle Extensions

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Lin, Jeff; Ruf, Joe; Guidos, Mike

2012-01-01

There was interest in understanding the impact of out-of-round nozzle extension on the nozzle side load during transient startup operations. The out-of-round nozzle extension could be the result of asymmetric internal stresses, deformation induced by previous tests, and asymmetric loads induced by hardware attached to the nozzle. The objective of this study was therefore to computationally investigate the effect of out-of-round nozzle extension on the nozzle side loads during an engine startup transient. The rocket engine studied encompasses a regeneratively cooled chamber and nozzle, along with a film cooled nozzle extension. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and transient inlet boundary flow properties derived from an engine system simulation. Six three-dimensional cases were performed with the out-of-roundness achieved by three different degrees of ovalization, elongated on lateral y and z axes: one slightly out-of-round, one more out-of-round, and one significantly out-of-round. The results show that the separation line jump was the primary source of the peak side loads. Comparing to the peak side load of the perfectly round nozzle, the peak side loads increased for the slightly and more ovalized nozzle extensions, and either increased or decreased for the two significantly ovalized nozzle extensions. A theory based on the counteraction of the flow destabilizing effect of an exacerbated asymmetrical flow caused by a lower degree of ovalization, and the flow stabilizing effect of a more symmetrical flow, created also by ovalization, is presented to explain the observations obtained in this effort.

Electronic Printed Ward Round Proformas: Freeing Up Doctors' Time.

PubMed

Fernandes, Darren; Eneje, Philip

2017-01-01

The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement. Our baseline measurement found that the average time taken to write up the proforma for each patient was 1 minute 9 seconds and that the average time taken per patient on the ward round was 8 minutes 30 seconds. With the changes we made during our 3 PDSA cycles and the implementation of an electronic, printed ward round proforma, we found that we were able to reduce the average time spent per patient on the ward round to 6 minutes 32 seconds, an improvement of 1 min 58 seconds per patient. The project has thus enabled us to reduce the time taken per patient during the ward round. This improved efficiency will enable patients to be identified earlier for discharge. It will also aid in freeing up the time of junior doctors, allowing them to complete discharge letters sooner, order investigations earlier and enable them to complete their allocated tasks within contracted hours.

Choroidal Round Hyporeflectivities in Geographic Atrophy.

PubMed

Corbelli, Eleonora; Sacconi, Riccardo; De Vitis, Luigi Antonio; Carnevali, Adriano; Rabiolo, Alessandro; Querques, Lea; Bandello, Francesco; Querques, Giuseppe

2016-01-01

In geographic atrophy (GA), choroidal vessels typically appear on structural optical coherence tomography (OCT) as hyperreflective round areas with highly reflective borders. We observed that some GA eyes show choroidal round hyporeflectivities with highly reflective borders beneath the atrophy, and futher investigated the charcteristcs by comparing structural OCT, indocyanine green angiography (ICGA) and OCT angiography (OCT-A). Round hyporeflectivities were individuated from a pool of patients with GA secondary to non-neovascular age-related macular degeneration consecutively presenting between October 2015 and March 2016 at the Medical Retina & Imaging Unit of the University Vita-Salute San Raffaele. Patients underwent a complete ophthalmologic examination including ICGA, structural OCT and OCT-A. The correspondence between choroidal round hyporeflectivities beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed. Fifty eyes of 26 consecutive patients (17 females and 9 males; mean age 76.8±6.2 years) with GA were included. Twenty-nine round hyporeflectivities have been found by OCT in choroidal layers in 21 eyes of 21 patients (42.0%; estimated prevalence of 57.7%). All 29 round hyporeflectivities showed constantly a hyperreflective border and a backscattering on structural OCT, and appeared as hypofluorescent in late phase ICGA and as dark foci with non detectable flow in the choroidal segmentation of OCT-A. Interestingly, the GA area was greater in eyes with compared to eyes without round hyporeflectivities (9.30±5.74 and 5.57±4.48mm2, respectively; p = 0.01). Our results suggest that most round hyporeflectivities beneath GA may represent non-perfused or hypo-perfused choroidal vessels with non-detectable flow.

1. Entrance to Heintooga Round Bottom Road and sign looking ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Entrance to Heintooga Round Bottom Road and sign looking N. - Great Smoky Mountains National Park Roads & Bridges, Heintooga Round Bottom Road & Balsam Mountain Road, Between Blue Ridge Parkway & Big Cove Road, Gatlinburg, Sevier County, TN

National Football League Skilled and Unskilled Positions Vary in Opportunity and Yield in Return to Play After an Anterior Cruciate Ligament Injury

PubMed Central

Yang, JaeWon; Hodax, Jonathan D.; Machan, Jason T.; Secrist, Eric S.; Durand, Wesley M.; Owens, Brett D.; Eltorai, Adam E.M.; Dodson, Christopher C.

2017-01-01

Background: Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions. Purpose: To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round. We hypothesized that skilled positions would return at a lower rate compared to unskilled positions. We further hypothesized that early draft-round status would relate to a greater rate of RTP and that skilled positions and a lower draft round would correlate with decreased performance for players who return to sport. Study Design: Case-control study; Level of evidence, 3. Methods: Utilizing a previously established database of publicly available information regarding ACL tears among NFL players, athletes with ACL tears occurring between the 2010 and 2013 seasons were identified. Generalized linear models and Kaplan-Meier time-to-event models were used to test the study hypotheses. Results: The overall RTP rate was 61.7%, with skilled players and unskilled players returning at rates of 64.1% and 60.4%, respectively (P = .74). Early draft-round players and unskilled late draft-round players had greater rates of RTP compared to skilled late draft-round players and both unskilled and skilled undrafted free agents (UDFAs). Skilled early draft-round players constituted the only cohort that played significantly fewer games after an injury. Unskilled UDFAs constituted the only cohort to show a significant increase in the number of games started and ratio of games started to games played, starting more games in which they played, after an injury. Conclusion: Early draft-round and unskilled players were more likely to return compared to their later draft-round and skilled peers. Skilled early draft-round players, who displayed relatively high rates of RTP, constituted the only cohort to show a decline in performance. Unskilled UDFAs, who exhibited relatively low rates of RTP, constituted the only cohort to show an increase in performance. The significant effect of draft round and position type on RTP may be caused by a combination of differences in talent levels and in opportunities given to returning to play. PMID:28975136

Finite element model study of the effect of corner rounding on detectability of corner cracks using bolt hole eddy current

NASA Astrophysics Data System (ADS)

Underhill, P. R.; Krause, T. W.

2017-02-01

Recent work has shown that the detectability of corner cracks in bolt-holes is compromised when rounding of corners arises, as might occur during bolt-hole removal. Probability of Detection (POD) studies normally require a large number of samples of both fatigue cracks and electric discharge machined notches. In the particular instance of rounding of bolt-hole corners the generation of such a large set of samples representing the full spectrum of potential rounding would be prohibitive. In this paper, the application of Finite Element Method (FEM) modeling is used to supplement the study of detection of cracks forming at the rounded corners of bolt-holes. FEM models show that rounding of the corner of the bolt-hole reduces the size of the response to a corner crack to a greater extent than can be accounted for by loss of crack area. This reduced sensitivity can be ascribed to a lower concentration of eddy currents at the rounded corner surface and greater lift-off of pick-up coils relative to that of a straight-edge corner. A rounding with a radius of 0.4 mm (.016 inch) showed a 20% reduction in the strength of the crack signal. Assuming linearity of the crack signal with crack size, this would suggest an increase in the minimum detectable size by 25%.

Definition of a COPD self-management intervention: International Expert Group consensus.

PubMed

Effing, Tanja W; Vercoulen, Jan H; Bourbeau, Jean; Trappenburg, Jaap; Lenferink, Anke; Cafarella, Paul; Coultas, David; Meek, Paula; van der Valk, Paul; Bischoff, Erik W M A; Bucknall, Christine; Dewan, Naresh A; Early, Frances; Fan, Vincent; Frith, Peter; Janssen, Daisy J A; Mitchell, Katy; Morgan, Mike; Nici, Linda; Patel, Irem; Walters, Haydn; Rice, Kathryn L; Singh, Sally; Zuwallack, Richard; Benzo, Roberto; Goldstein, Roger; Partridge, Martyn R; van der Palen, Job

2016-07-01

There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management experts using Delphi technique features and an additional group meeting.In each consensus round the experts were asked to provide feedback on the proposed definition and to score their level of agreement (1=totally disagree; 5=totally agree). The information provided was used to modify the definition for the next consensus round. Thematic analysis was used for free text responses and descriptive statistics were used for agreement scores.In total, 28 experts participated. The consensus round response rate varied randomly over the five rounds (ranging from 48% (n=13) to 85% (n=23)), and mean definition agreement scores increased from 3.8 (round 1) to 4.8 (round 5) with an increasing percentage of experts allocating the highest score of 5 (round 1: 14% (n=3); round 5: 83% (n=19)).In this study we reached consensus regarding a conceptual definition of what should be a COPD self-management intervention, clarifying the requisites for such an intervention. Operationalisation of this conceptual definition in the near future will be an essential next step. The content of this work is not subject to copyright. Design and branding are copyright ©ERS 2016.

Effectiveness of piscicides for controlling round gobies (Neogobius melanostomus)

USGS Publications Warehouse

Schreier, Theresa M.; Dawson, V.K.; Larson, W.

2008-01-01

Round gobies (Neogobius melanostomus) were introduced to the Great Lakes presumably as a result of ballast water releases from seagoing freighters returning from European water bodies. These unwelcome fish have become established in the Great Lakes region and are expanding their range to suitable portions of other interior drainage basins including the Mississippi River traversing the central United States and the Trent-Severn waterway spanning south-central Ontario. If the invasion continues, use of chemical toxicants as a control measure may be necessary. Toxicity tests of the currently registered piscicides antimycin, rotenone, 3-trifluoromethyl-4-nitrophenol (TFM), and Bayluscide?? were conducted with three fish species native to the Great Lakes and round gobies collected from the Illinois Waterway. Tests indicated that round gobies are sensitive to all of the piscicides, however, the level of sensitivity is similar to that of the native fish species tested. Therefore, currently registered piscicides have limited potential to selectively remove round gobies. Bottom-release formulations of Bayluscide?? and antimycin were also evaluated as control agents for the normally bottom-dwelling round goby. Avoidance behavior tests demonstrated that the round goby did not react to the presence of either chemical. Therefore, the bottom-release formulations may have some application for the selective removal of round gobies, and may be one of the few tools presently available to fishery managers to help limit the range expansion of this invasive fish.

Performance of the round window soft coupler for the backward stimulation of the cochlea in a temporal bone model.

PubMed

Gostian, Antoniu-Oreste; Schwarz, David; Mandt, Philipp; Anagiotos, Andreas; Ortmann, Magdalene; Pazen, David; Beutner, Dirk; Hüttenbrink, Karl-Bernd

2016-11-01

The round window vibroplasty is a feasible option for the treatment of conductive, sensorineural and mixed hearing loss. Although clinical data suggest a satisfying clinical outcome with various coupling methods, the most efficient coupling technique of the floating mass transducer to the round window is still a matter of debate. For this, a soft silicone-made coupler has been developed recently that aims to ease and optimize the stimulation of the round window membrane of this middle ear implant. We performed a temporal bone study evaluating the performance of the soft coupler compared to the coupling with individually shaped cartilage, perichondrium and the titanium round window coupler with loads up to 20 mN at the unaltered and fully exposed round window niche. The stimulation of the cochlea was measured by the volume velocities of the stapes footplate detected by a laser Doppler vibrometer. The coupling method was computed as significant factor with cartilage and perichondrium allowing for the highest volume velocities followed by the soft and titanium coupler. Exposure of the round window niche allowed for higher volume velocities while the applied load did not significantly affect the results. The soft coupler allows for a good contact to the round window membrane and an effective backward stimulation of the cochlea. Clinical data are mandatory to evaluate performance of this novel coupling method in vivo.

The round window region and contiguous areas: endoscopic anatomy and surgical implications.

PubMed

Marchioni, Daniele; Alicandri-Ciufelli, Matteo; Pothier, David D; Rubini, Alessia; Presutti, Livio

2015-05-01

The round window region is a critical area of the middle ear; the aim of this paper is to describe its anatomy from an endoscopic perspective, emphasizing some structures, the knowledge of which could have important implications during surgery, as well as to evaluate what involvement cholesteatoma may have with these structures. Retrospective review of video recordings of endoscopic ear surgeries and retrospective database review were conducted in Tertiary university referral center. Videos from endoscopic middle ear procedures carried out between June 2010 and September 2012 and stored in a shared database were reviewed retrospectively. Surgeries in which an endoscopic magnification of the round window region and the inferior retrotympanum area was performed intraoperatively were included in the study. Involvement by cholesteatoma of those regions was also documented based on information obtained from the surgical database. Conformation of the tegmen of the round window niche may influence the surgical view of round window membrane. A structure connecting the round window area to the petrous apex, named the subcochlear canaliculus, is described. Cholesteatoma can invade the round window areas in some patients. Endoscopic approaches can guarantee a very detailed view and allow the exploration of the round window region. Exact anatomical knowledge of this region can have important advantages during surgery, since some pathology can invade inside cavities or tunnels otherwise not seen by instrumentation that produces a straight-line view (e.g. microscope).

Hypercellular round cell liposarcoma: A comprehensive cytomorphologic study and review of 8 cases.

PubMed

Chufal, Sanjay S; Chufal, Kundan S; Pant, Prabhat; Rizvi, Ghazala; Pandey, Hari S; Shahi, Kedar S

2017-01-01

Myxoid and round cell liposarcomas (RCL) are low and high-grade counterparts of a common subtype of liposarcomas (LPS), representing a histologic continuum. The aim was to study the cytomorphology of hypercellular RCL and to look for features that differentiate RCL from other sarcomas displaying round cells with myxoid change. Eight cases of hypercellular RCL were identified retrospectively in which round cell component constituted greater than 75% of the area. Cytomorphological features were studied in detail. Four cases were predominantly composed of round cells, out of which 2 were entirely composed of round cells. Myxoid metachromatic stroma was absent in 2 cases, while it was present in ample amounts in the remaining 6 cases. Spindle cells were completely absent in 5 cases and lipoblasts were observed in a single case of RCL. Plexiform vascular capillaries were seen in 4 cases. Adherence of neoplastic round cells around thin capillaries (ANAC) was observed in 7 cases. Plexiform capillary plexus and ANAC should be separately evaluated. The latter feature is the most consistent one, and is an important clue to the adipocytic nature of the neoplasm when hypercellular round cell areas are aspirated. Confident diagnosis of hypercellular RCL can be made on the basis of this feature. Lipoblasts, although specific, are seen in few cases. The rest of the features are nonspecific and useful only in combination.

Round window chamber and fustis: endoscopic anatomy and surgical implications.

PubMed

Marchioni, Daniele; Soloperto, Davide; Colleselli, Elena; Tatti, Maria Fatima; Patel, Nirmal; Jufas, Nicholas

2016-11-01

The round window region is of critical importance in the anatomy of the middle ear. The aim of this paper is to describe its anatomy from an endoscopic point of view, emphasizing structures that have important surgical implications, in particular the fustis and the subcochlear canaliculus. The fustis, a smooth bony structure that forms the floor of the round window region, is a constant and important structure. It seems to indicate the round window membrane and the correct position of scala tympani. A structure connecting the round window region to the petrous apex, named the subcochlear canaliculus, is also described. A retrospective review of video recordings of endoscopic dissection and surgical procedures, carried out between June 2014 and February 2015, was conducted across two Tertiary university referral centers. A total of 42 dissections were analyzed in the study. We observed the fustis in all the cases and we identify two different anatomical conformations. The subcochlear canaliculus was found in 81.0 %, with a pneumatization direct to the petrous apex in 47.7 %. Conformation and limits of the round window niche may influence the surgical view of the round window membrane. Endoscopic approaches allow a very detailed view, which enables a comprehensive exploration of the round window region. Accurate knowledge of the anatomical relationships of this region has important advantages during middle ear surgery.

Age and growth of round gobies in Lake Huron: Implications for food web dynamics

USGS Publications Warehouse

Duan, You J.; Madenjian, Charles P.; Xie, Cong X.; Diana, James S.; O'Brien, Timothy P.; Zhao, Ying M.; He, Ji X.; Farha, Steve A.; Huo, Bin

2016-01-01

Although the round goby (Neogobius melanostomus) has become established throughout the Laurentian Great Lakes, information is scarce on spatial variation in round goby growth between and within lakes. Based on a sample of 754 specimens captured in 2014, age, growth, and mortality of round gobies at four locations in Lake Huron were assessed via otolith analysis. Total length (TL) of round gobies ranged from 44 to 111 mm for Saginaw Bay, from 45 to 115 mm for Rockport, from 50 to 123 mm for Hammond Bay, and from 51 to 118 mm for Thunder Bay. Estimated ages of round gobies ranged from 2 to 5 years for Saginaw Bay, from 2 to 6 years for Rockport, and from 2 to 7 years for Hammond Bay and Thunder Bay. Sex-specific, body–otolith relationships were used to back-calculate total lengths at age, which were then fitted to von Bertalanffy growth models. For each sex, round goby growth showed significant spatial variation among the four locations within Lake Huron. At all four locations in Lake Huron, males grew significantly faster than females and attained a larger asymptotic length than females. Annual mortality rate estimates were high (62 to 85%), based on catch-curve analysis, suggesting that round gobies may be under predatory control in Lake Huron.

Preoperative evaluation of cochlear implantation through the round window membrane in the facial recess using high-resolution computed tomography.

PubMed

Xie, Li-Hong; Tang, Jie; Miao, Wen-Jie; Tang, Xiang-Long; Li, Heng; Tang, An-Zhou

2018-06-01

We evaluated the risk of cochlear implantation through the round window membrane in the facial recess through a preoperative analysis of the angle between the facial nerve-round window and the cranial midline using high-resolution temporal bone CT. Temporal bone CT films of 176 patients with profound sensorineural hearing loss at our hospital from 2013 to 2015 were reviewed. The preoperative temporal bone CT scans of the patients were retrospectively analysed. The vertical distance (d value) from the leading edge of the facial nerve to the posterior wall of the external auditory canal and the angle (α value) between the line from the leading edge of the facial nerve to the midpoint of the round window membrane and the median sagittal line on the round window membrane plane were measured. Based on intraoperative observation, the round window membrane was divided into complete round window membrane exposure (group A), partial exposure (group B), and unexposed (group C) groups, and statistical analysis was performed. The α value could be effectively measured for all 176 patients (62.60 ± 7.12), and the d value could be effectively measured for 95 cases (5.53 ± 1.00). An analysis of the correlation between the α and d values of these 95 cases found a negative correlation. Of the 176 cases, one-way analysis of variance (ANOVA) showed that the differences among the groups were significant [P = 0.000 (< 0.05)]. The angle (α value) between the line connecting the leading edge of the facial nerve to the midpoint of the round window and the median sagittal line measured in preoperative CT scans was associated with the difficulty of intraoperatively exposing the round window membrane. When the α value was larger than a certain degree, the difficulty of exposing the round window membrane was increased. In such cases, the surgeon should fully expose the round window membrane during surgery, which could result decrease the likelihood of complications.

The trials methodological research agenda: results from a priority setting exercise.

PubMed

Tudur Smith, Catrin; Hickey, Helen; Clarke, Mike; Blazeby, Jane; Williamson, Paula

2014-01-23

Research into the methods used in the design, conduct, analysis, and reporting of clinical trials is essential to ensure that effective methods are available and that clinical decisions made using results from trials are based on the best available evidence, which is reliable and robust. An on-line Delphi survey of 48 UK Clinical Research Collaboration registered Clinical Trials Units (CTUs) was undertaken. During round one, CTU Directors were asked to identify important topics that require methodological research. During round two, their opinion about the level of importance of each topic was recorded, and during round three, they were asked to review the group's average opinion and revise their previous opinion if appropriate. Direct reminders were sent to maximise the number of responses at each round. Results are summarised using descriptive methods. Forty one (85%) CTU Directors responded to at least one round of the Delphi process: 25 (52%) responded in round one, 32 (67%) responded in round two, 24 (50%) responded in round three. There were only 12 (25%) who responded to all three rounds and 18 (38%) who responded to both rounds two and three. Consensus was achieved amongst CTU Directors that the top three priorities for trials methodological research were 'Research into methods to boost recruitment in trials' (considered the highest priority), 'Methods to minimise attrition' and 'Choosing appropriate outcomes to measure'. Fifty other topics were included in the list of priorities and consensus was reached that two topics, 'Radiotherapy study designs' and 'Low carbon trials', were not priorities. This priority setting exercise has identified the research topics felt to be most important to the key stakeholder group of Directors of UKCRC registered CTUs. The use of robust methodology to identify these priorities will help ensure that this work informs the trials methodological research agenda, with a focus on topics that will have most impact and relevance.

HRCT Correlation with Round Window Identification during Cochlear Implantation in Children.

PubMed

Pendem, Sai Kiran; Rangasami, Rajeswaran; Arunachalam, Ravi Kumar; Mohanarangam, Venkata Sai Pulivadulu; Natarajan, Paarthipan

2014-01-01

To determine the accuracy of High Resolution Computer Tomography (HRCT) temporal bone measurements in predicting the actual visualization of round window niche as viewed through posterior tympanotomy (i.e. facial recess). This is a prospective study of 37 cochlear implant candidates, aged between 1and 6 years, who were referred for HRCT temporal bone during the period December 2013 to July 2014. Cochlear implantation was done in 37 children (25 in the right ear and 12 in the left ear). The distance between the short process of incus and the round window niche and the distance between the oval window and the round window niche were measured preoperatively on sub-millimeter (0.7 mm) HRCT images. We classified the visibility of round window niche based on the surgical view (i.e. through posterior tympanotomy) during surgery into three types: 1) Type 1- fully visible, 2) Type 2- partially visible, and 3) Type 3- difficult to visualize. The preoperative HRCT measurements were used to predict the type of visualization of round window niche before surgery and correlated with the findings during surgery. The mean and standard deviation for the distance between the short process of incus and the round window niche and for the distance between the oval window and the round window niche for Types 1, 2, and 3 were 8.5 ± 0.2 mm and 3.2 ± 0.2 mm, 8.0 ± 0.4 mm and 3.8 ± 0.2 mm, 7.5 ± 0.2 mm and 4.4 ± 0.2 mm respectively, and showed statistically significant difference (P < 0.01) between them. The preoperative HRCT measurements had a sensitivity and specificity of 92.3% and 96.2%, respectively, in determining the actual visualization of round window niche. This study shows preoperative HRCT temporal bone measurements are useful in predicting the actual visualization of round window niche as viewed through posterior tympanotomy.

Prevention and control of major non-communicable diseases in China from 1990 to 2009: results of a two-round Delphi survey.

PubMed

Lv, Jun; Liu, Miao; Jiang, Yu; Li, Li-Ming

2013-02-12

The aim of this study was to learn about the progress of the prevention and control of major non-communicable diseases (NCDs) in China from 1990 to 2009 and to determine what prevention and control gaps remain based on the opinions of a group of panellists. Sixty-four panellists, who are members of the Subcommittee of the Non-Communicable Diseases, the Expert Committee on Disease Control and Prevention established by China's Ministry of Health in 2010, were invited to participate in an email-based, two-round Delphi survey. In each round, a structured questionnaire was given to participants, who were asked to rate the importance and practical implementation of items relevant to the prevention and control of NCDs over two periods, 1990-1999 and 2000-2009, on a 10-point scale. Of the 64 panellists invited, 20 (31.3%) completed the first-round survey, and, of those, 14 (70.0%) completed the second-round survey. Of the 237 common variables in the two survey rounds, there were 161 (67.9%) and 209 (88.2%) with an interquartile range ≤2 in the first round and second round, respectively. These results indicated a better expert consensus in the second round. There were 92 items in total in the second round of the questionnaire, 88 (95.7%) of which had median importance rating scores of equal to or greater than 7.00. The median scores for the practical implementation items during 2000-2009 were greater than those for the 1990-1999 period. The results indicate improved implementation in the recent decade. China has made progress in the prevention and control of NCDs during the 21st century. However, these intuitive rating results indicate that there are still large action gaps in the fight against epidemic NCDs in China.

The trials methodological research agenda: results from a priority setting exercise

PubMed Central

2014-01-01

Background Research into the methods used in the design, conduct, analysis, and reporting of clinical trials is essential to ensure that effective methods are available and that clinical decisions made using results from trials are based on the best available evidence, which is reliable and robust. Methods An on-line Delphi survey of 48 UK Clinical Research Collaboration registered Clinical Trials Units (CTUs) was undertaken. During round one, CTU Directors were asked to identify important topics that require methodological research. During round two, their opinion about the level of importance of each topic was recorded, and during round three, they were asked to review the group’s average opinion and revise their previous opinion if appropriate. Direct reminders were sent to maximise the number of responses at each round. Results are summarised using descriptive methods. Results Forty one (85%) CTU Directors responded to at least one round of the Delphi process: 25 (52%) responded in round one, 32 (67%) responded in round two, 24 (50%) responded in round three. There were only 12 (25%) who responded to all three rounds and 18 (38%) who responded to both rounds two and three. Consensus was achieved amongst CTU Directors that the top three priorities for trials methodological research were ‘Research into methods to boost recruitment in trials’ (considered the highest priority), ‘Methods to minimise attrition’ and ‘Choosing appropriate outcomes to measure’. Fifty other topics were included in the list of priorities and consensus was reached that two topics, ‘Radiotherapy study designs’ and ‘Low carbon trials’, were not priorities. Conclusions This priority setting exercise has identified the research topics felt to be most important to the key stakeholder group of Directors of UKCRC registered CTUs. The use of robust methodology to identify these priorities will help ensure that this work informs the trials methodological research agenda, with a focus on topics that will have most impact and relevance. PMID:24456928

Tales from a distant swamp: Petrological and paleobotanical clues for the origin of the sand coal lithotype (Mississippian, Valley Fields, Virginia)

USGS Publications Warehouse

Hower, J.C.; O'Keefe, J.M.K.; Eble, C.F.

2008-01-01

Tournasian (Mississippian) Price Formation semianthracites (Rmax = 2.40%) in the Valley Fields of southwestern Virginia contain a lithotype described in an early-20th-century report as a "sand" coal. The Center for Applied Energy Research inherited a collection of coals containing sand coal specimens, making it possible to study the lithotype from the long-closed mines. The sand coal consists of rounded quartz sand and maceral assemblages (secretinite, corpogelinite, and rounded collotelinite) along with banded collotelinite, vitrodetrinite, and inertodetrinite assemblages. The association of rounded macerals and similar-size quartz grains suggests transport. Oxidation rims surrounding the rounded collotelinite provides further evidence for transport. Due to the semianthracite rank, palynology could not be performed. Stratigraphic evidence indicates that the Lepidodendropsis flora would have been the dominant mire vegetation. Pteridosperms in this assemblage could have contributed resin rodlets, subsequently metamorphosed to collogelinite or secretinite. While a resin rodlet origin is an intriguing possibility for the origin of the rounded macerals (at least some of the rounded maceral, the rounded collotelinite clearly has a different origin), we cannot definitively prove this origin. ?? 2008 Elsevier B.V. All rights reserved.

Identification of competencies for patient education in physiotherapy using a Delphi approach.

PubMed

Forbes, Roma; Mandrusiak, Allison; Smith, Michelle; Russell, Trevor

2018-06-01

Patient education is a critical part of physiotherapy practice however an empirically derived set of competencies for its use does not exist. This study aimed to generate a set of competencies for patient education in physiotherapy using a consensus approach. A Delphi study with two rounds using a panel of expert physiotherapists within Australia was undertaken. In the first round, the panel of 12 specialist physiotherapists identified competencies required for patient education in the physiotherapy setting. Framework analysis was applied to develop a set of competencies that were assessed in the second round where ≥80% agreement of importance from the panel indicated consensus. Response rates of specialist physiotherapists agreeing to participate were 67% for the first round and 100% for the second round. Analysis following the first round produced 25 competencies. The second round resulted in agreement on a final set of 22 competencies. This study developed a concise list of competencies for patient education with a high level of expert agreement. By identifying the key competencies in this area, there is potential to benchmark patient education training and assessment of physiotherapists for improved educational and professional outcomes. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

In-vitro maturation of round spermatids using co-culture on Vero cells.

PubMed

Cremades, N; Bernabeu, R; Barros, A; Sousa, M

1999-05-01

In an attempt to determine whether co-culture could promote sperm maturation, three patients with non-obstructive azoospermia, two with maturation arrest at the level of primary spermatocytes and one patient with <1% tubules showing complete spermatogenesis, and one patient with total globozoospermia, gave consent to experimentally co-culture round spermatids retrieved from the testicle on Vero cell monolayers. In all azoospermic patients elongating spermatids could be obtained from round spermatids. In one case of maturation arrest, of 37 round spermatids co-cultured for up to 5 days, 30% developed flagella, 46% matured to elongating and 19% to elongated spermatids, with one mature spermatozoon also obtained (3%). In the same patient, primary cultures of three round spermatids with flagella enabled development of one further mature spermatozoon. In the case with total globozoospermia, of six round spermatids co-cultured for up to 5 days, one mature spermatozoon was obtained, with a flagellum and normal head morphology. These preliminary findings suggest that it may be possible to overcome the round spermatid block, and even the triggering of morphological abnormalities arising at the spermiogenic level, by in-vitro maturation under special environmental conditions.

2. HISTORIC PHOTOGRAPH, MERRITT PARKWAY UNDER CONSTRUCTION,LOOKING WEST TO ROUND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. HISTORIC PHOTOGRAPH, MERRITT PARKWAY UNDER CONSTRUCTION,LOOKING WEST TO ROUND HILL ROAD BRIDGE, CA. 1936. COLLECTION OF GEORGE L. LARNED. - Merritt Parkway, Round Hill Road Bridge, Spanning Merritt Parkway at 3.5 mile mark, Greenwich, Fairfield County, CT

Air Force Dynamic Mechanical Analysis of NATO Round Robin Propellant Testing for Development of AOP-4717

DTIC Science & Technology

2015-09-23

Round Robin Propellant Testing for Development of AOP-4717 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...area code) N/A Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. 239.18 0 Air Force Dynamic Mechanical Analysis of NATO Round Robin ...the clamps are tight at the coldest temperature. • Long tests such as the frequency sweep sequences prescribed in this round robin may be

IFLA General Conference, 1990. Division of Libraries Serving the General Public: Section on Public Libraries; Section of Children's Libraries, Children's Literature Documentation Centres, Round Table; Section of School Libraries; Section of Libraries for the Blind; INTAMEL, Round Table; Mobile Libraries, Round Table. Booklet 3.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

The 28 papers in this collection were presented at meetings of four sections and three round tables within the Division of Libraries Serving the General Public: (1) "Rural Community Information Services: Guidelines for Researching Need, Setting Up Services and Evaluating Performance" (Elaine Kempson); (2) "Library Activities at the Workplace"…

Oncoplastic round block technique has comparable operative parameters as standard wide local excision: a matched case-control study.

PubMed

Lim, Geok-Hoon; Allen, John Carson; Ng, Ruey Pyng

2017-08-01

Although oncoplastic breast surgery is used to resect larger tumors with lower re-excision rates compared to standard wide local excision (sWLE), criticisms of oncoplastic surgery include a longer-albeit, well concealed-scar, longer operating time and hospital stay, and increased risk of complications. Round block technique has been reported to be very suitable for patients with relatively smaller breasts and minimal ptosis. We aim to determine if round block technique will result in operative parameters comparable with sWLE. Breast cancer patients who underwent a round block procedure from 1st May 2014 to 31st January 2016 were included in the study. These patients were then matched for the type of axillary procedure, on a one to one basis, with breast cancer patients who had undergone sWLE from 1st August 2011 to 31st January 2016. The operative parameters between the 2 groups were compared. 22 patients were included in the study. Patient demographics and histologic parameters were similar in the 2 groups. No complications were reported in either group. The mean operating time was 122 and 114 minutes in the round block and sWLE groups, respectively (P=0.64). Length of stay was similar in the 2 groups (P=0.11). Round block patients had better cosmesis and lower re-excision rates. A higher rate of recurrence was observed in the sWLE group. The round block technique has comparable operative parameters to sWLE with no evidence of increased complications. Lower re-excision rate and better cosmesis were observed in the round block patients suggesting that the round block technique is not only comparable in general, but may have advantages to sWLE in selected cases.

Maximizing efficiency on trauma surgeon rounds.

PubMed

Ramaniuk, Aliaksandr; Dickson, Barbara J; Mahoney, Sean; O'Mara, Michael S

2017-01-01

Rounding by trauma surgeons is a complex multidisciplinary team-based process in the inpatient setting. Implementation of lean methodology aims to increase understanding of the value stream and eliminate nonvalue-added (NVA) components. We hypothesized that analysis of trauma rounds with education and intervention would improve surgeon efficacy. Level 1 trauma center with 4300 admissions per year. Average non-intensive care unit census was 55. Five full-time attending trauma surgeons were evaluated. Value-added (VA) and NVA components of rounding were identified. The components of each patient interaction during daily rounds were documented. Summary data were presented to the surgeons. An action plan of improvement was provided at group and individual interventions. Change plans were presented to the multidisciplinary team. Data were recollected 6 mo after intervention. The percent of interactions with NVA components decreased (16.0% to 10.7%, P = 0.0001). There was no change between the two periods in time of evaluation of individual patients (4.0 and 3.5 min, P = 0.43). Overall time to complete rounds did not change. There was a reduction in the number of interactions containing NVA components (odds ratio = 2.5). The trauma surgeons were able to reduce the NVA components of rounds. We did not see a decrease in rounding time or individual patient time. This implies that surgeons were able to reinvest freed time into patient care, or that the NVA components were somehow not increasing process time. Direct intervention for isolated improvements can be effective in the rounding process, and efforts should be focused upon improving the value of time spent rather than reducing time invested. Copyright © 2016 Elsevier Inc. All rights reserved.

The positional relationship between facial nerve and round window niche in patients with congenital aural atresia and stenosis.

PubMed

Chen, Keguang; Lyu, Huiying; Xie, Youzhou; Yang, Lin; Zhang, Tianyu; Dai, Peidong

2016-03-01

To investigate whether differences existing in the distance between facial nerve (FN) and round window niche opening among congenital aural atresia (CAA), congenital aural stenosis (CAS) and a normal control group and to assess its effect on the round window implantation of vibrant soundbridge, CT images of 10 normal subjects (20 ears), 27 CAS patients (30 ears) and 25 CAA patients (30 ears) were analyzed. The distances from the central point of round window niche opening to the terminal point of the horizontal segment, the salient point of pyramidal segment, the beginning point of the vertical segment, and the vertical segment of the facial nerve (abbreviate as OA, OB, OC, OE, respectively) were calculated based on three-dimensional reconstruction using mimics software. The results suggested that the pyramidal segment of the FN was positioned more closely to round window niche opening in patients with both CAA and CAS groups than that in control group, whereas there was no significant difference between CAA and CAS group (P < 0.05). The vertical portion of the FN was positioned more closely to round window niche opening in the CAA group than those in both the CAS and control groups with statistical significance (P < 0.05). Furthermore, the vertical portion of the FN was positioned more closely to round window niche opening in the CAS group than that in control group (P < 0.05). In conclusion, the dislocation between facial nerve and round window niche in patients with congenital auditory canal malformations could have significant effects on the round window implantation of vibrant soundbridge. Moreover, three-dimensional measurements and assessments before surgery might be helpful for a safer surgical approach and implantation of vibrant soundbridge.

Early Compared With Delayed Physician Rounds on Patient Satisfaction of Postpartum Women: A Randomized Controlled Trial.

PubMed

Roberts, Robyn P; Blackwell, Sean C; Brown, Kelly M; Pedroza, Claudia; Sibai, Baha M; Tyson, Jon E

2016-08-01

To investigate whether delayed timing of physician rounds improves patient satisfaction for postpartum women. Women were randomized to early (5-7 AM) or delayed (8-10 AM) physician rounding. Women with stillbirth, high-risk pregnancy, or complications precluding delayed rounding were excluded. At discharge, women completed a modified Hospital Consumer Assessment of Healthcare Providers and Systems survey. The primary outcome was rating of the hospital. Secondary outcomes included patient assessment of patient-physician communication, various hospital experiences, and timing of maternal and neonatal discharge. We estimated that 74 women were needed to detect a 20% difference in rating of the hospital (0-10 score) between groups (assumption P=.05, power 90%). Given limited information on primary outcome, an a priori plan was in place to conduct the study for 2 months. One hundred fifty-two women were randomized (n=76 early rounding; n=76 delayed rounding). More women had a cesarean delivery in the early compared with the delayed rounding group (47.4% compared with 22.4%). Median rating of the hospital was higher in the delayed as compared with the early rounding group (9.0 [7.0-9.0] compared with 7.0 [6.0-8.0]; P<.01). Median scores regarding physician communication and perception of hospital experiences were higher in the delayed compared with the early group (8.0 [7.0-9.0] compared with 6.0 [5.0-7.0]; P<.001). Adjustment for delivery mode did not alter results (P<.01). No differences in timing of maternal (P=.47) or neonatal hospital discharge (P=.35) were observed. Postpartum women receiving delayed physician rounding were more satisfied with their hospital experience and patient-physician communication without prolonging maternal or neonatal discharge. ClinicalTrials.gov, https://clinicaltrials.gov, NCT02432573.

Psychosocial care for persons affected by emergencies and major incidents: a Delphi study to determine the needs of professional first responders for education, training and support.

PubMed

Drury, John; Kemp, Verity; Newman, Jonathan; Novelli, David; Doyle, Christopher; Walter, Darren; Williams, Richard

2013-10-01

The role of ambulance clinicians in providing psychosocial care in major incidents and emergencies is recognised in recent Department of Health guidance. The study described in this paper identified NHS professional first responders' needs for education about survivors' psychosocial responses, training in psychosocial skills, and continuing support. Ambulance staff participated in an online Delphi questionnaire, comprising 74 items (Round 1) on 7-point Likert scales. Second-round and third-round participants each received feedback based on the previous round, and responded to modified versions of the original items and to new items for clarification. One hundred and two participants took part in Round 1; 47 statements (64%) achieved consensus. In Round 2, 72 people from Round 1 participated; 15 out of 39 statements (38%) achieved consensus. In Round 3, 49 people from Round 2 participated; 15 out of 27 statements (59%) achieved consensus. Overall, there was consensus in the following areas: 'psychosocial needs of patients' (consensus in 34/37 items); 'possible sources of stress in your work' (8/9); 'impacts of distress in your work' (7/10); 'meeting your own emotional needs' (4/5); 'support within your organisation' (2/5); 'needs for training in psychosocial skills for patients' (15/15); 'my needs for psychosocial training and support' (5/6). Ambulance clinicians recognise their own education needs and the importance of their being offered psychosocial training and support. The authors recommend that, in order to meet patients' psychosocial needs effectively, ambulance clinicians are provided with education and training in a number of skills and their own psychosocial support should be enhanced.

Acute effects of Surya Namaskar on the cardiovascular & metabolic system.

PubMed

Mody, Bhavesh Surendra

2011-07-01

With the recent rise in obesity awareness and the increased understanding of the importance of physical activity in promoting overall health, greater emphasis has been placed on improving physical fitness to enhance quality of life. Surya Namaskar, a component of Hatha Yoga, has been practiced by Asian Indians for hundreds of years and is often used in place of a typical fitness program. It consists of a series of postures (asanas) that are repeated 12 times per round. Only one published study has looked specifically at Surya Namaskar, measuring the energy cost of individual asanas (Sinha et al., 2004). However, practitioners typically perform several rounds of the asanas during a session. To assess the cardiorespiratory and metabolic responses of four rounds of Surya Namaskar, a typical amount performed by practitioners, to determine its potential as a training and weight loss tool. Six healthy Asian Indian men and women (18-22 years) who had trained in Surya Namaskar for over two years participated in the study. Testing was completed in a single session lasting about 30 min. To measure heart rate and oxygen consumption while performing the four rounds, participants were connected to a heart rate monitor and the Oxycon Mobile Metabolic System. Participants exercised at 80% of age-predicted maximal heart rate (HRmax) during Round 2, 84% during Round 3, and 90% during Round 4. Average intensity during the four rounds was 80% HRmax, sufficient to elicit a cardiorespiratory training effect. Oxygen consumption averaged 26 ml/kg/min during each round, resulting in an energy expenditure of 230 kcals during a 30 min session for a 60 kg individual. Regular practice of Surya Namaskar may maintain or improve cardiorespiratory fitness, as well as promote weight management. Copyright © 2010 Elsevier Ltd. All rights reserved.

Impact of rounded electrode corners on breakdown characteristics of AlGaN/GaN high-electron mobility transistors

NASA Astrophysics Data System (ADS)

Yamazaki, Taisei; Asubar, Joel T.; Tokuda, Hirokuni; Kuzuhara, Masaaki

2018-05-01

We investigated the impact of rounded electrode corners on the breakdown characteristics of AlGaN/GaN high-electron mobility transistors. For standard reference devices, catastrophic breakdown occurred predominantly near the sharp electrode corners. By introducing a rounded-electrode architecture, premature breakdown at the corners was mitigated. Moreover, the rate of breakdown voltage (V BR) degradation with an increasing gate width (W G) was significantly lower for devices with rounded corners. When W G was increased from 100 µm to 10 mm, the V BR of the reference device dropped drastically, from 1,200 to 300 V, whereas that of the rounded-electrode device only decreased to a respectable value of 730 V.

Putting the Family Back in the Center: A Teach-Back Protocol to Improve Communication During Rounds in a Pediatric Intensive Care Unit.

PubMed

Bogue, Terri L; Mohr, Lynn

2017-06-01

Patient- and family-centered care is endorsed by leading health care organizations. To incorporate the family in interdisciplinary rounds in the pediatric intensive care unit, it is necessary to prepare the family to be an integral member of the child's health care team. When the family is part of the health care team, interdisciplinary rounds ensure that the family understands the process of interdisciplinary rounds and that it is an integral part of the discussion. An evidence-based protocol to provide understanding and support to families related to interdisciplinary rounds has significant impact on satisfaction, trust, and patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Electrically-conductive proppant and methods for making and using same

DOEpatents

Cannan, Chad; Roper, Todd; Savoy, Steve; Mitchell, Daniel R.

2016-09-06

Electrically-conductive sintered, substantially round and spherical particles and methods for producing such electrically-conductive sintered, substantially round and spherical particles from an alumina-containing raw material. Methods for using such electrically-conductive sintered, substantially round and spherical particles in hydraulic fracturing operations.

20 CFR 653.500 - Purpose and scope of subpart.

Code of Federal Regulations, 2012 CFR

2012-04-01

... year round basis. Orders seeking workers to perform agricultural or food processing work on a year round basis which involves permanent relocation are not subject to the requirements of this subpart... interstate clearance systems for less than year round agricultural or food processing work. ...

20 CFR 653.500 - Purpose and scope of subpart.

Code of Federal Regulations, 2011 CFR

2011-04-01

... year round basis. Orders seeking workers to perform agricultural or food processing work on a year round basis which involves permanent relocation are not subject to the requirements of this subpart... interstate clearance systems for less than year round agricultural or food processing work. ...

Investigating Discourses for Administrators' Learning within Instructional Rounds

ERIC Educational Resources Information Center

Allen, David; Roegman, Rachel; Hatch, Thomas

2016-01-01

Instructional rounds is a professional learning practice for supporting school and district leaders' understanding of the instructional core, the interaction among curricular content, instruction, and student learning, which is a foundation for instructional leadership practices. This article examines instructional rounds visits within a network…

20 CFR 653.500 - Purpose and scope of subpart.

Code of Federal Regulations, 2014 CFR

2014-04-01

... year round basis. Orders seeking workers to perform agricultural or food processing work on a year round basis which involves permanent relocation are not subject to the requirements of this subpart... interstate clearance systems for less than year round agricultural or food processing work. ...

20 CFR 653.500 - Purpose and scope of subpart.

Code of Federal Regulations, 2013 CFR

2013-04-01

... year round basis. Orders seeking workers to perform agricultural or food processing work on a year round basis which involves permanent relocation are not subject to the requirements of this subpart... interstate clearance systems for less than year round agricultural or food processing work. ...

Difference of auditory brainstem responses by stimulating to round and oval window in animal experiments.

PubMed

Lee, Jyung Hyun; Park, Hyo Soon; Wei, Qun; Kim, Myoung Nam; Cho, Jin-Ho

2017-01-02

ABSTACT To ensure the safety and efficacy of implantable hearing aids, animal experiments are an essential developmental procedure, in particular, auditory brainstem responses (ABRs) can be used to verify the objective effectiveness of implantable hearing aids. This study measured and compared the ABRs generated when applying the same vibration stimuli to an oval window and round window. The ABRs were measured using a TDT system 3 (TDT, USA), while the vibration stimuli were applied to a round window and oval window in 4 guinea pigs using a piezo-electric transducer with a proper contact tip. A paired t-test was used to determine any differences between the ABR amplitudes when applying the stimulation to an oval window and round window. The paired t-test revealed a significant difference between the ABR amplitudes generated by the round and oval window stimulation (t = 10.079, α < .0001). Therefore, the results confirmed that the biological response to round window stimulation was not the same as that to oval window stimulation.

Ethics rounds do not improve the handling of ethical issues by psychiatric staff.

PubMed

Silén, Marit; Haglund, Kristina; Hansson, Mats G; Ramklint, Mia

2015-08-01

One way to support healthcare staff in handling ethically difficult situations is through ethics rounds that consist of discussions based on clinical cases and are moderated by an ethicist. Previous research indicates that the handling of ethically difficult situations in the workplace might have changed after ethics rounds. This, in turn, would mean that the "ethical climate", i.e. perceptions of how ethical issues are handled, would have changed. To investigate whether ethics rounds could improve the ethical climate perceived by staff working in psychiatry outpatient clinics. In this quasi-experimental study, six inter-professional ethics rounds led by a philosopher/ethicist were conducted at two psychiatry outpatient clinics. Changes in ethical climate were measured at these clinics as well as at two control clinics at baseline and after the intervention period using the instrument Hospital Ethical Climate Survey. Within-groups comparisons of median sum scores of ethical climate showed that no statistically significant differences were found in the intervention group before or after the intervention period. The median sum scores for ethical climate were significantly higher, both at baseline and after the intervention period (P ≤ 0.001; P = 0.046), in the intervention group. Ethics rounds in psychiatric outpatient clinics did not result in significant changes in ethical climate. Outcomes of ethics rounds might, to a higher degree, be directed towards patient-related outcomes rather than towards the staff's working environment, as the questions brought up for discussion during the ethics rounds concerned patient-related issues.

Round window closure affects cochlear responses to suprathreshold stimuli.

PubMed

Cai, Qunfeng; Whitcomb, Carolyn; Eggleston, Jessica; Sun, Wei; Salvi, Richard; Hu, Bo Hua

2013-12-01

The round window acts as a vent for releasing inner ear pressure and facilitating basilar membrane vibration. Loss of this venting function affects cochlear function, which leads to hearing impairment. In an effort to identify functional changes that might be used in clinical diagnosis of round window atresia, the current investigation was designed to examine how the cochlea responds to suprathreshold stimuli following round window closure. Prospective, controlled, animal study. A rat model of round window occlusion (RWO) was established. With this model, the thresholds of auditory brainstem responses (ABR) and the input/output (IO) functions of distortion product otoacoustic emissions (DPOAEs) and acoustic startle responses were examined. Round window closure caused a mild shift in the thresholds of the auditory brainstem response (13.5 ± 9.1 dB). It also reduced the amplitudes of the distortion product otoacoustic emissions and the slope of the input/output functions. This peripheral change was accompanied by a significant reduction in the amplitude, but not the threshold, of the acoustic startle reflex, a motor response to suprathreshold sounds. In addition to causing mild increase in the threshold of the auditory brainstem response, round window occlusion reduced the slopes of both distortion product otoacoustic emissions and startle reflex input/output functions. These changes differ from those observed for typical conductive or sensory hearing loss, and could be present in patients with round window atresia. However, future clinical observations in patients are needed to confirm these findings. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Adaptation of a hospital electronic referral system for antimicrobial stewardship prospective audit and feedback rounds.

PubMed

Rawlins, Matthew D M; Raby, Edward; Sanfilippo, Frank M; Douglass, Rae; Chambers, Jonathan; McLellan, Duncan; Dyer, John R

2018-05-04

To evaluate the impact of the adaptation of an existing electronic referral application for use in antimicrobial stewardship prospective audit and feedback rounds (antimicrobial rounds). Retrospective, single-centre observational study between March 2015 and February 2016. A new quaternary referral centre. Adults referred for antimicrobial rounds outside of the intensive care and haematology units. Adaptation of an electronic referral application used by medical and allied health staff. A questionnaire-style referral form was designed to capture patient clinical details using a combination of free text and dropdown menus. Clinical pharmacists were educated and granted access to the system. The proportion of completed electronic referrals of total round reviews by month for the 12 months after implementation. The time from request to completion of reviews. The impact on adherence to advice provided on rounds. The impact on the institutional usage of broad-spectrum antibiotics: glycopeptides, carbapenems, third and fourth generation cephalosporins, fluoroquinolones and piperacillin/tazobactam. Over the study period, the proportion of electronic referrals of completed antimicrobial round reviews increased from 59% to 88% (P < 0.001); 75.7% of accepted electronic referrals were seen within 48 h of request. The proportion of advice ignored fell from 18% to 8.5% (P < 0.001). Piperacillin/tazobactam, fluoroquinolone and glycopeptide usage decreased. The adaptation of an electronic referral application for antimicrobial rounds was associated with increased adherence to advice and reduction in use in target antibiotics. Our model is now used at other institutions.

[Priorities for health policy and systems research focused on human resources in health].

PubMed

Reveiz, Ludovic; Chapman, Evelina; Flórez, Carlos E Pinzón; Torres, Rubén

2013-11-01

Identify priorities for health policy and systems research related to human resources in Latin America and Caribbean countries. An online survey was designed based on a search in PubMed, Cochrane Library, and LILACS that contributed previously prioritized research questions. Respondents, mainly researchers and decision-makers, were identified through various sources. The first round, directed at researchers, aimed at refining and adding research questions and prioritizing questions that researchers regarded as relevant or very relevant. The second round was directed at researchers and decision-makers. A question was considered a priority when 50% (or more) of respondents described it as "relevant" or "very relevant." The first round included 20 questions on human resources and 33/66 researchers responded. Questions suggested by the researchers were added, resulting in 26 questions for the second round, which were sent to 121 researchers and decision-makers. Respondent representation by country was uniform in both rounds. In the second round, 14/26 (54%) questions were described as very relevant. Priority issues related to regulation of the market, integration of education and health care needs, and distribution of human resources. The response rate was 50% in the first round (33/66), and 34% in the second round (41/121). The results of this exercise provide a starting point for mobilization of resources for health policy and systems research. Identification of health systems research priorities is an effective and efficient strategy for reorienting political, financial, management, and social organization efforts for attaining universal health coverage.

Discretization vs. Rounding Error in Euler's Method

ERIC Educational Resources Information Center

Borges, Carlos F.

2011-01-01

Euler's method for solving initial value problems is an excellent vehicle for observing the relationship between discretization error and rounding error in numerical computation. Reductions in stepsize, in order to decrease discretization error, necessarily increase the number of steps and so introduce additional rounding error. The problem is…

77 FR 32591 - Procurement List; Proposed Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... NSN: 5120-00-NIB-0014--Shovel, Round Point, Closed Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0015--Shovel, Round Point, Open Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0016--Shovel, Round Point, Open Back, Industrial Grade, 29...

77 FR 44218 - Procurement List; Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-27

..., Fiberglass Handle NSN: 5120-00-NIB-0014--Shovel, Round Point, Closed Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0015--Shovel, Round Point, Open Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0016--Shovel, Round Point, Open Back, Industrial Grade, 29...

Surface structure of micro-diamond from ultrahigh-pressure felsic granulite, Bohemian Massif: AFM study of growth and resorption phenomena

NASA Astrophysics Data System (ADS)

Kotková, J.; Klapetek, P.

2012-04-01

Morphology, associated phases and retrogression phenomena of in-situ microdiamonds formed at extreme pressures in ultrahigh-pressure metamorphic terranes represent excellent tools to study character of diamond-forming media at great depths. Well-preserved microdiamonds discovered recently along with coesite in ultrahigh-pressure granulites of the north Bohemian crystalline basement, European Variscan belt (Kotková et al., 2011), provide unique material for such investigations. The diamonds are enclosed in major granulite phases, i.e. garnet both in felsic and intermediate lithologies and in kyanite in the felsic sample, as well as in zircon. Transmitted and reflected light microscopy of the felsic granulite sample, with peak mineral assemblage garnet, kyanite, feldspar and quartz, revealed presence of numerous, 5-20 μm-sized, perfectly preserved diamond crystals enclosed in kyanite grains. In contrast, diamonds within garnet are rare, can reach up to 30 μm in size, and graphite rims as well as polycrystalline graphite aggregates possibly representing complete diamond retrogression are common. We applied atomic force microscopy to study in-situ crystal morphology and surface microtopographic features, representing clues to the conditions and mechanisms of crystal formation as well as diamond resorption and retrogression. Both diamond enclosed in garnet and in kyanite of the felsic granulite occur exclusively as single crystals. The crystals have octahedral crystal shapes with straight but rounded edges and rounded corners. Concentric triangular terraces delimiting a flat triangular table on crystal scale and small micron-sized negatively oriented downward-pointing trigons developed on the octahedron crystal faces. Higher magnification reveals presence of discontinuous elongate hillocks oriented parallel to the octahedron face edge with positively oriented trigons. We suggest that the large-scale triangular terraces represent growth features. In contrast, the rounding of crystal edges and corners and development of negative trigons reflect diamond resorption. According to experimental works, such features are attributed to high temperature resorption, i.e. oxidation above ~ 950°C due to interaction with CO2 and/or H2O-bearing fluids (or fluid-bearing melts). Our results are consistent with presence of supercritical C-O-H fluid in the rocks in subduction zones documented from other ultrahigh-pressure metamorphic terranes, the resorption morphology corresponding rather to the interaction with water-rich than CO2-rich fluids. Kotková J., ÓBrien P., Ziemann M. (2011): Diamond and coesite discovered in Saxony-type granulite: Solution to the Variscan garnet peridotite enigma. Geology, 39, 7, 667-670.

Explaining the Role of Proximate Determinants on Fertility Decline among Poor and Non-Poor in Asian Countries

PubMed Central

Majumder, Nabanita; Ram, Faujdar

2015-01-01

Objectives We examined the overall contributions of the poor and non-poor in fertility decline across the Asian countries. Further, we analyzed the direct and indirect factors that determine the reproductive behaviour of two distinct population sub-groups. Design Data from several new rounds of DHS surveys are available over the past few years. The DHS provides cross-nationally comparable and useful data on fertility, family planning, maternal and child health along with the other information. Six selected Asian countries namely: Bangladesh, India, Indonesia, Nepal, Philippines, and Vietnam are considered for the purpose of the study. Three rounds of DHS surveys for each country (except Vietnam) are considered in the present study. Methods Economic status is measured by computing a “wealth index”, i.e. a composite indicator constructed by aggregating data on asset ownership and housing characteristics using principal components analysis (PCA). Computed household wealth index has been broken into three equal parts (33.3 percent each) and the lowest and the highest 33.3 percent is considered as poor and non-poor respectively. The Bongaarts model was employed to quantify the contribution of each of the proximate determinants of fertility among poor and non-poor women. Results Fertility reduction across all population subgroups is now an established fact despite the diversity in the level of socio-economic development in Asian countries. It is clear from the analysis that fertility has declined irrespective of economic status at varying degrees within and across the countries which can be attributed to the increasing level of contraceptive use especially among poor women. Over the period of time changing marriage pattern and induced abortion are playing an important role in reducing fertility among poor women. Conclusions Fertility decline among majority of the poor women across the Asian countries is accompanied by high prevalence of contraceptive use followed by changing marriage pattern and induced abortion. PMID:25689843

Characteristics and EGFP expression of goat mammary gland epithelial cells.

PubMed

Zheng, Y-M; He, X-Y; Zhang, Y

2010-12-01

The aims of this study were (i) to establish a goat mammary gland epithelial (GMGE) cell line, and (ii) to determine if these GMGE cells could be maintained long-term in culture by continuous subculturing following transfection with a reporter gene, enhanced green fluorescence protein (EGFP). Primary culture of GMGE cells was achieved by outgrowth of migrating cells from the fragments of the mammary gland tissue of a lactating goat. The passage 16 GMGE cells were transfected with EGFP gene using lipofection. The expression of Cell keratins of epithelial cells in GMGE cells was test by immunofluorescence. Βeta-Casein gene mRNA was test for GMGE cells by RT-PCR. The results showed that when grown at low density on a plastic substratum, the GMGE cells formed islands, and when grown to confluency, the cells formed a monolayer and aggregated with the characteristic cobble-stone morphology of epithelial cells. GMGE cells could form dome-like structure which looked like nipple, and the lumen-like structures formed among the cells. Several blister-like structures appeared in the appearance of the cells. The GMGE cells contained different cell types, majority of the cells were short shuttle-like or polygon which were beehive-like. A part of cells were round and flat, a small number of cells were elongated. Some of the GMGE cells contained milk drops. The cell nuclei were round which had 2-4 obvious cores. The expression of Cell keratins demonstrated the property of epithelial cells in GMGE cells by immunofluorescence. The GMGE cells could express transcript encoding a Βeta-Casein protein. EGFP gene was successfully transferred into the GMGE cells, and the transfected cells could be maintained long-term in culture by continuous subculturing. In conclusion, we have established a EGFP gene transfected GMGE (ET-GMGE) cell line and maintained it long-term in culture by continuous subculturing. © 2010 Blackwell Verlag GmbH.

40 CFR 86.001-28 - Compliance with emission standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

...)(iii) of this section rounded to two significant figures in accordance with the Rounding-Off Method specified in ASTM E29-90, Standard Practice for Using Significant Digits in Test Data to Determine... adjusted emission value of paragraph (b)(8)(iii) of this section rounded to two significant figures in...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

40 CFR 86.001-28 - Compliance with emission standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

...)(iii) of this section rounded to two significant figures in accordance with the Rounding-Off Method specified in ASTM E29-90, Standard Practice for Using Significant Digits in Test Data to Determine... adjusted emission value of paragraph (b)(8)(iii) of this section rounded to two significant figures in...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

40 CFR 86.001-28 - Compliance with emission standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

...)(iii) of this section rounded to two significant figures in accordance with the Rounding-Off Method specified in ASTM E29-90, Standard Practice for Using Significant Digits in Test Data to Determine... adjusted emission value of paragraph (b)(8)(iii) of this section rounded to two significant figures in...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

77 FR 13172 - Guidance on the Use of Rounding in Air Fare Advertisements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... Advertisements AGENCY: Office of the Secretary, Department of Transportation. ACTION: Notice Providing Guidance on the Use of Rounding in Air Fare Advertisements. SUMMARY: The Department is publishing the following notice providing guidance on the use of rounding in air fare advertisements. FOR FURTHER...

76 FR 62006 - Proposed Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... Sea Level, rounded to the nearest 0.1 meter. ** BFEs to be changed include the listed downstream and... above ground. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ** BFEs to be changed include... Datum. + North American Vertical Datum. Depth in feet above ground. [caret] Mean Sea Level, rounded to...

77 FR 73324 - Final Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

.... Depth in feet above ground. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. [[Page 73326.... + North American Vertical Datum. Depth in feet above ground. [caret] Mean Sea Level, rounded to the... Sea Level, rounded to the nearest 0.1 meter. ADDRESSES City of Walnut Ridge Maps are available for...

Relationships, Instruction, Understandings: One District's Implementation of Rounds

ERIC Educational Resources Information Center

Roegman, Rachel; Hatch, Thomas; Hill, Kathryn; Kniewel, Victoria S.

2015-01-01

Purpose: The purpose of this paper is to show how instructional rounds contributes to shared understandings and facilitates the development of relationships among administrators. Design/methodology/approach: This mixed methods study draws on three years of data in a district engaged in rounds. Administrators annually completed a social network…

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 4 2013-10-01 2013-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

Year-Round School. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2009-01-01

Despite the numerous advantages of a year-round schedule, there are significant political hurdles to its implementation. The most successful year-round schools are those where leaders worked closely with staff and families to maximize the benefits, minimize the costs, and build support for modifying the traditional school calendar. The research on…

7 CFR 25.1 - Applicability and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Reconciliation Act of 1993, title XIII, subchapter C, part I (Round I), the Taxpayer Relief Act of 1997, title IX, subtitle F (Round II), the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1999 (Public Law 105-277) (Round IIS), and the Community Renewal Tax Relief...

Rounds Process: Puts Teachers in Charge of Learning

ERIC Educational Resources Information Center

Troen, Vivian; Boles, Katherine C.

2014-01-01

Most people are familiar with the practice of medical rounds, in which interns and mentoring physicians visit patients in an institutional setting, observe their various conditions, discuss what they observed, and analyze possible treatment options and outcomes. In the medical profession, making these rounds is viewed as a significant and highly…

46 CFR 11.705 - Route familiarization requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... limitations specified in this section, the number of round trips required to qualify an applicant for a... endorsement as first-class pilot shall furnish evidence of having completed a minimum number of round trips... sought. Evidence of having completed a minimum number of round trips while serving as an observer...

Test/QA Plan for Verification of Semi-Continuous Ambient Air Monitoring Systems - Second Round

EPA Science Inventory

Test/QA Plan for Verification of Semi-Continuous Ambient Air Monitoring Systems - Second Round. Changes reflect performance of second round of testing at new location and with various changes to personnel. Additional changes reflect general improvements to the Version 1 test/QA...

46 CFR 11.705 - Route familiarization requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... limitations specified in this section, the number of round trips required to qualify an applicant for a... endorsement as first-class pilot shall furnish evidence of having completed a minimum number of round trips... sought. Evidence of having completed a minimum number of round trips while serving as an observer...

46 CFR 11.705 - Route familiarization requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... limitations specified in this section, the number of round trips required to qualify an applicant for a... endorsement as first-class pilot shall furnish evidence of having completed a minimum number of round trips... sought. Evidence of having completed a minimum number of round trips while serving as an observer...

7 CFR 25.1 - Applicability and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Reconciliation Act of 1993, title XIII, subchapter C, part I (Round I), the Taxpayer Relief Act of 1997, title IX, subtitle F (Round II), the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1999 (Public Law 105-277) (Round IIS), and the Community Renewal Tax Relief...

7 CFR 25.1 - Applicability and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Reconciliation Act of 1993, title XIII, subchapter C, part I (Round I), the Taxpayer Relief Act of 1997, title IX, subtitle F (Round II), the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1999 (Public Law 105-277) (Round IIS), and the Community Renewal Tax Relief...

Australia: round module handling and cotton classing

USDA-ARS?s Scientific Manuscript database

Round modules of seed cotton produced via on-board module building harvesters are the reality of the cotton industry, worldwide. Although round modules have been available to the industry for almost a decade, there is still no consensus on the best method to handle the modules, particularly when th...

7 CFR 25.602 - Eligible recipients.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Eligible recipients. 25.602 Section 25.602 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Round II and... made to the lead managing entities on behalf of the Round II rural empowerment zones and Round IIS...

Creating a Cycle of Continuous Improvement through Instructional Rounds

ERIC Educational Resources Information Center

Meyer-Looze, Catherine L.

2015-01-01

Instructional Rounds is a continuous improvement strategy that focuses on the technical core of educational systems as well as educators collaborating side-by-side. Concentrating on collective learning, this process only makes sense within an overall strategy of improvement. This case study examined the Instructional Rounds process in a northern…

7 CFR 25.602 - Eligible recipients.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Eligible recipients. 25.602 Section 25.602 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Round II and... made to the lead managing entities on behalf of the Round II rural empowerment zones and Round IIS...

A proposed standard round compact specimen for plane strain fracture toughness testing

NASA Technical Reports Server (NTRS)

Underwood, J. H.; Newman, J. C., Jr.; Seeley, R. R.

1980-01-01

A round, disk-shaped specimen is proposed as a standard test specimen for addition to ASTM Test for Plane-Strain Fracture Toughness of Metallic Materials (E 399-78A). The specimen is diametrically cracked, and loaded in the same way as the existing standard compact specimen. Tests and analyses were performed to verify that the proposed round compact specimen and associated stress intensity factor K solution are appropriate for a standard plane strain fracture toughness test. The use of the round compact specimen for other fracture tests is described.

Weapon Performance Testing and Analysis: The MODI-PAC Round, the Number 4 Lead-Shot Round, and the Flying Baton

DTIC Science & Technology

1976-01-01

items. The items tested were the MODI-PAC, a proprietary item of Reming)on Arms Company, a standard 12 - gauge round of No. 4 lead shot, and an...to refrain from testing this item. Therefore, the final selection of items for testing were (1) the MODI-PAC, (2) a standard 12 - gauge shotgun round of...The first item evaluated was the MODI-PAC5. The MOQ1-PAC which standsfor “modified impact “ is a 12 - gauge shotgun shell loaded with approximately 320

Time signal distribution in communication networks based on synchronous digital hierarchy

NASA Technical Reports Server (NTRS)

Imaoka, Atsushi; Kihara, Masami

1993-01-01

A new method that uses round-trip paths to accurately measure transmission delay for time synchronization is proposed. The performance of the method in Synchronous Digital Hierarchy networks is discussed. The feature of this method is that it separately measures the initial round trip path delay and the variations in round-trip path delay. The delay generated in SDH equipment is determined by measuring the initial round-trip path delay. In an experiment with actual SDH equipment, the error of initial delay measurement was suppressed to 30ns.

Relationship between HPLC precision and number of significant figures when reporting impurities and when setting specifications.

PubMed

Agut, Christophe; Segalini, Audrey; Bauer, Michel; Boccardi, Giovanni

2006-05-03

The rounding of an analytical result is a process that should take into account the uncertainty of the result, which is in turn assessed during the validation exercise. Rounding rules are known in physical and analytical chemistry since a long time, but are often not used or misused in pharmaceutical analysis. The paper describes the theoretical background of the most common rules and their application to fix the rounding of results and specifications. The paper makes use of uncertainty values of impurity determination acquired during studies of reproducibility and intermediate precision with regards to 22 impurities of drug substances or drug products. As a general rule, authors propose the use of sound and well-established rounding rules to derive rounding from the results of the validation package.

Short Round Sub-Linear Zero-Knowledge Argument for Linear Algebraic Relations

NASA Astrophysics Data System (ADS)

Seo, Jae Hong

Zero-knowledge arguments allows one party to prove that a statement is true, without leaking any other information than the truth of the statement. In many applications such as verifiable shuffle (as a practical application) and circuit satisfiability (as a theoretical application), zero-knowledge arguments for mathematical statements related to linear algebra are essentially used. Groth proposed (at CRYPTO 2009) an elegant methodology for zero-knowledge arguments for linear algebraic relations over finite fields. He obtained zero-knowledge arguments of the sub-linear size for linear algebra using reductions from linear algebraic relations to equations of the form z = x *' y, where x, y ∈ Fnp are committed vectors, z ∈ Fp is a committed element, and *' : Fnp × Fnp → Fp is a bilinear map. These reductions impose additional rounds on zero-knowledge arguments of the sub-linear size. The round complexity of interactive zero-knowledge arguments is an important measure along with communication and computational complexities. We focus on minimizing the round complexity of sub-linear zero-knowledge arguments for linear algebra. To reduce round complexity, we propose a general transformation from a t-round zero-knowledge argument, satisfying mild conditions, to a (t - 2)-round zero-knowledge argument; this transformation is of independent interest.

Fourteen babies born after round spermatid injection into human oocytes

PubMed Central

Tanaka, Atsushi; Nagayoshi, Motoi; Takemoto, Youichi; Tanaka, Izumi; Kusunoki, Hiroshi; Watanabe, Seiji; Kuroda, Keiji; Takeda, Satoru; Ito, Masahiko; Yanagimachi, Ryuzo

2015-01-01

During the human in vitro fertilization procedure in the assisted reproductive technology, intracytoplasmic sperm injection is routinely used to inject a spermatozoon or a less mature elongating spermatid into the oocyte. In some infertile men, round spermatids (haploid male germ cells that have completed meiosis) are the most mature cells visible during testicular biopsy. The microsurgical injection of a round spermatid into an oocyte as a substitute is commonly referred to as round spermatid injection (ROSI). Currently, human ROSI is considered a very inefficient procedure and of no clinical value. Herein, we report the birth and development of 14 children born to 12 women following ROSI of 734 oocytes previously activated by an electric current. The round spermatids came from men who had been diagnosed as not having spermatozoa or elongated spermatids by andrologists at other hospitals after a first Micro-TESE. A key to our success was our ability to identify round spermatids accurately before oocyte injection. As of today, all children born after ROSI in our clinic are without any unusual physical, mental, or epigenetic problems. Thus, for men whose germ cells are unable to develop beyond the round spermatid stage, ROSI can, as a last resort, enable them to have their own genetic offspring. PMID:26575628

Fourteen babies born after round spermatid injection into human oocytes.

PubMed

Tanaka, Atsushi; Nagayoshi, Motoi; Takemoto, Youichi; Tanaka, Izumi; Kusunoki, Hiroshi; Watanabe, Seiji; Kuroda, Keiji; Takeda, Satoru; Ito, Masahiko; Yanagimachi, Ryuzo

2015-11-24

During the human in vitro fertilization procedure in the assisted reproductive technology, intracytoplasmic sperm injection is routinely used to inject a spermatozoon or a less mature elongating spermatid into the oocyte. In some infertile men, round spermatids (haploid male germ cells that have completed meiosis) are the most mature cells visible during testicular biopsy. The microsurgical injection of a round spermatid into an oocyte as a substitute is commonly referred to as round spermatid injection (ROSI). Currently, human ROSI is considered a very inefficient procedure and of no clinical value. Herein, we report the birth and development of 14 children born to 12 women following ROSI of 734 oocytes previously activated by an electric current. The round spermatids came from men who had been diagnosed as not having spermatozoa or elongated spermatids by andrologists at other hospitals after a first Micro-TESE. A key to our success was our ability to identify round spermatids accurately before oocyte injection. As of today, all children born after ROSI in our clinic are without any unusual physical, mental, or epigenetic problems. Thus, for men whose germ cells are unable to develop beyond the round spermatid stage, ROSI can, as a last resort, enable them to have their own genetic offspring.

Retrofacial approach to access the round window for cochlear implantation of malformed ears.

PubMed

Rizk, Habib; O'Connell, Brendan; Stevens, Shawn; Meyer, Ted

2015-03-01

To report the use of the retrofacial approach for cochlear implantation in three cases of malformed ears with inaccessible round windows through the standard facial recess. Two children with bilateral profound sensorineural hearing loss who were cochlear implant candidates. One patient had bilateral sequential cochlear implantations and the other a unilateral implant. Retrofacial approach to access the posterior mesotympanum and visualize the round window. Ability to complete the surgery with full insertion of the implant and no complications such as facial nerve injury. We implanted three ears in two patients with multiple external and middle ear malformations with an aberrant facial nerve or a posteriorly displaced round window niche. The standard facial recess approach did not allow visualization of the round window. We resorted to a retrofacial approach to access the posterior mesotympanum and proceeded with the surgery through an anterior and inferior cochleostomy or through the round window. In cases with an aberrant facial nerve or inaccessible round window through the facial recess, the retrofacial approach is a good alternative but requires a certain level of expertise and familiarity with temporal bone anatomy. The decision to use an unconventional approach should be considered before surgery, but the ultimate decision may require intraoperative assessment.

Diet shift of double-crested cormorants in eastern Lake Ontario associated with the expansion of the invasive round goby

USGS Publications Warehouse

Johnson, James H.; Ross, Robert M.; McCullough, Russell D.; Mathers, Alastair

2010-01-01

The proliferation of the invasive round goby (Apollonia melanostoma) in the Great Lakes has caused shifts in the trophic ecology in some areas. We examined the diet of double-crested cormorants (Phalacrocorax auritas) prior to, and immediately after, round goby population expansion at two colonies, Pigeon and Snake Islands, in eastern Lake Ontario from 1999 to 2007. Cormorant diet was determined from the examination of 10,167 pellets collected over the nine-year period. By the second year round gobies were found in the diet (2002 at Snake Island and 2003 at Pigeon Island) they were the main species consumed by cormorants at each colony. The dominance of round goby in cormorant diets had a significant effect on both daily fish consumption and seasonal trends in fish consumption compared to the pre-goby years. Seasonal differences that were observed during the pre-goby years were lost once gobies became the main diet component of cormorants. The rapid switch to a benthic prey such as round goby, from a largely limnetic fish diet demonstrates the adaptive foraging ability of cormorants. Round goby may act as a buffer for yellow perch and smallmouth bass, two sport fish impacted by cormorant predation in eastern Lake Ontario.

Leadership rounds to reduce health care-associated infections.

PubMed

Knobloch, Mary Jo; Chewning, Betty; Musuuza, Jackson; Rees, Susan; Green, Christopher; Patterson, Erin; Safdar, Nasia

2018-03-01

Evidence-based guidelines exist to reduce health care-associated infections (HAIs). Leadership rounds are one tool leaders can use to ensure compliance with guidelines, but have not been studied specifically for the reduction of HAIs. This study examines HAI leadership rounds at one facility. We explored unit-based HAI leadership rounds led by 2 hospital leaders at a large academic hospital. Leadership rounds were observed on 19 units, recorded, and coded to identify themes. Themes were linked to the Consolidated Framework for Implementation Research and used to guide interviews with frontline staff members. Staff members disclosed unit-specific problems and readily engaged in problem-solving with top hospital leaders. These themes appeared over 350 times within 22 rounds. Findings revealed that leaders used words that demonstrated fallibility and modeled curiosity, 2 factors associated with learning climate and psychologic safety. These 2 themes appeared 115 and 142 times, respectively. The flexible nature of the rounds appeared to be conducive for reflection and evaluation, which was coded 161 times. Each interaction between leaders and frontline staff can foster psychologic safety, which can lead to open problem-solving to reduce barriers to implementation. Discovering specific communication and structural factors that contribute to psychologic safety may be powerful in reducing HAIs. Published by Elsevier Inc.

The role of immunohistochemistry in the analysis of the spectrum of small round cell tumours at a tertiary care centre.

PubMed

D'cruze, Lawrence; Dutta, Ruma; Rao, Shalinee; R, Anuradha; Varadarajan, Suresh; Kuruvilla, Sarah

2013-07-01

The term, "Small Round - Cell Tumours" (SRCT) describes a group of highly aggressive malignant neoplasms which are composed predominantly of small and monotonous undifferentiated cells with high nucleocytoplasmic ratios. Immunohistochemistry (IHC) plays a crucial role in catagorizing the small round - cell tumours. This study was done to analyse the spectrum of small round cell tumours over a period of five years at a tertiary care centre and to study the relevance of immunohistochemistry in making precise diagnoses of the small round cell tumours. Formalin - fixed, paraffin - embedded sections of tumours which were diagnosed as small round cell tumours on small biopsies and resected specimens were retrieved from the files of the Department of Pathology of Sri Ramachandra Medical College and Research institute, in the period from January 2005 to December 2009. This study was confined to the bone and the soft tissues. Decalcification was performed on the bony tissues before the routine processing was done. The patients belonging to all age groups were included in this study. The small round cell tumours of the bone marrow, the spleen and the lymph node was excluded from our study. Immunohistochemical stains were performed to differentiate and categorise the small round blue cell tumours. The immunomarkers which were utilised in this study included CD45/LCA (the lymphocyte common antigen), CD20, CD3, CD99 (cluster of differentiation 99 also known as MIC2), desmin, EMA (epithelial membrane antigen), CK(cytokeratin), synaptophysin, chromogranin and GFAP (Glial fibrillary acidic protein). Forty three cases of small round cell tumours were analysed, which included 19 cases of NHL (non Hodgkin's lymphoma), 6 cases of Ewing/PNETs (primitive neuroectodermal tumours), 3 cases of atypical carcinoid, 3 cases of olfactory neuroblastoma, 2 cases each of rhabdomyosarcoma, Wilms tumour, neuroblastoma and synovial sarcoma and 1 case each of small cell osteosarcoma, small (oat) cell carcinoma, medulloblastoma and hepatoblastoma. By using a panel of monoclonal antibodies, we could arrive at a final diagnosis for all the 40 cases in which immunohistochemistry was performed. Our study showed that the use of immunohistochemistry was extremely beneficial. A majority of the small round cell tumours occurred between the ages of 15-45 years and the most common small round cell tumour was Non-Hodgkins lymphoma (extra lymphoreticular).

Research priorities of the Canadian chiropractic profession: a consensus study using a modified Delphi technique.

PubMed

French, Simon D; Beliveau, Peter J H; Bruno, Paul; Passmore, Steven R; Hayden, Jill A; Srbely, John; Kawchuk, Greg N

2017-01-01

Research funds are limited and a healthcare profession that supports research activity should establish research priority areas. The study objective was to identify research priority areas for the Canadian chiropractic profession, and for stakeholders in the chiropractic profession to rank these in order of importance. We conducted a modified Delphi consensus study between August 2015 and May 2017 to determine the views of Canadian chiropractic organisations (e.g. Canadian Chiropractic Association; provincial associations) and stakeholder groups (e.g. chiropractic educational institutions; researchers). Participants completed three online Delphi survey rounds. In Round 1, participants suggested research areas within four broad research themes: 1) Basic science; 2) Clinical; 3) Health services; and 4) Population health. In Round 2, researchers created sub-themes by categorising the areas suggested in Round 1, and participants judged the importance of the research sub-themes. We defined consensus as at least 70% of participants agreeing that a research area was "essential" or "very important". In Round 3, results from Round 2 were presented to the participants to re-evaluate the importance of sub-themes. Finally, participants completed an online pairwise ranking activity to determine the rank order of the list of important research sub-themes. Fifty-seven participants, of 85 people invited, completed Round 1 (response rate 67%). Fifty-six participants completed Round 2, 55 completed Round 3, and 53 completed the ranking activity. After three Delphi rounds and the pairwise ranking activity was completed, the ranked list of research sub-themes considered important were: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services; 4) Effects of chiropractic care; 5) Safety/side effects of chiropractic care; 6) Chiropractic care for older adults; 7) Neurophysiological mechanisms and effects of spinal manipulative therapy; 8) General mechanisms and effects of spinal manipulative therapy. This project identified research priority areas for the Canadian chiropractic profession. The top three priority areas were all in the area of health services research: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services.

Rounding Behavior in the Reporting of Headache Frequency Complicates Headache Chronification Research

PubMed Central

Houle, Timothy T.; Turner, Dana P.; Houle, Thomas A.; Smitherman, Todd A.; Martin, Vincent; Penzien, Donald B.; Lipton, Richard B.

2013-01-01

Objectives To characterize the extent of measurement error arising from rounding in headache frequency reporting (days per month) in a population sample of headache sufferers. Background When reporting numerical health information, individuals tend to round their estimates. The tendency to round to the nearest 5 days when reporting headache frequency can distort distributions and engender unreliability in frequency estimates in both clinical and research contexts. Methods This secondary analysis of the 2005 American Migraine Prevalence and Prevention study (AMPP) survey characterized the population distribution of 30-day headache frequency among community headache sufferers and determined the extent of numerical rounding (“heaping”) in self-reported data. Headache frequency distributions (days per month) were examined using a simplified version of Wang and Heitjan’s (2008) approach to heaping to estimate the probability that headache sufferers round to a multiple of 5 when providing frequency reports. Multiple imputation was used to estimate a theoretical “true” headache frequency. Results Of the 24,000 surveys, headache frequency data were available for 15,976 respondents diagnosed with migraine (68.6%), probable migraine (8.3%), or episodic tension-type headache (10.0%); the remainder had other headache types. The mean number of headaches days/month was 3.7 (SD = 5.6). Examination of the distribution of headache frequency reports revealed a disproportionate number of responses centered on multiples of 5 days. The odds that headache frequency was rounded to 5 increased by 24% with each one-day increase in headache frequency (OR: 1.24, 95% CI: 1.23 to 1.25), indicating that heaping occurs most commonly at higher headache frequencies. Women were more likely to round than men, and rounding decreased with increasing age and increased with symptoms of depression. Conclusions Because of the coarsening induced by rounding, caution should be used when distinguishing between episodic and chronic headache sufferers using self-reported estimates of headache frequency. Unreliability in frequency estimates is of particular concern among individuals with high-frequency (chronic) headache. Employing shorter recall intervals when assessing headache frequency, preferably using daily diaries, may improve accuracy and allow more precise estimation of chronic migraine onset and remission. PMID:23721238

Round-the-table teaching: a novel approach to resuscitation education

PubMed Central

McGarvey, Kathryn; Scott, Karen; O'Leary, Fenton

2014-01-01

Background Effective cardiopulmonary resuscitation saves lives. Health professionals who care for acutely unwell children need to be prepared to care for a child in arrest. Hospitals must ensure that their staff have the knowledge, confidence and ability to respond to a child in cardiac arrest. RESUS4KIDS is a programme designed to teach paediatric resuscitation to health care professionals who care for acutely unwell children. The programme is delivered in two components: an e–learning component for pre-learning, followed by a short, practical, face-to-face course that is taught using the round-the-table teaching approach. Context Round-the-table teaching is a novel, evidence-based small group teaching approach designed to teach paediatric resuscitation skills and knowledge. Round-the-table teaching uses a structured approach to managing a collapsed child, and ensures that each participant has the opportunity to practise the essential resuscitation skills of airway manoeuvres, bag mask ventilation and cardiac compressions. Innovation Round-the-table teaching is an engaging, non-threatening approach to delivering interdisciplinary paediatric resuscitation education. The methodology ensures that all participants have the opportunity to practise each of the different essential skills associated with the Danger, Response, Send for help, Airway, Breathing, Circulation, Defibrillation or rhythm recognition (DRSABCD) approach to the collapsed child. Implications Round-the-table teaching is based on evidence-based small group teaching methods. The methodology of round-the-table teaching can be applied to any topic where participants must demonstrate an understanding of a sequential approach to a clinical skill. Round-the-table teaching uses a structured approach to managing a collapsed child PMID:25212931

Integration of Mobile Devices to Facilitate Patient Care and Teaching During Family-Centered Rounds.

PubMed

Byrd, Angela S; McMahon, Pamela M; Vath, Richard J; Bolton, Michael; Roy, Melissa

2018-01-01

The increasing prevalence of mobile devices in clinical settings has the potential to improve both patient care and education. The benefits are particularly promising in the context of family-centered rounds in inpatient pediatric settings. We aimed to increase mobile device usage by inpatient rounding teams by 50% in 6 months. We hoped to demonstrate that use of mobile devices would improve access to patient care and educational information and to determine if use would improve efficiency and perceptions of clinical teaching. We designed a mixed-methods study involving pre- and post-implementation surveys to residents, families, and faculty as well as direct observations of family-centered rounds. We conducted rapid cycles of continual quality improvement by using the Plan-Do-Study-Act framework involving 3 interventions. Pre-intervention, the mobile computing cart was used for resident education on average 3.3 times per rounding session. After cycle 3, teaching through the use of mobile devices increased by ∼79% to 5.9 times per rounding session. On the basis of survey data, we determined there was a statistically significant increase in residents' perception of feeling prepared for rounds, receiving teaching on clinical care, and ability to teach families. Additionally, average time spent per patient on rounds decreased after implementation of mobile devices. Integration of mobile devices into a pediatric hospital medicine teaching service can facilitate patient care and perception of resident teaching by extending the utility of electronic medical records in care decisions and by improving access to knowledge resources. Copyright © 2018 by the American Academy of Pediatrics.

Mesothelial Cysts of the Round Ligament of the Uterus in 9 Patients: a 15-year experience.

PubMed

Tirnaksiz, Mehmet; Erkan, Arman; Dogrul, Ahmet Bulent; Abbasoglu, Osman

2016-04-04

Aim of this study was to evaluate the characteristic features of patients with mesothelial cyst of the round ligament of the uterus and the incidence of this entity. This was a retrospective review of 3065 patients who underwent inguinal exploration for groin mass from 1998 to 2013. Clinical, radiological and histopathological features of patients with a diagnosis of mesothelial cyst of the round ligament were analyzed. Of the 405 female patients reviewed 9 mesothelial cysts of the round ligament were identified (2.2%). The median age was 37 (range 19-82 years). In all patients the groin mass was manually irreducible on physical examination. The lesions were on the right side in 6 (66.6%) patients. These were identified before surgery in 4 (all by groin ultrasonography). Three were misidentified as a hernia before surgery. The remaining 2 (22%) had both hernia and the mesothelial cyst of the round ligament. The cysts were identified after surgery at the time of histopathological examination in these two patients. In all patients histopathological examination revealed multilobular cystic lesion lined by a single layer of mesothelial cells. Cystic lesions arising from the round ligament were identified and excised along with the round ligament in 7 patients. In the remaining 2, a hernia repair was also performed. There was no recurrence at follow-up. Mesothelial cysts of the round ligament are rare. They are easily misidentified as groin hernia. An accurate diagnosis requires a high index of suspicion and is greatly aided by preoperative imaging studies.

Cell shape changes induced by cationic anesthetics

PubMed Central

1976-01-01

The effects of local anesthetics on cultivated macrophages were studied in living preparations and recorded in still pictures and time-lapse cine-micrographs. Exposure to 12mM lidocaine or 1.5 mM tetracaine resulted in rounding in 10-15 min. Rounding was characterized by cell contraction, marked increase in retraction fibrils, withdrawal of cell processes, and, in late stages, pulsation-like activity and zeiosis. Cells showed appreciable membrane activity as they rounded. Respreading was complete within 15 min of perfusion in drug-free medium and entailed a marked increase in surface motility over control periods. As many as eight successive cycles of rounding and spreading were obtained with lidocaine without evidence of cell damage. The effects of anesthetics were similar to those observed with EDTA, but ethylene- glycol-bis(beta-aminoethylether)-N, N'-tetraacetic acid-Mg was ineffective. Rounding was also induced by benzocaine, an anesthetic nearly uncharged at pH 7.0. Quaternary (nondischargeable) compounds were of low activity, presumably because they are slow permeants. Lidocaine induced rounding at 10 degrees C and above but was less effective at 5 degrees C and ineffective at 0 degrees C. Rounding by the anesthetic was also obtained in media depleted or Na or enriched with 10 mM Ca or Mg. The latter finding, together with the failure of tetrodotoxin to induce rounding, suggests that the anesthetic effect is unrelated to inhibition of sodium conductance. It is possible that the drugs influence divalent ion fluxes or some component of the contractile cells' machinery, but a metabolic target of action cannot yet be excluded. PMID:814194

Global research priorities for interpersonal violence prevention: a modified Delphi study.

PubMed

Mikton, Christopher R; Tanaka, Masako; Tomlinson, Mark; Streiner, David L; Tonmyr, Lil; Lee, Bandy X; Fisher, Jane; Hegadoren, Kathy; Pim, Joam Evans; Wang, Shr-Jie Sharlenna; MacMillan, Harriet L

2017-01-01

To establish global research priorities for interpersonal violence prevention using a systematic approach. Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. In round 2, "developing, implementing and evaluating interventions" was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, "scaling up interventions and evaluating their cost-effectiveness" was ranked lowest for all types of violence. In round 3, research into "developing, implementing and evaluating interventions" that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority.

Global research priorities for interpersonal violence prevention: a modified Delphi study

PubMed Central

Tanaka, Masako; Tomlinson, Mark; Streiner, David L; Tonmyr, Lil; Lee, Bandy X; Fisher, Jane; Hegadoren, Kathy; Pim, Joam Evans; Wang, Shr-Jie Sharlenna; MacMillan, Harriet L

2017-01-01

Abstract Objective To establish global research priorities for interpersonal violence prevention using a systematic approach. Methods Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. Findings In round 2, “developing, implementing and evaluating interventions” was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, “scaling up interventions and evaluating their cost–effectiveness” was ranked lowest for all types of violence. In round 3, research into “developing, implementing and evaluating interventions” that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. Conclusion These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority. PMID:28053363

A new way to experience the International Gastric Cancer Association Congress: the Web Round Tables.

PubMed

Morgagni, Paolo; Verlato, Giuseppe; Marrelli, Daniele; Roviello, Franco; de Manzoni, Giovanni

2014-10-01

In an attempt to attract a wider diversity of professionals to the 10th International Gastric Cancer Association Congress (IGCC) held in June 2013, the Scientific Committee of the conference organized a number of pre-congress Web Round Tables to discuss cutting-edge topics relating to gastric cancer treatment. Twenty Web Round Tables, each coordinated by a different chairman, were proposed on the IGCC Website 1 year before the congress. Each chairman identified a number of studies related to the theme of his/her Round Table and invited corresponding authors to send an update of their conclusions in light of their subsequent experience, which would then form the basis of discussion of the Web Round Tables. The chairmen posted several questions regarding these updates on the web and opened a forum for a period of 1-2 months. The forum was free and specifically intended for congress participants. Fifty-one (9.9 %) of the 516 authors contacted took part in the initiative. Two hundred fifty participants from 21 countries joined the forum discussion and posted 671 comments. The Web Round Tables were viewed 15,810 times while the forum was open. Overall, the Web Round Tables aroused considerable interest, especially among young professionals working in the area of gastric cancer who had the opportunity to contact and interact with experts in what often turned out to be an interesting and lively exchange of views. All the discussions are now freely available for consultation on the IGCC website. The Web Round Table experience was presented, with great success, during the conference at special afternoon sessions.

Nucleus structure and dust morphology: Post-Rosetta understanding and implications

NASA Astrophysics Data System (ADS)

Levasseur-Regourd, A.; Bentley, Mark; Ciarletti, Valérie; Kofman, Woldek; Lasue, Jeremie; Mannel, Thurid; Herique, Alain

2017-10-01

The structure of cometary nuclei and the morphology of dust particles they eject have long been unknowns in cometary science. The combination of these two subjects, as revealed by the Rosetta mission at 67P/C-G, is currently providing an unprecedented insight about Solar System formation and early evolution.Rosetta has established that the bulk porosity of 67P/C-G nucleus is high, in the 70% to 85% range, both from the determination of its density and from permittivity measurements with CONSERT bistatic radar experiment [1-2]. CONSERT, through operations after Philae landing on 12-13 November 2014, has also allowed us to estimate that i) the porosity is likely to be higher inside the nucleus than on its subsurface, ii) a major component of the nucleus is refractory carbonaceous compounds, and iii) the small lobe is homogeneous at a scale of a few wavelengths (i.e., about 10 m), while heterogeneities in the 3-m range (similar to the rounded nodules noticed on walls of large pits) cannot be ruled out [2-4].Rosetta has also established, through its 26 months rendezvous with 67P/C-G, the aggregated structure of dust particles within a wide range of sizes in the inner cometary coma. The MIDAS atomic force microscope experiment has given us evidence (from 3D topographic images with nano- to micrometer resolution) for i) a hierarchical structure of aggregated dust particles, down to tens of nm-sized grains, ii) one extremely porous dust particle, with a fractal dimension of (1.7 ± 0.1) [5-6]. The accuracy of comparisons between cometary dust particles and interplanetary dust particles collected in the stratosphere (including CP-IDPs) could thus be improved.Such results should further refine the main processes (e.g., low velocity aggregation) that allowed the formation of comets in the early Solar System, and the implications of a possible late heavy bombardment on the interplanetary dust clouds and on telluric planets.References. 1. Pätzold et al. Nature 530 63 2016. 2. Kofman et al. Science 349 6247 2015. 3. Herique et al. MNRAS 462 S516 2016. 4. Ciarletti et al. A&A 583 A40 2015. 5. Bentley et al., Nature 537 73 2016. 6. Mannel et al., MNRAS 462 S304 2016.

76 FR 7824 - Procurement List; Proposed Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... NSNs: 8465-00-NIB-0211--Pouch, Four 3-round magazines, M26 12-guage shotgun MASS, Camouflage 8465-00-NIB-0212--Pouch, Four 5-round magazines, M26 12-guage shotgun MASS, Camouflage 8465-00-NIB-0213--Soft carrying case, Shotgun, 3-round magazine, M26 12-guage shotgun MASS, Camouflage 8465-00-NIB-0214--Soft...

ASBESTOS CONTAINING MATERIALS IN SCHOOL BUILDINGS: BULK SAMPLE ANALYSIS QUALITY ASSURANCE PROGRAM. BULK SAMPLE ROUNDS 12, 13 AND BLIND ROUND III

EPA Science Inventory

The report presents the results of laboratories participating in the twelveth, thirteenth and third (III) blind round of the bulk sample analysis quality assurance program sponsored by the U.S. Environmental Protection Agency. Three hundred twenty-three, 386 and 51 laboratories w...

77 FR 66555 - Final Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

.... [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ADDRESSES City of Chiefland Maps are available... American Vertical Datum. Depth in feet above ground. [caret] Mean Sea Level, rounded to the nearest 0.1... feet above ground. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ADDRESSES City of...

75 FR 31347 - Proposed Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... Datum. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ** BFEs to be changed include the... in feet above ground. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ** BFEs to be changed... in feet above ground. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ** BFEs to be changed...

76 FR 46705 - Proposed Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... ground. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ** BFEs to be changed include the.... Depth in feet above ground. [caret] Mean Sea Level, rounded to the nearest 0.1 meter. ** BFEs to be... Datum. + North American Vertical Datum. Depth in feet above ground. [caret] Mean Sea Level, rounded to...

19 CFR 159.3 - Rounding of fractions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Rounding of fractions. 159.3 Section 159.3 Customs... (CONTINUED) LIQUIDATION OF DUTIES General Provisions § 159.3 Rounding of fractions. (a) Value. In the... cents or more, the lower fractions shall be dropped, and if it is necessary to take up as whole dollars...

Transitioning to Year-Round Education: Satisfaction and Factors of Choice

ERIC Educational Resources Information Center

Ramos, Barbara K.

2012-01-01

This study examines a mid-west elementary school transitioning from a school-within-a-school calendar, offering both year-round and traditional calendars, to a year-round only calendar. The satisfaction of teachers and families with the transition, and the factors that teachers and families consider in making a calendar selection, were examined…

Rounding Technique for High-Speed Digital Signal Processing

NASA Technical Reports Server (NTRS)

Wechsler, E. R.

1983-01-01

Arithmetic technique facilitates high-speed rounding of 2's complement binary data. Conventional rounding of 2's complement numbers presents problems in high-speed digital circuits. Proposed technique consists of truncating K + 1 bits then attaching bit in least significant position. Mean output error is zero, eliminating introducing voltage offset at input.

Bridging Theory to Practice with Classroom Rounds

ERIC Educational Resources Information Center

Bowman, Connie L.; Herrelko, Janet M.

2014-01-01

Pre-service candidates' perceptions of how to teach were challenged after going through the process of Classroom Rounds, the process that was used in this study. Classroom Rounds consisted of a pre-conference meeting with an inservice teacher, followed by a classroom observation of that teacher, and finally a discussion focusing on proven…

7 CFR 52.1845 - Sizes of seedless raisins.

Code of Federal Regulations, 2013 CFR

2013-01-01

... percent, by weight, of all the raisins will pass through round perforations 22/64-inch in diameter, but not more than 10 percent, by weight, of all the raisins may pass through round perforations 20/64-inch... will pass through round perforations 24/64-inch in diameter, and not less than 70 percent, by weight...

Quality Teaching Rounds in Mathematics Teacher Education

ERIC Educational Resources Information Center

Prieto, Elena; Howley, Peter; Holmes, Kathryn; Osborn, Judy-anne; Roberts, Malcolm; Kepert, Andrew

2015-01-01

The purpose of the study reported in this paper is to evaluate the effectiveness of an implementation of teaching rounds as a practice-based approach to pre-service teacher education in mathematics. The teaching rounds implemented in the study utilised the NSW Quality Teaching model pedagogical framework as a tool for learning about and reflecting…

7 CFR 52.1845 - Sizes of seedless raisins.

Code of Federal Regulations, 2014 CFR

2014-01-01

... percent, by weight, of all the raisins will pass through round perforations 22/64-inch in diameter, but not more than 10 percent, by weight, of all the raisins may pass through round perforations 20/64-inch... will pass through round perforations 24/64-inch in diameter, and not less than 70 percent, by weight...

7 CFR 51.2952 - Size specifications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 percent, by count, pass through a round opening 96/64 inches in diameter; (b) Jumbo size. Jumbo size means walnuts of which not over 12 percent, by count, pass through a round opening 80/64 inches in... round opening 77/64 inches in diameter; except that for walnuts of the Eureka variety and type, such...

7 CFR 52.1845 - Sizes of seedless raisins.

Code of Federal Regulations, 2012 CFR

2012-01-01

... raisins will pass through round perforations 22/64-inch in diameter, but not more than 10 percent, by weight, of all the raisins may pass through round perforations 20/64-inch in diameter. (b) Small or midget size raisins means that 95 percent, by weight, of all the raisins will pass through round...

7 CFR 51.2952 - Size specifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 percent, by count, pass through a round opening 96/64 inches in diameter; (b) Jumbo size. Jumbo size means walnuts of which not over 12 percent, by count, pass through a round opening 80/64 inches in... round opening 77/64 inches in diameter; except that for walnuts of the Eureka variety and type, such...

7 CFR 51.2952 - Size specifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... a round opening 96/64 inches in diameter; (b) Jumbo size. Jumbo size means walnuts of which not over 12 percent, by count, pass through a round opening 80/64 inches in diameter; (c) Large size. Large size means walnuts of which not over 12 percent, by count, pass through a round opening 77/64 inches in...

National Retired Senior Volunteer Program Participant Impact Evaluation. Final Report.

ERIC Educational Resources Information Center

Booz Allen and Hamilton, Inc., Washington, DC.

A study examined the long-term effects of participation in the Retired Senior Volunteer Program (RSVP) on participants from 20 RSVP projects nationwide. Three rounds of interviews were conducted. In Round 1, 750 volunteers were interviewed: 595 veteran volunteers and 155 new volunteers. In Round 2, 792 volunteers were intereviewed: 175 new…

7 CFR 25.104 - Poverty rate.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Poverty rate. 25.104 Section 25.104 Agriculture Office... § 25.104 Poverty rate. (a) General. Eligibility of an area on the basis of poverty shall be established in accordance with the following poverty rate criteria specific to Round I, Round II, Round IIS and...

7 CFR 25.104 - Poverty rate.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 1 2012-01-01 2012-01-01 false Poverty rate. 25.104 Section 25.104 Agriculture Office... § 25.104 Poverty rate. (a) General. Eligibility of an area on the basis of poverty shall be established in accordance with the following poverty rate criteria specific to Round I, Round II, Round IIS and...

7 CFR 25.104 - Poverty rate.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 1 2014-01-01 2014-01-01 false Poverty rate. 25.104 Section 25.104 Agriculture Office... § 25.104 Poverty rate. (a) General. Eligibility of an area on the basis of poverty shall be established in accordance with the following poverty rate criteria specific to Round I, Round II, Round IIS and...

7 CFR 25.104 - Poverty rate.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 1 2013-01-01 2013-01-01 false Poverty rate. 25.104 Section 25.104 Agriculture Office... § 25.104 Poverty rate. (a) General. Eligibility of an area on the basis of poverty shall be established in accordance with the following poverty rate criteria specific to Round I, Round II, Round IIS and...

Georgetown University Round Table on Languages and Linguistics 2001. Linguistics, Language, and the Real World: Discourse and Beyond.

ERIC Educational Resources Information Center

Tannen, Deborah, Ed.; Alatis, James E., Ed.

This book contains papers from the 2001 Georgetown University Round Table on Languages and Linguistics, "Linguistics, Language, and the Real World: Discourse and Beyond." Papers include: "Introduction" (Deborah Tannen); "A Brief History of the Georgetown University Round Table on Languages and Linguistics" (James E.…

RCRA, Superfund and EPCRA hotline training module. Introduction to: Superfund administrative improvements/reforms (update February 1998); Directive

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

NONE

1998-06-01

This module includes the following: Administrative Improvements (Round 1) (Enhance Enforcement Fairness and Reduce Transaction Costs; Enhance Cleanup Effectiveness and Consistency; Enhance Public Involvement; Enhance State Role; and On-going Initiatives); Administration Reforms (February 1995 Reforms (Round 2); and October 1995 Reforms (Round 3)); and Summary.

7 CFR 25.104 - Poverty rate.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Poverty rate. 25.104 Section 25.104 Agriculture Office... § 25.104 Poverty rate. (a) General. Eligibility of an area on the basis of poverty shall be established in accordance with the following poverty rate criteria specific to Round I, Round II, Round IIS and...

Recommended Protocol for Round Robin Studies in Additive Manufacturing

PubMed Central

Moylan, Shawn; Brown, Christopher U.; Slotwinski, John

2016-01-01

One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST’s experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed. PMID:27274602

[Modified Delphi method in the constitution of school sanitation standard].

PubMed

Yin, Xunqiang; Liang, Ying; Tan, Hongzhuan; Gong, Wenjie; Deng, Jing; Luo, Jiayou; Di, Xiaokang; Wu, Yue

2012-11-01

To constitute school sanitation standard using modified Delphi method, and to explore the feasibility and the predominance of Delphi method in the constitution of school sanitation standard. Two rounds of expert consultations were adopted in this study. The data were analyzed with SPSS15.0 to screen indices of school sanitation standard. Thirty-two experts accomplished the 2 rounds of consultations. The average length of expert service was (24.69 ±8.53) years. The authority coefficient was 0.729 ±0.172. The expert positive coefficient was 94.12% (32/34) in the first round and 100% (32/32) in the second round. The harmonious coefficients of importance, feasibility and rationality in the second round were 0.493 (P<0.05), 0.527 (P<0.01), and 0.535 (P<0.01), respectively, suggesting unanimous expert opinions. According to the second round of consultation, 38 indices were included in the framework. Theoretical analysis, literature review, investigation and so on are generally used in health standard constitution currently. Delphi method is a rapid, effective and feasible method in this field.

Improved line-end foreshortening and corner-rounding control in optical proximity correction using radius of curvature method

NASA Astrophysics Data System (ADS)

Mukherjee, Maharaj; Phan, Vinhthuy

2002-07-01

We describe how to generate better Optical Proximity Corrections (OPC) for line-ends and corners by using rounded anchors and serifs. These rounded serifs and anchors can be made smaller in size and shape than the traditional rectilinear anchors and serifs. The smaller size of the serifs tend to have less problems in satisfying mask-rule constraints. They also have less adverse effects on the printability of neighboring shapes. We refer to these rounded anchors and serifs as Mouse-Ears. The rounding is done by circles which are regular octagons with Ortho-45 straight lines. The main idea of this paper stems from the physical description of the lithographic process, which can be conceptualized as a low-pass filter. The low-pass filter eliminates the sharp corners of the feature which are made of high spatial-frequency components and retains the low spatial-frequency components. Since the rounded anchors and serifs have fewer high-frequency components than their rectilinear counterparts they get less deformed in the lithographic process.

Recommended Protocol for Round Robin Studies in Additive Manufacturing.

PubMed

Moylan, Shawn; Brown, Christopher U; Slotwinski, John

2016-03-01

One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST's experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed.

Rounding, work intensification and new public management.

PubMed

Willis, Eileen; Toffoli, Luisa; Henderson, Julie; Couzner, Leah; Hamilton, Patricia; Verrall, Claire; Blackman, Ian

2016-06-01

In this study, we argue that contemporary nursing care has been overtaken by new public management strategies aimed at curtailing budgets in the public hospital sector in Australia. Drawing on qualitative interviews with 15 nurses from one public acute hospital with supporting documentary evidence, we demonstrate what happens to nursing work when management imposes rounding as a risk reduction strategy. In the case study outlined rounding was introduced across all wards in response to missed care, which in turn arose as a result of work intensification produced by efficiency, productivity, effectiveness and accountability demands. Rounding is a commercially sponsored practice consistent with new public management. Our study illustrates the impact that new public management strategies such as rounding have on how nurses work, both in terms of work intensity and in who controls their labour. © 2015 John Wiley & Sons Ltd.

The Determination of Relevant Goals and Criteria Used to Select an Automated Patient Care Information System

PubMed Central

Chocholik, Joan K.; Bouchard, Susan E.; Tan, Joseph K. H.; Ostrow, David N.

1999-01-01

Objectives: To determine the relevant weighted goals and criteria for use in the selection of an automated patient care information system (PCIS) using a modified Delphi technique to achieve consensus. Design: A three-phase, six-round modified Delphi process was implemented by a ten-member PCIS selection task force. The first phase consisted of an exploratory round. It was followed by the second phase, of two rounds, to determine the selection goals and finally the third phase, of three rounds, to finalize the selection criteria. Results: Consensus on the goals and criteria for selecting a PCIS was measured during the Delphi process by reviewing the mean and standard deviation of the previous round's responses. After the study was completed, the results were analyzed using a limits-of-agreement indicator that showed strong agreement of each individual's responses between each of the goal determination rounds. Further analysis for variability in the group's response showed a significant movement to consensus after the first goal-determination iteration, with consensus reached on all goals by the end of the second iteration. Conclusion: The results indicated that the relevant weighted goals and criteria used to make the final decision for an automated PCIS were developed as a result of strong agreement among members of the PCIS selection task force. It is therefore recognized that the use of the Delphi process was beneficial in achieving consensus among clinical and nonclinical members in a relatively short time while avoiding a decision based on political biases and the “groupthink” of traditional committee meetings. The results suggest that improvements could be made in lessening the number of rounds by having information available through side conversations, by having other statistical indicators besides the mean and standard deviation available between rounds, and by having a content expert address questions between rounds. PMID:10332655

Exploring the adoption of Schwartz Center Rounds as an organisational innovation to improve staff well-being in England, 2009-2015.

PubMed

Robert, Glenn; Philippou, Julia; Leamy, Mary; Reynolds, Ellie; Ross, Shilpa; Bennett, Laura; Taylor, Cath; Shuldham, Caroline; Maben, Jill

2017-01-05

Schwartz Center Rounds ('Rounds') are a multidisciplinary forum in which healthcare staff within an organisation discuss the psychological, emotional and social challenges associated with their work in a confidential and safe environment. Implemented in over 375 North American organisations, since 2009, they have been increasingly adopted in England. This study aimed to establish how many and what types of organisations have adopted Rounds in England, and to explore why they did so. Public healthcare organisations in England. Secondary data analysis was used to map and profile all 116 public healthcare organisations that had adopted Rounds in England by July 2015. Semistructured telephone interviews were conducted with 45 Round coordinators within adopting organisations. The rate of adoption increased after a major national report in 2013. Rounds were typically adopted in order to improve staff well-being. Adopting organisations scored better on staff engagement than non-adopters; among adopting organisations, those performing better on patient experience were more likely to adopt earlier. Most adoption decision-making processes were straightforward. A confluence of factors-a generally favourable set of innovation attributes (including low cost), advocacy from opinion leaders in different professional networks, active dissemination by change agents and a felt need to be seen to be addressing staff well-being-initially led to Rounds being seen as 'an idea whose time had come'. More recent adoption patterns have been shaped by the timing of charitable and other agency funding in specific geographical areas and sectors, as well as several forms of 'mimetic pressure'. The innate attributes of Rounds, favourable circumstances and the cumulative impact of a sequence of distinct informal and formal social processes have shaped the pattern of their adoption in England. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A Drug Combination Screen Identifies Drugs Active against Amoxicillin-Induced Round Bodies of In Vitro Borrelia burgdorferi Persisters from an FDA Drug Library

PubMed Central

Feng, Jie; Shi, Wanliang; Zhang, Shuo; Sullivan, David; Auwaerter, Paul G.; Zhang, Ying

2016-01-01

Although currently recommended antibiotics for Lyme disease such as doxycycline or amoxicillin cure the majority of the patients, about 10–20% of patients treated for Lyme disease may experience lingering symptoms including fatigue, pain, or joint and muscle aches. Under experimental stress conditions such as starvation or antibiotic exposure, Borrelia burgdorferi can develop round body forms, which are a type of persister bacteria that appear resistant in vitro to customary first-line antibiotics for Lyme disease. To identify more effective drugs with activity against the round body form of B. burgdorferi, we established a round body persister model induced by exposure to amoxicillin (50 μg/ml) and then screened the Food and Drug Administration drug library consisting of 1581 drug compounds and also 22 drug combinations using the SYBR Green I/propidium iodide viability assay. We identified 23 drug candidates that have higher activity against the round bodies of B. burgdorferi than either amoxicillin or doxycycline. Eleven individual drugs scored better than metronidazole and tinidazole which have been previously described to be active against round bodies. In this amoxicillin-induced round body model, some drug candidates such as daptomycin and clofazimine also displayed enhanced activity which was similar to a previous screen against stationary phase B. burgdorferi persisters not exposure to amoxicillin. Additional candidate drugs active against round bodies identified include artemisinin, ciprofloxacin, nifuroxime, fosfomycin, chlortetracycline, sulfacetamide, sulfamethoxypyridazine and sulfathiozole. Two triple drug combinations had the highest activity against amoxicillin-induced round bodies and stationary phase B. burgdorferi persisters: artemisinin/cefoperazone/doxycycline and sulfachlorpyridazine/daptomycin/doxycycline. These findings confirm and extend previous findings that certain drug combinations have superior activity against B. burgdorferi persisters in vitro, even when pre-treated with amoxicillin. These findings may have implications for improved treatment of Lyme disease. PMID:27242757

A Drug Combination Screen Identifies Drugs Active against Amoxicillin-Induced Round Bodies of In Vitro Borrelia burgdorferi Persisters from an FDA Drug Library.

PubMed

Feng, Jie; Shi, Wanliang; Zhang, Shuo; Sullivan, David; Auwaerter, Paul G; Zhang, Ying

2016-01-01

Although currently recommended antibiotics for Lyme disease such as doxycycline or amoxicillin cure the majority of the patients, about 10-20% of patients treated for Lyme disease may experience lingering symptoms including fatigue, pain, or joint and muscle aches. Under experimental stress conditions such as starvation or antibiotic exposure, Borrelia burgdorferi can develop round body forms, which are a type of persister bacteria that appear resistant in vitro to customary first-line antibiotics for Lyme disease. To identify more effective drugs with activity against the round body form of B. burgdorferi, we established a round body persister model induced by exposure to amoxicillin (50 μg/ml) and then screened the Food and Drug Administration drug library consisting of 1581 drug compounds and also 22 drug combinations using the SYBR Green I/propidium iodide viability assay. We identified 23 drug candidates that have higher activity against the round bodies of B. burgdorferi than either amoxicillin or doxycycline. Eleven individual drugs scored better than metronidazole and tinidazole which have been previously described to be active against round bodies. In this amoxicillin-induced round body model, some drug candidates such as daptomycin and clofazimine also displayed enhanced activity which was similar to a previous screen against stationary phase B. burgdorferi persisters not exposure to amoxicillin. Additional candidate drugs active against round bodies identified include artemisinin, ciprofloxacin, nifuroxime, fosfomycin, chlortetracycline, sulfacetamide, sulfamethoxypyridazine and sulfathiozole. Two triple drug combinations had the highest activity against amoxicillin-induced round bodies and stationary phase B. burgdorferi persisters: artemisinin/cefoperazone/doxycycline and sulfachlorpyridazine/daptomycin/doxycycline. These findings confirm and extend previous findings that certain drug combinations have superior activity against B. burgdorferi persisters in vitro, even when pre-treated with amoxicillin. These findings may have implications for improved treatment of Lyme disease.

Which Dimensions of Patient-Centeredness Matter? - Results of a Web-Based Expert Delphi Survey.

PubMed

Zill, Jördis M; Scholl, Isabelle; Härter, Martin; Dirmaier, Jörg

2015-01-01

Present models and definitions of patient-centeredness revealed a lack of conceptual clarity. Based on a prior systematic literature review, we developed an integrative model with 15 dimensions of patient-centeredness. The aims of this study were to 1) validate, and 2) prioritize these dimensions. A two-round web-based Delphi study was conducted. 297 international experts were invited to participate. In round one they were asked to 1) give an individual rating on a nine-point-scale on relevance and clarity of the dimensions, 2) add missing dimensions, and 3) prioritize the dimensions. In round two, experts received feedback about the results of round one and were asked to reflect and re-rate their own results. The cut-off for the validation of a dimension was a median < 7 on one of the criteria. 105 experts participated in round one and 71 in round two. In round one, one new dimension was suggested and included for discussion in round two. In round two, this dimension did not reach sufficient ratings to be included in the model. Eleven dimensions reached a median ≥ 7 on both criteria (relevance and clarity). Four dimensions had a median < 7 on one or both criteria. The five dimensions rated as most important were: patient as a unique person, patient involvement in care, patient information, clinician-patient communication and patient empowerment. 11 out of the 15 dimensions have been validated through experts' ratings. Further research on the four dimensions that received insufficient ratings is recommended. The priority order of the dimensions can help researchers and clinicians to focus on the most important dimensions of patient-centeredness. Overall, the model provides a useful framework that can be used in the development of measures, interventions, and medical education curricula, as well as the adoption of a new perspective in health policy.

Which Dimensions of Patient-Centeredness Matter? - Results of a Web-Based Expert Delphi Survey

PubMed Central

Zill, Jördis M.; Scholl, Isabelle; Härter, Martin; Dirmaier, Jörg

2015-01-01

Background Present models and definitions of patient-centeredness revealed a lack of conceptual clarity. Based on a prior systematic literature review, we developed an integrative model with 15 dimensions of patient-centeredness. The aims of this study were to 1) validate, and 2) prioritize these dimensions. Method A two-round web-based Delphi study was conducted. 297 international experts were invited to participate. In round one they were asked to 1) give an individual rating on a nine-point-scale on relevance and clarity of the dimensions, 2) add missing dimensions, and 3) prioritize the dimensions. In round two, experts received feedback about the results of round one and were asked to reflect and re-rate their own results. The cut-off for the validation of a dimension was a median < 7 on one of the criteria. Results 105 experts participated in round one and 71 in round two. In round one, one new dimension was suggested and included for discussion in round two. In round two, this dimension did not reach sufficient ratings to be included in the model. Eleven dimensions reached a median ≥ 7 on both criteria (relevance and clarity). Four dimensions had a median < 7 on one or both criteria. The five dimensions rated as most important were: patient as a unique person, patient involvement in care, patient information, clinician-patient communication and patient empowerment. Discussion 11 out of the 15 dimensions have been validated through experts’ ratings. Further research on the four dimensions that received insufficient ratings is recommended. The priority order of the dimensions can help researchers and clinicians to focus on the most important dimensions of patient-centeredness. Overall, the model provides a useful framework that can be used in the development of measures, interventions, and medical education curricula, as well as the adoption of a new perspective in health policy. PMID:26539990

Experience with Round Beam Operation at The Advanced Photon Source

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

Xiao, A.; Emery, L.; Sajaev, V.

2015-01-01

Very short Touschek lifetime becomes a common issue for next-generation ultra-low emittance storage ring light sources. In order to reach a longer beamlifetime, such amachine often requires operating with a vertical-to-horizontal emittance ratio close to an unity, i.e. a “round beam”. In tests at the APS storage ring, we determined how a round beam can be reached experimentally. Some general issues, such as beam injection, optics measurement and corrections, and orbit correction have been tested also. To demonstrate that a round beam was achieved, the beam size ratio is calibrated using beam lifetime measurement.

Analyzing "Inconsistencies" in Practice: Teachers' Continued Use of Round Robin Reading

ERIC Educational Resources Information Center

Ash, Gwynne Ellen; Kuhn, Melanie R.; Walpole, Sharon

2009-01-01

This study analyzed in-service teachers' and literacy coaches' perceptions of Round Robin Reading to begin developing an understanding of the persistence of this practice in public schools in the United States. Surveying 80 teachers and 27 literacy coaches using an open-ended instrument, we found that many teachers continued to use Round Robin…

Multivariate regression model for partitioning tree volume of white oak into round-product classes

Treesearch

Daniel A. Yaussy; David L. Sonderman

1984-01-01

Describes the development of multivariate equations that predict the expected cubic volume of four round-product classes from independent variables composed of individual tree-quality characteristics. Although the model has limited application at this time, it does demonstrate the feasibility of partitioning total tree cubic volume into round-product classes based on...

Interprofessional Rhetoric and Operational Realities: An Ethnographic Study of Rounds in Four Intensive Care Units

ERIC Educational Resources Information Center

Paradis, Elise; Leslie, Myles; Gropper, Michael A.

2016-01-01

Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the…

Missouri School Superintendent Perceptions of Year-Round School Calendars

ERIC Educational Resources Information Center

Cook, Becca Christine

2016-01-01

The purpose of this study is to synthesize perceptions of Missouri superintendents with regards to year-round school calendars and correlate them to the four themes of Time, Student Learning and Achievement, District Cost, and Family Cost and Support. The idea behind year-round school calendars is that by going to school throughout the year with…

Prospects and Problems of the Year-Round School in Contemporary American Education: A Sociological Examination.

ERIC Educational Resources Information Center

Ibsen, C. A.

A number of school divisions have entered year-round education without fully realizing the effects of such a program on the family and the community. Family vacations, child care, and routine living are disrupted by year-round educational programs. Community recreational facilities, church activities, public service programs, police work, and…