Usage of energy reserves in crustaceans during starvation: status and future directions.

PubMed

Sánchez-Paz, Arturo; García-Carreño, Fernando; Muhlia-Almazán, Adriana; Peregrino-Uriarte, Alma B; Hernández-López, Jorge; Yepiz-Plascencia, Gloria

2006-04-01

In this paper, we review the current knowledge about the usage of carbohydrates, lipids and proteins as energy source by marine crustaceans during starvation. Crustaceans are a large and diverse group including some economically important species. The efforts to culture them for human consumption has prompted the interest to understand the preferences of energy sources to be applied for feed formulation and cost reduction. Important differences have been found among species and appear to be related not only to the biochemistry and physiology of nutrition, but also to the living environment of the crustaceans. Furthermore, crustaceans undergo morphological, physiological and behavioral changes due to their natural growing process that affect their feeding habits, an aspect that should be carefully considered. We discuss the current information on marine crustaceans about energy usage and describe areas of future research, where starvation studies render important insights.

Airtankers and wildfire management in the US Forest Service: examining data availability and exploring usage and cost trends

Treesearch

Matthew P. Thompson; David E. Calkin; Jason Herynk; Charles W. McHugh; Karen C. Short

2012-01-01

Evaluating the effectiveness and efficiency of fixed- and rotary-wing aircraft is a crucial component of strategic wildfire management and planning. In this manuscript, we focus on the economics of fire and aviation management within the US Forest Service. Substantial uncertainties challenge comprehensive analysis of airtanker use, prompting calls from federal...

Clonal variation in morphology of Populus root systems following irrigation with landfill leachate or water during 2 years of establishment

Treesearch

Jill A. Zalesny; Ronald S., Jr. Zalesny; David R. Coyle; Richard B. Hall; Edmund O. Bauer

2009-01-01

Increased municipal solid waste generation in North America has prompted the use of Populus for phytoremediation of waste waters including landfill leachate. Populus species and hybrids are ideal for such applications because of their high water usage rates, fast growth, and extensive root systems. Adventitious rooting (i.e.,...

Enzymatic Recovery of Elemental Palladium by Using Sulfate-Reducing Bacteria

PubMed Central

Lloyd, Jon R.; Yong, Ping; Macaskie, Lynne E.

1998-01-01

Worldwide usage of platinum group metals is increasing, prompting new recovery technologies. Resting cells of Desulfovibrio desulfuricans reduced soluble Pd2+ to elemental, cell-bound Pd0 supported by pyruvate, formate, or H2 as the electron donor without biochemical cofactors. Pd reduction was O2 insensitive, opening the way for recycling and recovery of Pd under oxic conditions. PMID:9797331

[Computer usage among primary health care physicians in the Vukovar-Srijem County].

PubMed

Iveković, Hrvoje

2002-01-01

A survey was carried out, aiming at identification of the current usage of computers among primary health care physicians of the Vukovar-Srijem County. The results indicated poor knowledge and practice concerning the computer usage among examinees: 58% of the responders are not aware of the possibilities of computer usage in a GP office and 82% have not had an opportunity to see the software specialised for usage at GP offices. The results obtained from this survey indicate that none of the examinees use computer during daily routine work at the GP office. Only 26% of the examinees have got a computer, and use it at home, mostly for text processing. The Internet is used actively by 8% of examinees. Lack of education and equipment have been identified as main obstacles in the process of introducing computers to GP offices. Positive attitude towards computer usage has been identified, representing an important stimulus towards a more active role of the health centres management in solving this problem.

Variable size computer-aided detection prompts and mammography film reader decisions

PubMed Central

Gilbert, Fiona J; Astley, Susan M; Boggis, Caroline RM; McGee, Magnus A; Griffiths, Pamela M; Duffy, Stephen W; Agbaje, Olorunsola F; Gillan, Maureen GC; Wilson, Mary; Jain, Anil K; Barr, Nicola; Beetles, Ursula M; Griffiths, Miriam A; Johnson, Jill; Roberts, Rita M; Deans, Heather E; Duncan, Karen A; Iyengar, Geeta

2008-01-01

Introduction The purpose of the present study was to investigate the effect of computer-aided detection (CAD) prompts on reader behaviour in a large sample of breast screening mammograms by analysing the relationship of the presence and size of prompts to the recall decision. Methods Local research ethics committee approval was obtained; informed consent was not required. Mammograms were obtained from women attending routine mammography at two breast screening centres in 1996. Films, previously double read, were re-read by a different reader using CAD. The study material included 315 cancer cases comprising all screen-detected cancer cases, all subsequent interval cancers and 861 normal cases randomly selected from 10,267 cases. Ground truth data were used to assess the efficacy of CAD prompting. Associations between prompt attributes and tumour features or reader recall decisions were assessed by chi-squared tests. Results There was a highly significant relationship between prompting and a decision to recall for cancer cases and for a random sample of normal cases (P < 0.001). Sixty-four per cent of all cases contained at least one CAD prompt. In cancer cases, larger prompts were more likely to be recalled (P = 0.02) for masses but there was no such association for calcifications (P = 0.9). In a random sample of 861 normal cases, larger prompts were more likely to be recalled (P = 0.02) for both mass and calcification prompts. Significant associations were observed with prompting and breast density (p = 0.009) for cancer cases but not for normal cases (P = 0.05). Conclusions For both normal cases and cancer cases, prompted mammograms were more likely to be recalled and the prompt size was also associated with a recall decision. PMID:18724867

Variable size computer-aided detection prompts and mammography film reader decisions.

PubMed

Gilbert, Fiona J; Astley, Susan M; Boggis, Caroline Rm; McGee, Magnus A; Griffiths, Pamela M; Duffy, Stephen W; Agbaje, Olorunsola F; Gillan, Maureen Gc; Wilson, Mary; Jain, Anil K; Barr, Nicola; Beetles, Ursula M; Griffiths, Miriam A; Johnson, Jill; Roberts, Rita M; Deans, Heather E; Duncan, Karen A; Iyengar, Geeta

2008-01-01

The purpose of the present study was to investigate the effect of computer-aided detection (CAD) prompts on reader behaviour in a large sample of breast screening mammograms by analysing the relationship of the presence and size of prompts to the recall decision. Local research ethics committee approval was obtained; informed consent was not required. Mammograms were obtained from women attending routine mammography at two breast screening centres in 1996. Films, previously double read, were re-read by a different reader using CAD. The study material included 315 cancer cases comprising all screen-detected cancer cases, all subsequent interval cancers and 861 normal cases randomly selected from 10,267 cases. Ground truth data were used to assess the efficacy of CAD prompting. Associations between prompt attributes and tumour features or reader recall decisions were assessed by chi-squared tests. There was a highly significant relationship between prompting and a decision to recall for cancer cases and for a random sample of normal cases (P < 0.001). Sixty-four per cent of all cases contained at least one CAD prompt. In cancer cases, larger prompts were more likely to be recalled (P = 0.02) for masses but there was no such association for calcifications (P = 0.9). In a random sample of 861 normal cases, larger prompts were more likely to be recalled (P = 0.02) for both mass and calcification prompts. Significant associations were observed with prompting and breast density (p = 0.009) for cancer cases but not for normal cases (P = 0.05). For both normal cases and cancer cases, prompted mammograms were more likely to be recalled and the prompt size was also associated with a recall decision.

A Case of Human Infection by Rickettsia slovaca in Greece.

PubMed

Kostopoulou, Vasiliki; Chochlakis, Dimosthenis; Kanta, Chrysoula; Katsanou, Andromachi; Rossiou, Konstantina; Rammos, Aidonis; Papadopoulos, Spyridon-Filippos; Katsarou, Theodora; Tselentis, Yannis; Psaroulaki, Anna; Boukas, Chrysostomos

2016-07-22

Although tick-borne rickettsiosis is endemic in Greece, until recently, human samples arriving at the National Reference Centre under suspicion of rickettsial infection were routinely tested only for Rickettsia typhi and R. conorii. However, identification of additional rickettsia species in ticks prompted revision of the protocol in 2010. Until that year, all human samples received by the laboratory were tested for antibodies against R. conorii and R. typhi only. Now, tests for R. slovaca, R. felis, and R. mongolotimonae are all included in routine analysis. The current description of a human R. slovaca case is possible as a result of these changes in routine testing.

Writing a Writing Assessment: Saying What You Want to Say Isn't as Simple as It Seems.

ERIC Educational Resources Information Center

Escoe, Adrienne

Since acceptable writing is essential to success in job training programs and in many entry-level jobs, a writing sample was included in the Training and Employment Prerequisites Survey, a multiple-choice test about skills like mechanics, usage, and spelling. The two writing prompts asked students to give directions for finding a location in a…

Characterization of scintillator crystals for usage as prompt gamma monitors in particle therapy

NASA Astrophysics Data System (ADS)

Roemer, K.; Pausch, G.; Bemmerer, D.; Berthel, M.; Dreyer, A.; Golnik, C.; Hueso-González, F.; Kormoll, T.; Petzoldt, J.; Rohling, H.; Thirolf, P.; Wagner, A.; Wagner, L.; Weinberger, D.; Fiedler, F.

2015-10-01

Particle therapy in oncology is advantageous compared to classical radiotherapy due to its well-defined penetration depth. In the so-called Bragg peak, the highest dose is deposited; the tissue behind the cancerous area is not exposed. Different factors influence the range of the particle and thus the target area, e.g. organ motion, mispositioning of the patient or anatomical changes. In order to avoid over-exposure of healthy tissue and under-dosage of cancerous regions, the penetration depth of the particle has to be monitored, preferably already during the ongoing therapy session. The verification of the ion range can be performed using prompt gamma emissions, which are produced by interactions between projectile and tissue, and originate from the same location and time of the nuclear reaction. The prompt gamma emission profile and the clinically relevant penetration depth are correlated. Various imaging concepts based on the detection of prompt gamma rays are currently discussed: collimated systems with counting detectors, Compton cameras with (at least) two detector planes, or the prompt gamma timing method, utilizing the particle time-of-flight within the body. For each concept, the detection system must meet special requirements regarding energy, time, and spatial resolution. Nonetheless, the prerequisites remain the same: the gamma energy region (2 to 10 MeV), high counting rates and the stability in strong background radiation fields. The aim of this work is the comparison of different scintillation crystals regarding energy and time resolution for optimized prompt gamma detection.

A parameter estimation subroutine package

NASA Technical Reports Server (NTRS)

Bierman, G. J.; Nead, M. W.

1978-01-01

Linear least squares estimation and regression analyses continue to play a major role in orbit determination and related areas. In this report we document a library of FORTRAN subroutines that have been developed to facilitate analyses of a variety of estimation problems. Our purpose is to present an easy to use, multi-purpose set of algorithms that are reasonably efficient and which use a minimal amount of computer storage. Subroutine inputs, outputs, usage and listings are given along with examples of how these routines can be used. The following outline indicates the scope of this report: Section (1) introduction with reference to background material; Section (2) examples and applications; Section (3) subroutine directory summary; Section (4) the subroutine directory user description with input, output, and usage explained; and Section (5) subroutine FORTRAN listings. The routines are compact and efficient and are far superior to the normal equation and Kalman filter data processing algorithms that are often used for least squares analyses.

Immobilization of gold nanoparticles on cell culture surfaces for safe and enhanced gold nanoparticle-mediated laser transfection.

PubMed

Kalies, Stefan; Heinemann, Dag; Schomaker, Markus; Gentemann, Lara; Meyer, Heiko; Ripken, Tammo

2014-01-01

In comparison to standard transfection methods, gold nanoparticle-mediated laser transfection has proven to be a versatile alternative. This is based on its minor influence on cell viability and its high efficiency, especially for the delivery of small molecules like small interfering RNA. However, in order to transfer it to routine usage, a safety aspect is of major concern: The avoidance of nanoparticle uptake by the cells is desired. The immobilization of the gold nanoparticles on cell culture surfaces can address this issue. In this study, we achieved this by silanization of the appropriate surfaces and the binding of gold nanoparticles to them. Comparable perforation efficiencies to the previous approaches of gold nanoparticle-mediated laser transfection with free gold nanoparticles are demonstrated. The uptake of the immobilized particles by the cells is unlikely. Consequently, these investigations offer the possibility of bringing gold nanoparticle-mediated laser transfection closer to routine usage.

Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff.

PubMed

Squires, Ray W; Montero-Gomez, Aura; Allison, Thomas G; Thomas, Randal J

2008-01-01

Randomized-clinical trials have demonstrated the benefits of disease management for patients with coronary disease. It is not known if long-term disease management in routine clinical practice provided by cardiac rehabilitation (CR) program staff is possible. The goal of this study was to evaluate the feasibility and clinical benefits of a 3-year disease-management program in the setting of an outpatient CR facility. Consecutive patients (n = 503) referred to CR and who were available for long-term follow-up served as subjects. After a phase II CR program, disease managers assessed secondary-prevention goals every 3 to 6 months via face-to-face meetings with each patient. Outcome measures included use of cardioprotective medications, coronary risk factors, amount of habitual exercise training, and all-cause mortality. At 3 years, aspirin usage was 91%, statin usage 91%, beta-blocker usage 78%, and angiotensin-converting enzyme inhibitor usage 76%. Low-density lipoprotein cholesterol was 90 +/- 23 mg/dL, systolic blood pressure was 126 +/- 19 mm Hg, and body mass index was 29.0 +/- 5.1 kg/m2. Exercise training averaged 139 +/- 123 minutes per week. Annual mortality was 1.9%. There were no differences (P > .05) in medication usage or low-density lipoprotein cholesterol for men versus women, or for age below 65 years versus age 65 years or greater. Long-term disease management of patients with coronary disease in routine clinical practice by CR program staff is feasible and effective in achieving and maintaining secondary-prevention goals. Overweight remains a prevalent and persistent risk factor. We advocate expansion of CR programs into long-term coronary disease-management programs.

A feasibility study for a clinical decision support system prompting HIV testing.

PubMed

Chadwick, D R; Hall, C; Rae, C; Rayment, Ml; Branch, M; Littlewood, J; Sullivan, A

2017-07-01

Levels of undiagnosed HIV infection and late presentation remain high globally despite attempts to increase testing. The objective of this study was to evaluate a risk-based prototype application to prompt HIV testing when patients undergo routine blood tests. Two computer physician order entry (CPOE) systems were modified using the application to prompt health care workers (HCWs) to add an HIV test when other tests selected suggested that the patient was at higher risk of HIV infection. The application was applied for a 3-month period in two areas, in a large London hospital and in general practices in Teesside/North Yorkshire. At the end of the evaluation period, HCWs were interviewed to assess the usability and acceptability of the prompt. Numbers of HIV tests ordered in the general practice areas were also compared before and after the prompt's introduction. The system was found to be both useable and generally acceptable to hospital doctors, general practitioners and nurse practitioners, with little evidence of prompt/alert fatigue. The issue of the prompt appearing late in the patient consultation did lead to some difficulties, particularly around discussion of the test and consent. In the general practices, around 1 in 10 prompts were accepted and there was a 6% increase in testing rates over the 3-month study period (P = 0.169). Using a CPOE-based clinical decision support application to prompt HIV testing appears both feasible and acceptable to HCWs. Refining the application to provide more accurate risk stratification is likely to make it more effective. © 2016 British HIV Association.

Engaging Participation and Promoting Active Learning through Student Usage of the Internet to Create Notes for General Chemistry in Class

ERIC Educational Resources Information Center

Henry, Renee Monica

2017-01-01

Reported here is a study of an interactive component to General Chemistry I and General Chemistry II where a new pedagogy for taking notes in class was developed. These notes, called key word created class notes, prompted students to locate information using the Internet guided by a key word. Reference Web sites were added to a next generation of…

Reduction of Bridge Deck Cracking through Alternative Material Usage

DOT National Transportation Integrated Search

2017-12-01

ODOT routinely deploys a large number of continuous span structural slab bridges. Despite being designed to strictly satisfy all the relevant AASHTO and ODOT BDM requirements, many such bridge decks show transverse cracks, with widths greater than th...

A Preserved Context Indexing System for Microcomputers: PERMDEX.

ERIC Educational Resources Information Center

Yerkey, A. Neil

1983-01-01

Following a discussion of derivative versus assignment indexing, use of roles, and concept behind Preserved Concept Indexing System, features of PERMDEX (microcomputer program to assist in creation of permuted printed index) are described including indexer input and prompts, the shunting algorithm, and sorting and printing routines. Fourteen…

78 FR 76984 - Airworthiness Directives; Eurocopter France Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... inspecting each jettisonable emergency exit window panel (window) for sealant, and removing any sealant that exists in the window's extruded sections. This AD was prompted by jettison tests during routine maintenance inspections that showed the windows failed to jettison. The actions of this AD are intended to...

78 FR 37156 - Airworthiness Directives; Eurocopter France Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... inspecting each jettisonable emergency exit window panel (window) for sealant, and removing any sealant that exists in the window's extruded sections. This proposed AD is prompted by jettison tests during routine maintenance inspections that showed the windows failed to jettison. The proposed actions are intended to...

Desk-based workers' perspectives on using sit-stand workstations: a qualitative analysis of the Stand@Work study.

PubMed

Chau, Josephine Y; Daley, Michelle; Srinivasan, Anu; Dunn, Scott; Bauman, Adrian E; van der Ploeg, Hidde P

2014-07-25

Prolonged sitting time has been identified as a health risk factor. Sit-stand workstations allow desk workers to alternate between sitting and standing throughout the working day, but not much is known about their acceptability and feasibility. Hence, the aim of this study was to qualitatively evaluate the acceptability, feasibility and perceptions of using sit-stand workstations in a group of desk-based office workers. This article describes the qualitative evaluation of the randomized controlled cross-over Stand@Work pilot trial. Participants were adult employees recruited from a non-government health agency in Sydney, Australia. The intervention involved using an Ergotron Workfit S sit-stand workstation for four weeks. After the four week intervention, participants shared their perceptions and experiences of using the sit-stand workstation in focus group interviews with 4-5 participants. Topics covered in the focus groups included patterns of workstation use, barriers and facilitators to standing while working, effects on work performance, physical impacts, and feasibility in the office. Focus group field notes and transcripts were analysed in an iterative process during and after the data collection period to identify the main concepts and themes. During nine 45-min focus groups, a total of 42 participants were interviewed. Participants were largely intrinsically motivated to try the sit-stand workstation, mostly because of curiosity to try something new, interest in potential health benefits, and the relevance to the participant's own and organisation's work. Most participants used the sit-stand workstation and three common usage patterns were identified: task-based routine, time-based routine, and no particular routine. Common barriers to sit-stand workstation use were working in an open plan office, and issues with sit-stand workstation design. Common facilitators of sit-stand workstation use were a supportive work environment conducive to standing, perceived physical health benefits, and perceived work benefits. When prompted, most participants indicated they were interested in using a sit-stand workstation in the future. The use of a sit-stand workstation in this group of desk-based office workers was generally perceived as acceptable and feasible. Future studies are needed to explore this in different desk-based work populations and settings.

Dose Tracker Application for Monitoring Crew Medication Usage, Symptoms, and Adverse Effects During Missions

NASA Technical Reports Server (NTRS)

Wotring, Virginia; Smith, LaRona

2015-01-01

Medication usage records can be used as a relatively nonintrusive means of monitoring health. This has been attempted previously through crew medical records, but these records are incomplete from the perspective of a research pharmacologist. During the shuttle era, NASA operations did not include routine questioning of crewmembers about their medication use until after missions were complete. The (long!) questionnaire was on paper. Asking crewmembers to recall medication use from weeks before questioning made getting complete and accurate information virtually impossible. This study will document medication usage of crewmembers before and during their missions. It will capture previously unrecorded data regarding medication use during spaceflight, including side effect qualities, frequencies and severities. The research-oriented data will be collected for research purposes, separate from medical records. Dose Tracker employs an iOS application (app) for fast & easy collection of medication usage data from crewmember participants during their missions.

Updates Technologies of Media Change

ERIC Educational Resources Information Center

Comer, Joshua

2015-01-01

Whether as status notifications in news feeds or interactive prompts in online video services, updates punctuate the background routines of media by bringing a variety of changes to the attention of users. In this dissertation I argue that updates rationalize media change by making previously obscure actions of users and movements of technologies…

Surgical wound management with adhesive polyurethane membrane: a preferred method for routine usage.

PubMed Central

Tinckler, L.

1983-01-01

The author gives an account of his experience of the use in some 1600 patients of adhesive polyurethane membrane, marketed as Op-site, both for skin closure and wound dressing, in combination, as a routine method of surgical wound management in a wide variety of surgical operations. The technique of utilising this method is described in detail, as also are the advantages for patients, nursing and medical staff. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6870136

Expanded HIV Testing Strategy Leveraging the Electronic Medical Record Uncovers Undiagnosed Infection Among Hospitalized Patients.

PubMed

Felsen, Uriel R; Cunningham, Chinazo O; Heo, Moonseong; Futterman, Donna C; Weiss, Jeffrey M; Zingman, Barry S

2017-05-01

Routine HIV testing of hospitalized patients is recommended, but few strategies to expand testing in the hospital setting have been described. We assessed the impact of an electronic medical record (EMR) prompt on HIV testing for hospitalized patients. We performed a pre-post study at 3 hospitals in the Bronx, NY. We compared the proportion of admissions of patients 21-64 years old with an HIV test performed, characteristics of patients tested, and rate of new HIV diagnoses made by screening while an EMR prompt recommending HIV testing was inactive vs. active. The prompt appeared for patients with no previous HIV test or a high-risk diagnosis after their last HIV test. Among 36,610 admissions while the prompt was inactive, 9.5% had an HIV test performed. Among 18,943 admissions while the prompt was active, 21.8% had an HIV test performed. Admission while the prompt was active was associated with increased HIV testing among total admissions [adjusted odds ratio (aOR) 2.78, 95% confidence interval (CI): 2.62 to 2.96], those without a previous HIV test (aOR 4.03, 95% CI: 3.70 to 4.40), and those with a previous negative test (aOR 1.52, 95% CI: 1.37 to 1.68) (P < 0.0001 for all). Although the prompt was active, testing increased across all patient characteristics. New HIV diagnoses made by screening increased from 8.2/100,000 admissions to 37.0/100,000 admissions while the prompt was inactive and active, respectively (OR 4.51 95% CI: 1.17 to 17.45, P = 0.03). An EMR prompt for hospitalized patients was associated with a large increase in HIV testing, a diversification of patients tested, and an increase in diagnoses made by screening.

Analysis of routine communication in the air traffic control system

NASA Technical Reports Server (NTRS)

Clark, Herbert H.; Morrow, Daniel; Rodvoid, Michelle

1990-01-01

The present project has three related goals. The first is to describe the organization of routine controller-pilot communication. This includes identifying the basic units of communication and how they are organized into discourse, how controllers and pilots use language to achieve their goals, and what topics they discuss. The second goal is to identify the type and frequency of problems that interrupt routine information transfer and prompt pilots and controllers to focus on the communication itself. The authors analyze the costs of these problems in terms of communication efficiency, and the techniques used to resolve these problems. Third, the authors hope to identify factors associated with communication problems, such as deviations from conventional air traffic control procedures.

NHEXAS PHASE I MARYLAND STUDY--QUALITY SYSTEMS AND IMPLEMENTATION PLAN (HSPH QSIP)

EPA Science Inventory

This document describes the project design and quality systems used by the Maryland Study for NHEXAS Phase 1. It contains the following sections: Project Planning and Organization, Project Implementation Plan, Data Acquisition and Management, Records Usage and Management, Routin...

Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial.

PubMed

Nishimura, Akiko; Harashima, Shin-Ichi; Fujita, Yoshihito; Tanaka, Daisuke; Wang, Yu; Liu, Yanyan; Inagaki, Nobuya

2017-01-01

To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients. Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change. HbA1c levels were significantly decreased by 0.32% (3.50mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94kg and 6.8/4.7mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG. Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

Current practice patterns of drain usage amongst UK and Irish surgeons performing bilateral breast reductions: Evidence down the drain.

PubMed

Sugrue, Conor M; McInerney, Niall; Joyce, Cormac W; Jones, Deidre; Hussey, Alan J; Kelly, Jack L; Kerin, Michael J; Regan, Padraic J

2015-01-01

Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs. An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test. Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07). Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.

Guidelines for Creating a Transition Routine: Changing from One Room to Another

ERIC Educational Resources Information Center

McCoy, Kathleen M.; Mathur, Sarup. R.; Czoka, Andrea

2010-01-01

Research strongly suggests that visual supports, such as pictures, prompts, cue cards, story boards, graphic schedules, and diagrams, have been effective for providing instructional structure for a wide variety of children and for multiple activities. Making successful transitions from one activity to another is difficult for many children,…

40 CFR 1033.250 - Reporting and recordkeeping.

Code of Federal Regulations, 2014 CFR

2014-07-01

... applications and any summary information you send us. (2) Any of the information we specify in § 1033.205 that.... (c) Keep data from routine emission tests (such as test cell temperatures and relative humidity... records in any format and on any media, as long as you can promptly send us organized, written records in...

40 CFR 1033.250 - Reporting and recordkeeping.

Code of Federal Regulations, 2011 CFR

2011-07-01

... applications and any summary information you send us. (2) Any of the information we specify in § 1033.205 that.... (c) Keep data from routine emission tests (such as test cell temperatures and relative humidity... records in any format and on any media, as long as you can promptly send us organized, written records in...

40 CFR 1033.250 - Reporting and recordkeeping.

Code of Federal Regulations, 2012 CFR

2012-07-01

... applications and any summary information you send us. (2) Any of the information we specify in § 1033.205 that.... (c) Keep data from routine emission tests (such as test cell temperatures and relative humidity... records in any format and on any media, as long as you can promptly send us organized, written records in...

40 CFR 1060.250 - What records must I keep?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) A copy of all applications and any summary information you send us. (2) Any of the information we...) Keep required data from routine emission tests (such as temperature measurements) for one year after we... on any media as long as you can promptly send us organized, written records in English if we ask for...

40 CFR 1060.250 - What records must I keep?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) A copy of all applications and any summary information you send us. (2) Any of the information we...) Keep required data from routine emission tests (such as temperature measurements) for one year after we... on any media as long as you can promptly send us organized, written records in English if we ask for...

40 CFR 1060.250 - What records must I keep?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) A copy of all applications and any summary information you send us. (2) Any of the information we...) Keep required data from routine emission tests (such as temperature measurements) for one year after we... on any media as long as you can promptly send us organized, written records in English if we ask for...

40 CFR 1060.250 - What records must I keep?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) A copy of all applications and any summary information you send us. (2) Any of the information we...) Keep required data from routine emission tests (such as temperature measurements) for one year after we... on any media as long as you can promptly send us organized, written records in English if we ask for...

40 CFR 1033.250 - Reporting and recordkeeping.

Code of Federal Regulations, 2013 CFR

2013-07-01

... applications and any summary information you send us. (2) Any of the information we specify in § 1033.205 that.... (c) Keep data from routine emission tests (such as test cell temperatures and relative humidity... records in any format and on any media, as long as you can promptly send us organized, written records in...

76 FR 4456 - Privacy Act of 1974; Report of Modified or Altered System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

..., computer systems analysis and computer programming services. The contractors promptly return data entry... Use Disclosures of Data in the System The Privacy Act allows us to disclose information without an...) for which the information was collected. Any such compatible use of data is known as a ``routine use...

Coming to Know More through and from Writing

ERIC Educational Resources Information Center

Prain, Vaughan; Hand, Brian

2016-01-01

Over the past 20 years, claims about how and why student writing can serve learning have changed markedly. This has been partly due to new technologies displacing writing as a predominant resource for learning, prompting new sense-making practices and shifts in how these changes are theorized. Learners now routinely collaborate to generate,…

Encouraging Sun Safety for Children and Adolescents

ERIC Educational Resources Information Center

Boe, Kathy; Tillotson, Elizabeth A.

2006-01-01

The rise in the number of cases of skin cancers, both melanomas and nonmelanomas, has prompted increased awareness and educational efforts to limit sun exposure. Because 80% of lifetime sun exposure occurs before the age of 18, educating parents and adolescents to incorporate sun-protective behaviors into daily routines is particularly important.…

Interpreting Visual Texts: Use of an Analytic Rubric to Evaluate Student Responses to Writing Prompts

ERIC Educational Resources Information Center

Sundeen, Todd H.; O'Neil, Kathleen; Fanselow, Stephanie A.

2017-01-01

Younger students' visual texts are statements and stories conveyed through drawings or other artwork and often convey meaning beyond the child's capability to communicate with written expression. Although opportunities for expression through drawing are routinely offered to children in the initial and middle stages of early childhood literacy…

Trusted materials using orthogonal testing. 2015 Annual report

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

Van Benthem, Mark

2015-09-01

The purpose of this project is to prove (or disprove) that a reasonable number of simple tests can be used to provide a unique data signature for materials, changes in which could serve as a harbinger of material deviation, prompting further evaluations. The routine tests are mutually orthogonal to any currently required materials specification tests.

Hippity Hops Velcroed to the Floor and Other Strategies to Educate Kids with FAS or FAE.

ERIC Educational Resources Information Center

Wescott, Siobhan

1991-01-01

Children with fetal alcohol syndrome may exhibit hyperactivity, hypersensitivity to touch, attention deficit disorder, stimulus overload, or an overtrusting nature. Educational strategies include consistent routines, multisensory cues to prompt memory, problem-solving training to recognize options, and emphasis on social skills and daily living…

Informal Learning through Science Media Usage

ERIC Educational Resources Information Center

Maier, Michaela; Rothmund, Tobias; Retzbach, Andrea; Otto, Lukas; Besley, John C.

2014-01-01

This article reviews current research on informal science learning through news media. Based on a descriptive model of media-based science communication we distinguish between (a) the professional routines by which journalists select and depict scientific information in traditional media and (b) the psychological processes that account for how…

Benchmarking of hospital information systems: Monitoring of discharge letters and scheduling can reveal heterogeneities and time trends

PubMed Central

Dugas, Martin; Eckholt, Markus; Bunzemeier, Holger

2008-01-01

Background Monitoring of hospital information system (HIS) usage can provide insights into best practices within a hospital and help to assess time trends. In terms of effort and cost of benchmarking, figures derived automatically from the routine HIS system are preferable to manual methods like surveys, in particular for repeated analysis. Methods Due to relevance for quality management and efficient resource utilization we focused on time-to-completion of discharge letters (assessed by CT-plots) and usage of patient scheduling. We analyzed these parameters monthly during one year at a major university hospital in Germany. Results We found several distinct patterns of discharge letter documentation indicating a large heterogeneity of HIS usage between different specialties (completeness 51 – 99%, delays 0 – 90 days). Overall usage of scheduling increased during the observation period by 62%, but again showed a considerable variation between departments. Conclusion Regular monitoring of HIS key figures can contribute to a continuous HIS improvement process. PMID:18423046

EP and CD-ROM products - Current trends of production and market development -

NASA Astrophysics Data System (ADS)

Watanabe, Kazuhiko

The printed books and magazines/journals have been, and still even now are, dominant materials for public reading and reference usage. Microform publications have been also adopted for library collection build-up, but it is still within a very limited scale and coverage. As the first "new media" product, we should approve the fact that "CD-ROM" keeps amazingly large information storage capacity and also quite flexible application utility. So far, among the firstly released CD-ROMS, bibliographic databases, both for Japanese and English publications, look already quite widely purchased and now installed in many workstations of libraries. The users should evaluate its cost-effectiveness not only by its great data storage capacity but also by its frequent usage merit for library work rationalization. Multiple applied usage of CD-ROM will surely serve to such library routine works as searching, cataloguing, reading list preparation, inventory checking and new order placing, etc. 'CD-ROM' is the first EP product for quite wide usage.

The prompted optional randomization trial: a new design for comparative effectiveness research.

PubMed

Flory, James; Karlawish, Jason

2012-12-01

Randomized controlled trials are the gold standard for medical evidence because randomization provides the best-known protection against confounding of results. Randomization has practical and ethical problems that limit the number of trials that can be conducted, however. A different method for collecting clinical data retains the statistically useful properties of randomization without incurring its practical and ethical challenges. A computerized prompt introduces a random element into clinical decision-making that can be instantly overridden if it conflicts with optimal patient care. This creates a weak form of randomization that still eliminates the effect of all confounders, can be carried out without disturbing routine clinical care, and arguably will not require research-grade informed consent.

Effect of parental selection of healthy behavior topic during well child visit on plan to change childs eating or physical activity behavior

USDA-ARS?s Scientific Manuscript database

Current recommendations direct pediatricians to address obesity and obesity prevention routinely during well child visits and to tailor their counseling, but clinicians may feel ineffective because of time constraints and lack of parent interest. To prompt parents to select a healthy lifestyle topic...

ePortfolios Meet Social Software

ERIC Educational Resources Information Center

Waters, John K.

2007-01-01

Although a seemingly good idea, electronic portfolios have to date failed to gain significant traction in higher education. Institutions with ePortfolio implementations routinely report high numbers of accounts on their campuses, but few believe that those numbers are a meaningful reflection of actual usage. Change is in the air for the…

Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: A qualitative study.

PubMed

Summers, Rachael H; Moore, Michael; Ekberg, Stuart; Chew-Graham, Carolyn A; Little, Paul; Stevenson, Fiona; Brindle, Lucy; Leydon, Geraldine M

2016-05-01

To investigate the perspectives of general practitioners (GPs) on the practice of soliciting additional concerns (ACs) and the acceptability and utility of two brief interventions (prompts) designed to aid the solicitation. Eighteen GPs participating in a feasibility randomised controlled trial were interviewed. Interviews were semi-structured and audio-recorded. Data were analysed using a Framework Approach. Participants perceived eliciting ACs as important for: reducing the need for multiple visits, identifying serious illness early, and increasing patient and GP satisfaction. GPs found the prompts easy to use and some continued their use after the study had ended to aid time management. Others noted similarities between the intervention and their usual practice. Nevertheless, soliciting ACs in every consultation was not unanimously supported. The prompts were acceptable to GPs within a trial context, but there was disagreement as to whether ACs should be solicited routinely. Some GPs considered the intervention to aid their prioritisation efficiency within consultations. Some GPs will find prompts which encourage ACs to be solicited early in the consultation enable them to better organise priorities and manage time-limited consultations more effectively. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Enhancements in hepatobiliary imaging: the spectrum of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid usages in hepatobiliary magnetic resonance imaging.

PubMed

Channual, Stephanie; Pahwa, Anokh; Lu, David S; Raman, Steven S

2016-09-01

Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a unique hepatocyte-specific contrast agent approved for clinical use in the United States in 2008. Gd-EOB-DTPA-enhanced MR has shown to improve detection and characterization of hepatic lesions. Gd-EOB-DTPA is now being routinely used in daily clinical practice worldwide. Therefore, it is important for radiologists to be familiar with the potential uses and pitfalls of Gd-EOB-DTPA, which extends beyond the assessment of focal hepatic lesions. The purpose of this article is to review the various usages of Gd-EOB-DTPA in hepatobiliary MR imaging.

Cardiac asystole following cannabis (marijuana) usage--additional mechanism for sudden death?

PubMed

Menahem, Samuel

2013-12-10

A 21 year old university student previously operated during infancy for an unobstructed total anomalous pulmonary venous drainage with an excellent result, was noted on a routine follow up 24 h Holter monitor to have multiple pauses related to cardiac asystole, the longest lasting 5.8 s and temporally related to marijuana inhalation. A repeat Holter was normal following a two week cessation of marijuana usage and again when carried out 3 months later. The documented periods of asystole may be a precursor of sudden death seen in addicts even without evidence of ischaemic heart disease. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The persuasive power of oral health promotion messages: a theory of planned behavior approach to dental checkups among young adults.

PubMed

Anderson, Christina N; Noar, Seth M; Rogers, Brandi D

2013-01-01

Although routine dental checkups are important for both oral and overall health, several factors influence young adults' use or nonuse of dental services. The two studies included in this report tested the theory of reasoned action (TRA), the theory of planned behavior (TPB), and an expanded TPB model in predicting young adults' routine dental checkups. Additionally, the study tested the perceived message effectiveness of TPB-based messages. Results support the use of an expanded TPB model (particularly adding satisfaction with the dentist and environmental constraints to the traditional model) for an understanding of routine dental checkup intention and behavior, and, most notably, provide support for the use of subjective norm-based messages to prompt dental checkups. This study lays the groundwork for a health communication campaign encouraging routine dental checkups among young adults. The use of targeting and tailoring to design effective oral health media campaign messages is discussed.

A review on technologies and their usage in solid waste monitoring and management systems: Issues and challenges.

PubMed

Hannan, M A; Abdulla Al Mamun, Md; Hussain, Aini; Basri, Hassan; Begum, R A

2015-09-01

In the backdrop of prompt advancement, information and communication technology (ICT) has become an inevitable part to plan and design of modern solid waste management (SWM) systems. This study presents a critical review of the existing ICTs and their usage in SWM systems to unfold the issues and challenges towards using integrated technologies based system. To plan, monitor, collect and manage solid waste, the ICTs are divided into four categories such as spatial technologies, identification technologies, data acquisition technologies and data communication technologies. The ICT based SWM systems classified in this paper are based on the first three technologies while the forth one is employed by almost every systems. This review may guide the reader about the basics of available ICTs and their application in SWM to facilitate the search for planning and design of a sustainable new system. Copyright © 2015 Elsevier Ltd. All rights reserved.

A parameter estimation subroutine package

NASA Technical Reports Server (NTRS)

Bierman, G. J.; Nead, M. W.

1978-01-01

Linear least squares estimation and regression analyses continue to play a major role in orbit determination and related areas. A library of FORTRAN subroutines were developed to facilitate analyses of a variety of estimation problems. An easy to use, multi-purpose set of algorithms that are reasonably efficient and which use a minimal amount of computer storage are presented. Subroutine inputs, outputs, usage and listings are given, along with examples of how these routines can be used. The routines are compact and efficient and are far superior to the normal equation and Kalman filter data processing algorithms that are often used for least squares analyses.

The Analysis of New Generation Mobile Device Dependencies of Students in Faculty of Education

ERIC Educational Resources Information Center

Korucu, Agah Tugrul; Usta, Ertugrul

2016-01-01

The development of technology brought about some advantages as well as particular disadvantages. Smart phones which are new generation mobile devices are technological tools for meeting certain needs such as entertainment, social media, realization of daily routines and usage for educational purposes. The facts that new generation mobile devices…

A Model to Assess the Behavioral Impacts of Consultative Knowledge Based Systems.

ERIC Educational Resources Information Center

Mak, Brenda; Lyytinen, Kalle

1997-01-01

This research model studies the behavioral impacts of consultative knowledge based systems (KBS). A study of graduate students explored to what extent their decisions were affected by user participation in updating the knowledge base; ambiguity of decision setting; routinization of usage; and source credibility of the expertise embedded in the…

Adolescent use of electronic nicotine delivery systems.

PubMed

Vincent, Debra; Potts, Jeanne; Durbin, Jessica; Moore, Jill M; Eley, Susan

2018-03-12

Use of electronic nicotine delivery systems is flourishing among adolescents. The long-term effects have not been fully determined; however, literature suggests there is potential for significant harm. Providers must be aware of usage trends, device safety, and product knowledge. Adolescents should be evaluated through routine screening, and cessation counseling should be initiated.

Teacher Technology Acceptance and Usage for the Middle School Classroom

ERIC Educational Resources Information Center

Stone, Wilton, Jr.

2014-01-01

According to the U.S. Department of Education National Center for Education Statistics, students in the United States routinely perform poorly on international assessments. This study was focused specifically on the problem of the decrease in the number of middle school students meeting the requirements for one state's standardized tests for…

Before You Ban: Law Students' In-Class Laptop Usage and Academic Performance

ERIC Educational Resources Information Center

Morse, Kimberly Ann

2016-01-01

Legal educators are routinely banning students' laptops or wireless connectivity in law classes. Faculty assumes students are significantly off-task and in-class laptops are harmful to learning. Current research focuses almost exclusively on undergraduate students technology uses in- and out of the classroom. Only a handful of studies objectively…

Check-off logs for routine equipment maintenance.

PubMed

Brewster, M A; Carver, P H; Randolph, B

1995-12-01

The regulatory requirement for appropriate routine instrument maintenance documentation is approached by laboratories in numerous ways. Standard operating procedures (SOPs) may refer to maintenance listed in instrument manuals, may indicate "periodic" performance of an action, or may indicate specific tasks to be performed at certain frequencies. The Quality Assurance Unit (QAU) task of assuring the performance of these indicated maintenance tasks can be extremely laborious if these records are merged with other analysis records. Further, the lack of written maintenance schedules often leads to omission of infrequently performed tasks. We recommend creation of routine maintenance check-off logs for instruments with tasks grouped by frequency of expected performance. Usage of such logs should result in better laboratory compliance with SOPs and the compliance can be readily monitored by QAU or by regulatory agencies.

Relapsing Fever: Diagnosis Thanks to a Vigilant Hematology Laboratory.

PubMed

Fuchs, Inbal; Tarabin, Salman; Kafka, Michael

2015-07-01

Three cases of relapsing fever from southern Israel were diagnosed promptly thanks to vigilance of the hematology laboratory technicians. In this region of Israel, patients presenting with prolonged fever and leukopenia without localizing symptoms are generally suspected of having brucellosis or a rickettsial disease. Pediatric patients with prolonged fever, cytopenias, and negative aforementioned serologies are often hospitalized for further work-up. Because of the policy of performing a manual blood smear when results of the automated blood count demonstrate severe anemia and abnormal platelet and/or white blood cell counts, a diagnosis of tick-borne relapsing fever was confirmed and promptly relayed to the physician. This routine prevented unnecessary examinations and hospitalization days and provided important information to regional epidemiology and public health authorities.

Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility.

PubMed

Petzoldt, J; Roemer, K E; Enghardt, W; Fiedler, F; Golnik, C; Hueso-González, F; Helmbrecht, S; Kormoll, T; Rohling, H; Smeets, J; Werner, T; Pausch, G

2016-03-21

Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be key to exploit the major advantages of proton therapy. Prompt gamma rays, produced in nuclear reactions between projectile and target nuclei, can be used to measure the proton's range. The prompt gamma-ray timing (PGT) method aims at obtaining this information by determining the gamma-ray emission time along the proton path using a conventional time-of-flight detector setup. First tests at a clinical accelerator have shown the feasibility to observe range shifts of about 5 mm at clinically relevant doses. However, PGT spectra are smeared out by the bunch time spread. Additionally, accelerator related proton bunch drifts against the radio frequency have been detected, preventing a potential range verification. At OncoRay, first experiments using a proton bunch monitor (PBM) at a clinical pencil beam have been conducted. Elastic proton scattering at a hydrogen-containing foil could be utilized to create a coincident proton-proton signal in two identical PBMs. The selection of coincident events helped to suppress uncorrelated background. The PBM setup was used as time reference for a PGT detector to correct for potential bunch drifts. Furthermore, the corrected PGT data were used to image an inhomogeneous phantom. In a further systematic measurement campaign, the bunch time spread and the proton transmission rate were measured for several beam energies between 69 and 225 MeV as well as for variable momentum limiting slit openings. We conclude that the usage of a PBM increases the robustness of the PGT method in clinical conditions and that the obtained data will help to create reliable range verification procedures in clinical routine.

Assessment and improvements of Geant4 hadronic models in the context of prompt-gamma hadrontherapy monitoring

NASA Astrophysics Data System (ADS)

Dedes, G.; Pinto, M.; Dauvergne, D.; Freud, N.; Krimmer, J.; Létang, J. M.; Ray, C.; Testa, E.

2014-04-01

Monte Carlo simulations are nowadays essential tools for a wide range of research topics in the field of radiotherapy. They also play an important role in the effort to develop a real-time monitoring system for quality assurance in proton and carbon ion therapy, by means of prompt-gamma detection. The internal theoretical nuclear models of Monte Carlo simulation toolkits are of decisive importance for the accurate description of neutral or charged particle emission, produced by nuclear interactions between beam particles and target nuclei. We assess the performance of Geant4 nuclear models in the context of prompt-gamma emission, comparing them with experimental data from proton and carbon ion beams. As has been shown in the past and further indicated in our study, the prompt-gamma yields are consistently overestimated by Geant4 by a factor of about 100% to 200% over an energy range from 80 to 310 MeV/u for the case of 12C, and to a lesser extent for 160 MeV protons. Furthermore, we focus on the quantum molecular dynamics (QMD) modeling of ion-ion collisions, in order to optimize its description of light nuclei, which are abundant in the human body and mainly anticipated in hadrontherapy applications. The optimization has been performed by benchmarking QMD free parameters with well established nuclear properties. In addition, we study the effect of this optimization on charged particle emission. With the usage of the proposed parameter values, discrepancies reduce to less than 70%, with the highest values being attributed to the nucleon-ion induced prompt-gammas. This conclusion, also confirmed by the disagreement we observe in the case of proton beams, indicates the need for further investigation on nuclear models which describe proton and neutron induced nuclear reactions.

De-Gendering in the Use of E-Learning

ERIC Educational Resources Information Center

Remmele, Bernd; Holthaus, Matthias

2013-01-01

The starting point of the paper is the co-construction of gender and technology, that is, the theory that the usage of and the attitude to certain kinds of technology are a way to "do" one's gender. A survey is presented that supports the assumption that with the routinization of e-learning in higher education e-learning loses its…

The effects of implementing a point-of-care electronic template to prompt routine anxiety and depression screening in patients consulting for osteoarthritis (the Primary Care Osteoarthritis Trial): A cluster randomised trial in primary care.

PubMed

Mallen, Christian D; Nicholl, Barbara I; Lewis, Martyn; Bartlam, Bernadette; Green, Daniel; Jowett, Sue; Kigozi, Jesse; Belcher, John; Clarkson, Kris; Lingard, Zoe; Pope, Christopher; Chew-Graham, Carolyn A; Croft, Peter; Hay, Elaine M; Peat, George

2017-04-01

This study aimed to evaluate whether prompting general practitioners (GPs) to routinely assess and manage anxiety and depression in patients consulting with osteoarthritis (OA) improves pain outcomes. We conducted a cluster randomised controlled trial involving 45 English general practices. In intervention practices, patients aged ≥45 y consulting with OA received point-of-care anxiety and depression screening by the GP, prompted by an automated electronic template comprising five questions (a two-item Patient Health Questionnaire-2 for depression, a two-item Generalized Anxiety Disorder-2 questionnaire for anxiety, and a question about current pain intensity [0-10 numerical rating scale]). The template signposted GPs to follow National Institute for Health and Care Excellence clinical guidelines for anxiety, depression, and OA and was supported by a brief training package. The template in control practices prompted GPs to ask the pain intensity question only. The primary outcome was patient-reported current pain intensity post-consultation and at 3-, 6-, and 12-mo follow-up. Secondary outcomes included pain-related disability, anxiety, depression, and general health. During the trial period, 7,279 patients aged ≥45 y consulted with a relevant OA-related code, and 4,240 patients were deemed potentially eligible by participating GPs. Templates were completed for 2,042 patients (1,339 [31.6%] in the control arm and 703 [23.1%] in the intervention arm). Of these 2,042 patients, 1,412 returned questionnaires (501 [71.3%] from 20 intervention practices, 911 [68.0%] from 24 control practices). Follow-up rates were similar in both arms, totalling 1,093 (77.4%) at 3 mo, 1,064 (75.4%) at 6 mo, and 1,017 (72.0%) at 12 mo. For the primary endpoint, multilevel modelling yielded significantly higher average pain intensity across follow-up to 12 mo in the intervention group than the control group (adjusted mean difference 0.31; 95% CI 0.04, 0.59). Secondary outcomes were consistent with the primary outcome measure in reflecting better outcomes as a whole for the control group than the intervention group. Anxiety and depression scores did not reduce following the intervention. The main limitations of this study are two potential sources of bias: an imbalance in cluster size (mean practice size 7,397 [intervention] versus 5,850 [control]) and a difference in the proportion of patients for whom the GP deactivated the template (33.6% [intervention] versus 27.8% [control]). In this study, we observed no beneficial effect on pain outcomes of prompting GPs to routinely screen for and manage comorbid anxiety and depression in patients presenting with symptoms due to OA, with those in the intervention group reporting statistically significantly higher average pain scores over the four follow-up time points than those in the control group. ISRCTN registry ISRCTN40721988.

Advanced mathematical on-line analysis in nuclear experiments. Usage of parallel computing CUDA routines in standard root analysis

NASA Astrophysics Data System (ADS)

Grzeszczuk, A.; Kowalski, S.

2015-04-01

Compute Unified Device Architecture (CUDA) is a parallel computing platform developed by Nvidia for increase speed of graphics by usage of parallel mode for processes calculation. The success of this solution has opened technology General-Purpose Graphic Processor Units (GPGPUs) for applications not coupled with graphics. The GPGPUs system can be applying as effective tool for reducing huge number of data for pulse shape analysis measures, by on-line recalculation or by very quick system of compression. The simplified structure of CUDA system and model of programming based on example Nvidia GForce GTX580 card are presented by our poster contribution in stand-alone version and as ROOT application.

Chasing down the triple-negative myeloproliferative neoplasms: Implications for molecular diagnostics.

PubMed

Langabeer, Stephen E

2016-01-01

The majority of patients with classical myeloproliferative neoplasms (MPN) of polycythemia vera, essential thrombocythemia, and primary myelofibrosis harbor distinct disease-driving mutations within the JAK2 , CALR , or MPL genes. The term triple-negative has been recently applied to those MPN without evidence of these consistent mutations, prompting whole or targeted exome sequencing approaches to determine the driver mutational status of this subgroup. These strategies have identified numerous novel mutations that occur in alternative exons of both JAK2 and MPL , the majority of which result in functional activation. Current molecular diagnostic approaches may possess insufficient coverage to detect these alternative mutations, prompting further consideration of targeted exon sequencing into routine diagnostic practice. How to incorporate these illuminating findings into the expanding molecular diagnostic algorithm for MPN requires continual attention.

Routine versus selective contrast imaging to identify the need for early re-intervention following laparoscopic fundoplication: A retrospective cohort study.

PubMed

Shahzad, Khalid; Menon, Ashok; Turner, Paul; Ward, Jeremy; Pursnani, Kishore; Alkhaffaf, Bilal

2015-08-01

The prompt recognition of complications is essential in reducing morbidity following anti-reflux surgery. Consequently, many centres employ a policy of routine post-operative contrast studies. The study aimed to examine whether routine contrast studies more effectively recognised early post-operative complications following anti-reflux surgery compared with selective use. This was a retrospective analysis of 240 adults who had undergone primary anti-reflux surgery. Selective use of water-soluble contrast swallows was employed for 115 patients (Group 1) while 125 patients (Group 2) had routine studies. 10 (0.9%) patients from Group 1 underwent contrast studies, four (40%) of which were abnormal. Routine studies in Group 2 identified thirty-two abnormalities (27%) however the inter-group difference was not significant (p = 0.32). Only one case from group 2 required immediate re-intervention. This was not statistically significant (p = 0.78). Multivariate analysis found no significant association between selective or routine imaging and re-intervention rates. One patient from group 2 presented three days following discharge with wrap migration requiring reoperation despite a normal post-operative study. Routine use of contrast imaging following anti-reflux and hiatus hernia surgery is not necessary. It does not identify a significantly greater number of post-operative complications in comparison to selective use. Additionally, routine use of contrast studies does not ensure the diagnosis of all complications in the post-operative period. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Step It UP: a multicomponent intervention to increase stair use in a university residence building.

PubMed

Howie, Erin Kaye; Young, Deborah Rohm

2011-01-01

Examine the effects of a multicomponent intervention on stair usage. Nonrandomized controlled intervention. Two multistory university dormitories. Total of 5711 direct observations of university dormitory residents. The 2-week "Step It UP" intervention used poster prompts and fun/competitive challenges with incentives to encourage residents to take the stairs instead of the elevators. Ascending stair and elevator use was directly observed and coded for gender at high traffic times in intervention and control dormitories for 14 nonconsecutive hours over 1 week each at baseline, midintervention, and 1 week postintervention. The proportions of ascending stair and elevator users were compared using χ(2) analyses. Baseline stair use was equal between intervention and control dormitories (24.9% and 27.8%, respectively; χ(2)[1, N  =  1849]  =  .08; p  =  .77). Stair use significantly increased from baseline in the intervention dormitory to 33.24% (χ(2)[1, N  =  2192]  =  18.44; p < .001) compared with no change in the control. Stair use returned to baseline in the intervention dormitory at postintervention (25.4%; χ(2)[1, N  =  2297]  =  .08; p  =  .78). There were no significant differences between genders. This multicomponent, short-duration intervention significantly increased stair usage in a university dormitory relative to the control but was unable to sustain the increase when prompts were removed. Campaigns to sustain stair use are needed. Formative assessment is required to determine what combinations of components may yield the most cost-effective approach for future interventions.

Outcomes of support rod usage in loop stoma formation.

PubMed

Whiteley, Ian; Russell, Michael; Nassar, Natasha; Gladman, Marc A

2016-06-01

Traditionally, support rods have been used when creating loop stomas in the hope of preventing retraction. However, their effectiveness has not been clearly established. This study aimed to investigate the rate of stoma rod usage and its impact on stoma retraction and complication rates. A prospective cohort of 515 consecutive patients who underwent loop ileostomy/colostomy formation at a tertiary referral colorectal unit in Sydney, Australia were studied. Mortality and unplanned return to theatre rates were calculated. The primary outcome measure of interest was stoma retraction, occurring within 30 days of surgery. Secondary outcome measures included early stoma complications. The 10-year temporal trends for rod usage, stoma retraction, and complications were examined. Mortality occurred in 23 patients (4.1 %) and unplanned return to theatre in 4 patients (0.8 %). Stoma retraction occurred in four patients (0.78 %), all without rods. However, the rate of retraction was similar, irrespective of whether rods were used (P = 0.12). There was a significant decline in the use of rods during the study period (P < 0.001) but this was not associated with an increase in stoma retraction rates. Early complications occurred in 94/432 patients (21.8 %) and were more likely to occur in patients with rods (64/223 versus 30/209 without rods, P < 0.001). Stoma retraction is a rare complication and its incidence is not significantly affected by the use of support rods. Further, complications are common post-operatively, and the rate appears higher when rods are used. The routine use of rods warrants judicious application. WHAT DOES THIS PAPER ADD TO THE LITERATURE?: It remains unclear whether support rods prevent stoma retraction. This study, the largest to date, confirms that stoma retraction is a rare complication and is not significantly affected by the use of rods. Consequently, routine rod usage cannot be recommended, particularly as it is associated with increased stoma complications.

Detection and Whole-Genome Sequencing of Carbapenemase-Producing Aeromonas hydrophila Isolates from Routine Perirectal Surveillance Culture

PubMed Central

Hughes, Heather Y.; Lau, Anna F.; Dekker, John P.; Michelin, Angela V.; Youn, Jung-Ho; Henderson, David K.; Frank, Karen M.; Segre, Julia A.

2016-01-01

Perirectal surveillance cultures and a stool culture grew Aeromonas species from three patients over a 6-week period and were without epidemiological links. Detection of the blaKPC-2 gene in one isolate prompted inclusion of non-Enterobacteriaceae in our surveillance culture workup. Whole-genome sequencing confirmed that the isolates were unrelated and provided data for Aeromonas reference genomes. PMID:26888898

Can We Stop the Current Epidemic of Blindness From Retinopathy of Prematurity?

PubMed

Dutta, Sourabh; Raghuveer, Talkad; Vinekar, Anand; Dogra, Mangat Ram

2016-11-07

Retinopathy of Prematurity (ROP) is a retinal vascular disease of the premature infant. There have been significant advances in the understanding of the pathogenesis, prevention, detection and treatment of severe ROP. In developed countries, all premature infants at risk for ROP are screened routinely based on national guidelines and treatment is prompt, resulting in good visual outcomes. Blindness from ROP is a rare event in these countries. However, there is an ongoing epidemic of ROP- induced blindness in India. The reasons for this epidemic of ROP blindness are many and include increasing survival of premature infants, lack of equipment such as oxygen-blenders and pulse oximeters that are necessary for safe use of supplemental oxygen in premature infants, lack of routine screening for ROP, lack of trained personnel for ROP screening, and lack of Ophthalmologists to promptly initiate treatment when infants develop severe ROP. All the identified causes can be resolved with a concerted national co-operative effort of Pediatricians, Neonatologists, Ophthalmologists, Indian Academy of Pediatrics, National Neonatology Forum, Indian Academy of Ophthalmologists, Government of India, and parents of premature infants. We feel that tt is possible to stop the current epidemic of preventable childhood blindness from ROP with concerted action by all stakeholders.

Map projections: A working manual

USGS Publications Warehouse

Snyder, John P.

1987-01-01

With increased computerization, it is important to realize that rectangular coordinates for all these projections may be mathematically calculated with formulas which would have seemed too complicated in the past, but which now may be programmed routinely, especially if aided by numerical examples. A discussion of appearance, usage, and history is given together with both forward and inverse equations for each projection involved.

A User's Guide to CGNS. 1.0

NASA Technical Reports Server (NTRS)

Rumsey, Christopher L.; Poirier, Diane M. A.; Bush, Robert H.; Towne, Charles E.

2001-01-01

The CFD General Notation System (CGNS) was developed to be a self-descriptive, machine-independent standard for storing CFD aerodynamic data. This guide aids users in the implementation of CGNS. It is intended as a tutorial on the usage of the CGNS mid-level library routines for reading and writing grid and flow solution datasets for both structured and unstructured methodologies.

78 FR 57674 - Order Limiting Operations at Newark Liberty International Airport

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-19

... season. This waiver applies only to EWR slots for the following days and local times: (1) March 30... runway 4L/22R. Runway 4L/22R will be open during that period with reduced runway length. Night and... five or more consecutive days. However, the FAA does not routinely grant general waivers to the usage...

Metaphors for the Nature of Human-Computer Interaction in an Empowering Environment: Interaction Style Influences the Manner of Human Accomplishment.

ERIC Educational Resources Information Center

Weller, Herman G.; Hartson, H. Rex

1992-01-01

Describes human-computer interface needs for empowering environments in computer usage in which the machine handles the routine mechanics of problem solving while the user concentrates on its higher order meanings. A closed-loop model of interaction is described, interface as illusion is discussed, and metaphors for human-computer interaction are…

Poor hospital infection control practice in hand hygiene, glove utilization, and usage of tourniquets.

PubMed

Sacar, Suzan; Turgut, Huseyin; Kaleli, Ilknur; Cevahir, Nural; Asan, Ali; Sacar, Mustafa; Tekin, Koray

2006-11-01

Hospital-acquired infection often occurs because of lapses in accepted standards of practice on the part of health care personnel. The aim of this study is to attract attention on poor hospital infection control practice in venepuncture and use of tourniquets and emphasize the importance of hand hygiene. Overall compliance with hygiene during usage of tourniquets and routine patient care before and after implementation of a hospital infection control measures was evaluated. According to the questionnaire, only 26.9% of respondents always washed their hands both before and after venepuncture. In the second step of the study, based on direct observation, hands were washed both before and after venepuncture on only 41 (45.1%) occasions. Failure to remove gloves after patient contact was observed on 23.1% occasions. Our survey reveals poor infection control practice in hand hygiene, glove utilization, and usage of tourniquets and the implementation of infection control measures produced a moderate improvement in compliance with them.

Factors influencing the purity of electronic grade phosphine delivered to MOCVD tools

NASA Astrophysics Data System (ADS)

Feng, Jun; Owens, Mitch; Raynor, Mark W.

2010-04-01

Increasing mobility of InP films with usage time of one PH 3 cylinder prompted an investigation into factors influencing the purity of delivered PH 3. The presence of hygroscopic H xPO y residues in a delivery system greatly increases the dry-down time compared to that of a clean system. Static delivery system tests show increasing H 2O concentration with time and twice the increase in PH 3 versus N 2 over 48 h indicating reaction of metal oxides in components with PH 3 to generate H 2O. Gas purity may also vary during cylinder usage. Depletion of a high-purity PH 3 cylinder shows consistently low gas phase H 2O levels before phase-break but increasing levels after phase-break, as the cylinder depressurizes. The results highlight the importance of using pure PH 3, employing rigorous cycle-purging procedures to prevent H xPO y contamination, switching out cylinders in good time and using purification technology to control H 2O.

Mastitis treatment-Reduction in antibiotic usage in dairy cows.

PubMed

Krömker, V; Leimbach, S

2017-08-01

Animal-friendly, economical, resource-saving milk production provides the basis for sustained consumer acceptance. Bovine mastitis plays a decisive role in the dairy industry-disturbing animal health and welfare and causing considerable economic losses on the other hand. Currently, antimicrobial treatment is indispensable to keep bovine udder health, animal welfare and economic aspects in balance. On the contrary, emergence and spread of antimicrobial resistance (AMR) is an urgent matter of particular public interest, and as a consequence, antimicrobial usage (AMU) in production livestock is a critically discussed subject. In urgent need of future reduction in AMU in the dairy industry, this review article describes and discusses possible approaches promising prompt implementation, including therapeutical alternatives as well as pro- and metaphylactic concepts such as the implementation of evidence-based mastitis therapy concepts and selective dry cow treatment (sDCT), in search of the most effective and contemporary methods for decreasing AMU and AMR in dairy production. © 2017 Blackwell Verlag GmbH.

A change in the trend in dosulepin usage following the introduction of a prescribing indicator but not after two national safety warnings.

PubMed

Deslandes, P N; Jenkins, K S L; Haines, K E; Hutchings, S; Cannings-John, R; Lewis, T L; Bracchi, R C; Routledge, P A

2016-04-01

The tricyclic antidepressant dosulepin has been associated with an increased risk of toxicity in overdose compared with other antidepressants. In the UK, the MHRA and NICE have issued advice on the prescribing of dosulepin, and a National Prescribing Indicator (NPI) to monitor usage was introduced in Wales in 2011. The aim of this study was to assess whether trends in dosulepin usage in Wales and NE England changed following the two pieces of safety guidance and the introduction of the National Prescribing Indicator in Wales. Primary care dosulepin usage in the 12 months prior to and following MHRA safety advice (in 2007), NICE guideline CG90 (in 2009) and the introduction of the NPI (in 2011) was obtained. Usage was measured using defined daily doses (DDDs) per 1000 prescribing units (PUs). The trends in the 12 months prior to and following the introduction of prescribing advice and the NPI were compared using an autoregressive integrated moving average (ARIMA) model. In Wales, the trend in dosulepin usage did not change significantly prior to and following the MHRA advice: -0·18 and -0·43 DDDs/1000PUs per month, respectively (P = 0·07), or prior to and following NICE CG90: -0·30 and -0·49 DDDs/1000PUs per month, respectively (P = 0·35). In the 12 months prior to and following the introduction of the NPI, the trend was -0·45 and -0·98 DDDs/1000PUs per month, respectively (P = 0·001). In NE England, the trend did not alter significantly following the NICE advice or the introduction of the NPI in Wales. The trend in dosulepin usage in Wales altered significantly following the introduction of the NPI, but not after the other prescribing advice. This association, coupled with the absence of a significant change in NE England over the same period, provided some evidence of the effectiveness of the NPI in prompting a change in prescribing behaviour in Wales. © 2016 John Wiley & Sons Ltd.

Corneal edema and keratitis following selective laser trabeculoplasty.

PubMed

Liu, Erica Tan; Seery, Loren S; Arosemena, Analisa; Lamba, Tania; Chaya, Craig J

2017-06-01

To describe three cases of keratitis following Selective Laser Trabeculoplasty (SLT). Three females with a history of glaucoma presented with corneal edema, keratitis (endothelial, epithelial) and decreased visual acuity shortly after SLT. There was variable resolution of symptoms after starting treatment with oral antiherpetics and topical steroids. With the increase in usage of SLT as a treatment for glaucoma and subsequent reports of keratitis, it is imperative for ophthalmic surgeons to be aware of herpes simplex as a possible risk factor. Prompt treatment with antivirals and steroids can potentially prevent scarring and permanent damage to the cornea.

Map projections used by the U.S. Geological Survey

USGS Publications Warehouse

Snyder, John Parr

1982-01-01

With increased computerization, it is important to realize that rectangular coordinates for all these projections may be mathematically calculated with formulas which would have seemed too complicated in the past, but which now may be programed routinely, if clearly delineated with numerical examples. A discussion of appearance, usage, and history is given together with both forward and inverse equations for each projection involved.

A real-time digital computer program for the simulation of a single rotor helicopter

NASA Technical Reports Server (NTRS)

Houck, J. A.; Gibson, L. H.; Steinmetz, G. G.

1974-01-01

A computer program was developed for the study of a single-rotor helicopter on the Langley Research Center real-time digital simulation system. Descriptions of helicopter equations and data, program subroutines (including flow charts and listings), real-time simulation system routines, and program operation are included. Program usage is illustrated by standard check cases and a representative flight case.

Multinational institutional survey on patterns of intraoperative transesophageal echocardiography use in adult cardiac surgery.

PubMed

Dobbs, Heather A; Bennett-Guerrero, Elliott; White, William; Shernan, Stanton K; Nicoara, Alina; Del Rio, J Mauricio; Stafford-Smith, Mark; Swaminathan, Madhav

2014-02-01

To assess institutional patterns of perioperative transesophageal echocardiography (TEE) usage. The authors hypothesized that TEE is performed more frequently and comprehensively in academic centers, mainly by anesthesiologists, and barriers to performing TEE are due to inadequate resources. A survey was deployed to selected participants. Collated responses were assessed for demographic patterns in TEE practice, and 2-category comparisons were made with Chi-squared association tests. Web-based survey. Practitioners in cardiovascular anesthesia/surgery in 200 institutions. None. Surveys were completed by respondents representing 200 centers in 27 countries and 1,727 anesthesiologists with a mean annual institutional volume of 924 cases. Most centers were in the USA (53%) and were defined as academic (83%). Anesthesiologists performed (85%) and also read/reported TEEs (78%) in most centers. Three-dimensional TEE is performed routinely at 40% of centers. TEE is used routinely for valve surgery in 95% of institutions compared to 68% for coronary artery bypass graft surgery. Academic institutions assessed diastolic function more often than nonacademic centers (46% v 19%; p = 0.006). The most important reason cited for not using TEE in all cases was insufficient resource availability (47%). These results suggest that TEE is performed more comprehensively in academic centers, mainly by anesthesiologists, and that lack of resources is a significant barrier to routine TEE usage. TEE is used more often for valve surgery than for coronary artery bypass graft surgery, and many centers use 3D TEE. This survey describes international TEE practice patterns and identifies limitations to universal adoption of TEE in cardiac surgery. © 2013 Elsevier Inc. All rights reserved.

Achieving long-term use of solar water disinfection in Zimbabwe.

PubMed

Mosler, H-J; Kraemer, S M; Johnston, R B

2013-01-01

To use a psychological theory of behavioural change to measure and interpret the effectiveness of different promotional strategies for achieving long-term usage of a household water treatment and safe storage (HWTS) system in peri-urban Zimbabwe. Solar disinfection (SODIS) was introduced into five peri-urban communities near Harare, Zimbabwe. Six different interventions were developed and were applied in four communities in different combinations, with the fifth remaining as a control area where no interventions were implemented. Throughout the 26 months of the study nine longitudinal panel surveys were conducted in which SODIS usage was estimated using three separate metrics: reported, calculated, and observed. A total of 1551 people were interviewed. The three indicators of SODIS usage broadly agreed with one another. By any measure, the most effective intervention was household visits by trained promoters in combination with persuasion. Households which received household visits maintained SODIS usage rates of 65% or more, even six months after the cessation of all promotional activities. Households receiving other interventions were significantly less effective. Interventions like prompts or public commitment after the application of household visits were effective at maintaining good practices once these were established. Household promotion in combination with persuasion appears more effective than other approaches, especially when followed with interventions targeting the maintenance of the new behaviour. With this intervention it is possible that around 65% of the households continue to use solar water disinfection (SODIS) more than two years after the initial promotion, and six months after the end of all interventions. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Family caregivers' narratives of mental health treatment usage processes by their Latino adult relatives with serious and persistent mental illness.

PubMed

Marquez, Jorge A; Ramírez García, Jorge I

2013-06-01

Family caregivers' views and experiences related to treatment usage processes by their adult relatives with serious and persistent mental illness (SPMI) were empirically examined in a sample of Latino caregivers (n = 17) who were users of services at the National Alliance on Mental Illness (NAMI) in a predominantly Latino- (80%) and Mexican-descent large city in the Southwest United States. We conducted a stability check of qualitative findings with a second sample of Latino caregivers with no exposure to NAMI (n = 15). Overall, the combined sample (N = 32) compared similarly with larger samples of Latino adults and caregivers in quantitative measures of acculturation, familism, caregiver stigma, and depression symptoms. Together, caregivers' stigma and cultural beliefs, such as vergüenza (shame), use of folk healers, and lack of insurance, were major reported barriers to service usage. Family support (and lack of) for treatment also weighed heavily as a facilitator (and a barrier) of service usage, thus highlighting the complexity of family relationship contexts. Substantial portions of caregivers reported that treatment initiation was prompted by psychiatric hospitalization (50%), and that positive experiences with service providers were influential in treatment retention (72%). Given the high levels of family involvement reported among Latino caregivers, the findings underscore the potential role of family caregivers in treatment engagement and retention. Future research is needed that examines family caregivers' role in treatment with models that consider the interplay between cultural background, family level relationships, and service system contexts. PsycINFO Database Record (c) 2013 APA, all rights reserved.

[Use of Reusable Textile Undergloves for Medical Procedures: A Feasibility Study].

PubMed

Hübner, N-O; Rubbert, K; Pohrt, U; Heidecke, C-D; Partecke, L I; Kramer, A

2016-02-01

Undergloves are a way to reduce moisture-related skin damage. The aim of this feasibility study was to gain experience with logistics, applicability, acceptability and cost of the routine use of reusable textile undergloves in a hospital setting. Undergloves were tested with 18 health-care workers on an intensive care unit over three months. Data on usage as well as logistics were recorded. At baseline, personal data and knowledge and use of cotton undergloves, existing skin problems and the nursing behaviour of the hands by the subjects were determined by means of an input questionnaire. After each wearing, data on usage were collected by a questionnaire. Participants were interviewed by means of a questionnaire with respect to their experience with the use of the undergloves. Acceptance and compliance with the use of undergloves was remarkably good. This was partly due to the properties of the gloves, and partly to the reduction of sweating and very positive effect on the skin of the hands. In the study period 2165 underglove uses were documented, resulting in an average daily consumption of four pairs per person per day. The average wearing time was 28.6 min. The undergloves were suitable for application as well as reprocessing. Reprocessment-related fatigue was relatively low and did not lead to the loss of the properties, only few gloves had to be sorted out. Even if one assumes a complete write-off of the gloves with end of the study, costs for reprocessing were about 0.46 € or 64 % less than the single use. The routine use of textile, reprocessable undergloves is feasible. Major challenges for broad usage are within logistics and acceptance by the user. Georg Thieme Verlag KG Stuttgart · New York.

Routine colonic endoscopic evaluation following resolution of acute diverticulitis: Is it necessary?

PubMed Central

Agarwal, Amit K; Karanjawala, Burzeen E; Maykel, Justin A; Johnson, Eric K; Steele, Scott R

2014-01-01

Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations, low fiber diets, and in younger and obese patients. Twenty-five percent of patients with diverticulosis will develop acute diverticulitis. This imposes a significant burden on healthcare systems, resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion USD. Abdominal computed tomography (CT) is the diagnostic study of choice, with a sensitivity and specificity greater than 95%. Unfortunately, similar CT findings can be present in colonic neoplasia, especially when perforated or inflamed. This prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out malignancy. Yet, the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated technology. While any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation, in the era of widespread use of high-resolution computed tomography, routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs, comes with inherent risks, and may require further study. In this manuscript, we review the current data related to this recommendation. PMID:25253951

APL-UW Deep Water Propagation: Philippine Sea Signal Physics and North Pacific Ambient Noise

DTIC Science & Technology

2015-10-15

prompted an expansion of efforts to extract energy from ocean resources. Oil drilling is a well-known example, and recent projects include wind farms and...tidal turbines. The VLF sound contributions from these initiatives may be space/time limited (as with pile driving for wind farm towers or oil rig...decommissioning) or chronic (as with routine service vessel transportation to and from existing oil rigs). Additionally, the contributions are generally

A parameter estimation subroutine package

NASA Technical Reports Server (NTRS)

Bierman, G. J.; Nead, W. M.

1977-01-01

Linear least squares estimation and regression analyses continue to play a major role in orbit determination and related areas. FORTRAN subroutines have been developed to facilitate analyses of a variety of parameter estimation problems. Easy to use multipurpose sets of algorithms are reported that are reasonably efficient and which use a minimal amount of computer storage. Subroutine inputs, outputs, usage and listings are given, along with examples of how these routines can be used.

Variation in promptness of presentation among 10,297 patients subsequently diagnosed with one of 18 cancers: Evidence from a National Audit of Cancer Diagnosis in Primary Care

PubMed Central

Keeble, Stuart; Abel, Gary A; Saunders, Catherine L; McPhail, Sean; Walter, Fiona M; Neal, Richard D; Rubin, Gregory P; Lyratzopoulos, Georgios

2014-01-01

Cancer awareness public campaigns aim to shorten the interval between symptom onset and presentation to a doctor (the ‘patient interval’). Appreciating variation in promptness of presentation can help to better target awareness campaigns. We explored variation in patient intervals recorded in consultations with general practitioners among 10,297 English patients subsequently diagnosed with one of 18 cancers (bladder, brain, breast, colorectal, endometrial, leukaemia, lung, lymphoma, melanoma, multiple myeloma, oesophageal, oro-pharyngeal, ovarian, pancreatic, prostate, renal, stomach, and unknown primary) using data from of the National Audit of Cancer Diagnosis in Primary Care (2009–2010). Proportions of patients with ‘prompt’/‘non-prompt’ presentation (0–14 or 15+ days from symptom onset, respectively) were described and respective odds ratios were calculated by multivariable logistic regression. The overall median recorded patient interval was 10 days (IQR 0–38). Of all patients, 56% presented promptly. Prompt presentation was more frequent among older or housebound patients (p < 0.001). Prompt presentation was most frequent for bladder and renal cancer (74% and 70%, respectively); and least frequent for oro-pharyngeal and oesophageal cancer (34% and 39%, respectively, p <.001). Using lung cancer as reference, the adjusted odds ratios of non-prompt presentation were 2.26 (95% confidence interval 1.57–3.25) and 0.42 (0.34–0.52) for oro-pharyngeal and bladder cancer, respectively. Sensitivity analyses produced similar findings. Routinely recorded patient interval data reveal considerable variation in the promptness of presentation. These findings can help to prioritise public awareness initiatives and research focusing on symptoms of cancers associated with greater risk of non-prompt presentation, such as oro-pharyngeal and oesophageal cancer. What's new? A critical aspect of cancer diagnosis is how promptly patients consult a doctor after they first notice initial symptoms. Here, the authors examine differences in this so-called patient interval in English patients subsequently diagnosed with one of 18 cancers. On average, patients with bladder and renal cancer as well as older and housebound patients consulted a doctor relatively promptly while patients with oro-pharyngeal and oesophageal cancer took the longest until first presenting to a general practitioner. The authors point out that cancer awareness campaigns should encompass symptoms of oro-pharyngeal and oesophageal cancer aiming to shorten the patient interval for these cancers. PMID:24515930

Measurements of the dielectron continuum in pp, p-Pb and Pb-Pb collisions with ALICE at the LHC

NASA Astrophysics Data System (ADS)

Vázquez Doce, O.; Alice Collaboration

2017-11-01

Dielectrons produced in ultra-relativistic heavy-ion collisions provide a unique probe of the whole system evolution as they are unperturbed by final-state interactions. The dielectron continuum is extremely rich in physics sources: thermal radiation is of particular interest as it carries information about the temperature of the hot and dense system created in such collisions. The dielectron invariant mass distribution is sensitive to medium modifications of the spectral function of vector mesons that are linked to the potential restoration of chiral symmetry. Correlated electron pairs from semi-leptonic charm and beauty decays provide information about the heavy-quark energy loss. A summary of the LHC Run-1 preliminary results in all three collisions systems (pp, p-Pb and Pb-Pb) is presented. Furthermore, the status of the ongoing Run-2 analyses is discussed with a focus on pp collisions collected with a high charged-particle multiplicity trigger, on new analysis methods to separate prompt from non-prompt sources, and on the usage of machine learning methods for background rejection.

Dual-Routine HCV/HIV Testing: Seroprevalence and Linkage to Care in Four Community Health Centers in Philadelphia, Pennsylvania.

PubMed

Coyle, Catelyn; Kwakwa, Helena

2016-01-01

Despite common risk factors, screening for hepatitis C virus (HCV) and HIV at the same time as part of routine medical care (dual-routine HCV/HIV testing) is not commonly implemented in the United States. This study examined improvements in feasibility of implementation, screening increase, and linkage to care when a dual-routine HCV/HIV testing model was integrated into routine primary care. National Nursing Centers Consortium implemented a dual-routine HCV/HIV testing model at four community health centers in Philadelphia, Pennsylvania, on September 1, 2013. Routine HCV and opt-out HIV testing replaced the routine HCV and opt-in HIV testing model through medical assistant-led, laboratory-based testing and electronic medical record modification to prompt, track, report, and facilitate reimbursement for tests performed on uninsured individuals. This study examined testing, seropositivity, and linkage-to-care comparison data for the nine months before (December 1, 2012-August 31, 2013) and after (September 1, 2013-May 31, 2014) implementation of the dual-routine HCV/HIV testing model. A total of 1,526 HCV and 1,731 HIV tests were performed before, and 1,888 HCV and 3,890 HIV tests were performed after dual-routine testing implementation, resulting in a 23.7% increase in HCV tests and a 124.7% increase in HIV tests. A total of 70 currently HCV-infected and four new HIV-seropositive patients vs. 101 HCV-infected and 13 new HIV-seropositive patients were identified during these two periods, representing increases of 44.3% for HCV antibody-positive and RNA-positive tests and 225.0% for HIV-positive tests. Linkage to care increased from 27 currently infected HCV--positive and one HIV-positive patient pre-dual-routine testing to 39 HCV--positive and nine HIV-positive patients post-dual-routine testing. The dual-routine HCV/HIV testing model shows that integrating dual-routine testing in a primary care setting is possible and leads to increased HCV and HIV screening, enhanced seropositivity diagnosis, and improved linkage to care.

Dual-Routine HCV/HIV Testing: Seroprevalence and Linkage to Care in Four Community Health Centers in Philadelphia, Pennsylvania

PubMed Central

Kwakwa, Helena

2016-01-01

Objective Despite common risk factors, screening for hepatitis C virus (HCV) and HIV at the same time as part of routine medical care (dual-routine HCV/HIV testing) is not commonly implemented in the United States. This study examined improvements in feasibility of implementation, screening increase, and linkage to care when a dual-routine HCV/HIV testing model was integrated into routine primary care. Methods National Nursing Centers Consortium implemented a dual-routine HCV/HIV testing model at four community health centers in Philadelphia, Pennsylvania, on September 1, 2013. Routine HCV and opt-out HIV testing replaced the routine HCV and opt-in HIV testing model through medical assistant-led, laboratory-based testing and electronic medical record modification to prompt, track, report, and facilitate reimbursement for tests performed on uninsured individuals. This study examined testing, seropositivity, and linkage-to-care comparison data for the nine months before (December 1, 2012–August 31, 2013) and after (September 1, 2013–May 31, 2014) implementation of the dual-routine HCV/HIV testing model. Results A total of 1,526 HCV and 1,731 HIV tests were performed before, and 1,888 HCV and 3,890 HIV tests were performed after dual-routine testing implementation, resulting in a 23.7% increase in HCV tests and a 124.7% increase in HIV tests. A total of 70 currently HCV-infected and four new HIV-seropositive patients vs. 101 HCV-infected and 13 new HIV-seropositive patients were identified during these two periods, representing increases of 44.3% for HCV antibody-positive and RNA-positive tests and 225.0% for HIV-positive tests. Linkage to care increased from 27 currently infected HCV--positive and one HIV-positive patient pre-dual-routine testing to 39 HCV--positive and nine HIV-positive patients post-dual-routine testing. Conclusion The dual-routine HCV/HIV testing model shows that integrating dual-routine testing in a primary care setting is possible and leads to increased HCV and HIV screening, enhanced seropositivity diagnosis, and improved linkage to care. PMID:26862229

The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low.

PubMed

Graat, Marleen E; Choi, Goda; Wolthuis, Esther K; Korevaar, Johanna C; Spronk, Peter E; Stoker, Jaap; Vroom, Margreeth B; Schultz, Marcus J

2006-02-01

The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care for intensive care unit (ICU) patients. This was a prospective observational study conducted in a 28-bed, mixed medical-surgical ICU of a university hospital. Over a 5-month period, 2,457 daily routine CXRs were done in 754 consecutive ICU patients. The majority of these CXRs did not reveal any new predefined major finding. In only 5.8% of daily routine CXRs (14.3% of patients) was one or more new and unexpected abnormality encountered, including large atelectases (24 times in 20 patients), large infiltrates (23 in 22), severe pulmonary congestion (29 in 25), severe pleural effusion (13 in 13), pneumothorax/pneumomediastinum (14 in 13), and malposition of the orotracheal tube (32 in 26). Fewer than half of the CXRs with a new and unexpected finding were ultimately clinically relevant; in only 2.2% of all daily routine CXRs (6.4% of patients) did these radiologic abnormalities result in a change to therapy. Subgroup analysis revealed no differences between medical and surgical patients with regard to the incidence of new and unexpected findings on daily routine CXRs and the effect of new and unexpected CXR findings on daily care. In the ICU, daily routine CXRs seldom reveal unexpected, clinically relevant abnormalities, and they rarely prompt action. We propose that this diagnostic examination be abandoned in ICU patients.

Prompt access to effective malaria treatment among children under five in sub-Saharan Africa: a multi-country analysis of national household survey data.

PubMed

Shah, Jui A; Emina, Jacques B O; Eckert, Erin; Ye, Yazoume

2015-08-25

Scaling up diagnostic testing and treatment is a key strategy to reduce the burden of malaria. Delays in accessing treatment can have fatal consequences; however, few studies have systematically assessed these delays among children under five years of age in malaria-endemic countries of sub-Saharan Africa. This study identifies predictors of prompt treatment with first-line artemisinin combination therapy (ACT) and describes profiles of children who received this recommended treatment. This study uses data from the most recent Demographic and Health Survey, Malaria Indicator Survey, or Anaemia and Parasite Prevalence Survey conducted in 13 countries. A Chi square automatic interaction detector (CHAID) model was used to identify factors associated with prompt and effective treatment among children under five years of age. The percentage of children with fever who received any anti-malarial treatment varies from 3.6 % (95 % CI 2.8-4.4 %) in Ethiopia to 64.5 % (95 % CI 62.7-66.2 %) in Uganda. Among those who received prompt treatment with any anti-malarial medicine, the percentage who received ACT ranged from 32.2 % (95 % CI 26.1-38.4 %) in Zambia to nearly 100 % in Tanzania mainland and Zanzibar. The CHAID analysis revealed that country of residence is the best predictor of prompt and effective treatment (p < 0.001). Depending on the country, the second best predictor was maternal education (p = 0.004), place of residence (p = 0.008), or household wealth index (p < 0.001). This study reveals that country of residence, maternal education, place of residence, and socio-economic status are key predictors of prompt access to malaria treatment. Achieving universal coverage and the elimination agenda will require effective monitoring to detect disparities early and sustained investments in routine data collection and policy formulation.

Predicting Negative Emotions Based on Mobile Phone Usage Patterns: An Exploratory Study

PubMed Central

Yang, Pei-Ching; Chang, Chia-Chi; Chiang, Jung-Hsien; Chen, Ying-Yeh

2016-01-01

Background Prompt recognition and intervention of negative emotions is crucial for patients with depression. Mobile phones and mobile apps are suitable technologies that can be used to recognize negative emotions and intervene if necessary. Objective Mobile phone usage patterns can be associated with concurrent emotional states. The objective of this study is to adapt machine-learning methods to analyze such patterns for the prediction of negative emotion. Methods We developed an Android-based app to capture emotional states and mobile phone usage patterns, which included call logs (and use of apps). Visual analog scales (VASs) were used to report negative emotions in dimensions of depression, anxiety, and stress. In the system-training phase, participants were requested to tag their emotions for 14 consecutive days. Five feature-selection methods were used to determine individual usage patterns and four machine-learning methods were tested. Finally, rank product scoring was used to select the best combination to construct the prediction model. In the system evaluation phase, participants were then requested to verify the predicted negative emotions for at least 5 days. Results Out of 40 enrolled healthy participants, we analyzed data from 28 participants, including 30% (9/28) women with a mean (SD) age of 29.2 (5.1) years with sufficient emotion tags. The combination of time slots of 2 hours, greedy forward selection, and Naïve Bayes method was chosen for the prediction model. We further validated the personalized models in 18 participants who performed at least 5 days of model evaluation. Overall, the predictive accuracy for negative emotions was 86.17%. Conclusion We developed a system capable of predicting negative emotions based on mobile phone usage patterns. This system has potential for ecological momentary intervention (EMI) for depressive disorders by automatically recognizing negative emotions and providing people with preventive treatments before it escalates to clinical depression. PMID:27511748

Measuring preoperative anxiety in patients with breast cancer using the visual analog scale.

PubMed

Aviado-Langer, Jennifer

2014-10-01

Preoperative anxiety is a prevalent concern with deleterious effects in patient recovery and is not routinely assessed in the preoperative screening process. When it is assessed, it may prompt an increase in the use of anesthetic agents, heightened postoperative pain, and prolonged hospitalization. Preoperative women with breast cancer face anxiety as it relates to anesthesia, surgery, and recovery. The preoperative anxiety visual analog scale may identify and quantify anxiety in this population, provide advocacy and support, and improve the preoperative screening process.

Vasoplegic syndrome during Whipple procedure.

PubMed

Anandaswamy, Tejesh C; Rajappa, Geetha C; Krishnamachar, Harish

2017-02-01

Vasoplegic syndrome is an unusual cause of refractory hypotension under general anesthesia. It is commonly described in the setting of cardiac surgery, but rarely seen in noncardiac setting. We describe successful management of vasoplegic syndrome during Whipple procedure with vasopressin infusion. A high index of suspicion and prompt treatment with vasopressin can be lifesaving in patients with risk factors for vasoplegic syndrome who present with severe refractory hypotension and who respond poorly to fluid administration and routine vasopressor infusion. Copyright © 2016 Elsevier Inc. All rights reserved.

Extracorporeal membrane oxygenation: current clinical practice, coding, and reimbursement.

PubMed

Schuerer, Douglas J E; Kolovos, Nikoleta S; Boyd, Kayla V; Coopersmith, Craig M

2008-07-01

Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support for patients experiencing both pulmonary and cardiac failure by maintaining oxygenation and perfusion until native organ function is restored. ECMO is used routinely at many specialized hospitals for infants and less commonly for children with respiratory or cardiac failure from a variety of causes. Its usage is more controversial in adults, but select medical centers have reported favorable findings in patients with ARDS and other causes of severe pulmonary failure. ECMO is also rarely used as a rescue therapy in a small subset of adult patients with cardiac failure. This article will review the current uses and techniques of ECMO in the critical care setting as well as the evidence supporting its usage. In addition, current practice management related to coding and reimbursement for this intensive therapy will be discussed.

Energy monitoring system based on human activity in the workplace

NASA Astrophysics Data System (ADS)

Mustafa, Nur Hanim; Husain, Mohd Nor; Aziz, Mohamad Zoinol Abidin Abdul; Othman, Mohd Azlishah; Malek, Fareq

2015-05-01

Human behaviors always related to day routine activities in a smart house directly give the significant factor to manage energy usage in human life. An Addition that, the factor will contribute to the best efficiency of the system. This paper will focus on the monitoring efficiency based on duration time in office hours around 8am until 5pm which depend on human behavior at working place. Besides that, the correlation coefficient method is used to show the relation between energy consumption and energy saving based on the total hours of time energy spent. In future, the percentages of energy monitoring system usage will be increase to manage energy saving based on human behaviors. This scenario will help to see the human activity in the workplace in order to get the energy saving and support world green environment.

Artificial limb representation in amputees

PubMed Central

van den Heiligenberg, Fiona M Z; Orlov, Tanya; Macdonald, Scott N; Duff, Eugene P; Henderson Slater, David; Beckmann, Christian F; Johansen-Berg, Heidi; Culham, Jody C; Makin, Tamar R

2018-01-01

Abstract The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral occipitotemporal cortex respond to prosthesis images. This was found even when one-handers were presented with images of active prostheses that share the functionality of the hand but not necessarily its visual features (e.g. a ‘hook’ prosthesis). Further, we show that daily prosthesis usage determines large-scale inter-network communication across hand-selective areas. This was demonstrated by increased resting state functional connectivity between visual and sensorimotor hand-selective areas, proportional to the intensiveness of everyday prosthesis usage. Further analysis revealed a 3-fold coupling between prosthesis activity, visuomotor connectivity and usage, suggesting a possible role for the motor system in shaping use-dependent representation in visual hand-selective areas, and/or vice versa. Moreover, able-bodied control participants who routinely observe prosthesis usage (albeit less intensively than the prosthesis users) showed significantly weaker associations between degree of prosthesis observation and visual cortex activity or connectivity. Together, our findings suggest that altered daily motor behaviour facilitates prosthesis-related visual processing and shapes communication across hand-selective areas. This neurophysiological substrate for prosthesis embodiment may inspire rehabilitation approaches to improve usage of existing substitutionary devices and aid implementation of future assistive and augmentative technologies. PMID:29534154

Artificial limb representation in amputees.

PubMed

van den Heiligenberg, Fiona M Z; Orlov, Tanya; Macdonald, Scott N; Duff, Eugene P; Henderson Slater, David; Beckmann, Christian F; Johansen-Berg, Heidi; Culham, Jody C; Makin, Tamar R

2018-05-01

The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral occipitotemporal cortex respond to prosthesis images. This was found even when one-handers were presented with images of active prostheses that share the functionality of the hand but not necessarily its visual features (e.g. a 'hook' prosthesis). Further, we show that daily prosthesis usage determines large-scale inter-network communication across hand-selective areas. This was demonstrated by increased resting state functional connectivity between visual and sensorimotor hand-selective areas, proportional to the intensiveness of everyday prosthesis usage. Further analysis revealed a 3-fold coupling between prosthesis activity, visuomotor connectivity and usage, suggesting a possible role for the motor system in shaping use-dependent representation in visual hand-selective areas, and/or vice versa. Moreover, able-bodied control participants who routinely observe prosthesis usage (albeit less intensively than the prosthesis users) showed significantly weaker associations between degree of prosthesis observation and visual cortex activity or connectivity. Together, our findings suggest that altered daily motor behaviour facilitates prosthesis-related visual processing and shapes communication across hand-selective areas. This neurophysiological substrate for prosthesis embodiment may inspire rehabilitation approaches to improve usage of existing substitutionary devices and aid implementation of future assistive and augmentative technologies.

Gastric volvulus through morgagni hernia: an easily overlooked emergency.

PubMed

Sonthalia, Nikhil; Ray, Sayantan; Khanra, Dibbendhu; Saha, Avishek; Maitra, Subhasis; Saha, Manjari; Talukdar, Arunansu

2013-06-01

Intractable vomiting in an elderly patient is an emergency condition requiring prompt diagnosis and intervention. Acute gastric outlet obstruction due to gastric volvulus through Morgagni-type diaphragmatic hernia is an exceedingly rare cause of this nonspecific complaint. Our aim was to highlight that Morgagni hernia, although rare in adults, should be suspected in the appropriate clinical setting, and that a clue toward diagnosis often comes from routine chest and abdominal x-ray studies. In addition, we emphasize the atypical radiological findings and importance of emergency surgical intervention in such a case. We describe the case of a 78-year-old woman who presented to the Emergency Department with a 4-day history of intractable vomiting, and with no definitive clue to the diagnosis on examination. Her routine chest and abdomen x-ray studies suggested abnormal air-fluid level at right hemithorax, which prompted a computed tomography (CT) scan of the abdomen and an upper gastrointestinal contrast study. Gastric volvulus through a foramen of Morgagni was diagnosed and transthoracic reduction of the contents was performed, along with repair of the defect. A symptomatic Morgagni hernia in adults, although rare, can present with a variety of symptoms ranging from nonspecific complaints of bloating and indigestion to the more severe complaint of intestinal obstruction. Gastric volvulus and obstructive features are less frequently reported as acute complications of these hernias, which need early identification and intervention. Copyright © 2013 Elsevier Inc. All rights reserved.

Understanding nurses' views on a pressure ulcer prevention care bundle: a first step towards successful implementation.

PubMed

Chaboyer, Wendy; Gillespie, Brigid M

2014-12-01

To explore nurses' views of the barriers and facilitators to the use of a newly devised patient-centred pressure ulcer prevention care bundle. Given pressure ulcer prevention strategies are not implemented consistently, the use of a pressure ulcer care bundle may improve implementation given bundles generally assist in standardising care. A quality improvement project was undertaken after a pressure ulcer prevention care bundle was developed and pilot-tested. Short, conversational interviews with nurse explored their views of a patient-centred pressure ulcer care bundle. Interviews were audio-taped and transcribed. Inductive content analysis was used to analyse the transcripts. A total of 20 nurses were interviewed. Five categories with corresponding subcategories emerged from the analysis. They were increasing awareness of pressure ulcer prevention, prompting pressure ulcer prevention activities, promoting active patient participation, barriers to using a pressure ulcer prevention care bundle and enabling integration of the pressure ulcer prevention care bundle into routine practice. Benefits of using a patient-centred pressure ulcer prevention care bundle may include prompting patients and staff to implement prevention strategies and promote active patient participation in care. The success of the care bundle relied on both patients' willingness to participate and nurses' willingness to incorporate it into their routine work. A patient-centred pressure ulcer prevention care bundle may facilitate more consistent implementation of pressure ulcer prevention strategies and active patient participation in care. © 2014 John Wiley & Sons Ltd.

Clinician roles and responsibilities during care transitions of older adults.

PubMed

Schoenborn, Nancy L; Arbaje, Alicia I; Eubank, Kathryn J; Maynor, Kenric; Carrese, Joseph A

2013-02-01

To identify the perceived roles and responsibilities of clinicians during care transitions of older adults. Qualitative study involving 1-hour in-depth semistructured interviews. Audiotapes of interviews were transcribed, coded, and analyzed, and themes and subthemes were generated. An acute care hospital, a skilled nursing facility, two community-based outpatient practices, and one home healthcare agency. Forty healthcare professionals directly involved in care transitions of older adults (18 physicians, 11 home healthcare administrative and field staff, four social workers, three nurse practitioners, three physician assistants, and one hospital case manager). Perspectives of healthcare professionals regarding clinicians' roles and responsibilities during care transitions were examined and described. Content analysis revealed several themes: components of clinicians' roles during care transitions; congruence between self- and others' perceived ideal roles but incongruence between ideal and routine roles; ambiguity in accountability in the postdischarge period; factors prompting clinicians to act closer to ideal roles; and barriers to performing ideal roles. A conceptual framework was created to summarize clinicians' roles during care transitions. This study reports differences between what healthcare professionals perceive as ideal roles of clinicians during care transitions and what clinicians actually do routinely. Certain patient and clinician factors prompt clinicians to act closer to the ideal roles. Multiple barriers interfere with consistent practice of ideal roles. Future investigations could evaluate interventions targeting various components of the conceptual framework and relevant outcomes. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

A qualitative study of user perceptions of mobile health apps.

PubMed

Peng, Wei; Kanthawala, Shaheen; Yuan, Shupei; Hussain, Syed Ali

2016-11-14

Mobile apps for health exist in large numbers today, but oftentimes, consumers do not continue to use them after a brief period of initial usage, are averse toward using them at all, or are unaware that such apps even exist. The purpose of our study was to examine and qualitatively determine the design and content elements of health apps that facilitate or impede usage from the users' perceptive. In 2014, six focus groups and five individual interviews were conducted in the Midwest region of the U.S. with a mixture of 44 smartphone owners of various social economic status. The participants were asked about their general and health specific mobile app usage. They were then shown specific features of exemplar health apps and prompted to discuss their perceptions. The focus groups and interviews were audio recorded, transcribed verbatim, and coded using the software NVivo. Inductive thematic analysis was adopted to analyze the data and nine themes were identified: 1) barriers to adoption of health apps, 2) barriers to continued use of health apps, 3) motivators, 4) information and personalized guidance, 5) tracking for awareness and progress, 6) credibility, 7) goal setting, 8) reminders, and 9) sharing personal information. The themes were mapped to theories for interpretation of the results. This qualitative research with a diverse pool of participants extended previous research on challenges and opportunities of health apps. The findings provide researchers, app designers, and health care providers insights on how to develop and evaluate health apps from the users' perspective.

Transitioning to routine breast cancer risk assessment and management in primary care: what can we learn from cardiovascular disease?

PubMed

Phillips, Kelly-Anne; Steel, Emma J; Collins, Ian; Emery, Jon; Pirotta, Marie; Mann, G Bruce; Butow, Phyllis; Hopper, John L; Trainer, Alison; Moreton, Jane; Antoniou, Antonis C; Cuzick, Jack; Keogh, Louise

2016-01-01

To capitalise on advances in breast cancer prevention, all women would need to have their breast cancer risk formally assessed. With ~85% of Australians attending primary care clinics at least once a year, primary care is an opportune location for formal breast cancer risk assessment and management. This study assessed the current practice and needs of primary care clinicians regarding assessment and management of breast cancer risk. Two facilitated focus group discussions were held with 17 primary care clinicians (12 GPs and 5 practice nurses (PNs)) as part of a larger needs assessment. Primary care clinicians viewed assessment and management of cardiovascular risk as an intrinsic, expected part of their role, often triggered by practice software prompts and facilitated by use of an online tool. Conversely, assessment of breast cancer risk was not routine and was generally patient- (not clinician-) initiated, and risk management (apart from routine screening) was considered outside the primary care domain. Clinicians suggested that routine assessment and management of breast cancer risk might be achieved if it were widely endorsed as within the remit of primary care and supported by an online risk-assessment and decision aid tool that was integrated into primary care software. This study identified several key issues that would need to be addressed to facilitate the transition to routine assessment and management of breast cancer risk in primary care, based largely on the model used for cardiovascular disease.

Reasons for excision of skin tumors: a one-year prospective study in a tertiary skin cancer unit.

PubMed

Lallas, Aimilios; Longo, Caterina; Moscarella, Elvira; Lombardi, Mara; Specchio, Francesca; Raucci, Margherita; Zalaudek, Iris; Argenziano, Giuseppe

2015-01-01

Biopsies and surgical excisions represent routine procedures in clinical settings dealing with skin cancer. To evaluate the impact of clinical examination, dermoscopy, reflectance confocal microscopy and digital monitoring on the decision to excise or biopsy a lesion in routine practice. Patients scheduled for biopsy or excision of a skin lesion were prospectively enrolled. The expert dermatologist was asked to select the main factor that prompted him/her to excise or biopsy the lesion. The most common reason for melanoma excision was clinical and dermoscopic morphology (70.3%), followed by dermoscopy (11.4%), monitoring (8.9%) and clinical context (8.2%). Most basal and squamous cell carcinomas were recognized both clinically and dermoscopically, while 18.6 and 15.0%, respectively, could only be detected with dermoscopic examination. Each part of the clinical examination has a contributory role in the diagnosis of melanoma and other skin cancers.

Infections and apparent life-threatening events.

PubMed

Altman, Robin L; Li, Karl I; Brand, Donald A

2008-05-01

The need for routine sepsis evaluation in patients who have experienced an apparent life-threatening event but lack signs of infection remains controversial. To assess their risk of a serious occult bacterial infection, records were reviewed of 95 infants in whom infections were discovered during their inpatient evaluation after an apparent life-threatening event. Noted for each patient was the presence of any suggestive findings that would have prompted a physician to consider the given type of infection in the differential diagnosis. Thirty patients had bacterial infections; all but 5 had suggestive findings. The exceptions included 1 patient with pneumonia and 4 with urinary tract infections. None of the remaining 25 patients had occult bacterial infections. In patients with an apparent life-threatening event who appear well and lack signs suggestive of a serious bacterial infection, it may be possible to forego routine sepsis evaluation beyond a chest radiograph and urine culture without risking a serious missed diagnosis.

An interactive modular design for computerized photometry in spectrochemical analysis

NASA Technical Reports Server (NTRS)

Bair, V. L.

1980-01-01

A general functional description of totally automatic photometry of emission spectra is not available for an operating environment in which the sample compositions and analysis procedures are low-volume and non-routine. The advantages of using an interactive approach to computer control in such an operating environment are demonstrated. This approach includes modular subroutines selected at multiple-option, menu-style decision points. This style of programming is used to trace elemental determinations, including the automated reading of spectrographic plates produced by a 3.4 m Ebert mount spectrograph using a dc-arc in an argon atmosphere. The simplified control logic and modular subroutine approach facilitates innovative research and program development, yet is easily adapted to routine tasks. Operator confidence and control are increased by the built-in options including degree of automation, amount of intermediate data printed out, amount of user prompting, and multidirectional decision points.

[The role of microRNAs in molecular pathology of esophageal cancer and their potential usage in clinical oncology].

PubMed

Kovaříková, A; Héžová, R; Srovnal, J; Rédová-Lojová, M; Slabý, O

2014-01-01

MicroRNAs are an abundant class of noncoding RNAs (approx. 18- 25 nucleotides in length) that suppress translation through binding to their target mRNAs, eventually leading to mRNAs degradation. Sequences of these endogenous RNA molecules are highly conserved, even among unrelated species, indicating their involvement in basic bio-logical processes, such as development, differentiation, proliferation or apoptosis. MiRNAs also participate on regulation of cancer stem cell functioning, immune system and malignant transformation. This review provides a comprehensive overview of miRNAs functions in esophageal cancer, their roles in key pathogenetic pathways and disease development, as well as their potential usage in clinical routine as bio-markers improving dia-gnosis, prognosis and prediction of therapeutic response. Through regulation of signaling pathways important in malignant transformation, miRNAs present also promising therapeutic targets.

SCP -- A Simple CCD Processing Package

NASA Astrophysics Data System (ADS)

Lewis, J. R.

This note describes a small set of programs, written at RGO, which deal with basic CCD frame processing (e.g. bias subtraction, flat fielding, trimming etc.). The need to process large numbers of CCD frames from devices such as FOS or ISIS in order to extract spectra has prompted the writing of routines which will do the basic hack-work with a minimal amount of interaction from the user. Although they were written with spectral data in mind, there are no ``spectrum-specific'' features in the software which means they can be applied to any CCD data.

One-Class Classification-Based Real-Time Activity Error Detection in Smart Homes.

PubMed

Das, Barnan; Cook, Diane J; Krishnan, Narayanan C; Schmitter-Edgecombe, Maureen

2016-08-01

Caring for individuals with dementia is frequently associated with extreme physical and emotional stress, which often leads to depression. Smart home technology and advances in machine learning techniques can provide innovative solutions to reduce caregiver burden. One key service that caregivers provide is prompting individuals with memory limitations to initiate and complete daily activities. We hypothesize that sensor technologies combined with machine learning techniques can automate the process of providing reminder-based interventions. The first step towards automated interventions is to detect when an individual faces difficulty with activities. We propose machine learning approaches based on one-class classification that learn normal activity patterns. When we apply these classifiers to activity patterns that were not seen before, the classifiers are able to detect activity errors, which represent potential prompt situations. We validate our approaches on smart home sensor data obtained from older adult participants, some of whom faced difficulties performing routine activities and thus committed errors.

Reflections on multiple strategies to reduce transfusion in cancer patients: A joint narrative.

PubMed

Goubran, Hadi; Seghatchian, Jerard; Prokopchuk-Gauk, Oksana; Radosevic, Julia; Sabry, Waleed; Iqbal, Nayyer; Burnouf, Thierry

2017-06-01

Transfusion of red blood cells, platelets and plasma is widely used in the management of anemia and coagulopathy in cancer patients undergoing surgery, chemotherapy, and radiation. The decision to transfuse should not be made lightly as exposure to transfused blood, whether from an allogeneic or even autologous source, is not without risk and the long-term effect of blood transfusion on cancer outcomes remains questionable. Recognition of anemia associated with nutritional deficiency should be promptly corrected while avoiding the use of erythropoiesis stimulating agents. Minimizing blood loss and the prompt control of bleeding, coupled with a restrictive transfusion strategy, seem to be a reasonable approach that does not appear to be associated with long-term sequelae. Limiting platelet transfusion to patients with severe hypo-proliferative thrombocytopenia, and implementation of local hemostatic measures, together with the use of fractionated coagulation factor concentrates, as an alternative to frozen plasma transfusion, may reduce the exposure of cancer patients to potentially harmful thrombogenic and pro-inflammatory cellular microparticles. This joint narrative highlights current opinions for minimizing blood usage in patients with cancer. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

STS-1 environmental control and life support system. Consumables and thermal analysis

NASA Technical Reports Server (NTRS)

Steines, G.

1980-01-01

The Environmental Control and Life Support Systems (ECLSS)/thermal systems analysis for the Space Transportation System 1 Flight (STS-1) was performed using the shuttle environmental consumables usage requirements evaluation (SECURE) computer program. This program employs a nodal technique utilizing the Fortran Environmental Analysis Routines (FEAR). The output parameters evaluated were consumable quantities, fluid temperatures, heat transfer and rejection, and cabin atmospheric pressure. Analysis of these indicated that adequate margins exist for the nonpropulsive consumables and related thermal environment.

Knee arthroscopy routines and practice.

PubMed

Brattwall, M; Jacobson, E; Forssblad, M; Jakobsson, J

2010-12-01

Knee arthroscopy is one of most commonly performed day-case orthopaedic procedures, thus consuming huge medical resources. The aim of the present questionnaire survey was to study knee arthroscopy routines and practice. An electronic web-based survey including questions around pre-, per- and postoperative routines for elective knee arthroscopy was send to all orthopaedic units associated to the Swedish Arthroscopic Society (n = 60). Responses covering 37 centres out of 60 (response rate 62%) were returned. Preoperative radiograph routines varied considerable between centres; conventional radiograph varied between 5 and 100% and preoperative MRI between 5 and 80% of patients. General anaesthesia was the preferred intra-operative technique used in all centres (median 79% of patients), local anaesthesia with or without light sedation was used in all 28 out of the 37 centres responding (median 10% of cases) and spinal anaesthesia was used in 15 centres (median 5% of cases). Intra-articular local anaesthesia was provided in all but one of centres. Perioperative administration of oral NSAIDs was common (31 out 37), 6 centres (all teaching hospitals) did not routinely give pre- or postoperative NSAID. Analgesic prescription was provided on a regular base in 18 (49%) of centres; an NSAID being the most commonly prescribed. All but one centre provided written information and instruction at discharge. Referral to physiotherapy, prescribed sick leave and scheduled follow-up in the outpatient clinic diverged considerably. Routines and practice associated to elective knee arthroscopy differed; however, no clear differences in practice were seen between teaching centres, general or local hospitals apart from a lower usage of NSAID for perioperative analgesia. There is an obvious room for further standardisation in the routine handling of patients undergoing elective arthroscopy of the knee.

A review on technologies and their usage in solid waste monitoring and management systems: Issues and challenges

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

Hannan, M.A., E-mail: hannan@eng.ukm.my; Abdulla Al Mamun, Md., E-mail: md.abdulla@siswa.ukm.edu.my; Hussain, Aini, E-mail: aini@eng.ukm.my

Highlights: • Classification of available technologies for SWM system in four core category. • Organization of technology based SWM systems in three main groups. • Summary of SWM systems with target application, methodology and functional domain. • Issues and challenges are highlighted for further design of a sustainable system. - Abstract: In the backdrop of prompt advancement, information and communication technology (ICT) has become an inevitable part to plan and design of modern solid waste management (SWM) systems. This study presents a critical review of the existing ICTs and their usage in SWM systems to unfold the issues and challengesmore » towards using integrated technologies based system. To plan, monitor, collect and manage solid waste, the ICTs are divided into four categories such as spatial technologies, identification technologies, data acquisition technologies and data communication technologies. The ICT based SWM systems classified in this paper are based on the first three technologies while the forth one is employed by almost every systems. This review may guide the reader about the basics of available ICTs and their application in SWM to facilitate the search for planning and design of a sustainable new system.« less

Diagnosis of central nervous system relapse of pediatric acute lymphoblastic leukemia: Impact of routine cytological CSF analysis at the time of intrathecal chemotherapy.

PubMed

Gassas, Adam; Krueger, Joerg; Alvi, Saima; Sung, Lillian; Hitzler, Johanne; Lieberman, Lani

2014-12-01

Despite the success of central nervous system (CNS) directed therapy in pediatric acute lymphoblastic leukemia (ALL), relapse involving the CNS continues to be observed in 5-10% of children when utilizing standard intrathecal prophylactic chemotherapy. While most pediatric ALL treatment protocols mandate regular lumbar punctures (LP) for the intrathecal injection of chemotherapy, the value of routine cytological analysis of cerebrospinal fluid (CSF) during therapy is unknown. Our objective was to assess the diagnostic value of routine CSF analysis during ALL therapy. To allow for at least 10 years of follow up from ALL diagnosis, children (0-18 years) with ALL diagnosed and treated at SickKids, Toronto, Canada between 1994-2004 were studied. Medical records of patients with CNS relapse were examined to determine whether CNS relapse was diagnosed based on cytology of a routinely obtained CSF sample, a CSF sample obtained because of signs and symptoms or a CSF sample obtained after the diagnosis of a bone marrow relapse. Of 494 children treated for ALL, 31 (6.6%) developed a relapse of ALL involving the CNS. Twenty-two had an isolated CNS relapse and nine had a combined bone marrow and CNS relapse. Among patients with isolated CNS relapse, 73% (16/22) were diagnosed based on routine CSF samples obtained from asymptomatic children. Conversely, 89% (8/9) of children with combined bone marrow and CNS relapse presented with symptoms and signs that prompted CSF examination. Routine CSF examination at the time of LP for intrathecal chemotherapy is useful in detecting CNS relapse. © 2014 Wiley Periodicals, Inc.

The Association of Patient Factors, Digital Access, and Online Behavior on Sustained Patient Portal Use: A Prospective Cohort of Enrolled Users

PubMed Central

Nazi, Kim M; Hibbard, Judith H; Houston, Thomas K

2017-01-01

Background As electronic health records and computerized workflows expand, there are unprecedented opportunities to digitally connect with patients using secure portals. To realize the value of patient portals, initial reach across populations will need to be demonstrated, as well as sustained usage over time. Objective The study aim was to identify patient factors associated with short-term and long-term portal usage after patients registered to access all portal functions. Methods We prospectively followed a cohort of patients at a large Department of Veterans Affairs (VA) health care facility who recently completed identity proofing to use the VA patient portal. Information collected at baseline encompassed patient factors potentially associated with portal usage, including: demographics, Internet access and use, health literacy, patient activation, and self-reported health conditions. The primary outcome was the frequency of portal log-ins during 6-month and 18-month time intervals after study enrollment. Results A total of 270 study participants were followed prospectively. Almost all participants (260/268, 97.0%) reported going online, typically at home (248/268, 92.5%). At 6 months, 84.1% (227/270) of participants had visited the portal, with some variation in usage across demographic and health-related subgroups. There were no significant differences in portal log-ins by age, gender, education, marital status, race/ethnicity, distance to a VA facility, or patient activation measure. Significantly higher portal usage was seen among participants using high-speed broadband at home, greater self-reported ability using the Internet, and routinely going online. By 18 months, 91% participants had logged in to the portal, and no significant associations were found between usage and demographics, health status, or patient activation. When examining portal activity between 6 and 18 months, patients who were infrequent or high portal users remained in those categories, respectively. Conclusions Short-term and long-term portal usage was associated with having broadband at home, high self-rated ability when using the Internet, and overall online behavior. Digital inclusion, or ready access to the Internet and digital skills, appears to be a social determinant in patient exposure to portal services. PMID:29042345

Bacterial genome sequencing in clinical microbiology: a pathogen-oriented review.

PubMed

Tagini, F; Greub, G

2017-11-01

In recent years, whole-genome sequencing (WGS) has been perceived as a technology with the potential to revolutionise clinical microbiology. Herein, we reviewed the literature on the use of WGS for the most commonly encountered pathogens in clinical microbiology laboratories: Escherichia coli and other Enterobacteriaceae, Staphylococcus aureus and coagulase-negative staphylococci, streptococci and enterococci, mycobacteria and Chlamydia trachomatis. For each pathogen group, we focused on five different aspects: the genome characteristics, the most common genomic approaches and the clinical uses of WGS for (i) typing and outbreak analysis, (ii) virulence investigation and (iii) in silico antimicrobial susceptibility testing. Of all the clinical usages, the most frequent and straightforward usage was to type bacteria and to trace outbreaks back. A next step toward standardisation was made thanks to the development of several new genome-wide multi-locus sequence typing systems based on WGS data. Although virulence characterisation could help in various particular clinical settings, it was done mainly to describe outbreak strains. An increasing number of studies compared genotypic to phenotypic antibiotic susceptibility testing, with mostly promising results. However, routine implementation will preferentially be done in the workflow of particular pathogens, such as mycobacteria, rather than as a broadly applicable generic tool. Overall, concrete uses of WGS in routine clinical microbiology or infection control laboratories were done, but the next big challenges will be the standardisation and validation of the procedures and bioinformatics pipelines in order to reach clinical standards.

[The existence vomeronasal organ in adult humans].

PubMed

Rapiejko, Piotr; Zielnik-Jurkiewicz, Beata; Wojdas, Andrzej; Ratajczak, Jan; Jurkiewicz, Dariusz

2007-01-01

The influence of chemical substances (feromones) on human emotional and physical condition has fascinated psychologists, sexuologists and laryngologists since centurie. Literature conveys inconsistent information on vomeronasal organ (VNO) occurrence in humans. This organ is often called Jacobson's, and 2 symmetrical openings leading into it, located on both sides of septum, are called Ruyasch's ducts. The aim of the study was to analyze vomeronasal organ occurrence in humans in relation to age and sex. The study was conducted in a group of 634 patients, aged 18-80 years. All patients underwent routine ENT examination including rhinoscopy, nasal cavity examination with usage of 2.5x magnification lens (surgical glasses) and surgical microscope with 10x magnification. All persons had nasal cavities examined endoscopically. Every time presence of vomeronasal organ openings, along with localization, size and symmetry of these was noted. Subjects, who presented Jacobson's organ, were asked to fill a questionnaire concerning influence of smells on erotic sensations. Vomeronasal organ was fund in 312 persons, that is 49.21%. In 83.65% of cases vomeronasal organ opening size was smaller than 0.2 mm, what restricted its visibility to usage of magnifying lens, microscope, or endoscope. In 16.34% of cases only vomeronasal organ ducts openings were well visible in routine rhinoscopy without magnification. Vomeronasal organ was found more often in men than women. VNO was significantly more rare in patients with nasal septal deviation. In these cases, vomeronasal organ was usually found unilaterally, in all the cases on the concave side of deviated nasal septum.

Visual prompt poster for promoting patient-physician conversations on weight loss.

PubMed

Stephens, Gillian S; Blanken, Stephanie E; Greiner, K Allen; Chumley, Heidi S

2008-01-01

This study investigated the effect of a simple visual prompt in the form of a poster on the occurrence of patient-physician weight loss conversations during routine office encounters in a primary care outpatient clinic. We conducted a 2-phase study in a family medicine residency program outpatient clinic in August and September 2006. During the first phase, lasting 5 days, we surveyed all nonpregnant adult patients (preintervention group) about weight loss. We then implemented a visual prompt in the form of a colorful poster (11 x 17 inches) in both English and Spanish. The poster read "Do you want to lose weight? Ask your doctor today!" and included a picture of a bathroom scale. During the second phase, also lasting 5 days, we again surveyed all nonpregnant adult patients (postintervention group). Analyses were based on 283 patients in the preintervention group and 386 patients in the postintervention group. The mean body mass index, obtained from medical records, did not differ significantly between groups (31 vs 32 kg/m2, respectively). Fully 60% of patients in the postintervention group recalled seeing the poster during their visit; however, the percentage of patients who reported discussing weight loss with their physician did not differ between the preintervention and postintervention groups overall (29% vs 27%), among the two-thirds of patients who wanted to lose weight (26% vs 23%), or when only postintervention patients who saw the poster were included in the comparison (29% vs 29%). The large majority of patients in both groups who had such discussions--82% and 77%--indicated that they found them useful; the difference between groups was not significant. A simple visual prompt in the form of a poster directed at patients did not increase the occurrence of conversations between patients and their physicians about weight loss.

An estimation of the clinical mastitis incidence per 100 cows per year based on routinely collected herd data.

PubMed

Santman-Berends, I M G A; Lam, T J G M; Keurentjes, J; van Schaik, G

2015-10-01

The aim of this study was to evaluate whether it was possible to (1) estimate the clinical mastitis incidence rate (CMI) for all Dutch dairy herds and (2) to detect farms with a high CMI based on routinely collected herd data. For this study, 240 dairy farms with a conventional milking system that participated in the milk recording program every 4 to 6 wk were randomly selected and agreed to participate. From the initial 240 herds, data of clinical mastitis (CM) registrations and routinely collected herd data of 227 herds were complete and could be used for analysis. Routinely collected herd data consisted of identification and registration records, antimicrobial usage, test-day records from the milk recording program, bulk tank milk (BTM) somatic cell count data and results of diagnostic tests on BTM samples. For each of the 227 herds, the CMI per 100 cows per year was calculated per quarter of the year and was combined with the available herd data. Two models were developed to predict the CMI for all dairy herds and to detect individual herds that belonged to the 25% herds with the highest CMI. Records of 156 (67%) herds were used for development of the models and the remaining 71 (33%) were used for validation. The model that estimated the CMI in all herds consisted of 11 explanatory variables. The observed and predicted averages of the validation herds were not significantly different. The model estimated a CMI per 100 cows per year of 32.5 cases (95% confidence interval=30.2-34.8), whereas the farmers registered 33.4 cases (95% confidence interval=29.5-37.4). The model that aimed at detecting individual herds with a high CMI contained 6 explanatory variables and could correctly classify 77% of all validation herds at the quarter-year level. The most important variables in the model were antibiotic usage for treating CM and BTM somatic cell count. In conclusion, models based on routinely collected herd data gave an accurate prediction of CMI for all Dutch dairy herds and could detect individual dairy herds with a high CMI. With these models it is possible to periodically monitor CMI both at the herd and at the national level, which is valuable for monitoring purposes and can motivate farmers to continuously improve udder health in their herds. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Endovascular techniques in limb salvage: cutting, cryo, brachy, and drug-eluting balloons.

PubMed

Davies, Mark G; Anaya-Ayala, Javier E

2013-04-01

The complex pathophysiology response to injury of the lower-extremity arteries has prompted the development of several unique balloon technologies to overcome initial technical failures and short-term intimal hyperplasia. Cryoplasty alters the cellular and mechanical properties of the vessel wall during angioplasty. Cutting balloons incise the wall, preventing elastic recoil and allowing expansion of the lumen at a lower pressure, thus limiting barotrauma. Drug-eluting balloons actively transfer inhibitory compounds to the wall during the initial therapy, while brachytherapy balloons allow for localized delivery of radiation to inhibit the proliferative response seen after angioplasty. These platforms provide unique means to enhance immediate and short-term results and also reduce stent usage in the lower extremity.

Gender, technology and jobs.

PubMed

Brynin, Malcolm

2006-09-01

Men have traditionally gained more than women from access to technologies at work which bring prestige, job security, more satisfying work and higher pay. Typically female jobs have centred on technologies, if they have at all, which tend towards routine and possibly deskilled work. Typing is a prime example. It is possible that this is changing through computerization, which is extensive but also equally distributed by gender. Does the wage premium, which use of a computer has been found to confer on users, benefit women sufficiently to suggest some sort of equalization through technology, or possibly even a female advantage? This is tested using data from four European countries. There is no across-the-board benefit from the use of computers. For both men and women it depends on the nature of their occupation. Some, more routine usages of computers are associated with a negative outcome. However, this occupational balance itself varies by gender.

Design requirements for ubiquitous computing environments for healthcare professionals.

PubMed

Bång, Magnus; Larsson, Anders; Eriksson, Henrik

2004-01-01

Ubiquitous computing environments can support clinical administrative routines in new ways. The aim of such computing approaches is to enhance routine physical work, thus it is important to identify specific design requirements. We studied healthcare professionals in an emergency room and developed the computer-augmented environment NOSTOS to support teamwork in that setting. NOSTOS uses digital pens and paper-based media as the primary input interface for data capture and as a means of controlling the system. NOSTOS also includes a digital desk, walk-up displays, and sensor technology that allow the system to track documents and activities in the workplace. We propose a set of requirements and discuss the value of tangible user interfaces for healthcare personnel. Our results suggest that the key requirements are flexibility in terms of system usage and seamless integration between digital and physical components. We also discuss how ubiquitous computing approaches like NOSTOS can be beneficial in the medical workplace.

Integrating surgery and genetic testing for the modern surgeon.

PubMed

Caso, Raul; Beamer, Matthew; Lofthus, Alexander D; Sosin, Michael

2017-10-01

The field of cancer genetics is rapidly evolving and several genetic mutations have been identified in hereditary cancer syndromes. These mutations can be diagnosed via routine genetic testing allowing prompt intervention. This is especially true for certain variants of colorectal, breast, and thyroid cancers where genetic testing may guide surgical therapy. Ultimately, surgical intervention may drastically diminish disease manifestation or progression in individuals deemed as high-risk based on their genetic makeup. Understanding the concepts of gene-based testing and integrating into current surgical practice is crucial. This review addresses common genetic syndromes, tests, and interventions salient to the current surgeon.

Computer programs: Information retrieval and data analysis, a compilation

NASA Technical Reports Server (NTRS)

1972-01-01

The items presented in this compilation are divided into two sections. Section one treats of computer usage devoted to the retrieval of information that affords the user rapid entry into voluminous collections of data on a selective basis. Section two is a more generalized collection of computer options for the user who needs to take such data and reduce it to an analytical study within a specific discipline. These programs, routines, and subroutines should prove useful to users who do not have access to more sophisticated and expensive computer software.

An innovative use of instant messaging technology to support a library's single-service point.

PubMed

Horne, Andrea S; Ragon, Bart; Wilson, Daniel T

2012-01-01

A library service model that provides reference and instructional services by summoning reference librarians from a single service point is described. The system utilizes Libraryh3lp, an open-source, multioperator instant messaging system. The selection and refinement of this solution and technical challenges encountered are explored, as is the design of public services around this technology, usage of the system, and best practices. This service model, while a major cultural and procedural change at first, is now a routine aspect of customer service for this library.

The Alba ray tracing code: ART

NASA Astrophysics Data System (ADS)

Nicolas, Josep; Barla, Alessandro; Juanhuix, Jordi

2013-09-01

The Alba ray tracing code (ART) is a suite of Matlab functions and tools for the ray tracing simulation of x-ray beamlines. The code is structured in different layers, which allow its usage as part of optimization routines as well as an easy control from a graphical user interface. Additional tools for slope error handling and for grating efficiency calculations are also included. Generic characteristics of ART include the accumulation of rays to improve statistics without memory limitations, and still providing normalized values of flux and resolution in physically meaningful units.

OSCAR4: a flexible architecture for chemical text-mining.

PubMed

Jessop, David M; Adams, Sam E; Willighagen, Egon L; Hawizy, Lezan; Murray-Rust, Peter

2011-10-14

The Open-Source Chemistry Analysis Routines (OSCAR) software, a toolkit for the recognition of named entities and data in chemistry publications, has been developed since 2002. Recent work has resulted in the separation of the core OSCAR functionality and its release as the OSCAR4 library. This library features a modular API (based on reduction of surface coupling) that permits client programmers to easily incorporate it into external applications. OSCAR4 offers a domain-independent architecture upon which chemistry specific text-mining tools can be built, and its development and usage are discussed.

A pilot study investigating the feasibility of symptom assessment manager (SAM), a Web-based real-time tool for monitoring challenging behaviors.

PubMed

Loi, Samantha M; Wanasinghage, Sangeeth; Goh, Anita; Lautenschlager, Nicola T; Darby, David G; Velakoulis, Dennis

2018-04-01

Improving and minimizing challenging behaviors seen in psychiatric conditions, including behavioral and psychological symptoms of dementia are important in the care of people with these conditions. Yet there is a lack of systematic evaluation of these as a part of routine clinical care. The Neuropsychiatric Inventory is a validated and reliable tool for rating the severity and disruptiveness of challenging behaviors. We report on the evaluation of a Web-based symptom assessment manager (SAM), designed to address the limitation of previous tools using some of the Neuropsychiatric Inventory functions, to monitor behaviors by staff caring for people with dementia and other psychiatric conditions in inpatient and residential care settings. The SAM was piloted in an 8-bed inpatient neuropsychiatry unit over 5 months. Eleven nurses and 4 clinicians were trained in usage of SAM. Primary outcomes were usage of SAM and perceived usability, utility, and acceptance of SAM. Secondary outcomes were the frequencies of documented behavior. Usage data were analyzed using chi-square and logistic regression analyses. The SAM was used for all admitted patients regardless of diagnosis, with a usage rate of 64% for nurses regularly employed in the unit. Staff provided positive feedback regarding the utility of SAM. The SAM appeared to offer individualized behavior assessment by providing a quick, structured, and standardized platform for assessing behavior in a real-world setting. Further research would involve trialing SAM with more staff in alternative settings such as in home or residential care settings. Copyright © 2017 John Wiley & Sons, Ltd.

Laboratory Evaluation of the Alere q Point-of-Care System for Early Infant HIV Diagnosis.

PubMed

Hsiao, Nei-yuan; Dunning, Lorna; Kroon, Max; Myer, Landon

2016-01-01

Early infant diagnosis (EID) and prompt linkage to care are critical to minimise the high morbidity and mortality associated with infant HIV infection. Attrition in the "EID cascade" is common; however, point-of-care (POC) EID assays with same-day result could facilitate prompt linkage of HIV-infected infant to treatment. Despite a number of POC EID assays in development, few have been independently evaluated and data on new technologies are urgently needed to inform policy. We compared Alere q 1/2 Detect POC system laboratory test characteristics with the local standard of care (SOC), Roche CAP/CTM HIV-1 qualitative PCR in an independent laboratory-based evaluation in Cape Town, South Africa. Routinely EID samples collected between November 2013 and September 2014 were each tested by both SOC and POC systems. Repeat testing was done to troubleshoot any discrepancy between POC and SOC results. Overall, 1098 children with a median age of 47 days (IQR, 42-117) were included. Birth PCR (age <7 days) comprised of 8% (n = 92) tests while 56% (n = 620) of children tested as part of routine EID (ages 6-14 weeks). In the overall direct comparison, Alere q Detect achieved sensitivity of 95.5% (95% CI, 91.7-97.9%) and a specificity of 99.8% (95% CI, 99.1-100%). Following repeat testing of discordant samples and exclusion of any inconclusive results, the POC assay sensitivity and specificity were 96.9% (95% CI 93.4-98.9%) and 100% (lower 95% CI 98%) respectively. Among birth PCR tests the POC assay had slightly lower sensitivity (93.3% vs 96.5% in routine EID) and higher assay error rate (10% vs 5% in samples of older children, p = 0.04). Our results indicate this POC assay performs well for EID in the laboratory. The high specificity and thus high positive predictive value would suggest a positive POC result may be adequate for immediate infant ART initiation. While POC testing for EID may have particular utility for birth testing at delivery facilities, the lower sensitivity and error rate requires further attention, as does field implementation of POC EID technologies in other clinical care settings.

The British Association for Sexual Health and HIV 2016 UK national audit and survey of clinic policies in relation to risk assessment, HIV testing and follow-up.

PubMed

Bhaduri, S; Curtis, H; McClean, H; Sullivan, A K

2018-01-01

This national audit of 142 clinics demonstrated that the majority of clinics surveyed had policies and agreed clinical practice for alcohol and recreational drug enquiry, as well as documentation of HIV test refusal, although this was not the case in 24% of clinics as regards alcohol usage, 21% of clinics as regards recreational drugs use and 43% of clinics as regards chemsex usage. Regarding management of HIV test refusal, there was no policy or agreed practice in 13% of clinics with respect to men having sex with men (MSM) attenders, and in 18% of clinics for heterosexual attenders. Seventy percent of clinics had HIV point of care tests (POCT) available. Recommendations include: all clinics should have a policy of routine enquiry about alcohol, recreational drugs and chemsex, all clinics should record reasons for HIV test refusal and all clinics should provide testing alternatives to improve uptake, e.g. point of care testing or home sampling.

pmx Webserver: A User Friendly Interface for Alchemistry.

PubMed

Gapsys, Vytautas; de Groot, Bert L

2017-02-27

With the increase of available computational power and improvements in simulation algorithms, alchemical molecular dynamics based free energy calculations have developed into routine usage. To further facilitate the usability of alchemical methods for amino acid mutations, we have developed a web based infrastructure for obtaining hybrid protein structures and topologies. The presented webserver allows amino acid mutation selection in five contemporary molecular mechanics force fields. In addition, a complete mutation scan with a user defined amino acid is supported. The output generated by the webserver is directly compatible with the Gromacs molecular dynamics engine and can be used with any of the alchemical free energy calculation setup. Furthermore, we present a database of input files and precalculated free energy differences for tripeptides approximating a disordered state of a protein, of particular use for protein stability studies. Finally, the usage of the webserver and its output is exemplified by performing an alanine scan and investigating thermodynamic stability of the Trp cage mini protein. The webserver is accessible at http://pmx.mpibpc.mpg.de.

A study to assess the usage of MCR footwear in West Bengal, India.

PubMed

Lal, Vivek; Sarkar, Debajit; Das, Sukumar; Mahato, Mukunda; Srinivas, Govindrajulu

2015-09-01

The routine use of appropriate footwear is an important intervention to prevent disability in leprosy. We conducted a study to assess utilisation of MCR footwear and observe the condition of footwear. Fifty-six persons affected by leprosy who had been provided MCR footwear in the preceding 3 years were paid home visit and administered a semi-structured interview schedule. Although a total of 30 participants reported using special footwear currently, only 10 reported usage during participation in social events. On observation, 16 pairs were found to be in an unusable condition owing to foot deformity and another 14 pairs in poor condition. In order to ensure greater utilisation of special footwear, the National Programme may seek local solutions through engagement of cobblers and shoemakers with appropriate training in customisation. Persons affected by leprosy should be empowered to appreciate the benefits of special footwear and to take care of themselves, including taking responsibility for using their footwear.

Randomised controlled trial of routine individual feedback to improve rationality and reduce numbers of test requests.

PubMed

Winkens, R A; Pop, P; Bugter-Maessen, A M; Grol, R P; Kester, A D; Beusmans, G H; Knottnerus, J A

1995-02-25

Feedback can be described as a way to provide information on doctors' performance to enable changes in future behaviour. Feedback is used with the aim of changing test-ordering behaviour. It can lead to reductions in test usage and cost savings. It is not sufficiently clear, however, whether feedback leads to more appropriate test use. Since 1985, the Diagnostic Coordinating Center Maastricht has been giving feedback on diagnostic tests as a routine health care activity to all family doctors in its region. Both quantity and quality of requests are discussed. In a randomised, controlled trial over 2.5 years, discussion of tests not included previously was added to the existing routine feedback. One group of family doctors (n = 39) received feedback on test-group A (electrocardiography, endoscopy, cervical smears, and allergy tests), the other (n = 40) on test-group B (radiographic and ultrasonographic tests). Thus, each group of doctors acted as a control group for the other. Changes in volume and rationality of requests were analysed. The number of requests decreased during the trial (p = 0.036). Request numbers decreased particularly for test-group A (p = 0.04). The proportion of requests that were non-rational decreased more in the intervention than in the control groups (p = 0.009). Rationality improved predominantly for test-group B (p = 0.043). Thus, routine feedback can change the quantity and quality of requests.

Training support staff to embed teaching within natural routines of young children with disabilities in an inclusive preschool.

PubMed

Schepis, M M; Reid, D H; Ownbey, J; Parsons, M B

2001-01-01

We evaluated a program for training 4 support staff to embed instruction within the existing activities of 5 children with disabilities in an inclusive preschool. The program involved classroom-based instruction, role playing, and feedback regarding how to effectively prompt, correct, and reinforce child behavior. Descriptions of naturally occurring teaching opportunities in which to use the teaching skills were also provided. Following classroom training, brief on-the-job training was provided to each staff member, followed by on-the-job feedback. Results indicated that each staff member increased her use of correct teaching procedures when training was implemented. Improvements in child performance accompanied each application of the staff training program. Results are discussed in terms of using effective staff training as one means of increasing the use of recommended intervention procedures in inclusive settings. Areas for future research could focus on training staff to embed other types of recommended practices within typical preschool routines involving children with disabilities.

Incorporating delayed neutrons into the point-model equations routinely used for neutron coincidence counting in nuclear safeguards

DOE PAGES

Croft, Stephen; Favalli, Andrea

2016-09-21

Here, we extend the familiar Bӧhnel point-model equations, which are routinely used to interpret neutron coincidence counting rates, by including the contribution of delayed neutrons. After developing the necessary equations we use them to show, by providing some numerical results, what the quantitative impact of neglecting delayed neutrons is across the full range of practical nuclear safeguards applications. The influence of delayed neutrons is predicted to be small for the types of deeply sub-critical assay problems which concern the nuclear safeguards community, smaller than uncertainties arising from other factors. This is most clearly demonstrated by considering the change in themore » effective (α,n)-to-spontaneous fission prompt-neutron ratio that the inclusion of delayed neutrons gives rise to. That the influence of delayed neutrons is small is fortunate, and our results justify the long standing practice of simply neglecting them in the analysis of field measurements.« less

Characterisation and optimisation of the new Prompt Gamma-ray Activation Analysis (PGAA) facility at FRM II

NASA Astrophysics Data System (ADS)

Canella, Lea; Kudějová, Petra; Schulze, Ralf; Türler, Andreas; Jolie, Jan

2011-04-01

At the research reactor Forschungs-Neutronenquelle Heinz Maier-Leibnitz (FRM II) a new Prompt Gamma-ray Activation Analysis (PGAA) facility was installed. The instrument was originally built and operating at the spallation source at the Paul Scherrer Institute in Switzerland. After a careful re-design in 2004-2006, the new PGAA instrument was ready for operation at FRM II. In this paper the main characteristics and the current operation conditions of the facility are described. The neutron flux at the sample position can reach up 6.07×1010 [cm-2 s-1], thus the optimisation of some parameters, e.g. the beam background, was necessary in order to achieve a satisfactory analytical sensitivity for routine measurements. Once the optimal conditions were reached, detection limits and sensitivities for some elements, like for example H, B, C, Si, or Pb, were calculated and compared with other PGAA facilities. A standard reference material was also measured in order to show the reliability of the analysis under different conditions at this instrument.

The worldwide epidemic of diabetic retinopathy

PubMed Central

Zheng, Yingfeng; He, Mingguang; Congdon, Nathan

2012-01-01

Diabetic retinopathy (DR), a major microvascular complication of diabetes, has a significant impact on the world's health systems. Globally, the number of people with DR will grow from 126.6 million in 2010 to 191.0 million by 2030, and we estimate that the number with vision-threatening diabetic retinopathy (VTDR) will increase from 37.3 million to 56.3 million, if prompt action is not taken. Despite growing evidence documenting the effectiveness of routine DR screening and early treatment, DR frequently leads to poor visual functioning and represents the leading cause of blindness in working-age populations. DR has been neglected in health-care research and planning in many low-income countries, where access to trained eye-care professionals and tertiary eye-care services may be inadequate. Demand for, as well as, supply of services may be a problem. Rates of compliance with diabetes medications and annual eye examinations may be low, the reasons for which are multifactorial. Innovative and comprehensive approaches are needed to reduce the risk of vision loss by prompt diagnosis and early treatment of VTDR. PMID:22944754

The worldwide epidemic of diabetic retinopathy.

PubMed

Zheng, Yingfeng; He, Mingguang; Congdon, Nathan

2012-01-01

Diabetic retinopathy (DR), a major microvascular complication of diabetes, has a significant impact on the world's health systems. Globally, the number of people with DR will grow from 126.6 million in 2010 to 191.0 million by 2030, and we estimate that the number with vision-threatening diabetic retinopathy (VTDR) will increase from 37.3 million to 56.3 million, if prompt action is not taken. Despite growing evidence documenting the effectiveness of routine DR screening and early treatment, DR frequently leads to poor visual functioning and represents the leading cause of blindness in working-age populations. DR has been neglected in health-care research and planning in many low-income countries, where access to trained eye-care professionals and tertiary eye-care services may be inadequate. Demand for, as well as, supply of services may be a problem. Rates of compliance with diabetes medications and annual eye examinations may be low, the reasons for which are multifactorial. Innovative and comprehensive approaches are needed to reduce the risk of vision loss by prompt diagnosis and early treatment of VTDR.

Thromboembolic complications of thyroid storm.

PubMed

Min, T; Benjamin, S; Cozma, L

2014-01-01

Thyroid storm is a rare but potentially life-threatening complication of hyperthyroidism. Early recognition and prompt treatment are essential. Atrial fibrillation can occur in up to 40% of patients with thyroid storm. Studies have shown that hyperthyroidism increases the risk of thromboembolic events. There is no consensus with regard to the initiation of anticoagulation for atrial fibrillation in severe thyrotoxicosis. Anticoagulation is not routinely initiated if the risk is low on a CHADS2 score; however, this should be considered in patients with thyroid storm or severe thyrotoxicosis with impending storm irrespective of the CHADS2 risk, as it appears to increase the risk of thromboembolic episodes. Herein, we describe a case of thyroid storm complicated by massive pulmonary embolism. Diagnosis of thyroid storm is based on clinical findings. Early recognition and prompt treatment could lead to a favourable outcome.Hypercoagulable state is a recognised complication of thyrotoxicosis.Atrial fibrillation is strongly associated with hyperthyroidism and thyroid storm.Anticoagulation should be considered for patients with severe thyrotoxicosis and atrial fibrillation irrespective of the CHADS2 score.Patients with severe thyrotoxicosis and clinical evidence of thrombosis should be immediately anticoagulated until hyperthyroidism is under control.

Clinical emergency treatment of 68 critical patients with severe organophosphorus poisoning and prognosis analysis after rescue.

PubMed

Dong, Hui; Weng, Yi-Bing; Zhen, Gen-Shen; Li, Feng-Jie; Jin, Ai-Chun; Liu, Jie

2017-06-01

This study reports the clinical emergency treatment of 68 critical patients with severe organophosphorus poisoning, and analyzes the prognosis after rescue.The general data of 68 patients with severe organophosphorus poisoning treated in our hospital were retrospectively analyzed. These patients were divided into 2 groups: treatment group, and control group. Patients in the control group received routine emergency treatment, while patients in the treatment group additionally received hemoperfusion plus hemodialysis on the basis of routine emergency treatment. The curative effects in these 2 groups and the prognosis after rescue were compared.Compared with the control group, atropinization time, recovery time of cholinesterase activity, recovery time of consciousness, extubation time, and length of hospital stay were shorter (P < .05); the total usage of atropine was significantly lower (P < .05); Glasgow Coma Score was significantly higher (P < .05); acute physiology and chronic health score (APACHE II) was significantly lower (P < .05); and mortality and poisoning rebound rate was significantly lower (P < .05) in the treatment group.Hemoperfusion and hemodialysis on the basis of routine emergency treatment for critical patients with organophosphorus poisoning can improve rescue outcomes and improve the prognosis of patients, which should be popularized.

User Participation and Engagement With the See Me Smoke-Free mHealth App: Prospective Feasibility Trial

PubMed Central

Bell, Melanie L; Armin, Julie

2017-01-01

Background The See Me Smoke-Free (SMSF) mobile health (mHealth) app was developed to help women quit smoking by targeting concerns about body weight, body image, and self-efficacy through cognitive behavioral techniques and guided imagery audio files addressing smoking, diet, and physical activity. A feasibility trial found associations between SMSF usage and positive treatment outcomes. This paper reports a detailed exploration of program use among eligible individuals consenting to study participation and completing the baseline survey (participants) and ineligible or nonconsenting app installers (nonparticipants), as well as the relationship between program use and treatment outcomes. Objective The aim of this study was to determine whether (1) participants were more likely to set quit dates, be current smokers, and report higher levels of smoking at baseline than nonparticipants; (2) participants opened the app and listened to audio files more frequently than nonparticipants; and (3) participants with more app usage had a higher likelihood of self-reported smoking abstinence at follow up. Methods The SMSF feasibility trial was a single arm, within-subjects, prospective cohort study with assessments at baseline and 30 and 90 days post enrollment. The SMSF app was deployed on the Google Play Store for download, and basic profile characteristics were obtained for all app installers. Additional variables were assessed for study participants. Participants were prompted to use the app daily during study participation. Crude differences in baseline characteristics between trial participants and nonparticipants were evaluated using t tests (continuous variables) and Fisher exact tests (categorical variables). Exact Poisson tests were used to assess group-level differences in mean usage rates over the full study period using aggregate Google Analytics data on participation and usage. Negative binomial regression models were used to estimate associations of app usage with participant baseline characteristics after adjustment for putative confounders. Associations between app usage and self-reported smoking abstinence were assessed using separate logistic regression models for each outcome measure. Results Participants (n=151) were more likely than nonparticipants (n=96) to report female gender (P<.02) and smoking in the 30 days before enrollment (P<.001). Participants and nonparticipants opened the app and updated quit dates at the same average rate (rate ratio [RR] 0.98; 95% CI 0.92-1.04; P=.43), but participants started audio files (RR 1.07; 95% CI 1.00-1.13; P<.04) and completed audio files (RR 1.11; 95% CI 1.03-1.18; P<.003) at significantly higher rates than nonparticipants. Higher app usage among participants was positively associated with some smoking cessation outcomes. Conclusions This study suggests potential efficacy of the SMSF app, as increased usage was generally associated with higher self-reported smoking abstinence. A planned randomized controlled trial will assess the SMSF app’s efficacy as an intervention tool to help women quit smoking. PMID:28993302

The quality mammographic image. A review of its components.

PubMed

Rickard, M T

1989-11-01

Seven major factors resulting in a quality or high contrast and high resolution mammographic image have been discussed. The following is a summary of their key features: 1) Dedicated mammographic equipment. --Molybdenum target material --Molybdenum filter, beryllium window --Low kVp usage, in range of 24 to 30 --Routine contact mammography performed at 25 kVp --Slightly lower kVp for coned compression --Slightly higher kVp for microfocus magnification 2) Film density --Phototimer with adjustable position --Calibration of phototimer to optimal optical density of approx. 1.4 over full kVp range 3) Breast Compression --General and focal (coned compression). --Essential to achieve proper contrast, resolution and breast immobility. --Foot controls preferable. 4) Focal Spot. --Size recommendation for contact work 0.3 mm. --Minimum power output of 100 mA at 25 kVp desirable to avoid movement blurring in contact grid work. --Size recommendation for magnification work 0.1 mm. 5) Grid. --Usage recommended as routine in all but magnification work. 6) Film-screen Combination. --High contrast--high speed film. --High resolution screen. --Specifically designed cassette for close film-screen contact and low radiation absorption. --Use of faster screens for magnification techniques. 7) Dedicated processing. --Increased developing time--40 to 45 seconds. --Increased developer temperature--35 to 38 degrees. --Adjusted replenishment rate and dryer temperature. All seven factors contributing to image contrast and resolution affect radiation dosage to the breast. The risk of increased dosage associated with the use of various techniques needs to be balanced against the risks of incorrect diagnosis associated with their non-use.(ABSTRACT TRUNCATED AT 250 WORDS)

The Association of Patient Factors, Digital Access, and Online Behavior on Sustained Patient Portal Use: A Prospective Cohort of Enrolled Users.

PubMed

Woods, Susan S; Forsberg, Christopher W; Schwartz, Erin C; Nazi, Kim M; Hibbard, Judith H; Houston, Thomas K; Gerrity, Martha

2017-10-17

As electronic health records and computerized workflows expand, there are unprecedented opportunities to digitally connect with patients using secure portals. To realize the value of patient portals, initial reach across populations will need to be demonstrated, as well as sustained usage over time. The study aim was to identify patient factors associated with short-term and long-term portal usage after patients registered to access all portal functions. We prospectively followed a cohort of patients at a large Department of Veterans Affairs (VA) health care facility who recently completed identity proofing to use the VA patient portal. Information collected at baseline encompassed patient factors potentially associated with portal usage, including: demographics, Internet access and use, health literacy, patient activation, and self-reported health conditions. The primary outcome was the frequency of portal log-ins during 6-month and 18-month time intervals after study enrollment. A total of 270 study participants were followed prospectively. Almost all participants (260/268, 97.0%) reported going online, typically at home (248/268, 92.5%). At 6 months, 84.1% (227/270) of participants had visited the portal, with some variation in usage across demographic and health-related subgroups. There were no significant differences in portal log-ins by age, gender, education, marital status, race/ethnicity, distance to a VA facility, or patient activation measure. Significantly higher portal usage was seen among participants using high-speed broadband at home, greater self-reported ability using the Internet, and routinely going online. By 18 months, 91% participants had logged in to the portal, and no significant associations were found between usage and demographics, health status, or patient activation. When examining portal activity between 6 and 18 months, patients who were infrequent or high portal users remained in those categories, respectively. Short-term and long-term portal usage was associated with having broadband at home, high self-rated ability when using the Internet, and overall online behavior. Digital inclusion, or ready access to the Internet and digital skills, appears to be a social determinant in patient exposure to portal services. ©Susan S Woods, Christopher W Forsberg, Erin C Schwartz, Kim M Nazi, Judith H Hibbard, Thomas K Houston, Martha Gerrity. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.10.2017.

The strategy of fusion genes construction determines efficient expression of introduced transcription factors.

PubMed

Adamus, Tomasz; Konieczny, Paweł; Sekuła, Małgorzata; Sułkowski, Maciej; Majka, Marcin

2014-01-01

The main goal in gene therapy and biomedical research is an efficient transcription factors (TFs) delivery system. SNAIL, a zinc finger transcription factor, is strongly involved in tumor, what makes its signaling pathways an interesting research subject. The necessity of tracking activation of intracellular pathways has prompted fluorescent proteins usage as localization markers. Advanced molecular cloning techniques allow to generate fusion proteins from fluorescent markers and transcription factors. Depending on fusion strategy, the protein expression levels and nuclear transport ability are significantly different. The P2A self-cleavage motif through its cleavage ability allows two single proteins to be simultaneously expressed. The aim of this study was to compare two strategies for introducing a pair of genes using expression vector system. We have examined GFP and SNAI1 gene fusions by comprising common nucleotide polylinker (multiple cloning site) or P2A motif in between them, resulting in one fusion or two independent protein expressions respectively. In each case transgene expression levels and translation efficiency as well as nuclear localization of expressed protein have been analyzed. Our data showed that usage of P2A motif provides more effective nuclear transport of SNAIL transcription factor than conventional genes linker. At the same time the fluorescent marker spreads evenly in subcellular space.

Formation of readiness for future physics teachers by using interactive learning tools

NASA Astrophysics Data System (ADS)

Kulikova, N. U.; Danilchuk, E. V.; Zhidkova, A. V.

2017-01-01

In this article we give the reviewing of approaches to the preparedness of future physics teachers for the usage of interactive means of education as an important part of their professional activity. We discuss the key concepts such as interactivity, an interactive dialogue, and interactive means of education. The conception of interactive means of education as a tool of teachers' professional activity, which provides a way for the students to intensify their learning in class by using interactive tools and electronic educational resources, is validated. Furthermore, it is proved that interactive means of education allow the students to intensify their learning in the course of an interactive dialogue by means of organization different types of feedback in electronic educational resources (the program behavior depending on a user actions in the form of comments, prompts, elements of arrangement of objects, etc, the control and correction of students' actions by the program, providing with recommendations for further learning, carrying out constant access to reference information, etc), involving in different types of educational activity (modeling, investigation, etc), self-selection of time, speed, content of learning, complexity and priority of the usage of educational information on the screen, etc. By training students - future teachers of physics authors consider technological aspects, methodical features and examples of creation of these resources for physics lesson.

Dicotyledon Weed Quantification Algorithm for Selective Herbicide Application in Maize Crops.

PubMed

Laursen, Morten Stigaard; Jørgensen, Rasmus Nyholm; Midtiby, Henrik Skov; Jensen, Kjeld; Christiansen, Martin Peter; Giselsson, Thomas Mosgaard; Mortensen, Anders Krogh; Jensen, Peter Kryger

2016-11-04

The stricter legislation within the European Union for the regulation of herbicides that are prone to leaching causes a greater economic burden on the agricultural industry through taxation. Owing to the increased economic burden, research in reducing herbicide usage has been prompted. High-resolution images from digital cameras support the studying of plant characteristics. These images can also be utilized to analyze shape and texture characteristics for weed identification. Instead of detecting weed patches, weed density can be estimated at a sub-patch level, through which even the identification of a single plant is possible. The aim of this study is to adapt the monocot and dicot coverage ratio vision (MoDiCoVi) algorithm to estimate dicotyledon leaf cover, perform grid spraying in real time, and present initial results in terms of potential herbicide savings in maize. The authors designed and executed an automated, large-scale field trial supported by the Armadillo autonomous tool carrier robot. The field trial consisted of 299 maize plots. Half of the plots (parcels) were planned with additional seeded weeds; the other half were planned with naturally occurring weeds. The in-situ evaluation showed that, compared to conventional broadcast spraying, the proposed method can reduce herbicide usage by 65% without measurable loss in biological effect.

Dicotyledon Weed Quantification Algorithm for Selective Herbicide Application in Maize Crops

PubMed Central

Laursen, Morten Stigaard; Jørgensen, Rasmus Nyholm; Midtiby, Henrik Skov; Jensen, Kjeld; Christiansen, Martin Peter; Giselsson, Thomas Mosgaard; Mortensen, Anders Krogh; Jensen, Peter Kryger

2016-01-01

The stricter legislation within the European Union for the regulation of herbicides that are prone to leaching causes a greater economic burden on the agricultural industry through taxation. Owing to the increased economic burden, research in reducing herbicide usage has been prompted. High-resolution images from digital cameras support the studying of plant characteristics. These images can also be utilized to analyze shape and texture characteristics for weed identification. Instead of detecting weed patches, weed density can be estimated at a sub-patch level, through which even the identification of a single plant is possible. The aim of this study is to adapt the monocot and dicot coverage ratio vision (MoDiCoVi) algorithm to estimate dicotyledon leaf cover, perform grid spraying in real time, and present initial results in terms of potential herbicide savings in maize. The authors designed and executed an automated, large-scale field trial supported by the Armadillo autonomous tool carrier robot. The field trial consisted of 299 maize plots. Half of the plots (parcels) were planned with additional seeded weeds; the other half were planned with naturally occurring weeds. The in-situ evaluation showed that, compared to conventional broadcast spraying, the proposed method can reduce herbicide usage by 65% without measurable loss in biological effect. PMID:27827908

Testing the causal theory of reference.

PubMed

Domaneschi, Filippo; Vignolo, Massimiliano; Di Paola, Simona

2017-04-01

Theories of reference are a crucial research topic in analytic philosophy. Since the publication of Kripke's Naming and Necessity, most philosophers have endorsed the causal/historical theory of reference. The goal of this paper is twofold: (i) to discuss a method for testing experimentally the causal theory of reference for proper names by investigating linguistic usage and (ii) to present the results from two experiments conducted with that method. Data collected in our experiments confirm the causal theory of reference for people proper names and for geographical proper names. A secondary but interesting result is that the semantic domain affects reference assignment: while with people proper names speakers tend to assign the semantic reference, with geographical proper names they are prompted to assign the speaker's reference. Copyright © 2016 Elsevier B.V. All rights reserved.

First test of the prompt gamma ray timing method with heterogeneous targets at a clinical proton therapy facility

NASA Astrophysics Data System (ADS)

Hueso-González, Fernando; Enghardt, Wolfgang; Fiedler, Fine; Golnik, Christian; Janssens, Guillaume; Petzoldt, Johannes; Prieels, Damien; Priegnitz, Marlen; Römer, Katja E.; Smeets, Julien; Vander Stappen, François; Wagner, Andreas; Pausch, Guntram

2015-08-01

Ion beam therapy promises enhanced tumour coverage compared to conventional radiotherapy, but particle range uncertainties significantly blunt the achievable precision. Experimental tools for range verification in real-time are not yet available in clinical routine. The prompt gamma ray timing method has been recently proposed as an alternative to collimated imaging systems. The detection times of prompt gamma rays encode essential information about the depth-dose profile thanks to the measurable transit time of ions through matter. In a collaboration between OncoRay, Helmholtz-Zentrum Dresden-Rossendorf and IBA, the first test at a clinical proton accelerator (Westdeutsches Protonentherapiezentrum Essen, Germany) with several detectors and phantoms is performed. The robustness of the method against background and stability of the beam bunch time profile is explored, and the bunch time spread is characterized for different proton energies. For a beam spot with a hundred million protons and a single detector, range differences of 5 mm in defined heterogeneous targets are identified by numerical comparison of the spectrum shape. For higher statistics, range shifts down to 2 mm are detectable. A proton bunch monitor, higher detector throughput and quantitative range retrieval are the upcoming steps towards a clinically applicable prototype. In conclusion, the experimental results highlight the prospects of this straightforward verification method at a clinical pencil beam and settle this novel approach as a promising alternative in the field of in vivo dosimetry.

Effect of a Quality Improvement Intervention With Daily Round Checklists, Goal Setting, and Clinician Prompting on Mortality of Critically Ill Patients: A Randomized Clinical Trial.

PubMed

Cavalcanti, Alexandre B; Bozza, Fernando Augusto; Machado, Flavia R; Salluh, Jorge I F; Campagnucci, Valquiria Pelisser; Vendramim, Patricia; Guimaraes, Helio Penna; Normilio-Silva, Karina; Damiani, Lucas Petri; Romano, Edson; Carrara, Fernanda; Lubarino Diniz de Souza, Juliana; Silva, Aline Reis; Ramos, Grazielle Viana; Teixeira, Cassiano; Brandão da Silva, Nilton; Chang, Chung-Chou H; Angus, Derek C; Berwanger, Otavio

2016-04-12

The effectiveness of checklists, daily goal assessments, and clinician prompts as quality improvement interventions in intensive care units (ICUs) is uncertain. To determine whether a multifaceted quality improvement intervention reduces the mortality of critically ill adults. This study had 2 phases. Phase 1 was an observational study to assess baseline data on work climate, care processes, and clinical outcomes, conducted between August 2013 and March 2014 in 118 Brazilian ICUs. Phase 2 was a cluster randomized trial conducted between April and November 2014 with the same ICUs. The first 60 admissions of longer than 48 hours per ICU were enrolled in each phase. Intensive care units were randomized to a quality improvement intervention, including a daily checklist and goal setting during multidisciplinary rounds with follow-up clinician prompting for 11 care processes, or to routine care. In-hospital mortality truncated at 60 days (primary outcome) was analyzed using a random-effects logistic regression model, adjusted for patients' severity and the ICU's baseline standardized mortality ratio. Exploratory secondary outcomes included adherence to care processes, safety climate, and clinical events. A total of 6877 patients (mean age, 59.7 years; 3218 [46.8%] women) were enrolled in the baseline (observational) phase and 6761 (mean age, 59.6 years; 3098 [45.8%] women) in the randomized phase, with 3327 patients enrolled in ICUs (n = 59) assigned to the intervention group and 3434 patients in ICUs (n = 59) assigned to routine care. There was no significant difference in in-hospital mortality between the intervention group and the usual care group, with 1096 deaths (32.9%) and 1196 deaths (34.8%), respectively (odds ratio, 1.02; 95% CI, 0.82-1.26; P = .88). Among 20 prespecified secondary outcomes not adjusted for multiple comparisons, 6 were significantly improved in the intervention group (use of low tidal volumes, avoidance of heavy sedation, use of central venous catheters, use of urinary catheters, perception of team work, and perception of patient safety climate), whereas there were no significant differences between the intervention group and the control group for 14 outcomes (ICU mortality, central line-associated bloodstream infection, ventilator-associated pneumonia, urinary tract infection, mean ventilator-free days, mean ICU length of stay, mean hospital length of stay, bed elevation to ≥30°, venous thromboembolism prophylaxis, diet administration, job satisfaction, stress reduction, perception of management, and perception of working conditions). Among critically ill patients treated in ICUs in Brazil, implementation of a multifaceted quality improvement intervention with daily checklists, goal setting, and clinician prompting did not reduce in-hospital mortality. clinicaltrials.gov Identifier: NCT01785966.

Qualitative study of factors associated with antimicrobial usage in seven small animal veterinary practices in the UK.

PubMed

Mateus, Ana L P; Brodbelt, David C; Barber, Nick; Stärk, Katharina D C

2014-11-01

Responsible use of antimicrobials by veterinarians is essential to contain antimicrobial resistance in pathogens relevant to public health. Inappropriate antimicrobial use has been previously described in practice. However, there is scarce information on factors influencing antimicrobial usage in dogs and cats. We investigated intrinsic and extrinsic factors influencing decision-making of antimicrobial usage in first opinion small animal practices in the UK through the application of qualitative research methods. Semi-structured interviews were conducted with 21 veterinarians from seven veterinary first opinion practices in the UK in 2010. Topics investigated included: a) criteria used for selection of antimicrobials, b) influences by colleagues, c) influences by clients, d) pet characteristics, e) sources of knowledge, f) awareness of guidelines and g) protocols implemented in practice that may affect antimicrobial usage by veterinarians. Hypothetical scenarios selected to assess appropriateness of antimicrobial usage were: a) vomiting in a Yorkshire Terrier due to dietary indiscretion, b) deep pyoderma in a Shar-Pei, c) Feline Lower Urinary Tract disease in an 7 year-old male neutered cat and d) neutering of a 6-months dog. Interviews were recorded and transcribed by the interviewer. Thematic analysis was used to analyse content of transcribed interviews. Data management and analysis was conducted with qualitative analysis software NVivo8 (QSR International Pty Ltd). Antimicrobial usage by participants was influenced by factors other than clinical evidence and scientific knowledge. Intrinsic factors included veterinarian's preference of substances and previous experience. Extrinsic factors influencing antimicrobial selection were; perceived efficacy, ease of administration of formulations, perceived compliance, willingness and ability to treat by pet owners, and animal characteristics. Cost of therapy was only perceived as an influential factor in low, mixed socioeconomic areas. Veterinarians had limited awareness of current recommendations for responsible use in small animal practice. Social norms, particularly verbally agreed protocols influenced veterinarians. Inappropriate antimicrobial usage was identified in the therapy of non-infectious diseases and prophylaxis of routine clean surgical procedures. Discussion of clinical cases with peers and effectiveness meetings in the workplace were useful to veterinarians to share scientific knowledge. Effectiveness meetings can be a common ground for veterinarians to discuss and agree protocols for clinical conditions and surgical procedures. Protocols should be evidence-based, follow current recommendations and take into account the resources available in the workplace. Targeted training of veterinarians in the workplace with peer support should be used to promote responsible antimicrobial usage. Copyright © 2014 Elsevier B.V. All rights reserved.

Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use

PubMed Central

Johnson, Kevin B; Lorenzi, Nancy M

2011-01-01

Objective The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites. Materials and Methods The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times. Results HIE-related workflow was modeled for each ED site and ambulatory clinic group and substantial site-to-site workflow differences were identified. Common patterns in HIE-related workflow were also identified across all sites, leading to the development of two role-based workflow models: nurse based and physician based. The workflow elements framework was applied to the two role-based patterns. An in-depth description was developed of how providers integrated HIE into existing clinical workflow, including prompts for HIE use. Discussion Workflow differed substantially among sites, but two general role-based HIE usage models were identified. Although providers used HIE to improve continuity of patient care, patient–provider trust played a significant role. Types of information retrieved related to roles, with nurses seeking to retrieve recent hospitalization data and more open-ended usage by nurse practitioners and physicians. User and role-specific customization to accommodate differences in workflow and information needs may increase the adoption and use of HIE. Conclusion Understanding end users' perspectives towards HIE technology is crucial to the long-term success of HIE. By applying qualitative methods, an in-depth understanding of HIE usage was developed. PMID:22003156

Impact of routine cerebral CT angiography on treatment decisions in infective endocarditis.

PubMed

Meshaal, Marwa Sayed; Kassem, Hussein Heshmat; Samir, Ahmad; Zakaria, Ayman; Baghdady, Yasser; Rizk, Hussein Hassan

2015-01-01

Infective endocarditis (IE) is commonly complicated by cerebral embolization and hemorrhage secondary to intracranial mycotic aneurysms (ICMAs). These complications are associated with poor outcome and may require diagnostic and therapeutic plans to be modified. However, routine screening by brain CT and CT angiography (CTA) is not standard practice. We aimed to study the impact of routine cerebral CTA on treatment decisions for patients with IE. From July 2007 to December 2012, we prospectively recruited 81 consecutive patients with definite left-sided IE according to modified Duke's criteria. All patients had routine brain CTA conducted within one week of admission. All patients with ICMA underwent four-vessel conventional angiography. Invasive treatment was performed for ruptured aneurysms, aneurysms ≥ 5 mm, and persistent aneurysms despite appropriate therapy. Surgical clipping was performed for leaking aneurysms if not amenable to intervention. The mean age was 30.43 ± 8.8 years and 60.5% were males. Staph aureus was the most common organism (32.3%). Among the patients, 37% had underlying rheumatic heart disease, 26% had prosthetic valves, 23.5% developed IE on top of a structurally normal heart and 8.6% had underlying congenital heart disease. Brain CT/CTA revealed that 51 patients had evidence of cerebral embolization, of them 17 were clinically silent. Twenty-six patients (32%) had ICMA, of whom 15 were clinically silent. Among the patients with ICMAs, 11 underwent endovascular treatment and 2 underwent neurovascular surgery. The brain CTA findings prompted different treatment choices in 21 patients (25.6%). The choices were aneurysm treatment before cardiac surgery rather than at follow-up, valve replacement by biological valve instead of mechanical valve, and withholding anticoagulation in patients with prosthetic valve endocarditis for fear of aneurysm rupture. Routine brain CT/CTA resulted in changes in the treatment plan in a significant proportion of patients with IE, even those without clinically evident neurological disease. Routine brain CT/CTA may be indicated in all hospitalized patients with IE.

Perioperative considerations for the patient with asthma and bronchospasm.

PubMed

Woods, B D; Sladen, R N

2009-12-01

The incidence of asthma is increasing worldwide, but morbidity and mortality are decreasing because of improvements in medical care. Although the incidence of severe perioperative bronchospasm is relatively low in asthmatics undergoing anaesthesia, when it does occur it may be life-threatening. The keys to an uncomplicated perioperative course are assiduous attention to detail in preoperative assessment, and maintenance of the anti-inflammatory and bronchodilatory regimens through the perioperative period. Potential trigger agents should be identified and avoided. Many routinely used anaesthetic agents have an ameliorative effect on airway constriction. Nonetheless, acute bronchospasm can still occur, especially at induction and emergence, and should be promptly and methodically managed.

Emergency management of heat exchanger leak on cardiopulmonary bypass with hypothermia.

PubMed

Gukop, P; Tiezzi, A; Mattam, K; Sarsam, M

2015-11-01

Heat exchanger leak on cardiopulmonary bypass is very rare, but serious. The exact incidence is not known. It is an emergency associated with the potential risk of blood contamination, air embolism and haemolysis, difficulty with re-warming, acidosis, subsequent septic shock, multi-organ failure and death. We present a prompt, highly co-ordinated algorithm for the successful management of this important rare complication. There is need for further research to look for safety devices that detect leaks and techniques to reduce bacterial load. It is essential that teams practice oxygenator change-out routines and have a well-established change-out protocol. © The Author(s) 2015.

Laboratory Assays in Evaluation of Lynch Syndrome in Patients with Endometrial Carcinoma.

PubMed

Djordjevic, Bojana; Broaddus, Russell R

2016-06-01

This article reviews the main tissue testing modalities for Lynch Syndrome in the pathology laboratory, such as immunohistochemistry and PCR based analyses, and discusses their routine application, interpretation pitfalls, and troubleshooting of common technical performance issues. Discrepancies between laboratory and genetic testing may arise, and are examined in the context of the complexity of molecular abnormalities associated with Lynch Syndrome. The merits of targeted versus universal screening in a changing healthcare climate are addressed. In the absence of comprehensive screening programs, specific tumor topography and histological features that may prompt pathologist-initiated molecular tumor testing are outlined. Copyright © 2016 Elsevier Inc. All rights reserved.

Training and generalization of laundry skills: a multiple probe evaluation with handicapped persons.

PubMed Central

Thompson, T J; Braam, S J; Fugua, R W

1982-01-01

An instructional procedure composed of a graded sequence of prompts and token reinforcement was used to train a complex chain of behaviors which included sorting, washing, and drying clothes. A multiple probe design with sequential instruction across seven major components of the laundering routine was used to demonstrate experimental control. Students were taught to launder clothing using machines located in their school and generalization was assessed later on machines located in the public laundromat. A comparison of students' laundry skills with those of normal peers indicated similar levels of proficiency. Follow-up probes demonstrated maintenance of laundry skills over a 10-month period. PMID:7096228

Training and generalization of laundry skills: a multiple probe evaluation with handicapped persons.

PubMed

Thompson, T J; Braam, S J; Fugua, R W

1982-01-01

An instructional procedure composed of a graded sequence of prompts and token reinforcement was used to train a complex chain of behaviors which included sorting, washing, and drying clothes. A multiple probe design with sequential instruction across seven major components of the laundering routine was used to demonstrate experimental control. Students were taught to launder clothing using machines located in their school and generalization was assessed later on machines located in the public laundromat. A comparison of students' laundry skills with those of normal peers indicated similar levels of proficiency. Follow-up probes demonstrated maintenance of laundry skills over a 10-month period.

On being green: can flow chemistry help?

PubMed

Ley, Steven V

2012-08-01

The principles of Green Chemistry are important but challenging drivers for most modern synthesis programs. To meet these challenges new flow chemistry tools are proving to be very effective by providing improved heat/mass transfer opportunities, lower solvent usage, less waste generation, hazardous compound containment, and the possibility of a 24/7 working regime. This machine-assisted approach can be used to effect repetitive or routine scale-up steps or when combined with reagent and scavenger cartridges, to achieve multi-step synthesis of complex natural products and pharmaceutical agents. Copyright © 2012 The Japan Chemical Journal Forum and Wiley Periodicals, Inc.

OSCAR4: a flexible architecture for chemical text-mining

PubMed Central

2011-01-01

The Open-Source Chemistry Analysis Routines (OSCAR) software, a toolkit for the recognition of named entities and data in chemistry publications, has been developed since 2002. Recent work has resulted in the separation of the core OSCAR functionality and its release as the OSCAR4 library. This library features a modular API (based on reduction of surface coupling) that permits client programmers to easily incorporate it into external applications. OSCAR4 offers a domain-independent architecture upon which chemistry specific text-mining tools can be built, and its development and usage are discussed. PMID:21999457

[Evaluation of a context sensitive system for intra-operative usage of the electronic patient record].

PubMed

Dressler, C R; Fischer, M; Burgert, O; Strauß, G

2012-06-01

This article analyzes the usage of an electronic patient record (EPR), which may be accessed intra-operatively by the surgeon. The focus lies on the automatic prioritization of documents to dramatically reduce the surgeon's interaction with the EPR system. An EPR system has been developed, which displays documents in accordance to the current procedure. The system is controlled by a foot switch and the documents are displayed on a large-scale screen in the operating room. The usage of the system by 2 surgeons has been recorded in clinical routine. 55 surgical procedures have been recorded. The EPR system has been used 2 times per procedure in average for surgeries at the middle ear, for surgeries of the paranasal sinuses, it has been used 1.3 times per procedure. The EPR-system has been used pre-operatively in 58% of cases. The surgeons did not have to interact with the EPR system for more than the half of the procedures to view the desired document. The existence of digitized documents in a clinic does not automatically lead to improved workflows. The evaluated EPR system presented the patient data in a simple and comfortable way. The extensive pre-operative usage had not been expected. Because of the low barrier to view patient data, higher patient safety may be assumed. On the other hand, the surgeon could be encouraged to skip the important preparation before the procedure. Due to the low pervasiveness of medical communication standards at this time, the integrated connection between clinic IT and an EPR system would nowadays only be possible by great efforts. © Georg Thieme Verlag KG Stuttgart · New York.

Prevailing practices in the use of antibiotics by dairy farmers in Eastern Haryana region of India

PubMed Central

Kumar, Vikash; Gupta, Jancy

2018-01-01

Aim: The aim of the study was to assess the antibiotic use in dairy animals and to trace its usage pattern among the small, medium, and large dairy farmers in Eastern Haryana region of India. Materials and Methods: Karnal and Kurukshetra districts from Eastern region of Haryana state were purposively selected, and four villages from each district were selected randomly. From each village, 21 farmers were selected using stratified random sampling by categorizing into small, medium, and large farmers constituting a total of 168 farmers as respondents. An antibiotic usage index (AUI) was developed to assess usage of antibiotics by dairy farmers. Results: Frequency of veterinary consultancy was high among large dairy farmers, and they mostly preferred veterinarians over para-veterinarians for treatment of dairy animals. Small farmers demanded low-cost antibiotics from veterinarians whereas large farmers rarely went for it. Antibiotics were used maximum for therapeutic purposes by all categories of farmers. Completion of treatment schedules and follow-up were strictly practiced by the majority of large farmers. AUI revealed that large farmers were more consistent on decision-making about prudent use of antibiotics. Routine use of antibiotics after parturition to prevent disease and sale of milk without adhering to withdrawal period was responsible for aggravating the antibiotic resistance. The extent of antibiotic use by small farmers depended on the severity of disease. The large farmers opted for the prophylactic use of antibiotics at the herd level. Conclusion: Antibiotic usage practices were judicious among large dairy farmers, moderately prudent by medium dairy farmers and faulty by small farmers. The frequency of veterinary consultancy promoted better veterinary-client relationship among large farmers. PMID:29657416

Effect of routine mental health screening in a low-resource pediatric primary care population.

PubMed

Berger-Jenkins, Evelyn; McCord, Mary; Gallagher, Trish; Olfson, Mark

2012-04-01

Despite evidence for its feasibility, the usage of mental health screening in primary care practices with overburdened providers and few referral options remains unclear. This study explores the effects of routine screening on mental health problem identification and management in a low-resource setting. Medical records of 5 to 12 year-old children presenting for well visits before and after screening was implemented were reviewed. Multivariate logistic regression was used to explore associations between study period and identification/management practices. Changes in the number of visits and wait times for a co-located referral service were assessed post hoc. Parents disclosed more mental health problems, and providers initiated more workups but referred fewer patients after screening was implemented. The proportion of new visits and wait times for the referral service did not change. Even in low-resource settings, screening may facilitate parental disclosure and increase clinical attention to mental health problems without overburdening referral services.

Magic and Misdirection: The Influence of Social Cues on the Allocation of Visual Attention While Watching a Cups-and-Balls Routine

PubMed Central

Hergovich, Andreas; Oberfichtner, Bernhard

2016-01-01

In recent years, a body of research that regards the scientific study of magic performances as a promising method of investigating psychological phenomena in an ecologically valid setting has emerged. Seemingly contradictory findings concerning the ability of social cues to strengthen a magic trick’s effectiveness have been published. In this experiment, an effort was made to disentangle the unique influence of different social and physical triggers of attentional misdirection on observers’ overt and covert attention. The ability of 120 participants to detect the mechanism of a cups-and-balls trick was assessed, and their visual fixations were recorded using an eye-tracker while they were watching the routine. All the investigated techniques of misdirection, including sole usage of social cues, were shown to increase the probability of missing the trick mechanism. Depending on the technique of misdirection used, very different gaze patterns were observed. A combination of social and physical techniques of misdirection influenced participants’ overt attention most effectively. PMID:27303327

Vaccine wastage in Nigeria: An assessment of wastage rates and related vaccinator knowledge, attitudes and practices.

PubMed

Wallace, Aaron S; Willis, Fred; Nwaze, Eric; Dieng, Boubacar; Sipilanyambe, Naawa; Daniels, Danni; Abanida, Emmanuel; Gasasira, Alex; Mahmud, Mustapha; Ryman, Tove K

2017-12-04

The introduction of new vaccines highlights concerns about high vaccine wastage, knowledge of wastage policies and quality of stock management. However, an emphasis on minimizing wastage rates may cause confusion when recommendations are also being made to reduce missed opportunities to routinely vaccinate children. This concern is most relevant for lyophilized vaccines without preservatives [e.g. measles-containing vaccine (MCV)], which can be used for a limited time once reconstituted. We sampled 54 health facilities within 11 local government areas (LGAs) in Nigeria and surveyed health sector personnel regarding routine vaccine usage and wastage-related knowledge and practices, conducted facility exit interviews with caregivers of children about missed opportunities for routine vaccination, and abstracted vaccine stock records and vaccination session data over a 6-month period to calculate wastage rates and vaccine vial usage patterns. Nearly half of facilities had incomplete vaccine stock data for calculating wastage rates. Among facilities with sufficient data, mean monthly facility-level wastage rates were between 18 and 35% across all reviewed vaccines, with little difference between lyophilized and liquid vaccines. Most (98%) vaccinators believed high wastage led to recent vaccine stockouts, yet only 55% were familiar with the multi-dose vial policy for minimizing wastage. On average, vaccinators reported that a minimum of six children must be present prior to opening a 10-dose MCV vial. Third dose of diphtheria-tetanus-pertussis vaccine (DTP3) was administered in 84% of sessions and MCV in 63%; however, the number of MCV and DTP3 doses administered were similar indicating the number of children vaccinated with DTP3 and MCV were similar despite less frequent MCV vaccination opportunities. Among caregivers, 30% reported being turned away for vaccination at least once; 53% of these children had not yet received the missed dose. Our findings show inadequate implementation of vaccine management guidelines, missed opportunities to vaccinate, and lyophilized vaccine wastage rates below expected rates. Missed opportunities for vaccination may occur due to how the health system's contradicting policies may force health workers to prioritize reduced wastage rates over vaccine administration, particularly for multi-dose vials. Published by Elsevier Ltd.

Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: Results from an international survey.

PubMed

Huysentruyt, Koen; Hulst, Jessie; Bian, Feifei; Shamir, Raanan; White, Melinda; Galera-Martinez, Raphael; Morais-Lopez, Anna; Kansu, Aydan; Gerasimidis, Konstantinos

2018-04-05

Lack of consensus on clinical indicators for the assessment of pediatric disease associated malnutrition (DAM) may explain its under-recognition in clinical practice. This study surveyed the opinions of health professionals (HP) on clinical indicators of DAM and barriers impeding routine nutritional screening in children. Web-based questionnaire survey (April 2013-August 2015) in Australia, Belgium, Israel, Spain, The Netherlands, Turkey and UK. There were 937 questionnaires returned via local professional associations, of which 693 respondents fulfilled the inclusion criteria and were included in the final analysis; 315 pediatric gastroenterologists and 378 pediatric dieticians. The most important clinical indicators of DAM were ongoing weight loss (80.4%), increased energy/nutrient losses (73.0%), suboptimal energy/macronutrient intake (68.6%), a high nutritional risk condition (67.2%) and increased energy/nutrient requirements (66.2%). These findings were consistent across countries and professions. The most common approach to screen for DAM was assessment of weight changes (85%), followed by the usage of growth charts (77-80%). Common perceived barriers for routine nutritional screening/assessment were low staff awareness (47.5%), no local policy or guidelines (33.4%) and lack of time to screen (33.4%). HP who routinely assess and treat children with DAM identified ongoing weight loss, increased losses, increased requirements, low intake and high nutritional risk conditions as the most important clinical indicators of DAM. These clinical indicators should now serve as a basis to form clinical-based criteria for the identification of DAM in routine clinical practice. Low awareness, lack of guidelines or local policy and lack of resources were the most important barriers of routine screening. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Sharing electronic structure and crystallographic data with ETSF_IO

NASA Astrophysics Data System (ADS)

Caliste, D.; Pouillon, Y.; Verstraete, M. J.; Olevano, V.; Gonze, X.

2008-11-01

We present a library of routines whose main goal is to read and write exchangeable files (NetCDF file format) storing electronic structure and crystallographic information. It is based on the specification agreed inside the European Theoretical Spectroscopy Facility (ETSF). Accordingly, this library is nicknamed ETSF_IO. The purpose of this article is to give both an overview of the ETSF_IO library and a closer look at its usage. ETSF_IO is designed to be robust and easy to use, close to Fortran read and write routines. To facilitate its adoption, a complete documentation of the input and output arguments of the routines is available in the package, as well as six tutorials explaining in detail various possible uses of the library routines. Catalogue identifier: AEBG_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEBG_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Gnu Lesser General Public License No. of lines in distributed program, including test data, etc.: 63 156 No. of bytes in distributed program, including test data, etc.: 363 390 Distribution format: tar.gz Programming language: Fortran 95 Computer: All systems with a Fortran95 compiler Operating system: All systems with a Fortran95 compiler Classification: 7.3, 8 External routines: NetCDF, http://www.unidata.ucar.edu/software/netcdf Nature of problem: Store and exchange electronic structure data and crystallographic data independently of the computational platform, language and generating software Solution method: Implement a library based both on NetCDF file format and an open specification (http://etsf.eu/index.php?page=standardization)

Diagnostic imaging for chronic orofacial pain, maxillofacial osseous and soft tissue pathology and temporomandibular disorders.

PubMed

Shintaku, Werner; Enciso, Reyes; Broussard, Jack; Clark, Glenn T

2006-08-01

Since dentists can be faced by unusual cases during their professional life, this article reviews the common orofacial disorders that are of concern to a dentist trying to diagnose the source of pain or dysfunction symptoms, providing an overview of the essential knowledge and usage of nowadays available advanced diagnostic imaging modalities. In addition to symptom-driven diagnostic dilemmas, where such imaging is utilized, occasionally there are asymptomatic anomalies discovered by routine clinical care and/or on dental or panoramic images that need more discussion. The correct selection criteria of an image exam should be based on the individual characteristics of the patient, and the type of imaging technique should be selected depending on the specific clinical problem, the kind of tissue to be visualized, the information obtained from the imaging modality, radiation exposure, and the cost of the examination. The usage of more specialized imaging modalities such as magnetic resonance imaging, computed tomography, ultrasound, as well as single photon computed tomography, positron electron tomography, and their hybrid machines, SPECT/ CT and PET/CT, are discussed.

Gorlin-Goltz syndrome: incidental finding on routine ct scan following car accident.

PubMed

Kalogeropoulou, Christina; Zampakis, Petros; Kazantzi, Santra; Kraniotis, Pantelis; Mastronikolis, Nicholas S

2009-11-25

Gorlin-Goltz syndrome is a rare hereditary disease. Pathogenesis of the syndrome is attributed to abnormalities in the long arm of chromosome 9 (q22.3-q31) and loss or mutations of human patched gene (PTCH1 gene). Multiple basal cell carcinomas (BCCs), odontogenic keratocysts, skeletal abnormalities, hyperkeratosis of palms and soles, intracranial ectopic calcifications of the falx cerebri and facial dysmorphism are considered the main clinical features. Diagnosis is based upon established major and minor clinical and radiological criteria and ideally confirmed by DNA analysis. Because of the different systems affected, a multidisciplinary approach team of various experts is required for a successful management. We report the case of a 19 year-old female who was involved in a car accident and found to present imaging findings of Gorlin-Goltz syndrome during a routine whole body computed tomography (CT) scan in order to exclude traumatic injuries. Radiologic findings of the syndrome are easily identifiable on CT scans and may prompt to early verification of the disease, which is very important for regular follow-up and better survival rates from the co-existent diseases.

Appendiceal mass: Is interval appendicectomy “something of the past”?

PubMed Central

Meshikhes, Abdul-Wahed Nasir

2011-01-01

The need for interval appendicectomy (I.A) after successful conservative management of appendiceal mass has recently been questioned. Furthermore, emergency appendicectomy for appendiceal mass is increasingly performed with equal success and safety to that performed in non-mass forming acute appendicitis. There is an increasing volume of evidence -although mostly retrospective- that if traditional conservative management is adopted, there is no need for routine I.A except for a small number of patients who continue to develop recurrent symptoms. On the other hand, the routine adoption of emergency laparoscopic appendicectomy (LA) in patients presenting with appendiceal mass obviates the need for a second admission and an operation for I.A with a considerable complication rate. It also abolishes misdiagnoses and deals promptly with any unexpected ileo-cecal pathology. Moreover, it may prove to be more cost-effective than conservative treatment even without I.A due to a much shorter hospital stay and a shorter period of intravenous antibiotic administration. If emergency LA is to become the standard of care for appendiceal mass, I.A will certainly become ‘something’ of the past. PMID:21799642

Children's understanding of and motivations for toothbrushing: a qualitative study.

PubMed

Gill, P; Stewart, K; Chetcuti, D; Chestnutt, I G

2011-02-01

To explore children's understanding of why they do or do not brush their teeth and their motivations for toothbrushing. Individual semi-structured interviews were conducted with 66 children aged 6-7 years and 10-11 years in four purposively selected primary schools in Cardiff, UK. Data were analysed using a constructive process of Thematic Content Analysis and techniques of open and selective coding. While a routine activity, toothbrushing was prompted rather than monitored by parents and easily fell by the wayside because of tiredness, excitement or distraction. Rationalizations for toothbrushing were poorly formed in the children's accounts and related to 'doom scenarios' such as teeth falling out, or to issues of personal grooming and cleanliness rather than caries prevention. Electric (powered) toothbrushes were popular and had engaged the children's interest. Social and domestic circumstances, such as when children stayed with different parents at different times, impacted on toothbrushing routines. This study has revealed information that is of value in directing oral health education messages, oral health promotion programmes and has identified issues that potentially affect compliance with toothbrushing that merit further investigation. © 2010 John Wiley & Sons A/S.

The Added Value of Log File Analyses of the Use of a Personal Health Record for Patients With Type 2 Diabetes Mellitus

PubMed Central

Kelders, Saskia M.; Braakman-Jansen, Louise M. A.; van Gemert-Pijnen, Julia E. W. C.

2014-01-01

The electronic personal health record (PHR) is a promising technology for improving the quality of chronic disease management. Until now, evaluations of such systems have provided only little insight into why a particular outcome occurred. The aim of this study is to gain insight into the navigation process (what functionalities are used, and in what sequence) of e-Vita, a PHR for patients with type 2 diabetes mellitus (T2DM), to increase the efficiency of the system and improve the long-term adherence. Log data of the first visits in the first 6 weeks after the release of a renewed version of e-Vita were analyzed to identify the usage patterns that emerge when users explore a new application. After receiving the invitation, 28% of all registered users visited e-Vita. In total, 70 unique usage patterns could be identified. When users visited the education service first, 93% of all users ended their session. Most users visited either 1 or 5 or more services during their first session, but the distribution of the routes was diffuse. In conclusion, log file analyses can provide valuable prompts for improving the system design of a PHR. In this way, the match between the system and its users and the long-term adherence has the potential to increase. PMID:24876574

Nurses' guide to early detection of umbilical arterial catheter complications in infants.

PubMed

Furdon, Susan Arana; Horgan, Michael J; Bradshaw, Wanda Todd; Clark, David A

2006-10-01

Umbilical arterial catheters (UAC) are routinely used in the care of critically ill newborns. Complications related to UACs include vascular compromise, hemorrhage, complications related to malposition, severance of the catheter itself, and infection. This article is Part II in a series dedicated to assessing infants with an umbilical catheter. Part I focused on infants with umbilical venous catheters; this article will focus on the physical assessment relevant to infants with an UAC. Complications related to UACs can occur during any phase of treatment: insertion, while indwelling, or after discontinuing the catheter. Review of clinical signs of complications along with clinical photographs, will assist caregivers in promptly recognizing UAC-related complications.

Perinatal detection of familial adenomatous polyposis.

PubMed

Birsner, Meredith L; Hoover-Fong, Julie; Bytyci Telegrafi, Aida; Hueppchen, Nancy A

2012-08-01

Hepatoblastoma is an uncommon fetal neoplasm that may represent an isolated malignancy or a component of a familial cancer or syndromic diagnosis. A large fetal liver mass was detected on routine ultrasound examination of a 23-year-old woman with thyroid nodules and hypertension. Inferior vena cava compression prompted delivery; postnatal biopsy revealed hepatoblastoma. Maternal thyroid biopsy revealed papillary carcinoma. Neonatal and maternal cytomolecular analysis revealed APC gene disruption at 5q22.2. Pedigree analysis exposed multigenerational colon cancer and thyroid cancer, which in conjunction with genetic testing is consistent with familial adenomatous polyposis. This is a novel means of familial adenomatous polyposis diagnosis. Obstetricians and perinatologists should be alert for familial cancer or syndromic diagnoses presenting as fetal neoplasms.

Hematological disorders at birth in complicated monochorionic twins.

PubMed

Verbeek, Lianne; Slaghekke, Femke; Sueters, Marieke; Middeldorp, Johanna M; Klumper, Frans J; Haak, Monique C; Oepkes, Dick; Lopriore, Enrico

2017-06-01

Monochorionic twins are at risk of severe complications including twin-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS) and acute peripartum TTTS. The pathophysiology is based on inter-twin blood transfusion through placental vascular anastomoses. Areas covered: This review focuses on the incidence, management and outcome of neonatal hematological complications at birth in TTTS, TAPS and acute peripartum TTTS. Expert commentary: Hematological disorders are often present at birth in monochorionic twins and include acute or chronic anemia, polycythemia and thrombocytopenia. Routine measurement of complete blood counts in all complicated monochorionic twins is strongly recommended. Increased awareness on these disorders and correct diagnostic tests will lead to prompt and adequate management at birth.

Too many rodent carcinogens: Mitogenesis increases mutagenesis

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

Ames, B.N.; Gold, L.S.

1990-08-31

A clarification of the mechanism of carcinogenesis is developing at a rapid rate. This new understanding undermines many assumptions of current regulatory policy toward rodent carcinogens and necessitates rethinking the utility and meaning of routine animal cancer tests. At a recent watershed meeting on carcinogenesis, much evidence was presented suggesting that mitogenesis plays a dominant role in carcinogenesis. Our own rethinking of mechanism was prompted by our findings that: spontaneous DNA damage caused by endogenous oxidants is remarkably frequent and in chronic testing at the maximum tolerated dose (MTD), more than half of all chemicals tested (both natural and synthetic)more » are carcinogens in rodents, and a high percentage of these carcinogens are not mutagens.« less

A new species of myxosporean (Sphaeromyxidae), a parasite of lined seahorses, Hippocampus erectus, from the Gulf of Mexico.

PubMed

Sears, B F; Anderson, P; Greiner, E C

2011-08-01

Sphaeromyxa cannolii sp. n. is described from the bile ducts of aquaria-maintained lined seahorses (Hippocampus erectus) from the Gulf of Mexico. Spores of the new species are linear, 17-18 µm long and 5-6 µm wide, with flattened tips; polar capsules measure 4 × 3 µm. Routine necropsies of H. erectus following planned death revealed liver inflammation, bile duct obstruction, bile accumulation, and myxozoan parasites in the bile ducts of 11 of 40 animals sampled (27.5%). The presence of S. cannolii in an aquaculture setting should prompt keepers to carefully quarantine new animals and exclude annelid fauna, a potential intermediate host of myxozoans.

Insidious strut fractures in a DeBakey-Surgitool aortic valve prosthesis.

PubMed

Scott, S M; Sethi, G K; Paulson, D M; Takaro, T

1978-04-01

Recent reports of cage wear occurring in DeBakey-Surgitool aortic valve prostheses prompted us to examine with image intensification all our patients who have had this type of prosthesis implanted. One patient, who was asymptomatic, was discovered to have a prosthesis with two fractured struts. This patient's prosthetic valve was replaced successfully with a stented porcine heterograft prosthesis. Including the valve removed from this patient, 8 DeBakey-Surgitool aortic valves with structural defects have been reported to the manufacturer. In the absence of a catastrophic event, patients with valves having fractured or worn struts may be totally asymptomatic, and routine periodic roentgenographic examination may be the only way of detecting strut wear or fracture.

The role of general nuclear medicine in breast cancer

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

Greene, Lacey R, E-mail: lgreene@csu.edu.au; Wilkinson, Deborah; Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales

The rising incidence of breast cancer worldwide has prompted many improvements to current care. Routine nuclear medicine is a major contributor to a full gamut of clinical studies such as early lesion detection and stratification; guiding, monitoring, and predicting response to therapy; and monitoring progression, recurrence or metastases. Developments in instrumentation such as the high-resolution dedicated breast device coupled with the diagnostic versatility of conventional cameras have reinserted nuclear medicine as a valuable tool in the broader clinical setting. This review outlines the role of general nuclear medicine, concluding that targeted radiopharmaceuticals and versatile instrumentation position nuclear medicine as amore » powerful modality for patients with breast cancer.« less

Chromate Dermatitis from Paint

PubMed Central

Engel, H. O.; Calnan, C. D.

1963-01-01

Among 250 workers engaged on wet sandpapering of primer paint on car bodies 65 developed a contact dermatitis. The average latent period before dermatitis developed was 4·6 months: only 60% of the patients made a completely satisfactory recovery. The average duration of dermatitis was 5·3 months. Two thirds of the men used one of two barrier creams supplied, while one third used none. Routine patch testing showed that the majority was allergic to chromate. It was found that a primer paint contained zinc chromate, which had been introduced into the paint by the manufacturers shortly before the first cases occurred. Removal of chromate from the paint resulted in a prompt cessation of new cases of dermatitis. Images PMID:14046155

Current usage and future trends in gross digital photography in Canada.

PubMed

Horn, Christopher L; DeKoning, Lawrence; Klonowski, Paul; Naugler, Christopher

2014-01-14

The purpose of this study was to assess the current usage, utilization and future direction of digital photography of gross surgical specimens in pathology laboratories across Canada. An online survey consisting of 23 multiple choice and free-text questions regarding gross digital photography was sent out to via email to laboratory staff across Canada involved in gross dissection of surgical specimens. Sixty surveys were returned with representation from most of the provinces. Results showed that gross digital photography is utilized at most institutions (90.0%) and the primary users of the technology are Pathologists (88.0%), Pathologists' Assistants (54.0%) and Pathology residents (50.0%). Most respondents felt that there is a definite need for routine digital imaging of gross surgical specimens in their practice (80.0%). The top two applications for gross digital photography are for documentation of interesting/ complex cases (98.0%) and for teaching purposes (84.0%). The main limitations identified by the survey group are storage space (42.5%) and security issues (40.0%). Respondents indicated that future applications of gross digital photography mostly include teaching (96.6%), presentation at tumour boards/ clinical rounds (89.8%), medico-legal documentation (72.9%) and usage for consultation purposes (69.5%). The results of this survey indicate that pathology staff across Canada currently utilizes gross digital images for regular documentation and educational reasons. They also show that the technology will be needed for future applications in teaching, consultation and medico-legal purposes.

Defining a region of optimization based on engine usage data

DOEpatents

Jiang, Li; Lee, Donghoon; Yilmaz, Hakan; Stefanopoulou, Anna

2015-08-04

Methods and systems for engine control optimization are provided. One or more operating conditions of a vehicle engine are detected. A value for each of a plurality of engine control parameters is determined based on the detected one or more operating conditions of the vehicle engine. A range of the most commonly detected operating conditions of the vehicle engine is identified and a region of optimization is defined based on the range of the most commonly detected operating conditions of the vehicle engine. The engine control optimization routine is initiated when the one or more operating conditions of the vehicle engine are within the defined region of optimization.

SOFIP: A Short Orbital Flux Integration Program

NASA Technical Reports Server (NTRS)

Stassinopoulos, E. G.; Hebert, J. J.; Butler, E. L.; Barth, J. L.

1979-01-01

A computer code was developed to evaluate the space radiation environment encountered by geocentric satellites. The Short Orbital Flux Integration Program (SOFIP) is a compact routine of modular compositions, designed mostly with structured programming techniques in order to provide core and time economy and ease of use. The program in its simplest form produces for a given input trajectory a composite integral orbital spectrum of either protons or electrons. Additional features are available separately or in combination with the inclusion of the corresponding (optional) modules. The code is described in detail, and the function and usage of the various modules are explained. A program listing and sample outputs are attached.

Secondary radiation measurements for particle therapy applications: prompt photons produced by 4He, 12C and 16O ion beams in a PMMA target.

PubMed

Mattei, I; Bini, F; Collamati, F; De Lucia, E; Frallicciardi, P M; Iarocci, E; Mancini-Terracciano, C; Marafini, M; Muraro, S; Paramatti, R; Patera, V; Piersanti, L; Pinci, D; Rucinski, A; Russomando, A; Sarti, A; Sciubba, A; Solfaroli Camillocci, E; Toppi, M; Traini, G; Voena, C; Battistoni, G

2017-02-21

Charged particle beams are used in particle therapy (PT) to treat oncological patients due to their selective dose deposition in tissues with respect to the photons and electrons used in conventional radiotherapy. Heavy (Z  >  1) PT beams can additionally be exploited for their high biological effectiveness in killing cancer cells. Nowadays, protons and carbon ions are used in PT clinical routines. Recently, interest in the potential application of helium and oxygen beams has been growing. With respect to protons, such beams are characterized by their reduced multiple scattering inside the body, increased linear energy transfer, relative biological effectiveness and oxygen enhancement ratio. The precision of PT demands online dose monitoring techniques, crucial to improving the quality assurance of any treatment: possible patient mis-positioning and biological tissue changes with respect to the planning CT scan could negatively affect the outcome of the therapy. The beam range confined in the irradiated target can be monitored thanks to the neutral or charged secondary radiation emitted by the interactions of hadron beams with matter. Among these secondary products, prompt photons are produced by nuclear de-excitation processes, and at present, different dose monitoring and beam range verification techniques based on prompt-γ detection are being proposed. It is hence of importance to perform γ yield measurement in therapeutic-like conditions. In this paper we report on the yields of prompt photons produced by the interaction of helium, carbon and oxygen ion beams with a poly-methyl methacrylate (PMMA) beam stopping target. The measurements were performed at the Heidelberg Ion-Beam Therapy Center (HIT) with beams of different energies. An LYSO scintillator, placed at [Formula: see text] and [Formula: see text] with respect to the beam direction, was used as the photon detector. The obtained γ yields for the carbon ion beams are compared with results from the literature, while no other results from helium and oxygen beams have been published yet. A discussion on the expected resolution of a slit camera detector is presented, demonstrating the feasibility of a prompt-γ-based monitoring technique for PT treatments using helium, carbon and oxygen ion beams.

Secondary radiation measurements for particle therapy applications: prompt photons produced by 4He, 12C and 16O ion beams in a PMMA target

NASA Astrophysics Data System (ADS)

Mattei, I.; Bini, F.; Collamati, F.; De Lucia, E.; Frallicciardi, P. M.; Iarocci, E.; Mancini-Terracciano, C.; Marafini, M.; Muraro, S.; Paramatti, R.; Patera, V.; Piersanti, L.; Pinci, D.; Rucinski, A.; Russomando, A.; Sarti, A.; Sciubba, A.; Solfaroli Camillocci, E.; Toppi, M.; Traini, G.; Voena, C.; Battistoni, G.

2017-02-01

Charged particle beams are used in particle therapy (PT) to treat oncological patients due to their selective dose deposition in tissues with respect to the photons and electrons used in conventional radiotherapy. Heavy (Z  >  1) PT beams can additionally be exploited for their high biological effectiveness in killing cancer cells. Nowadays, protons and carbon ions are used in PT clinical routines. Recently, interest in the potential application of helium and oxygen beams has been growing. With respect to protons, such beams are characterized by their reduced multiple scattering inside the body, increased linear energy transfer, relative biological effectiveness and oxygen enhancement ratio. The precision of PT demands online dose monitoring techniques, crucial to improving the quality assurance of any treatment: possible patient mis-positioning and biological tissue changes with respect to the planning CT scan could negatively affect the outcome of the therapy. The beam range confined in the irradiated target can be monitored thanks to the neutral or charged secondary radiation emitted by the interactions of hadron beams with matter. Among these secondary products, prompt photons are produced by nuclear de-excitation processes, and at present, different dose monitoring and beam range verification techniques based on prompt-γ detection are being proposed. It is hence of importance to perform γ yield measurement in therapeutic-like conditions. In this paper we report on the yields of prompt photons produced by the interaction of helium, carbon and oxygen ion beams with a poly-methyl methacrylate (PMMA) beam stopping target. The measurements were performed at the Heidelberg Ion-Beam Therapy Center (HIT) with beams of different energies. An LYSO scintillator, placed at {{60}\\circ} and {{90}\\circ} with respect to the beam direction, was used as the photon detector. The obtained γ yields for the carbon ion beams are compared with results from the literature, while no other results from helium and oxygen beams have been published yet. A discussion on the expected resolution of a slit camera detector is presented, demonstrating the feasibility of a prompt-γ-based monitoring technique for PT treatments using helium, carbon and oxygen ion beams.

A methodological protocol for selecting and quantifying low-value prescribing practices in routinely collected data: an Australian case study.

PubMed

Brett, Jonathan; Elshaug, Adam G; Bhatia, R Sacha; Chalmers, Kelsey; Badgery-Parker, Tim; Pearson, Sallie-Anne

2017-05-03

Growing imperatives for safety, quality and responsible resource allocation have prompted renewed efforts to identify and quantify harmful or wasteful (low-value) medical practices such as test ordering, procedures and prescribing. Quantifying these practices at a population level using routinely collected health data allows us to understand the scale of low-value medical practices, measure practice change following specific interventions and prioritise policy decisions. To date, almost all research examining health care through the low-value lens has focused on medical services (tests and procedures) rather than on prescribing. The protocol described herein outlines a program of research funded by Australia's National Health and Medical Research Council to select and quantify low-value prescribing practices within Australian routinely collected health data. We start by describing our process for identifying and cataloguing international low-value prescribing practices. We then outline our approach to translate these prescribing practices into indicators that can be applied to Australian routinely collected health data. Next, we detail methods of using Australian health data to quantify these prescribing practices (e.g. prevalence of low-value prescribing and related costs) and their downstream health consequences. We have approval from the necessary Australian state and commonwealth human research ethics and data access committees to undertake this work. The lack of systematic and transparent approaches to quantification of low-value practices in routinely collected data has been noted in recent reviews. Here, we present a methodology applied in the Australian context with the aim of demonstrating principles that can be applied across jurisdictions in order to harmonise international efforts to measure low-value prescribing. The outcomes of this research will be submitted to international peer-reviewed journals. Results will also be presented at national and international pharmacoepidemiology and health policy forums such that other jurisdictions have guidance to adapt this methodology.

Facilitated Integrated Mood Management for adults with bipolar disorder.

PubMed

Miklowitz, David J; Price, Jonathan; Holmes, Emily A; Rendell, Jennifer; Bell, Sarah; Budge, Katie; Christensen, Jean; Wallace, Joshua; Simon, Judit; Armstrong, Neil M; McPeake, Lily; Goodwin, Guy M; Geddes, John R

2012-03-01

We describe the development of a five-session psychoeducational treatment, Facilitated Integrated Mood Management (FIMM), which contains many of the core elements of longer evidence-based psychosocial treatments for bipolar disorder. FIMM incorporated a novel mood monitoring program based on mobile phone technology. Adult patients with bipolar I and II disorders (N = 19) received six sessions (Pilot I: n = 14) or five sessions (Pilot II: n = 5) of FIMM with pharmacotherapy. Treatment facilitators were novice counselors who were trained in a three-day workshop and supervised for six months. FIMM sessions focused on identifying early signs of recurrence, maintaining regular daily and nightly routines, rehearsing mood management strategies, maintaining adherence to medications, and education about substance abuse. Patients sent daily text messages or e-mails containing ratings of their mood and sleep, and weekly messages containing self-ratings on the Quick Inventory of Depressive Symptomatology (QIDS) and the Altman Self Rating Mania Scale (ASRM). Patients also completed a weekly mood management strategies questionnaire. Of the 19 patients, 17 (89.5%) completed FIMM in an average of 9.2 ± 3.4 weeks (Pilot I) and 7.6 ± 0.9 weeks (Pilot II). Patients reported stable moods on the QIDS and ASRM over a 120-day period, and on average responded to 81% of the daily message prompts and 88% of the weekly QIDS and ASRM prompts. Facilitators maintained high levels of fidelity to the FIMM manual. Patients' knowledge of mood management strategies increased significantly between the first and last weeks of treatment. Patients with bipolar disorder can be engaged in a short program of facilitated mood management. The effects of FIMM on the course of bipolar disorder await evaluation in randomized trials. The program may be a useful adjunct to pharmacotherapy in community centers that cannot routinely administer full courses of psychosocial treatment. © 2012 John Wiley and Sons A/S.

Algorithm of first-aid management of dental trauma for medics and corpsmen.

PubMed

Zadik, Yehuda

2008-12-01

In order to fill the discrepancy between the necessity of providing prompt and proper treatment to dental trauma patients, and the inadequate knowledge among medics and corpsmen, as well as the lack of instructions in first-aid textbook and manuals, and after reviewing the dental literature, a simple algorithm for non-professional first-aid management for various injuries to hard (teeth) and soft oral tissues, is presented. The recommended management of tooth avulsion, subluxation and luxation, crown fracture and lip, tongue or gingival laceration included in the algorithm. Along with a list of after-hour dental clinics, this symptoms- and clinical-appearance-based algorithm is suited to tuck easily into a pocket for quick utilization by medics/corpsmen in an emergency situation. Although the algorithm was developed for the usage of military non-dental health-care providers, this method could be adjusted and employed in the civilian environment as well.

Study of a variable mass Atwood's machine using a smartphone

NASA Astrophysics Data System (ADS)

Lopez, Dany; Caprile, Isidora; Corvacho, Fernando; Reyes, Orfa

2018-03-01

The Atwood machine was invented in 1784 by George Atwood and this system has been widely studied both theoretically and experimentally over the years. Nowadays, it is commonplace that many experimental physics courses include both Atwood's machine and variable mass to introduce more complex concepts in physics. To study the dynamics of the masses that compose the variable Atwood's machine, laboratories typically use a smart pulley. Now, the first work that introduced a smartphone as data acquisition equipment to study the acceleration in the Atwood's machine was the one by M. Monteiro et al. Since then, there has been no further information available on the usage of smartphones in variable mass systems. This prompted us to do a study of this kind of system by means of data obtained with a smartphone and to show the practicality of using smartphones in complex experimental situations.

Rapid and simple preparation of rhodamine 6G loaded HY zeolite for highly selective nitrite detection

NASA Astrophysics Data System (ADS)

Viboonratanasri, Duangkamon; Pabchanda, Suwat; Prompinit, Panida

2018-05-01

In this study, a simple, rapid and relatively less toxic method for rhodamine 6G dye adsorption on hydrogen-form Y-type zeolite for highly selective nitrite detection was demonstrated. The adsorption behavior was described by Langmuir isotherm and the adsorption process reached the equilibrium promptly within a minute. The developed test papers characterized by fluorescence technique display high sensing performance with wide working range (0.04-20.0 mg L-1) and high selectivity. The test papers show good reproducibility with relative standard deviation (RSD) of 7% for five replicated determinations of 3 mg L-1 of nitrite. The nitrite concentration determined by using the test paper was in the same range as using ion chromatography within a 95% confidence level. The test papers offer advantages in terms of low cost and practical usage enabling them to be a promising candidate for nitrite sensor in environmental samples, food, and fertilizers.

Validity of using semipermeable membrane devices for determining aqueous concentrations of freely dissolved PAHs

USGS Publications Warehouse

Prest, Harry; Petty, J.D.; Huckins, J.N.

1998-01-01

An in-depth review of the recent contribution to this journal by Gustafson and Dickhut [1] prompts us to share our concerns regarding some of their conclusions. The paper presents data comparing three techniques for determining aqueous concentrations of freely dissolved polycyclic aromatic hydrocarbons (PAHs) gas sparging, lipid-containing semipermeable membrane devices (SPMDs) of the U.S. Geological Survey (USGS) design, and filtration followed by sorption using XAD-2 resin. Space limitations force us to limit our comments to problems resulting from an apparent lack of understanding of how SPMDs function. Several recent publications [2–13] have described the theoretical and practical considerations of SPMD usage. Gustafson and Dickhut fail to cite any papers describing SPMDs published after 1992, even though some 18 papers have been published in American and European journals since then and several SPMD studies have been presented at many major meetings.

Large Data at Small Universities: Astronomical processing using a computer classroom

NASA Astrophysics Data System (ADS)

Fuller, Nathaniel James; Clarkson, William I.; Fluharty, Bill; Belanger, Zach; Dage, Kristen

2016-06-01

The use of large computing clusters for astronomy research is becoming more commonplace as datasets expand, but access to these required resources is sometimes difficult for research groups working at smaller Universities. As an alternative to purchasing processing time on an off-site computing cluster, or purchasing dedicated hardware, we show how one can easily build a crude on-site cluster by utilizing idle cycles on instructional computers in computer-lab classrooms. Since these computers are maintained as part of the educational mission of the University, the resource impact on the investigator is generally low.By using open source Python routines, it is possible to have a large number of desktop computers working together via a local network to sort through large data sets. By running traditional analysis routines in an “embarrassingly parallel” manner, gains in speed are accomplished without requiring the investigator to learn how to write routines using highly specialized methodology. We demonstrate this concept here applied to 1. photometry of large-format images and 2. Statistical significance-tests for X-ray lightcurve analysis. In these scenarios, we see a speed-up factor which scales almost linearly with the number of cores in the cluster. Additionally, we show that the usage of the cluster does not severely limit performance for a local user, and indeed the processing can be performed while the computers are in use for classroom purposes.

The relationship of interictal epileptiform discharges to clinical epilepsy severity: A study of routine EEGs and review of the literature

PubMed Central

Selvitelli, Megan F.; Walker, Linsey M.; Schomer, Donald L.; Chang, Bernard S.

2010-01-01

Purpose EEGs are widely used to detect interictal epileptiform discharges (IEDs) in patients with a known history of seizures. However, prior studies have not found a consistent association between the presence or frequency of IEDs and clinical epilepsy severity, possibly because of differences in subject characteristics and recording techniques. We sought to investigate this relationship in a population and setting reflective of the most common clinical usage. Methods We analyzed EEGs and clinical records of all consenting patients with a history of at least two presumed focal-onset seizures who presented for routine EEG recording over one year’s time in an academic neurophysiology laboratory (n = 129). Results Despite adequate statistical power, we did not find an association between the presence or absence of IEDs or IED frequency and the most recently determined seizure frequency (median 4 per year). A higher IED incidence was seen in subjects with longer epilepsy duration (p = 0.04). Neither IED incidence nor frequency (median 10.0 per hour) correlated with age or antiepileptic drug use. Conclusions Our results differ from those of some prior studies, most of which focused on more narrow subject populations, suggesting that the patient’s clinical circumstances must be taken into account before assuming the utility of IEDs on routine EEG in predicting epilepsy severity. PMID:20234317

Adverse events, toxicity and post-mortem data on duloxetine: case reports and literature survey.

PubMed

Vey, Eric L; Kovelman, Inna

2010-05-01

Duloxetine, a dual acting norepinephrine serotonin reuptake inhibitor, is a relatively new pharmacologic agent utilized in the treatment of depression, as well as diabetic neuropathic pain, fibromyalgia, and female stress urinary incontinence. This expanding scope of usage will inevitably lead to its eventual appearance during routine post-mortem toxicologic assays. Currently there is a paucity of post-mortem toxicologic data concerning duloxetine. The current report provides six additional case reports of post-mortem duloxetine levels, along with a review of duloxetine's pharmacokinetics, and the toxicologic manifestations which have been reported in the literature. The post-mortem levels reported, including the highest level recorded to date, are integrated with previously published reports to generate a foundation for a nascent guide to the interpretation of post-mortem duloxetine levels that could be encountered during routine post-mortem toxicologic analyses, and establish a basis upon which the establishment of toxic and lethal thresholds for this compound can be further elucidated with greater clarity. Copyright (c) 2010 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Complementary and alternative medicines use among pediatric patients with epilepsy in a multiethnic community.

PubMed

Chen, Chunliang; Chong, Ying Jie; Hie, Szu Liang; Sultana, Rehena; Lee, Sze Huay Dorothy; Chan, Wei Shih Derrick; Chan, Sui Yung; Cheong, Han Hui

2016-07-01

Prior studies highlighted that patients on chronic medications who used complementary and alternative medicines (CAMs) did not share this information with their healthcare providers. Furthermore, there might be potential adverse interactions between CAMs and antiepileptic drug (AED) therapy. However, there are no studies that investigate the effect of religion or race on CAM use in a multiethnic community. Therefore, we aimed to investigate CAM usage among pediatric patients with epilepsy (PPE) and identify predictors of CAM usage in our multiethnic setting. This was a cross-sectional study where caregivers of recruited at an outpatient epilepsy clinic between September 2013 and July 2014 completed a self-administered survey. Those who declined participation, lacked understanding of English or Mandarin, or missed the clinic appointments were excluded. Those caring for more than one patient participated only once. Of the 195 surveys collected, 178 were used for analysis. The PPE used an average of 1.50 AEDs (range: 0-4). Forty-nine (27.5%) caregivers reported giving CAMs to their PPE. Commonly used CAMs were multivitamins (44.4%), traditional herbs (42.2%), and acupuncture (17.4%). Multivitamins were mostly given by Christian/Catholic caregivers while Buddhist caregivers mostly gave traditional herbs or acupuncture. The majority of the CAM users were Chinese. Univariate analysis showed that caregivers with secondary school (high school) education were 3.52 times more likely to use CAMs compared to those with primary school (elementary school) education. While some caregivers gave CAMs to their PPE, they had various misconceptions and did not discuss the usage with their healthcare providers. We propose that the predictors identified in this study can help to identify potential CAM users. Healthcare providers should routinely probe about the usage of CAMs by PPE, and thereafter, the suitability of CAM use could be evaluated. The caregivers will benefit from open discussion with healthcare professionals on the safe use of AEDs with or without CAMs. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of active transition, a website-delivered physical activity intervention for university students: pilot study.

PubMed

Kwan, Matthew; Faulkner, Guy; Bray, Steven

2013-04-29

While physical activity in individuals tends to decline steadily with age, there are certain periods where this decline occurs more rapidly, such as during early adulthood. Interventions aimed at attenuating the declines in physical activity during this transition period appear warranted. The purpose of the study was to test the feasibility and efficacy of a theoretically informed, website-delivered physical activity intervention aimed at students entering university. Using a quasi-experimental design, 65 participants (44 females; mean age 18.51, SD 0.91) were assigned to either an intervention (receiving website access plus weekly prompts) or comparison condition (receiving unprompted website access only), completing questionnaires at baseline and follow-up 8 weeks later. The intervention website, "Active Transition", was specifically designed to target students' physical activity cognitions and self-regulatory skills. Intervention usage was low, with only 47% (18/38) of participants assigned to the intervention condition logging into the website 2 or more times. Among the broader student sample, there were significant declines in students' physical activity behaviors (F1,63=18.10, P<.001), attitudes (F1,62=55.19, P<.001), and perceived behavioral control (F1,62 =17.56, P<.001). In comparisons between intervention users (29/65, individuals logging in 2 or more times) and non-users (36/65, individuals logging in once or not at all), there was a significant interaction effect for intervention usage and time on perceived behavioral control (F1,62=5.13, P=.03). Poor intervention usage suggests that future efforts need to incorporate innovative strategies to increase intervention uptake and better engage the student population. The findings, however, suggest that a website-delivered intervention aimed at this critical life stage may have positive impact on students' physical activity cognitions. Future studies with more rigorous sampling designs are required.

Single Molecule Analysis of Replicated DNA Reveals the Usage of Multiple KSHV Genome Regions for Latent Replication

PubMed Central

Verma, Subhash C.; Lu, Jie; Cai, Qiliang; Kosiyatrakul, Settapong; McDowell, Maria E.; Schildkraut, Carl L.; Robertson, Erle S.

2011-01-01

Kaposi's sarcoma associated herpesvirus (KSHV), an etiologic agent of Kaposi's sarcoma, Body Cavity Based Lymphoma and Multicentric Castleman's Disease, establishes lifelong latency in infected cells. The KSHV genome tethers to the host chromosome with the help of a latency associated nuclear antigen (LANA). Additionally, LANA supports replication of the latent origins within the terminal repeats by recruiting cellular factors. Our previous studies identified and characterized another latent origin, which supported the replication of plasmids ex-vivo without LANA expression in trans. Therefore identification of an additional origin site prompted us to analyze the entire KSHV genome for replication initiation sites using single molecule analysis of replicated DNA (SMARD). Our results showed that replication of DNA can initiate throughout the KSHV genome and the usage of these regions is not conserved in two different KSHV strains investigated. SMARD also showed that the utilization of multiple replication initiation sites occurs across large regions of the genome rather than a specified sequence. The replication origin of the terminal repeats showed only a slight preference for their usage indicating that LANA dependent origin at the terminal repeats (TR) plays only a limited role in genome duplication. Furthermore, we performed chromatin immunoprecipitation for ORC2 and MCM3, which are part of the pre-replication initiation complex to determine the genomic sites where these proteins accumulate, to provide further characterization of potential replication initiation sites on the KSHV genome. The ChIP data confirmed accumulation of these pre-RC proteins at multiple genomic sites in a cell cycle dependent manner. Our data also show that both the frequency and the sites of replication initiation vary within the two KSHV genomes studied here, suggesting that initiation of replication is likely to be affected by the genomic context rather than the DNA sequences. PMID:22072974

Using mass-media communications to increase population usage of Australia’s Get Healthy Information and Coaching Service®

PubMed Central

2012-01-01

Background Global obesity prevalence is increasing and population health programs are required to support changes to modifiable lifestyle risk factors. Such interventions benefit from mass-communications to promote their use. The Get Healthy Information and Coaching Service ® (GHS) utilised mass-reach media advertising to recruit participants to an Australian state-wide program. Methods A stand alone population survey collected awareness, knowledge and behavioural variables before the first advertising phase, (n = 1,544; August -September 2010), during (n = 1,500; February - March 2011) and after the advertising period (n = 1,500; June-July 2011). GHS usage data (n = 6,375) was collated during July 2010 – June 2011. Results The results showed that television-lead mass-media significantly increased unprompted awareness (0% to 31.8%, p < 0.001); prompted awareness (2.5% to 23.7%, p < 0.001); and understanding (10.2% to 32.2%, p < 0.001). Mass-media (television, print and mail out information) was more often cited as the source of referral by males, those aged 18 – 49 years, employed, and from the lowest socio-economic groups. During the weeks when mass-media advertising was present, 4 and 2.5 times more information and coaching participants respectively registered than when there was no advertising present. Participants who cited television and print were less likely to enrol in GHS coaching, but this was not the case for mail out information and secondary referral sources. Conclusions GHS mass-communications campaigns are effective at increasing awareness and usage of the GHS, especially among hard-to-reach population groups. Television advertising provides universal reach, but should be supplemented by health professional referrals and targeted mail-out information to recruit participants to the intensive GHS coaching program. PMID:22967230

Indigenous knowledge of zootherapeutic use among the Biate tribe of Dima Hasao District, Assam, Northeastern India

PubMed Central

2013-01-01

Background The present study addresses the use of zootherapy in the traditional healthcare system of the Biate tribe of Dima Hasao district, Assam, India. It sought to identify the different species used for zootherapeutic use with the detailed methods of usages to create awareness and contribute to the conservation and sustainable utilization of the resources. Method 15 Biate villages within the district of Dima Hasao were surveyed through semi-structured questionnaires and informal interviews. Detailed information on the uses of each animal was recorded. Species were identified using standard literature. Fidelity level (FL) was calculated to demonstrate the percentage of respondents claiming the use of a certain animal for the same major purposes. Result The study documents 34 species for the treatment of about 34 different ailments. The largest number of species reported was mammals with17 species. Maximum number of species has been reported for the treatment of diabetes and its high fidelity levels warrants in-depth studies to establish its pharmacological activity. The usages documented herein are unique to the Biate tribe. Very often, these animals are hunted and sold openly at the local markets in the lure of quick money. A 300 gm live Gekko gecko may fetch a sum of 2,50,000 Indian Rupees (INR), and smoked meat of Hoolock hoolock cost approximately 250–300 INR per kg. Animals are also hunted for its hide. The unrestricted hunting of species like Capricornis sumatraensis has almost wiped out the population within the district. Some species are also reared as pets while some are used for display as a sign of expertise in hunting. The present study has documented the usage of at least 15 animals listed in the IUCN Red List. Conclusion The study illustrates the in-depth knowledge of the Biate tribe on zootherapy. Systematic investigation to identify the active ingredient may lead to the development of new drugs, which would prompt protection of these valuable resources. PMID:23938109

A mild Grave's ophthalmopathy during pregnancy.

PubMed

Abbouda, Alessandro; Trimboli, Pierpaolo; Bruscolini, Alice

2014-01-01

Thyroid ophthalmopathy is a complication most commonly associated with Grave's disease. The disease course ranges from mild to severe, with severe cases resulting in major visual impairment. A complete ophthalmic examination in a 35-year-old secundigravida to 14 weeks of gestation presented to the hospital for a routine ophthalmological examination with eyelid retraction in the right eye was made. We studied the course of ocular disease through the gestation with orbit ecography and a 3T MRI. A diagnosis of Grave's Ophthalmopathy was made. This case presents an unusual course of the GD during pregnancy and a normal post-partum relapse, according to the Th1/Th2 balance. The frequent follow-up and the use of MRI allowed a prompt identification and complete control of the disease.

Undertaking clinical audit, with reference to a Prescribing Observatory for Mental Health audit of lithium monitoring.

PubMed

Paton, Carol; Barnes, Thomas R E

2014-06-01

Audit is an important tool for quality improvement. The collection of data on clinical performance against evidence-based and clinically relevant standards, which are considered by clinicians to be realistic in routine practice, can usefully prompt reflective practice and the implementation of change. Evidence of participation in clinical audit is required to achieve intended learning outcomes for trainees in psychiatry and revalidation for those who are members of the Royal College of Psychiatrists. This article addresses some of the practical steps involved in conducting an audit project, and, to illustrate key points, draws on lessons learnt from a national, audit-based, quality improvement programme of lithium prescribing and monitoring conducted through the Prescribing Observatory for Mental Health.

The supersonic molecular beam injector as a reliable tool for plasma fueling and physics experiment on HL-2A.

PubMed

Chen, C Y; Yu, D L; Feng, B B; Yao, L H; Song, X M; Zang, L G; Gao, X Y; Yang, Q W; Duan, X R

2016-09-01

On HL-2A tokamak, supersonic molecular beam injection (SMBI) has been developed as a routine refueling method. The key components of the system are an electromagnetic valve and a conic nozzle. The valve and conic nozzle are assembled to compose the simplified Laval nozzle for generating the pulsed beam. The appurtenance of the system includes the cooling system serving the cooled SMBI generation and the in situ calibration component for quantitative injection. Compared with the conventional gas puffing, the SMBI features prompt response and larger fueling flux. These merits devote the SMBI a good fueling method, an excellent plasma density feedback control tool, and an edge localized mode mitigation resource.

Effects of social stories on prosocial behavior of preschool children with autism spectrum disorders.

PubMed

Crozier, Shannon; Tincani, Matt

2007-10-01

Social Stories are a popular intervention for preschool children with autism spectrum disorders (ASD), but little research on Social Stories has been conducted with this population. This study investigated the effects of Social Stories on prosocial behavior of three preschool children with ASD in an inclusive setting. An ABAB design was used for two participants, while an ABACBC was used for the third. Social Stories increased appropriate behavior and decreased inappropriate behavior for two participants. The addition of verbal prompts (condition C) was necessary to increase appropriate behavior for the third participant. Maintenance probes were conducted to assess whether stories became imbedded in classroom routines. Results are discussed in relation to applications, study limitations, and areas for future research.

The role of histopathology in forensic practice: an overview.

PubMed

Dettmeyer, R B

2014-09-01

The role of forensic histopathology in routine practice is to establish the cause of death in particular cases. This is achieved on the basis of microscopic analysis of representative cell and tissue samples taken from the major internal organs and from abnormal findings made at autopsy. A prerequisite of this is adherence to the quality standards set out for conventional histological/cytological staining and enzyme histochemical and immunohistochemical methods. The interpretation of histological findings is performed by taking into account macroscopic autopsy findings and information on previous history. Histological analysis may prompt postmortem biochemical and chemical-toxicological investigations. The results of histological analysis need to be classified by experts in the context of the available information and the need to withstand the scrutiny of other experts.

When to consider thyroid dysfunction in the neurology clinic.

PubMed

Mistry, Niraj; Wass, John; Turner, Martin R

2009-06-01

There are many neurological manifestations of thyroid disease, and thyroid function has taken its place in the "routine bloods" of neurology practice. However, although conditions such as carpal tunnel syndrome prompt thyroid testing despite any clear evidence for this approach, other symptoms of potential significance in terms of thyroid disease may be overlooked in the busy general neurology clinic, or abnormal thyroid tests may be assumed to be incidental. Psychiatric disorders, loss of consciousness, movement disorders and weakness may all be manifestations of primary thyroid disease. This is a symptom-based review where we will consider the evidence (or lack of it) for the association of various neurological problems with thyroid dysfunction, and also the pitfalls in interpretation of the biochemical tests.

Tension Pneumothorax During Surgery for Thoracic Spine Stabilization in Prone Position: A Case Report and Review of Literature.

PubMed

Rankin, Demicha; Mathew, Paul S; Kurnutala, Lakshmi N; Soghomonyan, Suren; Bergese, Sergio D

2014-01-01

The intraoperative progression of a simple or occult pneumothorax into a tension pneumothorax can be a devastating clinical scenario. Routine use of prophylactic thoracostomy prior to anesthesia and initiation of controlled ventilation in patients with simple or occult pneumothorax remains controversial. We report the case of a 75-year-old trauma patient with an insignificant pneumothorax on the right who developed an intraoperative tension pneumothorax on the left side while undergoing thoracic spine stabilization surgery in the prone position. Management of an intraoperative tension pneumothorax requires prompt recognition and treatment; however, the prone position presents an additional challenge of readily accessing the standard anatomic sites for pleural puncture and air drainage.

The use of point-of-decision prompts to increase stair climbing in Singapore.

PubMed

Sloan, Robert Alan; Haaland, Benjamin Adam; Leung, Carol; Müller-Riemenschneider, Falk

2013-01-07

Physical inactivity is a significant contributor to worldwide mortality and morbidity associated with non-communicable diseases. An excellent avenue to incorporate lifestyle physical activity into regular routine is to encourage the use of stairs during daily commutes. We evaluated the effectiveness of point-of-decision prompts (PODPs) in promoting the use of stairs instead of the escalators in a Singapore Mass Rapid Transit (MRT) station. We measured the number of stair climbers before the PODPs were put up, during the 4 weeks that they were in use, and 2 weeks after they were removed. Measurements at a no intervention control site were additionally taken. The use of stair-riser banners was associated with an increase in the number of people using the stairs by a factor of 1.49 (95% CI 1.34-1.64). After the banners were removed, the number of stair climbers at the experimental station dropped to slightly below baseline levels. The Singapore MRT serves a diverse multi-ethnic population with an average daily ridership of over 2 million and 88 stations island-wide. An increase of physical activity among these MRT commuters would have a large impact at the population level. Our findings can be translated into part of the national strategy to encourage an active lifestyle in Singaporeans.

The Use of Point-of-Decision Prompts to Increase Stair Climbing in Singapore

PubMed Central

Sloan, Robert Alan; Haaland, Benjamin Adam; Leung, Carol; Müller-Riemenschneider, Falk

2013-01-01

Physical inactivity is a significant contributor to worldwide mortality and morbidity associated with non-communicable diseases. An excellent avenue to incorporate lifestyle physical activity into regular routine is to encourage the use of stairs during daily commutes. We evaluated the effectiveness of point-of-decision prompts (PODPs) in promoting the use of stairs instead of the escalators in a Singapore Mass Rapid Transit (MRT) station. We measured the number of stair climbers before the PODPs were put up, during the 4 weeks that they were in use, and 2 weeks after they were removed. Measurements at a no intervention control site were additionally taken. The use of stair-riser banners was associated with an increase in the number of people using the stairs by a factor of 1.49 (95% CI 1.34–1.64). After the banners were removed, the number of stair climbers at the experimental station dropped to slightly below baseline levels. The Singapore MRT serves a diverse multi-ethnic population with an average daily ridership of over 2 million and 88 stations island-wide. An increase of physical activity among these MRT commuters would have a large impact at the population level. Our findings can be translated into part of the national strategy to encourage an active lifestyle in Singaporeans. PMID:23296208

Series: Pragmatic trials and real world evidence: Paper 8. Data collection and management.

PubMed

Meinecke, Anna-Katharina; Welsing, Paco; Kafatos, George; Burke, Des; Trelle, Sven; Kubin, Maria; Nachbaur, Gaelle; Egger, Matthias; Zuidgeest, Mira

2017-11-01

Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory, and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice. Furthermore, it should allow for the involvement of a representative sample of practices, physicians, and patients who prescribe/receive treatment in routine care. This paper discusses challenges that are related to the different methods of data collection and presents potential solutions where possible. No one-size-fits-all recommendation can be given for the collection of data in pragmatic trials, although in general the application of existing routinely used data-collection systems and processes seems to best suit the pragmatic approach. However, data access and privacy, the time points of data collection, the level of detail in the data, and the lack of a clear understanding of the data-collection process were identified as main challenges for the usage of routinely collected data in pragmatic trials. A first step should be to determine to what extent existing health care databases provide the necessary study data and can accommodate data collection and management. When more elaborate or detailed data collection or more structured follow-up is required, data collection in a pragmatic trial will have to be tailor-made, often using a hybrid approach using a dedicated electronic case report form (eCRF). In this case, the eCRF should be kept as simple as possible to reduce the burden for practitioners and minimize influence on routine clinical practice. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Gorlin-Goltz syndrome: incidental finding on routine ct scan following car accident

PubMed Central

2009-01-01

Introduction Gorlin-Goltz syndrome is a rare hereditary disease. Pathogenesis of the syndrome is attributed to abnormalities in the long arm of chromosome 9 (q22.3-q31) and loss or mutations of human patched gene (PTCH1 gene). Multiple basal cell carcinomas (BCCs), odontogenic keratocysts, skeletal abnormalities, hyperkeratosis of palms and soles, intracranial ectopic calcifications of the falx cerebri and facial dysmorphism are considered the main clinical features. Diagnosis is based upon established major and minor clinical and radiological criteria and ideally confirmed by DNA analysis. Because of the different systems affected, a multidisciplinary approach team of various experts is required for a successful management. Case presentation We report the case of a 19 year-old female who was involved in a car accident and found to present imaging findings of Gorlin-Goltz syndrome during a routine whole body computed tomography (CT) scan in order to exclude traumatic injuries. Conclusion Radiologic findings of the syndrome are easily identifiable on CT scans and may prompt to early verification of the disease, which is very important for regular follow-up and better survival rates from the co-existent diseases. PMID:20062724

A New Feedback-Based Method for Parameter Adaptation in Image Processing Routines.

PubMed

Khan, Arif Ul Maula; Mikut, Ralf; Reischl, Markus

2016-01-01

The parametrization of automatic image processing routines is time-consuming if a lot of image processing parameters are involved. An expert can tune parameters sequentially to get desired results. This may not be productive for applications with difficult image analysis tasks, e.g. when high noise and shading levels in an image are present or images vary in their characteristics due to different acquisition conditions. Parameters are required to be tuned simultaneously. We propose a framework to improve standard image segmentation methods by using feedback-based automatic parameter adaptation. Moreover, we compare algorithms by implementing them in a feedforward fashion and then adapting their parameters. This comparison is proposed to be evaluated by a benchmark data set that contains challenging image distortions in an increasing fashion. This promptly enables us to compare different standard image segmentation algorithms in a feedback vs. feedforward implementation by evaluating their segmentation quality and robustness. We also propose an efficient way of performing automatic image analysis when only abstract ground truth is present. Such a framework evaluates robustness of different image processing pipelines using a graded data set. This is useful for both end-users and experts.

Perceptions of Primary Care-Based Breastfeeding Promotion Interventions: Qualitative Analysis of Randomized Controlled Trial Participant Interviews

PubMed Central

Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-01-01

Abstract Objective This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. Subjects and Methods A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Results Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Conclusions Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates. PMID:22621223

A successful treatment of necrotizing fasciitis following the surgery of distal radius plate removal: A case report and literature review.

PubMed

Cai, Yuchen; Gan, Yaokai; Yu, Chao; Tang, Jian; Sun, Yuehua

2018-04-01

Necrotizing fasciitis (NF) is defined as a rare, rapidly progressive, and highly lethal skin infection characterized by necrosis of the fascia and subcutaneous tissue. The present study aims to discuss the case of a 35-year-old man who developed NF following a routine sterile right distal radius bone plate removal surgery. The patient was suspected of NF based on his clinical manifestations, laboratory tests, and imaging results. The diagnosis of NF was confirmed by histological examinations. Serial prompt and extensive debridement was performed during the rapid and aggressive extension of the skin infection, together with antibiotics and supportive treatments. The condition of the patient finally improved on the sixth day of disease progression. Skin grafting of his right forearm wound was performed successfully 2 months after the admission. NF can occur during the perioperative period for routine clean radius plate removal operation in patients with no risk factor for NF. The objective is to remind the physicians to stay aware of this disease, especially its early clinical signs and symptoms. Urgent subsequent treatment, including surgical debridement, antibiotic therapy, and supporting management, is the key to ensure the survival and better prognosis of patients.

Testing the predictions of coping styles theory in threespined sticklebacks

PubMed Central

Bensky, Miles K.; Paitz, Ryan; Pereira, Laura; Bell, Alison M.

2017-01-01

Coping styles theory provides a framework for understanding individual variation in how animals respond to environmental change, and predicts how individual differences in stress responsiveness and behavior might relate to cognitive differences. According to coping styles theory, proactive individuals are bolder, less reactive to stressors, and more routinized than their reactive counterparts. A key tenet of coping styles theory is that variation in coping styles is maintained by tradeoffs with behavioral flexibility: proactive individuals excel in stable environments while more flexible, reactive individuals perform better in variable environments. Here, we assess evidence for coping styles within a natural population of threespined sticklebacks (Gasterosteus aculeatus). We developed a criterion-based learning paradigm to evaluate individual variation in initial and reversal learning. We observed strong individual differences in boldness, cortisol production, and learning performance. Consistent with coping styles, fish that released more cortisol were more timid in response to a predator attack and slower to learn a color discrimination task. However, there was no evidence that reactive individuals performed better when the environment changed (when the rewarded color was reversed). The failure to detect trade-offs between behavioral routinization and flexibility prompts other explanations for the maintenance of differing coping styles. PMID:28017848

Perceptions of primary care-based breastfeeding promotion interventions: qualitative analysis of randomized controlled trial participant interviews.

PubMed

Andaya, Elise; Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-12-01

This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates.

Blood Glucose Monitoring Before and After Type 1 Diabetes Clinic Visits.

PubMed

Driscoll, Kimberly A; Johnson, Suzanne Bennett; Wang, Yuxia; Wright, Nancy; Deeb, Larry C

2017-12-23

To determine patterns of blood glucose monitoring in children and adolescents with type 1 diabetes (T1D) before and after routine T1D clinic visits. Blood glucose monitoring data were downloaded at four consecutive routine clinic visits from children and adolescents aged 5-18 years. Linear mixed models were used to analyze patterns of blood glucose monitoring in patients who had at least 28 days of data stored in their blood glucose monitors. In general, the frequency of blood glucose monitoring decreased across visits, and younger children engaged in more frequent blood glucose monitoring. Blood glucose monitoring increased before the T1D clinic visits in younger children, but not in adolescents. It declined after the visit regardless of age. Members of the T1D care team need to consider that a T1D clinic visit may prompt an increase in blood glucose monitoring when making treatment changes and recommendations. Tailored interventions are needed to maintain that higher level of adherence across time. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

A New Feedback-Based Method for Parameter Adaptation in Image Processing Routines

PubMed Central

Mikut, Ralf; Reischl, Markus

2016-01-01

The parametrization of automatic image processing routines is time-consuming if a lot of image processing parameters are involved. An expert can tune parameters sequentially to get desired results. This may not be productive for applications with difficult image analysis tasks, e.g. when high noise and shading levels in an image are present or images vary in their characteristics due to different acquisition conditions. Parameters are required to be tuned simultaneously. We propose a framework to improve standard image segmentation methods by using feedback-based automatic parameter adaptation. Moreover, we compare algorithms by implementing them in a feedforward fashion and then adapting their parameters. This comparison is proposed to be evaluated by a benchmark data set that contains challenging image distortions in an increasing fashion. This promptly enables us to compare different standard image segmentation algorithms in a feedback vs. feedforward implementation by evaluating their segmentation quality and robustness. We also propose an efficient way of performing automatic image analysis when only abstract ground truth is present. Such a framework evaluates robustness of different image processing pipelines using a graded data set. This is useful for both end-users and experts. PMID:27764213

An audit of fresh frozen plasma usage in a tertiary referral centre in a developing country.

PubMed

Prathiba, R; Jayaranee, S; Ramesh, J C; Lopez, C G; Vasanthi, N

2001-06-01

This paper evaluates the practice of fresh frozen plasma (FFP) transfusion at the University Hospital, Kuala Lumpur, and analyses its usage by the various clinical departments. The aim of this study is to identify where it is inappropriately used and the clinical indications in which such misuse is common. A retrospective analysis of the blood bank request forms and work sheets during a 6-month period between January 1998 and June 1998 formed the basis of this study. Overall, 40% of 2665 units transfused were considered appropriate. However, out of the 931 episodes of FFP transfusions only 31% were for appropriate indications. The average FFP requirement when used for appropriate indication was about 4 units per episode, whereas for inappropriate indication it was 2.5 units per episode. Inappropriate use in terms of the number of units was highest by the surgical services (68%) and Orthopaedics (64%), while the Department of Paediatrics had the lowest incidence of inappropriate use (40%). When Paediatrics was used as the benchmark, the incidence of inappropriate use by other departments was significantly higher (p < 0.01). As for FFP usage in common clinical indications, there was a high incidence of inappropriate use in burns (82%), perioperative period (73%), cardiac surgery (68%), massive bleeding (62%) and trauma (60%). The findings in this study, specifically the use of FFP for volume support in trauma, massive bleeding and burns, routine requests without identified indication in cardiac bypass surgery, and prophylactic use in the perioperative period can be the basis for recommendations to minimize the inappropriate use of FFP in the future.

Evaluation of the Turkish translation of the Minimal Standard Terminology for Digestive Endoscopy by development of an endoscopic information system.

PubMed

Atalağ, Koray; Bilgen, Semih; Gür, Gürden; Boyacioğlu, Sedat

2007-09-01

There are very few evaluation studies for the Minimal Standard Terminology for Digestive Endoscopy. This study aims to evaluate the usage of the Turkish translation of Minimal Standard Terminology by developing an endoscopic information system. After elicitation of requirements, database modeling and software development were performed. Minimal Standard Terminology driven forms were designed for rapid data entry. The endoscopic report was rapidly created by applying basic Turkish syntax and grammar rules. Entering free text and also editing of final report were possible. After three years of live usage, data analysis was performed and results were evaluated. The system has been used for reporting of all endoscopic examinations. 15,638 valid records were analyzed, including 11,381 esophagogastroduodenoscopies, 2,616 colonoscopies, 1,079 rectoscopies and 562 endoscopic retrograde cholangiopancreatographies. In accordance with other previous validation studies, the overall usage of Minimal Standard Terminology terms was very high: 85% for examination characteristics, 94% for endoscopic findings and 94% for endoscopic diagnoses. Some new terms, attributes and allowed values were also added for better clinical coverage. Minimal Standard Terminology has been shown to cover a high proportion of routine endoscopy reports. Good user acceptance proves that both the terms and structure of Minimal Standard Terminology were consistent with usual clinical thinking. However, future work on Minimal Standard Terminology is mandatory for better coverage of endoscopic retrograde cholangiopancreatographies examinations. Technically new software development methodologies have to be sought for lowering cost of development and the maintenance phase. They should also address integration and interoperability of disparate information systems.

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

Nalu is a Sierra ToolKit (STK) based application module, and it has provided a set of "lessons learned" for the STK transition effort through its early adoption of STK. It makes use of the open-sourced Trilinos/ Tpetra library. Through the investment of LORD and ASCR projects, the Nalu code module has been extended beyond prototype status. Physics capability includes low Mach, variable density turbulent flow. The ongoing objective for Nalu is to facilitate partnerships with external organizations in order to extend code capability and knowledge; however, it is not intended to support routine CFD analysis. The targeted usage of thismore » module is for non-NW applications that support work-for-others in the multiphysics energy sector.« less

[Clinical diagnosis of primary unknown cancer-the present situation and problems].

PubMed

Mukai, Hirofumi

2009-06-01

The first step of diagnosis of primary unknown cancer(PUC)the detailed history intake and physical examination including breast, genitourinary system and rectum. Laboratory test, chest X-p and systemic computed tomography are allowed to be performed for all patients with PUC. Other tests should be performed according to the results of clinical and pathological evaluation. Utility of the tumor marker is limited, and this test is not recommended as a routine usage. There is not enough evidence on the utility of FDG-PTT or FDG-PET/CT for patients with PUC. Diagnosis of PUC should be made within one month from a patient's first visit to a hospital.

The pEst version 2.1 user's manual

NASA Technical Reports Server (NTRS)

Murray, James E.; Maine, Richard E.

1987-01-01

This report is a user's manual for version 2.1 of pEst, a FORTRAN 77 computer program for interactive parameter estimation in nonlinear dynamic systems. The pEst program allows the user complete generality in definig the nonlinear equations of motion used in the analysis. The equations of motion are specified by a set of FORTRAN subroutines; a set of routines for a general aircraft model is supplied with the program and is described in the report. The report also briefly discusses the scope of the parameter estimation problem the program addresses. The report gives detailed explanations of the purpose and usage of all available program commands and a description of the computational algorithms used in the program.

Stress assessment in small ruminants kept on city farms in southern Germany.

PubMed

Schilling, Anna-Katarina; Reese, Sven; Palme, Rupert; Erhard, Michael; Wöhr, Anna-Caroline

2015-01-01

Sheep and goats are frequently used in nonhuman animal-assisted activities on city farms. There are few data available on this type of usage of small ruminants. Health evaluations, behavioral observations (feeding, resting, comfort, explorative and social behaviors), behavioral tests (human approach tests and touch test), and measurements of fecal cortisol metabolites and heart rate were performed to assess stress levels in 25 sheep and 32 goats on 7 city farms and 2 activity playgrounds in Germany. No evidence was found that the animals suffered from major distress. Health evaluations, behavioral observations, and behavioral tests proved to be the methods of stress assessment most suitable for routine on-farm checks in these settings.

Mathematical defense method of networked servers with controlled remote backups

NASA Astrophysics Data System (ADS)

Kim, Song-Kyoo

2006-05-01

The networked server defense model is focused on reliability and availability in security respects. The (remote) backup servers are hooked up by VPN (Virtual Private Network) with high-speed optical network and replace broken main severs immediately. The networked server can be represent as "machines" and then the system deals with main unreliable, spare, and auxiliary spare machine. During vacation periods, when the system performs a mandatory routine maintenance, auxiliary machines are being used for back-ups; the information on the system is naturally delayed. Analog of the N-policy to restrict the usage of auxiliary machines to some reasonable quantity. The results are demonstrated in the network architecture by using the stochastic optimization techniques.

Executive summary: conference on Dietary Supplement Use in the Elderly--proceedings of the conference held January 14-15, 2003, Natcher Auditorium, National, Institutes of Health, Bethesda, MD.

PubMed

2004-04-01

Several issues prompted the need for this conference. Among these were the reported high prevalence (> 50%) of use of supplements among individuals over 50 years of age, inadequate scientific evidence supporting the safety and benefits of use among these individuals, and a report issued by the General Accounting Office (GAO) in 2001. This GAO report entitled "Health Products for Seniors: 'Anti-Aging' Products Pose Potential for Physical and Economic Harm," arose from concerns among legislators that seniors were spending money from their limited incomes on products that were not only ineffective but also potentially harmful. The conference was organized around three sessions to address the issues highlighted above, which were usage of dietary supplements among the elderly, age-related changes and issues that affect the use of supplements, and the evidence base supporting the use of supplements in disease prevention and health maintenance. Each session was followed by a panel discussion. This Executive Summary is organized around the three major discussion topics. The summary does not explicitly follow the order of the conference presentations; rather it is intended to capture and examine the current research gaps in knowledge and identify future research opportunities. These research opportunities, as expressed by the conference speakers, panelists, and attendees are summarized at the end of this paper under five thematic areas: usage behaviors, methodology, pre-clinical studies and clinical studies, informational databases, and education and dissemination.

Comparison of Sedentary Behaviors in Office Workers Using Sit-Stand Tables With and Without Semiautomated Position Changes.

PubMed

Barbieri, Dechristian França; Srinivasan, Divya; Mathiassen, Svend Erik; Oliveira, Ana Beatriz

2017-08-01

We compared usage patterns of two different electronically controlled sit-stand tables during a 2-month intervention period among office workers. Office workers spend most of their working time sitting, which is likely detrimental to health. Although the introduction of sit-stand tables has been suggested as an effective intervention to decrease sitting time, limited evidence is available on usage patterns of sit-stand tables and whether patterns are influenced by table configuration. Twelve workers were provided with standard sit-stand tables (nonautomated table group) and 12 with semiautomated sit-stand tables programmed to change table position according to a preset pattern, if the user agreed to the system-generated prompt (semiautomated table group). Table position was monitored continuously for 2 months after introducing the tables, as a proxy for sit-stand behavior. On average, the table was in a "sit" position for 85% of the workday in both groups; this percentage did not change significantly during the 2-month period. Switches in table position from sit to stand were, however, more frequent in the semiautomated table group than in the nonautomated table group (0.65 vs. 0.29 hr -1 ; p = .001). Introducing a semiautomated sit-stand table appeared to be an attractive alternative to a standard sit-stand table, because it led to more posture variation. A semiautomated sit-stand table may effectively contribute to making postures more variable among office workers and thus aid in alleviating negative health effects of extensive sitting.

Introducing New Antimalarial Analogues of Chloroquine and Amodiaquine: A Narrative Review.

PubMed

Parhizgar, Arezoo Rafiee; Tahghighi, Azar

2017-03-01

Antimalarial drugs with the 4-aminoquinoline scaffold such as the important drugs, chloroquine (CQ) and amodiaquine (AQ), have been used to prevent and treat malaria for many years. The importance of these drugs is related to their simple usage, high efficacy, affordability, and cost-effectiveness of their synthesis. In recent years, with the spread of parasite resistance to CQ and cross-resistance to its other analogues have decreased their consumption in many geographical areas. On the other hand, AQ is an effective antimalarial drug which its usage has been restricted due to hepatic and hematological toxicities. The significance of the quinoline ring at quinoline-based antimalarial drugs has prompted research centers and pharmaceutical companies to focus on the design and synthesis of new analogues of these drugs, especially CQ and AQ analogues. Accordingly, various derivatives have been synthesized and evaluated in vitro and in vivo against the resistant strains of the malaria parasite to solve the problem of drug resistance. Also, the pharmacokinetic properties of these compounds have been evaluated to augment their efficacy and diminish their toxicity. Some of these analogues are currently in clinical and preclinical development. Consequently, the recent researches showed yet 4-aminoquinoline scaffold is active moiety in new compounds with antiplasmodial activity. Hence, the aim of this review article is to introduce of the novel synthetic analogues of CQ and AQ, which may constitute the next generation of antimalarial drugs with the 4-aminoquinoline scaffold.

Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement

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

Mothiram, Ursula; Brennan, Patrick C; Robinson, John

2013-12-15

Following X-ray exposure, radiographers receive immediate feedback on detector exposure in the form of the exposure index (EI). To identify whether radiographers are meeting manufacturer-recommended EI (MREI) ranges for routine chest, abdomen and pelvis X-ray examinations under a variety of conditions and to examine factors affecting the EI. Data on 5000 adult X-ray examinations including the following variables were collected: examination parameters, EI values, patient gender, date of birth, date and time of examination, grid usage and the presence of implant or prosthesis. Descriptive statistics were used to summarize each data set and the Mann–Whitney U test was used tomore » determine significant differences, with P < 0.05 indicating significance for all tests. Most examinations demonstrated EI values that were outside the MREI ranges, with significantly higher median EI values recorded for female patient radiographs than those for male patients for all manufacturers, indicating higher detector exposures for all units except for Philips digital radiography (DR), where increased EI values indicate lower exposure (P = 0.01). Median EI values for out of hours radiography were also significantly higher compared with normal working hours for all technologies (P ≤ 0.02). Significantly higher median EI values were demonstrated for Philips DR chest X-rays without as compared to those with the employment of a grid (P = 0.03), while significantly lower median EI values were recorded for Carestream Health computed radiography (CR) chest X-rays when an implant or prosthesis was present (P = 0.02). Non-adherence to MREIs has been demonstrated with EI value discrepancies being dependent on patient gender, time/day of exposure, grid usage and the presence of an implant or prosthesis. Retrospective evaluation of EI databases is a valuable tool to assess the need of quality improvement in routine DR.« less

Trends in bednet ownership and usage, and the effect of bednets on malaria hospitalization in the Kilifi Health and Demographic Surveillance System (KHDSS): 2008-2015.

PubMed

Kamau, Alice; Nyaga, Victoria; Bauni, Evasius; Tsofa, Benjamin; Noor, Abdisalan M; Bejon, Philip; Scott, J Anthony G; Hammitt, Laura L

2017-11-15

Use of bednets reduces malaria morbidity and mortality. In Kilifi, Kenya, there was a mass distribution of free nets to children < 5 years in 2006. In 2009, a new policy was implemented to offer bednets to pregnant women and children < 5 years free of charge. Nets were again distributed to children and adults through national mass campaigns in 2012 and 2015. We aimed to evaluate trends in bednet ownership and usage, and the effect of bednets on the incidence of malaria hospitalization in children < 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS). Bednet ownership and usage were assessed during eight routine enumeration rounds of the KHDSS between 2008 and 2015. Malaria admissions (i.e. admissions to hospital with P. falciparum > 2500 parasitemia per μl) among children < 5 years were captured using a system of continuous vital registration that links admissions at Kilifi County Hospital to the KHDSS population register. Survival analysis was used to assess relative risk of hospitalization with malaria among children that reported using a bednet compared to those who did not. We observed 63% and 62% mean bednet ownership and usage, respectively, over the eight-survey period. Among children < 5 years, reported bednet ownership in October-December 2008 was 69% and in March-August 2009 was 73% (p < 0.001). An increase was also observed following the mass distribution campaigns in 2012 (62% in May-July 2012 vs 90% in May-October 2013, p < 0.001) and 2015 (68% in June-September 2015 vs 93% in October-November 2015, p < 0.001). Among children <5 years who reported using a net the night prior to the survey, the incidence of malaria hospitalization per 1000 child-years was 2.91 compared to 4.37 among those who did not (HR = 0.67, 95% CI: 0.52, 0.85 [p = 0.001]). On longitudinal surveillance, increasing bednet ownership and usage corresponded to mass distribution campaigns; however, this method of delivering bednets did not result in sustained improvements in coverage. Among children < 5 years old bednet use was associated with a 33% decreased incidence of malaria hospitalization.

Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems

PubMed Central

Menychtas, Andreas; Tsanakas, Panayiotis

2016-01-01

The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging. PMID:27222731

[The Laboratório de Biologia Infantil, 1935-1941: from forensic medicine to social assistance].

PubMed

Silva, Renato da

2011-12-01

This analysis of the history of the Laboratório de Biologia Infantil (Children's Biology Laboratory) discusses topics related to childhood and adolescence published in the Arquivos de Medicina Legal e Identificação do Rio de Janeiro. It underscores the political-institutional and intellectual contexts that prompted the 1930s debate about childhood among physicians, teachers, educators, and politicians, with a special focus on Leonídio Ribeiro, founder and first editor of the journal. The Laboratório inaugurated a medical and scientific routine for studying, treating, and providing assistance within institutions that had been created to repress, care for, and cure, and as such it represented an important chapter in the history of so-called abandoned and delinquent childhood.

Delayed diagnosis of Addison's disease: an approach to management.

PubMed

Mascarenhas, Janice V; Jude, Edward B

2014-07-18

Addison's disease accounts for the majority of cases of adrenal failure that are detected during hospital admissions. Unfortunately, prompt diagnosis of this condition is often delayed due to varied atypical manifestations and inadequate assessment at the time of presentation. We report a case of a 52-year-old woman who was detected to have hypotension during routine colonoscopy for evaluation of anaemia and progressive weight loss. During admission for evaluation of hypotension, she was also detected to have hyponatremia. Hyponatremia and hypotension failed to improve despite fluid resuscitation. Our endocrinological opinion was sought for and on further evaluation she was diagnosed with primary adrenal insufficiency. Glucocorticoid and mineralocorticoid replacement therapy were eventually instituted, which was followed by restoration of blood pressure and normalisation of serum sodium levels. 2014 BMJ Publishing Group Ltd.

The kinds of questions asked by novice teachers in learning mathematics

NASA Astrophysics Data System (ADS)

Zahra, L.; Kusmayadi, T. A.; Usodo, B.

2018-05-01

This study describes the kinds of questions asked by novice teachers during mathematics learning process in senior high school. This study used descriptive analysis. The subjects of this study were two novice teachers who teach mathematics in 10th grade. The result showed that the frequently asked questions by novice teachers based on the objective were compliance questions, rethorical questions and sometimes prompting questions and probing questions. The frequently questions asked by novice teacher based on the cognitive process dimension of Revised Bloom’s Taxonomy were questions of remembering, questions of understanding, questions of applying, questions of analyzing and questions of evaluating. The novice teachers asked the routine questions which had same thinking level. The question with the highest level of thinking did not asked by the novice teachers.

Intuition in medical practice: A reflection on Donald Schön's reflective practitioner.

PubMed

Mickleborough, Tim

2015-01-01

In a recent commentary, Dr. Abhishek Biswas asks the question whether physicians should rely on their "gut feeling" when making clinical decisions. Biswas describes a situation where his intuition resulted in an immediate course of action that prompted urgent medical attention for a patient who had "routine" pain. Inspired by the author's account, I would like to further Biswas' discussion and examine its importance using the educational theories of Donald Schön and his concept of the reflective practitioner. Schön argues that technical knowledge alone is not sufficient to solve the complex problems that professionals face on a daily basis and intuition, developed through a reflective practice, is crucial for any professional's practice, especially in a time of greater uncertainty in the workplace.

Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems.

PubMed

Menychtas, Andreas; Tsanakas, Panayiotis; Maglogiannis, Ilias

2016-03-01

The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging.

Longer term impact of the mass media campaign to promote the Get Healthy Information and Coaching Service®: increasing the saliency of a new public health program.

PubMed

O'Hara, Blythe J; Phongsavan, Philayrath; Gebel, Klaus; Banovic, Debbie; Buffett, Kym M; Bauman, Adrian E

2014-11-01

The Get Healthy Information and Coaching Service® (GHS) was introduced in New South Wales in February 2009. It used mass reach media advertising and direct mail and/or proactive marketing to recruit participants. This article reports on the long-term impact of the campaign on GHS participation from July 2011 to June 2012. A stand-alone population survey collected awareness, knowledge, and behavioral variables before the first advertising phase, (n = 1,544, August-September 2010), during the advertising period (n = 1,500, February-March 2011; n = 1,500, June-July 2011; n = 1,500, February 2012), and after the advertising period (n = 1,500, June-July 2012). GHS usage data (n = 6,095) were collated during July 2011-June 2012. Unprompted and prompted awareness of GHS mass media significantly increased (0% to 8.0%, p < .001; and 14.1% to 43.9%, p < .001, respectively) as well as knowledge and perceived effectiveness of the GHS. Those from the lowest three quintiles of socioeconomic disadvantage and respondents who were overweight or obese were significantly more likely to report prompted campaign awareness. The majority (84.4%) of new GHS calls occurred when television advertising was present. Participants who cited mass media as their referral source were significantly more likely to enroll in the intensive coaching program. Mass media campaigns remain an effective method of promoting a telephone-based statewide lifestyle program. © 2014 Society for Public Health Education.

Oxygen therapy for acute myocardial infarction.

PubMed

Cabello, Juan B; Burls, Amanda; Emparanza, José I; Bayliss, Susan E; Quinn, Tom

2016-12-19

Oxygen (O 2 ) is widely used in people with acute myocardial infarction (AMI). Previous systematic reviews concluded that there was insufficient evidence to know whether oxygen reduced, increased or had no effect on heart ischaemia or infarct size. Our first Cochrane review in 2010 also concluded there was insufficient evidence to know whether oxygen should be used. Since 2010, the lack of evidence to support this widely used intervention has attracted considerable attention, prompting further trials of oxygen therapy in myocardial infarction patients. It is thus important to update this Cochrane review. To assess the effects of routine use of inhaled oxygen for acute myocardial infarction (AMI). We searched the following bibliographic databases on 6 June 2015: the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE (OVID), Embase (OVID), CINAHL (EBSCO) and Web of Science (Thomson Reuters). LILACS (Latin American and Caribbean Health Sciences Literature) was last searched in September 2016. We also contacted experts to identify eligible studies. We applied no language restrictions. Randomised controlled trials in people with suspected or proven AMI (ST-segment elevation myocardial infarction (STEMI) or non-STEMI) within 24 hours after onset, in which the intervention was inhaled oxygen (at normal pressure) compared to air, regardless of co-therapies provided to participants in both arms of the trial. Two authors independently reviewed the titles and abstracts of identified studies to see if they met the inclusion criteria and independently undertook the data extraction. We assessed the quality of studies and the risk of bias according to guidance in the Cochrane Handbook for Systematic Reviews of Interventions. The primary outcome was death. The measure of effect used was the risk ratio (RR) with a 95% confidence interval (CI). We used the GRADE approach to evaluate the quality of the evidence and the GRADE profiler (GRADEpro) to import data from Review Manager 5 and create 'Summary of findings' tables. The updated search yielded one new trial, for a total of five included studies involving 1173 participants, 32 of whom died. The pooled risk ratio (RR) of all-cause mortality in the intention-to-treat analysis was 0.99 (95% CI 0.50 to 1.95; 4 studies, N = 1123; I 2 = 46%; quality of evidence: very low) and 1.02 (95% CI 0.52 to 1.98; 4 studies, N = 871; I 2 = 49%; quality of evidence: very low) when only analysing participants with confirmed AMI. One trial measured pain directly, and two others measured it by opiate usage. The trial showed no effect, with a pooled RR of 0.97 for the use of opiates (95% CI 0.78 to 1.20; 2 studies, N = 250). The result on mortality and pain are inconclusive. There is no clear effect for oxygen on infarct size (the evidence is inconsistent and low quality). There is no evidence from randomised controlled trials to support the routine use of inhaled oxygen in people with AMI, and we cannot rule out a harmful effect. Given the uncertainty surrounding the effect of oxygen therapy on all-cause mortality and on other outcomes critical for clinical decision, well-conducted, high quality randomised controlled trials are urgently required to inform guidelines in order to give definitive recommendations about the routine use of oxygen in AMI.

A model for planning local contraceptive services.

PubMed

Wilson, S

1989-09-01

Data were collected on abortion referral rates, single young maternity rates and uptake of contraceptive services in order to identify specific areas of unmet need in the Nottingham Health District. Comparisons were made between boroughs and in the City of Nottingham between electoral wards. There was a direct relationship between abortion rate, single young maternity rate and social disadvantage. Analysis of contraceptive usage suggested a more ineffective service in the inner city, which has implications for the more efficient use of resources in the future. Targeting of consumer acceptable services to residents of the inner city and teenagers in general was recommended as a result of the study. For future planning a more useful routine data set was developed to record the activity at family planning clinics.

Technical aspects and limitations of fractional flow reserve measurement.

PubMed

Jerabek, Stepan; Kovarnik, Tomas

2018-02-27

The only indication for coronary revascularization is elimination of ischaemia. Invasive hemodynamic methods (fractional flow reserve - FFR and instantaneous wave-free ratio (iFR) are superior to coronary angiography in detection of lesions causing myocardial ischaemia. Current European guidelines for myocardial revascularization recommend using of FFR for detection of functional assessment of lesions severity in category IA and number of these procedures increases. However, routine usage of these methods requires knowledge of technical requirements and limitations. The aim of the study is to summarise good clinical practice for FFR and iFR measurements with explanation of possible technical challenges, that are necessary for increasing of measurement accuracy. Authors describe frequent technical mistakes and malpractice during invasive assessment of lesion severity in coronary arteries.

Imaging mass spectrometry statistical analysis.

PubMed

Jones, Emrys A; Deininger, Sören-Oliver; Hogendoorn, Pancras C W; Deelder, André M; McDonnell, Liam A

2012-08-30

Imaging mass spectrometry is increasingly used to identify new candidate biomarkers. This clinical application of imaging mass spectrometry is highly multidisciplinary: expertise in mass spectrometry is necessary to acquire high quality data, histology is required to accurately label the origin of each pixel's mass spectrum, disease biology is necessary to understand the potential meaning of the imaging mass spectrometry results, and statistics to assess the confidence of any findings. Imaging mass spectrometry data analysis is further complicated because of the unique nature of the data (within the mass spectrometry field); several of the assumptions implicit in the analysis of LC-MS/profiling datasets are not applicable to imaging. The very large size of imaging datasets and the reporting of many data analysis routines, combined with inadequate training and accessible reviews, have exacerbated this problem. In this paper we provide an accessible review of the nature of imaging data and the different strategies by which the data may be analyzed. Particular attention is paid to the assumptions of the data analysis routines to ensure that the reader is apprised of their correct usage in imaging mass spectrometry research. Copyright © 2012 Elsevier B.V. All rights reserved.

The impact of using student-dictated oral review stories on science vocabulary, content knowledge, and non-fiction writing skills of first grade students

NASA Astrophysics Data System (ADS)

Bishoff, Sandra Wells

The purpose of this study was to determine if using an intervention called Student Dictated Oral Review Stories (SDORS) had an effect on science vocabulary usage and content knowledge for ninety-three students in six first grade classrooms and the subgroup of economically disadvantaged students in a mid-sized north Texas school district. The five science units involved in the study were written incorporating the strand of physical science. Data from pre- and posttests from each unit and an end-of-study assessment were compiled and analyzed. This study also looked at integration of science with literacy through analysis of students' science journal writings. Journal writings were analyzed for vocabulary usage and non-fiction writing skills of capitalization and punctuation. Average sentence length was also analyzed for Units 1--5 of the treatment group. It was anticipated that the outcomes of this study would allow school districts and curriculum writers to determine how to best integrate key concepts and important vocabulary with literacy particularly in the area of science. Results from the study showed significant differences in the end-of-study assessment, vocabulary usage as evidenced in journal writings, and average sentence length. Although there was gain over time for every student in the study in vocabulary and content knowledge, these gains could not be attributed to the intervention. This study also hoped to establish whether students were using science vocabulary routinely in their discussions and their writings and were building and continually assessing their own schemas about scientific concepts through using Student Dictated Oral Review Stories.

Effects of Pre-Existing Liver Disease on Acute Pain Management Using Patient-Controlled Analgesia Fentanyl With Parecoxib After Major Liver Resection: A Retrospective, Pragmatic Study.

PubMed

Lim, K I; Chiu, Y C; Chen, C L; Wang, C H; Huang, C J; Cheng, K W; Wu, S C; Shih, T H; Yang, S C; Juang, S E; Huang, C E; Jawan, B; Lee, Y E

2016-05-01

The aim of this study was to compare the outcomes of pain management with the use of patient-controlled analgesia (PCA) fentanyl with IV parecoxib between patients with healthy liver with patients with diseased liver undergoing major liver resection. Patients with healthy liver undergoing partial hepatectomy as liver donors for liver transplantation (group 1) and patients with liver cirrhosis (Child's criteria A) undergoing major liver resection for hepatoma (group 2) were identified retrospectively. Both groups routinely received post-operative IV PCA fentanyl and a single dose of parecoxib 40 mg. They were followed up for 3 days or until PCA fentanyl was discontinued post-operatively. Daily Visual Analog Scale, PCA fentanyl usage, rescue attempts, and common drug side effects were collected and analyzed with the use of SPSS version 20. One hundred one patients were included in the study: 54 in group 1, and 47 in group 2. There were no statistical differences between the two groups in terms of the daily and total fentanyl usage, VAS resting, and incidence of itchiness. The rate of rescue analgesia on post-operative day (POD) 1 was lower in group 2, with a value of P = .045. VAS dynamics were better on POD 1 and 2 for group 2, with P = .05 and P = .012, respectively. We found that combining a single dose of IV parecoxib 40 mg with PCA fentanyl is an easy and effective method of acute pain control after major liver resection. We propose the careful usage of post-operative fentanyl and parecoxib in patients with diseased liver, given the difference in effect as compared with healthy liver. Copyright © 2016 Elsevier Inc. All rights reserved.

Application of process mapping to understand integration of high risk medicine care bundles within community pharmacy practice.

PubMed

Weir, Natalie M; Newham, Rosemary; Corcoran, Emma D; Ali Atallah Al-Gethami, Ashwag; Mohammed Abd Alridha, Ali; Bowie, Paul; Watson, Anne; Bennie, Marion

2017-11-21

The Scottish Patient Safety Programme - Pharmacy in Primary Care collaborative is a quality improvement initiative adopting the Institute of Healthcare Improvement Breakthrough Series collaborative approach. The programme developed and piloted High Risk Medicine (HRM) Care Bundles (CB), focused on warfarin and non-steroidal anti-inflammatories (NSAIDs), within 27 community pharmacies over 4 NHS Regions. Each CB involves clinical assessment and patient education, although the CB content varies between regions. To support national implementation, this study aims to understand how the pilot pharmacies integrated the HRM CBs into routine practice to inform the development of a generic HRM CB process map. Regional process maps were developed in 4 pharmacies through simulation of the CB process, staff interviews and documentation of resources. Commonalities were collated to develop a process map for each HRM, which were used to explore variation at a national event. A single, generic process map was developed which underwent validation by case study testing. The findings allowed development of a generic process map applicable to warfarin and NSAID CB implementation. Five steps were identified as required for successful CB delivery: patient identification; clinical assessment; pharmacy CB prompt; CB delivery; and documentation. The generic HRM CB process map encompasses the staff and patients' journey and the CB's integration into routine community pharmacy practice. Pharmacist involvement was required only for clinical assessment, indicating suitability for whole-team involvement. Understanding CB integration into routine practice has positive implications for successful implementation. The generic process map can be used to develop targeted resources, and/or be disseminated to facilitate CB delivery and foster whole team involvement. Similar methods could be utilised within other settings, to allow those developing novel services to distil the key processes and consider their integration within routine workflows to effect maximal, efficient implementation and benefit to patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

Searching for high-energy gamma-ray counterparts to gravitational-wave sources with Fermi-LAT: A needle in a haystack

DOE PAGES

Vianello, G.; Omodei, N.; Chiang, J.; ...

2017-05-20

At least a fraction of gravitational-wave (GW) progenitors are expected to emit an electromagnetic (EM) signal in the form of a short gamma-ray burst (sGRB). Discovering such a transient EM counterpart is challenging because the LIGO/VIRGO localization region is much larger (several hundreds of square degrees) than the field of view of X-ray, optical, and radio telescopes. The Fermi Large Area Telescope (LAT) has a wide field of view (~2.4 sr) and detects ~2–3 sGRBs per year above 100 MeV. It can detect them not only during the short prompt phase, but also during their long-lasting high-energy afterglow phase. If other wide-field, high-energy instruments such as Fermi-GBM, Swift-BAT, or INTEGRAL-ISGRI cannot detect or localize with enough precision an EM counterpart during the prompt phase, the LAT can potentially pinpoint it withmore » $$\\lesssim 10$$ arcmin accuracy during the afterglow phase. This routinely happens with gamma-ray bursts. Moreover, the LAT will cover the entire localization region within hours of any triggers during normal operations, allowing the γ-ray flux of any EM counterpart to be measured or constrained. As a result, we illustrate two new ad hoc methods to search for EM counterparts with the LAT and their application to the GW candidate LVT151012.« less

Searching for high-energy gamma-ray counterparts to gravitational-wave sources with Fermi-LAT: A needle in a haystack

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

Vianello, G.; Omodei, N.; Chiang, J.

At least a fraction of gravitational-wave (GW) progenitors are expected to emit an electromagnetic (EM) signal in the form of a short gamma-ray burst (sGRB). Discovering such a transient EM counterpart is challenging because the LIGO/VIRGO localization region is much larger (several hundreds of square degrees) than the field of view of X-ray, optical, and radio telescopes. The Fermi Large Area Telescope (LAT) has a wide field of view (~2.4 sr) and detects ~2–3 sGRBs per year above 100 MeV. It can detect them not only during the short prompt phase, but also during their long-lasting high-energy afterglow phase. If other wide-field, high-energy instruments such as Fermi-GBM, Swift-BAT, or INTEGRAL-ISGRI cannot detect or localize with enough precision an EM counterpart during the prompt phase, the LAT can potentially pinpoint it withmore » $$\\lesssim 10$$ arcmin accuracy during the afterglow phase. This routinely happens with gamma-ray bursts. Moreover, the LAT will cover the entire localization region within hours of any triggers during normal operations, allowing the γ-ray flux of any EM counterpart to be measured or constrained. As a result, we illustrate two new ad hoc methods to search for EM counterparts with the LAT and their application to the GW candidate LVT151012.« less

Cherenkov and scintillation light separation on the CheSS experiment

NASA Astrophysics Data System (ADS)

Caravaca, Javier; Land, Benjamin; Descamps, Freija; Orebi Gann, Gabriel D.

2016-09-01

Separation of the scintillation and Cherenkov light produced in liquid scintillators enables outstanding capabilities for future particle detectors, the most relevant being: particle directionality information in a low energy threshold detector and improved particle identification. The CheSS experiment uses an array of small, fast photomultipliers (PMTs) and state-of-the-art electronics to demonstrate the reconstruction of a Cherenkov ring in liquid scintillator using two techniques: based on the photon density and using the photon hit time information. A charged particle ionizing a scintillation medium produces a prompt Cherenkov cone and late isotropic scintillation light, typically delayed by several ns. The fast response of our PMTs and DAQ provides a precision well below the ns level, making possible the time separation. Furthermore, the usage of the new developed water-based liquid scintillators (WbLS) enhances the separation since it allows tuning of the Cherenkov/Scintillation ratio. Latest results on the separation for pure liquid scintillators and WbLS will be presented.

Edible insects - defining knowledge gaps in biological and ethical considerations of entomophagy.

PubMed

Pali-Schöll, Isabella; Binder, Regina; Moens, Yves; Polesny, Friedrich; Monsó, Susana

2018-04-25

While seeking novel food sources to feed the increasing population of the globe, several alternatives have been discussed, including algae, fungi or in vitro meat. The increasingly propagated usage of farmed insects for human nutrition raises issues regarding food safety, consumer information and animal protection. In line with law, insects like any other animals must not be reared or manipulated in a way that inflicts unnecessary pain, distress or harm on them. Currently, there is a great need for research in the area of insect welfare, especially regarding species-specific needs, health, farming systems and humane methods of killing. Recent results from neurophysiological, neuroanatomical and behavioral sciences prompt caution when denying consciousness and therefore the likelihood of presence of pain and suffering or something closely related to it to insects. From an animal protection point of view, these issues should be satisfyingly solved before propagating and establishing intensive husbandry systems for insects as a new type of mini-livestock factory farming.

Drug functionalized microbial polysaccharide based nanofibers as transdermal substitute.

PubMed

Vashisth, Priya; Srivastava, Amit Kumar; Nagar, Hemant; Raghuwanshi, Navdeep; Sharan, Shruti; Nikhil, Kumar; Pruthi, Parul A; Singh, Rajesh P; Roy, Partha; Pruthi, Vikas

2016-07-01

In order to promote the natural healing process, drug-functionalized nanofibrous transdermal substitute was fabricated using gellan as chief polymer and polyvinyl alcohol (PVA) as supporting polymer via electrospinning technique. These fabricated nanofibers physiochemically mimic the extracellular matrix (ECM) which supports the cell growth. For neo-tissue regeneration in a sterilized environment, amoxicillin (Amx) was entrapped within these nanofibers. Entrapment of Amx in the nanofibers was confirmed by FESEM, FTIR, XRD and TG analysis. In vitro cell culture studies revealed that the fabricated non-cytotoxic nanofibers promoted enhance cell adherence and proliferation of human keratinocytes. A preliminary in vivo study performed on rat model for full thickness skin excision wound demonstrated the prompt re-epithelialization in early phase and quicker collagen deposition in later phases of wound healing in case of Amx-functionalized gellan/PVA nanofibers. Data collectively confirmed the potential usage of gellan based electrospun nanofibers as transdermal substitute for faster skin restoration. Copyright © 2016 Elsevier Inc. All rights reserved.

Rapid Identification of Synthetic Cannabinoids in Herbal Incenses with DART-MS and NMR.

PubMed

Marino, Michael A; Voyer, Brandy; Cody, Robert B; Dane, A John; Veltri, Mercurio; Huang, Ling

2016-01-01

The usage of herbal incenses containing synthetic cannabinoids has caused an increase in medical incidents and triggered legislations to ban these products throughout the world. Law enforcement agencies are experiencing sample backlogs due to the variety of the products and the addition of new and still-legal compounds. In our study, proton nuclear magnetic resonance (NMR) spectroscopy was employed to promptly screen the synthetic cannabinoids after their rapid, direct detection on the herbs and in the powders by direct analysis in real time mass spectrometry (DART-MS). A simple sample preparation protocol was employed on 50 mg of herbal sample matrices for quick NMR detection. Ten synthetic cannabinoids were discovered in fifteen herbal incenses. The combined DART-MS and NMR methods can be used to quickly screen synthetic cannabinoids in powder and herbal samples, serving as a complementary approach to conventional GC-MS or LC-MS methods. © 2015 American Academy of Forensic Sciences.

Antimicrobial stewardship: English Surveillance Programme for Antimicrobial Utilization and Resistance (ESPAUR).

PubMed

Ashiru-Oredope, Diane; Hopkins, Susan

2013-11-01

The clinical, public health and economic implications of antimicrobial resistance present a major threat to future healthcare. Antimicrobial use is a major driver of resistance, and antimicrobial stewardship programmes are increasingly being advocated as a means of improving the quality of prescribing. However, to increase their impact and assess their success, a better understanding of antimicrobial usage, both in primary and secondary care, and linkage with antimicrobial resistance data are required. In England, national summaries of primary care dispensing data are issued annually by the Health and Social Care Information Centre. However, there is currently no routine public reporting of antimicrobial usage in hospitals. In response to the threat posed by antimicrobial resistance, as highlighted in the Report of the Chief Medical Officer and on the request of the Department of Health, Public Health England has developed a new national programme, the English Surveillance Programme for Antimicrobial Utilization and Resistance (ESPAUR). The programme will bring together the elements of antimicrobial utilization and resistance surveillance in both primary and secondary care settings, alongside the development of quality measures and methods to monitor unintended outcomes of antimicrobial stewardship and both public and professional behaviour interventions. This article reports on the background to the programme development, the current oversight group membership and the public reporting structure.

Phthalates impact human health: Epidemiological evidences and plausible mechanism of action.

PubMed

Benjamin, Sailas; Masai, Eiji; Kamimura, Naofumi; Takahashi, Kenji; Anderson, Robin C; Faisal, Panichikkal Abdul

2017-10-15

Disregarding the rising alarm on the hazardous nature of various phthalates and their metabolites, ruthless usage of phthalates as plasticizer in plastics and as additives in innumerable consumer products continues due low their cost, attractive properties, and lack of suitable alternatives. Globally, in silico computational, in vitro mechanistic, in vivo preclinical and limited clinical or epidemiological human studies showed that over a dozen phthalates and their metabolites ingested passively by man from the general environment, foods, drinks, breathing air, and routine household products cause various dysfunctions. Thus, this review addresses the health hazards posed by phthalates on children and adolescents, epigenetic modulation, reproductive toxicity in women and men; insulin resistance and type II diabetes; overweight and obesity, skeletal anomalies, allergy and asthma, cancer, etc., coupled with the description of major phthalates and their general uses, phthalate exposure routes, biomonitoring and risk assessment, special account on endocrine disruption; and finally, a plausible molecular cross-talk with a unique mechanism of action. This clinically focused comprehensive review on the hazards of phthalates would benefit the general population, academia, scientists, clinicians, environmentalists, and law or policy makers to decide upon whether usage of phthalates to be continued swiftly without sufficient deceleration or regulated by law or to be phased out from earth forever. Copyright © 2017. Published by Elsevier B.V.

Variability in the Propagation Phase of CFD-Based Noise Prediction: Summary of Results From Category 8 of the BANC-III Workshop

NASA Technical Reports Server (NTRS)

Lopes, Leonard; Redonnet, Stephane; Imamura, Taro; Ikeda, Tomoaki; Zawodny, Nikolas; Cunha, Guilherme

2015-01-01

The usage of Computational Fluid Dynamics (CFD) in noise prediction typically has been a two part process: accurately predicting the flow conditions in the near-field and then propagating the noise from the near-field to the observer. Due to the increase in computing power and the cost benefit when weighed against wind tunnel testing, the usage of CFD to estimate the local flow field of complex geometrical structures has become more routine. Recently, the Benchmark problems in Airframe Noise Computation (BANC) workshops have provided a community focus on accurately simulating the local flow field near the body with various CFD approaches. However, to date, little effort has been given into assessing the impact of the propagation phase of noise prediction. This paper includes results from the BANC-III workshop which explores variability in the propagation phase of CFD-based noise prediction. This includes two test cases: an analytical solution of a quadrupole source near a sphere and a computational solution around a nose landing gear. Agreement between three codes was very good for the analytic test case, but CFD-based noise predictions indicate that the propagation phase can introduce 3dB or more of variability in noise predictions.

Analytical Eco-Scale for Assessing the Greenness of a Developed RP-HPLC Method Used for Simultaneous Analysis of Combined Antihypertensive Medications.

PubMed

Mohamed, Heba M; Lamie, Nesrine T

2016-09-01

In the past few decades the analytical community has been focused on eliminating or reducing the usage of hazardous chemicals and solvents, in different analytical methodologies, that have been ascertained to be extremely dangerous to human health and environment. In this context, environmentally friendly, green, or clean practices have been implemented in different research areas. This study presents a greener alternative of conventional RP-HPLC methods for the simultaneous determination and quantitative analysis of a pharmaceutical ternary mixture composed of telmisartan, hydrochlorothiazide, and amlodipine besylate, using an ecofriendly mobile phase and short run time with the least amount of waste production. This solvent-replacement approach was feasible without compromising method performance criteria, such as separation efficiency, peak symmetry, and chromatographic retention. The greenness profile of the proposed method was assessed and compared with reported conventional methods using the analytical Eco-Scale as an assessment tool. The proposed method was found to be greener in terms of usage of hazardous chemicals and solvents, energy consumption, and production of waste. The proposed method can be safely used for the routine analysis of the studied pharmaceutical ternary mixture with a minimal detrimental impact on human health and the environment.

Helicobacter infections with rare bacteria or minimal gastritis: Expecting the unexpected.

PubMed

Glickman, Jonathan N; Noffsinger, Amy; Nevin, Daniel T; Ray, Mukunda; Lash, Richard H; Genta, Robert M

2015-07-01

The routine use of special stains for detection of Helicobacter remains controversial. To determine the frequency of histologically atypical Helicobacter infection. All gastric biopsies received at a large pathology reference laboratory over a 6-month period were stained for Helicobacter, and the histologic and clinicopathologic parameters evaluated. Amongst 7663 Helicobacter-positive biopsies, 823 (10.7%) did not show typical chronic active gastritis with numerous Helicobacter organisms, and were therefore considered histologically atypical. Rare Helicobacter pylori organisms accounted for 58.0% of all atypical infections; the next most common atypical Helicobacter infection was that with minimal or no gastric inflammation (23.3% of atypical infections). Patients in these groups did not differ demographically from those with other forms of atypical or typical Helicobacter infection, although a small subgroup (6%) was more likely to have had a previously treated infection. In many of these atypical infections, Helicobacter would not have been suspected based on the histologic findings alone, and would have been missed without routine special stains. Performing a sensitive stain could prevent additional testing and allow prompt treatment of the affected patients, thus substantially reducing the risk for peptic ulcer and gastric cancer and preventing the transmission of the infection to family members. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Statistical detection of geographic clusters of resistant Escherichia coli in a regional network with WHONET and SaTScan.

PubMed

Park, Rachel; O'Brien, Thomas F; Huang, Susan S; Baker, Meghan A; Yokoe, Deborah S; Kulldorff, Martin; Barrett, Craig; Swift, Jamie; Stelling, John

2016-11-01

While antimicrobial resistance threatens the prevention, treatment, and control of infectious diseases, systematic analysis of routine microbiology laboratory test results worldwide can alert new threats and promote timely response. This study explores statistical algorithms for recognizing geographic clustering of multi-resistant microbes within a healthcare network and monitoring the dissemination of new strains over time. Escherichia coli antimicrobial susceptibility data from a three-year period stored in WHONET were analyzed across ten facilities in a healthcare network utilizing SaTScan's spatial multinomial model with two models for defining geographic proximity. We explored geographic clustering of multi-resistance phenotypes within the network and changes in clustering over time. Geographic clustering identified from both latitude/longitude and non-parametric facility groupings geographic models were similar, while the latter was offers greater flexibility and generalizability. Iterative application of the clustering algorithms suggested the possible recognition of the initial appearance of invasive E. coli ST131 in the clinical database of a single hospital and subsequent dissemination to others. Systematic analysis of routine antimicrobial resistance susceptibility test results supports the recognition of geographic clustering of microbial phenotypic subpopulations with WHONET and SaTScan, and iterative application of these algorithms can detect the initial appearance in and dissemination across a region prompting early investigation, response, and containment measures.

Untreated Peristomal Skin Complications among Long-Term Colorectal Cancer Survivors with Ostomies: Lessons from a Study of Family Caregiving

PubMed Central

McMullen, Carmit K.; Wasserman, Joseph; Altschuler, Andrea; Grant, Marcia; Hornbrook, Mark C.; Liljestrand, Petra; Briggs, Catherine; Krouse, Robert S.

2013-01-01

This ethnography of family caregiving explored why peristomal skin complications are both common and undertreated among colorectal cancer (CRC) survivors with intestinal ostomies. We sought to identify factors that hinder or facilitate prompt detection and treatment of ostomy and skin problems. We collected data through in-depth interviews with 31 cancer survivors and their family caregivers, fieldwork, structured assessments, and medical records review. We analyzed data using qualitative theme and matrix analyses. We found that survivors who received help changing the skin barrier around their stoma had fewer obstacles to detection and treatment of peristomal skin complications. Half of the survivors received unpaid help with ostomy care. All such help came from spouses. Married couples who collaborated in ostomy care reported that having assistance in placing the ostomy appliance helped with preventing leaks, detecting skin changes, and modifying ostomy care routines. Survivors who struggled to manage ostomy care independently reported more obstacles to alleviating and seeking treatment for skin problems. Nurses who encounter CRC survivors with ostomies can improve treatment of peristomal skin problems by asking patients and caregivers about ostomy care and skin problems, examining the peristomal area, and facilitating routine checkups with a wound, ostomy and continence nurse. PMID:22119975

Usage of the www.2aida.org AIDA diabetes software Website: a pilot study.

PubMed

Lehmann, Eldon D

2003-01-01

AIDA is a diabetes-computing program freely available from www.2aida.org on the Web. The software is intended to serve as an educational support tool, and can be used by anyone who has an interest in diabetes, whether they be patients, relatives, health-care professionals, or students. In previous "Diabetes Information Technology & WebWatch" columns various indicators of usage of the AIDA program have been reviewed, and various comments from users of the software have been documented. One aspect of AIDA, though, that has been of considerable interest has been to investigate its Web-based distribution as a wider paradigm for more general medically related usage of the Internet. In this respect we have been keen to understand in general terms: (1) why people are turning to the Web for health-care/diabetes information; (2) more specifically, what sort of people are making use of the AIDA software; and (3) what benefits they feel might accrue from using the program. To answer these types of questions we have been conducting a series of audits/surveys via the AIDA Website, and via the software program itself, to learn as much as possible about who the AIDA end users really are. The rationale for this work is that, in this way, it should be possible to improve the program as well as tailor future versions of the software to the interests and needs of its users. However, a recurring observation is that data collection is easiest if it is as unobtrusive and innocuous as possible. One aspect of learning as much as possible about diabetes Website visitors and users may be to apply techniques that do not necessitate any visitor or user interaction. There are various programs that can monitor what pages visitors are viewing at a site. As these programs do not require visitors to do anything special, over time some interesting insights into Website usage may be obtained. For the current study we have reviewed anonymous logstats data, which are automatically collected at many Websites, to try and establish a baseline level of usage for the AIDA site. For the initial pilot study the analysis was performed from October 1, 2000 to November 1, 2001. The study has yielded an interesting insight into how the AIDA Website is being used. The results also confirm those of previous audits based on different self-reported methodologies, confirming, amongst other things, what countries people are visiting from and what operating systems/computers they are using. These analyses have been informative and useful. Given this, it is proposed to repeat the current pilot survey approach on a routine basis, in the future, as a way of monitoring on-going usage of the AIDA Website.

Model Verification and Validation Concepts for a Probabilistic Fracture Assessment Model to Predict Cracking of Knife Edge Seals in the Space Shuttle Main Engine High Pressure Oxidizer

NASA Technical Reports Server (NTRS)

Pai, Shantaram S.; Riha, David S.

2013-01-01

Physics-based models are routinely used to predict the performance of engineered systems to make decisions such as when to retire system components, how to extend the life of an aging system, or if a new design will be safe or available. Model verification and validation (V&V) is a process to establish credibility in model predictions. Ideally, carefully controlled validation experiments will be designed and performed to validate models or submodels. In reality, time and cost constraints limit experiments and even model development. This paper describes elements of model V&V during the development and application of a probabilistic fracture assessment model to predict cracking in space shuttle main engine high-pressure oxidizer turbopump knife-edge seals. The objective of this effort was to assess the probability of initiating and growing a crack to a specified failure length in specific flight units for different usage and inspection scenarios. The probabilistic fracture assessment model developed in this investigation combined a series of submodels describing the usage, temperature history, flutter tendencies, tooth stresses and numbers of cycles, fatigue cracking, nondestructive inspection, and finally the probability of failure. The analysis accounted for unit-to-unit variations in temperature, flutter limit state, flutter stress magnitude, and fatigue life properties. The investigation focused on the calculation of relative risk rather than absolute risk between the usage scenarios. Verification predictions were first performed for three units with known usage and cracking histories to establish credibility in the model predictions. Then, numerous predictions were performed for an assortment of operating units that had flown recently or that were projected for future flights. Calculations were performed using two NASA-developed software tools: NESSUS(Registered Trademark) for the probabilistic analysis, and NASGRO(Registered Trademark) for the fracture mechanics analysis. The goal of these predictions was to provide additional information to guide decisions on the potential of reusing existing and installed units prior to the new design certification.

Prompting technologies: A comparison of time-based and context-aware transition-based prompting

PubMed Central

Robertson, Kayela; Rosasco, Cody; Feuz, Kyle; Schmitter-Edgecombe, Maureen; Cook, Diane

2016-01-01

BACKGROUND While advancements in technology have encouraged the development of novel prompting systems to support cognitive interventions, little research has evaluated the best time to deliver prompts, which may impact the effectiveness of these interventions. OBJECTIVE This study examined whether transition-based context prompting (prompting an individual during task transitions) is more effective than traditional fixed time-based prompting. METHODS Participants were 42 healthy adults who completed 12 different everyday activities, each lasting 1–7 minutes, in an experimental smart home testbed and received prompts to record the completed activities from an electronic memory notebook. Half of the participants were delivered prompts during activity transitions, while the other half received prompts every 5 minutes. Participants also completed Likert-scale ratings regarding their perceptions of the prompting system. RESULTS Results revealed that participants in the transition-based context prompting condition responded to the first prompt more frequently and rated the system as more convenient, natural, and appropriate compared to participants in the time-based condition. CONCLUSIONS Our findings suggest that prompting during activity transitions produces higher adherence to the first prompt and more positive perceptions of the prompting system. This is an important finding given the benefits of prompting technology and the possibility of improving cognitive interventions by using context-aware transition prompting. PMID:26409520

HERALD (health economics using routine anonymised linked data).

PubMed

Husain, Muhammad J; Brophy, Sinead; Macey, Steven; Pinder, Leila M; Atkinson, Mark D; Cooksey, Roxanne; Phillips, Ceri J; Siebert, Stefan

2012-03-29

Health economic analysis traditionally relies on patient derived questionnaire data, routine datasets, and outcomes data from experimental randomised control trials and other clinical studies, which are generally used as stand-alone datasets. Herein, we outline the potential implications of linking these datasets to give one single joined up data-resource for health economic analysis. The linkage of individual level data from questionnaires with routinely-captured health care data allows the entire patient journey to be mapped both retrospectively and prospectively. We illustrate this with examples from an Ankylosing Spondylitis (AS) cohort by linking patient reported study dataset with the routinely collected general practitioner (GP) data, inpatient (IP) and outpatient (OP) datasets, and Accident and Emergency department data in Wales. The linked data system allows: (1) retrospective and prospective tracking of patient pathways through multiple healthcare facilities; (2) validation and clarification of patient-reported recall data, complementing the questionnaire/routine data information; (3) obtaining objective measure of the costs of chronic conditions for a longer time horizon, and during the pre-diagnosis period; (4) assessment of health service usage, referral histories, prescribed drugs and co-morbidities; and (5) profiling and stratification of patients relating to disease manifestation, lifestyles, co-morbidities, and associated costs. Using the GP data system we tracked about 183 AS patients retrospectively and prospectively from the date of questionnaire completion to gather the following information: (a) number of GP events; (b) presence of a GP 'drug' read codes; and (c) the presence of a GP 'diagnostic' read codes. We tracked 236 and 296 AS patients through the OP and IP data systems respectively to count the number of OP visits; and IP admissions and duration. The results are presented under several patient stratification schemes based on disease severity, functions, age, sex, and the onset of disease symptoms. The linked data system offers unique opportunities for enhanced longitudinal health economic analysis not possible through the use of traditional isolated datasets. Additionally, this data linkage provides important information to improve diagnostic and referral pathways, and thus helps maximise clinical efficiency and efficiency in the use of resources.

Comparing the Effects of Echoic Prompts and Echoic Prompts Plus Modeled Prompts on Intraverbal Behavior

ERIC Educational Resources Information Center

Valentino, Amber L.; Shillingsburg, M. Alice; Call, Nathan A.

2012-01-01

We compared strategies to teach vocal intraverbal responses to an adolescent diagnosed with autism and Down syndrome. One strategy involved echoic prompts only. The second strategy involved an echoic prompt paired with a modeled prompt in the form of sign language. Presenting the modeled prompt with the echoic prompt resulted in faster acquisition…

Multiple jaw cysts-unveiling the Gorlin-Goltz syndrome.

PubMed

Manjima, S; Naik, Zameera; Keluskar, Vaishali; Bagewadi, Anjana

2015-03-01

Gorlin-Goltz syndrome or basal cell nevus syndrome is a comparatively rare syndrome characterized by basal cell nevi, odontogenic keratocysts, and skeletal anomalies. Diagnosis is based on the major and minor clinical and radiographic criteria. Dentist plays a major role in the diagnosis of this disease due to the oral and maxillofacial manifestations of the syndrome. In some cases, jaw cysts are diagnosed by routine radiographs advised by the dentists. Odontogenic keratocysts in such syndromic patients will be multiple and extensive and in some cases results in cortical expansion and facial disfigurement. Thorough clinical examination and investigations prompt an early confirmation of the syndrome, which is very essential to avoid morbidity associated with the syndrome. Here, we report a case of multiple odontogenic cysts in a 16-year-old patient which later was diagnosed as a case of Gorlin Goltz syndrome.

Multiple jaw cysts-unveiling the Gorlin-Goltz syndrome

PubMed Central

Manjima, S.; Naik, Zameera; Keluskar, Vaishali; Bagewadi, Anjana

2015-01-01

Gorlin-Goltz syndrome or basal cell nevus syndrome is a comparatively rare syndrome characterized by basal cell nevi, odontogenic keratocysts, and skeletal anomalies. Diagnosis is based on the major and minor clinical and radiographic criteria. Dentist plays a major role in the diagnosis of this disease due to the oral and maxillofacial manifestations of the syndrome. In some cases, jaw cysts are diagnosed by routine radiographs advised by the dentists. Odontogenic keratocysts in such syndromic patients will be multiple and extensive and in some cases results in cortical expansion and facial disfigurement. Thorough clinical examination and investigations prompt an early confirmation of the syndrome, which is very essential to avoid morbidity associated with the syndrome. Here, we report a case of multiple odontogenic cysts in a 16-year-old patient which later was diagnosed as a case of Gorlin Goltz syndrome. PMID:25821359

Experts: despite time constraints, motivational interviewing techniques can have lasting impact on drinkers, drug abusers.

PubMed

2013-04-01

Researchers have found that the Brief Negotiation Interview (BNI), a tool developed at Yale School of Medicine in New Haven, CT, can curb harmful drinking in patients when the tool is used with these patients in the emergency setting. Further, by using the same motivational interviewing techniques employed in the tool, experts say providers can help patients curb other harmful behaviors as well. The BNI consists of a series of questions that take about seven minutes to discuss with patients. The tool prompts patients to come up with their own reasons for changing harmful behaviors. To implement the BNI, emergency providers need training and constant reinforcement. Ideally, experts say the motivational interviewing techniques employed in the BNI need to become routine to have a lasting impact on patient care.

[Metabolic disorders as paraneoplastic syndromes].

PubMed

Krug, S; Michl, P

2018-02-01

Paraneoplastic syndromes are characterized by the tumor-induced release of peptide hormones and/or the initiation of immune phenomena, which elicit clinical changes and alterations in laboratory parameters independent of the tumor size and spread. In addition to neurological, endocrinal and rheumatological phenotypes, metabolic alterations play a special role in the clinical routine as they commonly present with acute symptoms in an emergency situation and necessitate immediate diagnosis and prompt initiation of treatment. Metabolic alterations within the framework of malignant diseases should be treated in a multidisciplinary team and it is often necessary to perform monitoring and treatment in an intensive care unit. This article focuses on the diagnostic and therapeutic options for metabolic disorders due to paraneoplastic syndromes, such as hypercalcemia, hypocalcemia, hyperglycemia, hypoglycemia and a special variant of tumor-induced metabolic disorders due to tumor lysis syndrome.

Impact of Probiotics on Necrotizing Enterocolitis

PubMed Central

Underwood, Mark A.

2016-01-01

A large number of randomized placebo-controlled clinical trials and cohort studies have demonstrated a decrease in the incidence of necrotizing enterocolitis with administration of probiotic microbes. These studies have prompted many neonatologists to adopt routine prophylactic administration of probiotics while others await more definitive studies and/or probiotic products with demonstrated purity and stable numbers of live organisms. Cross-contamination and inadequate sample size limit the value of further traditional placebo-controlled randomized controlled trials. Key areas for future research include mechanisms of protection, optimum probiotic species or strains (or combinations thereof) and duration of treatment, interactions between diet and the administered probiotic, and the influence of genetic polymorphisms in the mother and infant on probiotic response. Next generation probiotics selected based on bacterial genetics rather than ease of production and large cluster-randomized clinical trials hold great promise for NEC prevention. PMID:27836423

Performance Characteristics of the Cepheid Xpert vanA Assay for Rapid Identification of Patients at High Risk for Carriage of Vancomycin-Resistant Enterococci

PubMed Central

Gilhuley, Kathleen; Cianciminio-Bordelon, Diane; Tang, Yi-Wei

2012-01-01

We compared the performance characteristics of culture and the Cepheid Xpert vanA assay for routine surveillance of vancomycin-resistant enterococci (VRE) from rectal swabs in patients at high risk for VRE carriage. The Cepheid Xpert vanA assay had a limit of detection of 100 CFU/ml and correctly detected 101 well-characterized clinical VRE isolates with no cross-reactivity in 27 non-VRE and related culture isolates. The clinical sensitivity, specificity, positive predictive value, and negative predictive value of the Xpert vanA PCR assay were 100%, 96.9%, 91.3%, and 100%, respectively, when tested on 300 consecutively collected rectal swabs. This assay provides excellent predictive values for prompt identification of VRE-colonized patients in hospitals with relatively high rates of VRE carriage. PMID:22972822

Barriers to Patient Use of Control Solution for Glucose Meters: Surveys of Patients, Pharmacists, and Providers in a Metropolitan Area.

PubMed

Johnson, Jeremy L; O'Neal, Katherine S; Pack, Christopher C; Carter, Sandra M

2017-05-01

An important factor in controlling diabetes is self-monitoring of blood glucose. Manufacturers of glucose meters recommend routine use of control solution to ensure accuracy. Previous studies have demonstrated that glucose meters vary in accuracy and that patients are not using control solution as recommended. The purpose of this study is to identify potential barriers to control solution use from multiple perspectives including patient, pharmacist, and provider. This study was a prospective, observational survey design. First, 25 randomly selected chain and independent pharmacies in the Tulsa metropolitan area were audited for control solution accessibility. These pharmacies were then used to survey pharmacists, via telephone, regarding control solution inventory and perception of importance of use. Next, providers were electronically surveyed on their routine practice recommendations, while 60 patients with diabetes were randomly selected for telephone survey on use and perceptions of control solution. Twenty-five pharmacies were audited and 23 pharmacists, 60 patients, and 29 providers were surveyed. Only 39% of pharmacies stated they supplied control solution, however, only 1 pharmacy visibly stocked it. The only patient factor that appeared to have an impact on control solution usage was having type 1 versus type 2 diabetes (38% vs 15%). Providers are aware of what control solution is (62%), but only half felt it should be routine practice with 44% of those never recommending it. This study raises awareness for the need to educate patients, providers, and pharmacists about use of control solution to ensure glucose meter accuracy.

Current UK practice of pediatric supraglottic airway devices - a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland.

PubMed

Bradley, Anthony E D; White, Michelle C; Engelhardt, Thomas; Bayley, Guy; Beringer, Richard M

2013-11-01

Over half of general anesthetics in the UK involve supraglottic airway devices (SADs). The National Audit Project 4 undertaken by the Royal College of Anaesthetists demonstrated that aspiration was the most frequent complication relating to SAD use. SADs designed to reduce this risk (second-generation devices) are increasingly recommended in both adults and children. As well as routine use, SADs are recommended for use in cases of 'difficult airway'. This survey assessed current usage of SADs in routine practice and difficult airways. Sixteen questions, approved by the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) survey committee, were distributed to all its members. Two hundred and forty-four members responded. Eighty-eight percent preferentially use first-generation rather than second-generation devices. The most important design feature was the availability of a complete range of sizes (84%). Seventy-seven percent felt that randomized controlled trials assessing SAD safety in children are needed. In cases of failed intubation, classically shaped SADs are preferred (79%). Three percent of responders intubate via an SAD routinely. Eighteen percent have employed this technique in an emergency. Thirty-six percent of responders have found an SAD to function poorly. Pediatric anesthesiologists appear slow to embrace second-generation SADs. The role of SADs in the management of difficult airways is widely accepted. Research currently has little influence over the choice of which SAD to use, which is more likely determined by personal choice and departmental preference. There is a risk that some SADs are unsafe. © 2013 John Wiley & Sons Ltd.

Automating CPM-GOMS

NASA Technical Reports Server (NTRS)

John, Bonnie; Vera, Alonso; Matessa, Michael; Freed, Michael; Remington, Roger

2002-01-01

CPM-GOMS is a modeling method that combines the task decomposition of a GOMS analysis with a model of human resource usage at the level of cognitive, perceptual, and motor operations. CPM-GOMS models have made accurate predictions about skilled user behavior in routine tasks, but developing such models is tedious and error-prone. We describe a process for automatically generating CPM-GOMS models from a hierarchical task decomposition expressed in a cognitive modeling tool called Apex. Resource scheduling in Apex automates the difficult task of interleaving the cognitive, perceptual, and motor resources underlying common task operators (e.g. mouse move-and-click). Apex's UI automatically generates PERT charts, which allow modelers to visualize a model's complex parallel behavior. Because interleaving and visualization is now automated, it is feasible to construct arbitrarily long sequences of behavior. To demonstrate the process, we present a model of automated teller interactions in Apex and discuss implications for user modeling. available to model human users, the Goals, Operators, Methods, and Selection (GOMS) method [6, 21] has been the most widely used, providing accurate, often zero-parameter, predictions of the routine performance of skilled users in a wide range of procedural tasks [6, 13, 15, 27, 28]. GOMS is meant to model routine behavior. The user is assumed to have methods that apply sequences of operators and to achieve a goal. Selection rules are applied when there is more than one method to achieve a goal. Many routine tasks lend themselves well to such decomposition. Decomposition produces a representation of the task as a set of nested goal states that include an initial state and a final state. The iterative decomposition into goals and nested subgoals can terminate in primitives of any desired granularity, the choice of level of detail dependent on the predictions required. Although GOMS has proven useful in HCI, tools to support the construction of GOMS models have not yet come into general use.

Prevalence and related factors of psychological distress among cancer inpatients using routine Distress Thermometer and Chinese Health Questionnaire screening

PubMed Central

Chiou, Yu-Jie; Chiu, Nien-Mu; Wang, Liang-Jen; Li, Shau-Hsuan; Lee, Chun-Yi; Wu, Ming-Kung; Chen, Chien-Chih; Wu, Yi-Shan; Lee, Yu

2016-01-01

Background Clinical practice guidelines suggest routine screening for distress among cancer patients for immediate early psychiatric care. However, previous studies focusing on routine screening for psychological distress among cancer inpatients in Taiwan are scant. Thus, the aim of this study was to evaluate the prevalence and related factors of psychological distress and mental illness among cancer inpatients in Taiwan. Patients and methods This study was conducted as a retrospective chart review in a general hospital in southern Taiwan. Cancer inpatients were regularly screened by nursing staff using the Distress Thermometer and the 12-item Chinese Health Questionnaire. Positive screening results on either instrument were followed by a non-commanded referral to psychiatrists for clinical psychiatric diagnosis and treatment. Results Of the 810 participants in this study, 179 (22.1%) were recognized as having psychological distress. Younger age (odds ratio [OR] =1.82), having head and neck cancer (OR =2.43), and having not received chemotherapy (OR =1.58) were significantly related to psychological distress. Among the 56 patients (31.3%) with psychological distress who were referred to psychiatrists, the most common mental illness was adjustment disorder (n=22, 39.2%), followed by major depressive disorder (n=13, 23.2%), depressive disorder not otherwise specified (n=6, 10.7%), and anxiety disorder not otherwise specified (n=4, 7.1%). Conclusion Our study indicated that cancer inpatients with psychological distress were more likely to be younger in age, have head and neck cancer, and have not received chemotherapy. The most common psychiatric disorder was adjustment disorder. Early detection of psychological distress and prompt psychiatric consultation and management are very important for cancer inpatients. PMID:27822049

Antecedent causes of a measles resurgence in the Democratic Republic of the Congo

PubMed Central

Scobie, Heather Melissa; Ilunga, Benoît Kebela; Mulumba, Audry; Shidi, Calixte; Coulibaly, Tiekoura; Obama, Ricardo; Tamfum, Jean-Jacques Muyembe; Simbu, Elisabeth Pukuta; Smit, Sheilagh Brigitte; Masresha, Balcha; Perry, Robert Tyrrell; Alleman, Mary Margaret; Kretsinger, Katrina; Goodson, James

2015-01-01

Introduction Despite accelerated measles control efforts, a massive measles resurgence occurred in the Democratic Republic of the Congo (DRC) starting in mid-2010, prompting an investigation into likely causes. Methods We conducted a descriptive epidemiological analysis using measles immunization and surveillance data to understand the causes of the measles resurgence and to develop recommendations for elimination efforts in DRC. Results During 2004-2012, performance indicator targets for case-based surveillance and routine measles vaccination were not met. Estimated coverage with the routine first dose of measles-containing vaccine (MCV1) increased from 57% to 73%. Phased supplementary immunization activities (SIAs) were conducted starting in 2002, in some cases with sub-optimal coverage (≤95%). In 2010, SIAs in five of 11 provinces were not implemented as planned, resulting in a prolonged interval between SIAs, and a missed birth cohort in one province. During July 1, 2010-December 30, 2012, high measles attack rates (>100 cases per 100,000 population) occurred in provinces that had estimated MCV1 coverage lower than the national estimate and did not implement planned 2010 SIAs. The majority of confirmed case-patients were aged <10 years (87%) and unvaccinated or with unknown vaccination status (75%). Surveillance detected two genotype B3 and one genotype B2 measles virus strains that were previously identified in the region. Conclusion The resurgence was likely caused by an accumulation of unvaccinated, measles-susceptible children due to low MCV1 coverage and suboptimal SIA implementation. To achieve the regional goal of measles elimination by 2020, efforts are needed in DRC to improve case-based surveillance and increase two-dose measles vaccination coverage through routine services and SIAs. PMID:26401224

Antecedent causes of a measles resurgence in the Democratic Republic of the Congo.

PubMed

Scobie, Heather Melissa; Ilunga, Benoît Kebela; Mulumba, Audry; Shidi, Calixte; Coulibaly, Tiekoura; Obama, Ricardo; Tamfum, Jean-Jacques Muyembe; Simbu, Elisabeth Pukuta; Smit, Sheilagh Brigitte; Masresha, Balcha; Perry, Robert Tyrrell; Alleman, Mary Margaret; Kretsinger, Katrina; Goodson, James

2015-01-01

Despite accelerated measles control efforts, a massive measles resurgence occurred in the Democratic Republic of the Congo (DRC) starting in mid-2010, prompting an investigation into likely causes. We conducted a descriptive epidemiological analysis using measles immunization and surveillance data to understand the causes of the measles resurgence and to develop recommendations for elimination efforts in DRC. During 2004-2012, performance indicator targets for case-based surveillance and routine measles vaccination were not met. Estimated coverage with the routine first dose of measles-containing vaccine (MCV1) increased from 57% to 73%. Phased supplementary immunization activities (SIAs) were conducted starting in 2002, in some cases with sub-optimal coverage (≤95%). In 2010, SIAs in five of 11 provinces were not implemented as planned, resulting in a prolonged interval between SIAs, and a missed birth cohort in one province. During July 1, 2010-December 30, 2012, high measles attack rates (>100 cases per 100,000 population) occurred in provinces that had estimated MCV1 coverage lower than the national estimate and did not implement planned 2010 SIAs. The majority of confirmed case-patients were aged <10 years (87%) and unvaccinated or with unknown vaccination status (75%). Surveillance detected two genotype B3 and one genotype B2 measles virus strains that were previously identified in the region. The resurgence was likely caused by an accumulation of unvaccinated, measles-susceptible children due to low MCV1 coverage and suboptimal SIA implementation. To achieve the regional goal of measles elimination by 2020, efforts are needed in DRC to improve case-based surveillance and increase two-dose measles vaccination coverage through routine services and SIAs.

Laser Applications in Orthodontics

PubMed Central

Heidari, Somayeh; Torkan, Sepideh

2013-01-01

A laser is a collimated single wavelength of light which delivers a concentrated source of energy. Soon after different types of lasers were invented, investigators began to examine the effects of different wavelengths of laser energy on oral tissues, routine dental procedures and experimental applications. Orthodontists, along with other specialist in different fields of dentistry, can now benefit from several different advantages that lasers provide during the treatment process, from the beginning of the treatment, when separators are placed, to the time of resin residues removal from the tooth surface at the end of orthodontic treatment. This article outlines some of the most common usages of laser beam in orthodontics and also provides a comparison between laser and other conventional method that were the standard of care prior to the advent of laser in this field. PMID:25606324

Evolution of Cardiac Biomodels from Computational to Therapeutics.

PubMed

Rathinam, Alwin Kumar; Mokhtar, Raja Amin Raja

2016-08-23

Biomodeling the human anatomy in exact structure and size is an exciting field of medical science. Utilizing medical data from various medical imaging topography, the data of an anatomical structure can be extracted and converted into a three-dimensional virtual biomodel; thereafter a physical biomodel can be generated utilizing rapid prototyping machines. Here, we have reviewed the utilization of this technology and have provided some guidelines to develop biomodels of cardiac structures. Cardiac biomodels provide insights for cardiothoracic surgeons, cardiologists, and patients alike. Additionally, the technology may have future usability for tissue engineering, robotic surgery, or routine hospital usage as a diagnostic and therapeutic tool for cardiovascular diseases (CVD). Given the broad areas of application of cardiac biomodels, attention should be given to further research and development of their potential.

Feasibility of Applied Gaming During Interdisciplinary Rehabilitation for Patients With Complex Chronic Pain and Fatigue Complaints: A Mixed-Methods Study.

PubMed

Vugts, Miel A P; Joosen, Margot C W; van Bergen, Alfonsus H M M; Vrijhoef, Hubertus J M

2016-04-01

Applied gaming holds potential as a convenient and engaging means for the delivery of behavioral interventions. For developing and evaluating feasible computer-based interventions, policy makers and designers rely on limited knowledge about what causes variation in usage. In this study, we looked closely at why and by whom an applied game (LAKA) is demanded and whether it is feasible (with respect to acceptability, demand, practicality, implementation, and efficacy) and devised a complementary intervention during an interdisciplinary rehabilitation program (IRP) for patients with complex chronic pain and fatigue complaints. A mixed-methods design was used. Quantitative process analyses and assessments of feasibility were carried out with patients of a Dutch rehabilitation center who received access to LAKA without professional support during a 16-week interdisciplinary outpatient program. The quantitative data included records of routinely collected baseline variables (t0), additional surveys to measure technology acceptance before (t1) and after 8 weeks of access to LAKA (t2), and automatic log files of usage behavior (frequency, length, and progress). Subsequently, semistructured interviews were held with purposively selected patients. Interview codes triangulated and illustrated explanations of usage and supplemented quantitative findings on other feasibility domains. Of the 410 eligible patients who started an IRP during the study period, 116 patients participated in additional data collections (108 with problematic fatigue and 47 with moderate or severe pain). Qualitative data verified that hedonic motivation was the most important factor for behavioral intentions to use LAKA (P<.001). Moreover, quotes illustrated a positive association between usage intentions (t1) and baseline level (t0) coping by active engagement (Spearman ρ=0.25; P=.008) and why patients who often respond by seeking social support were represented in a group of 71 patients who accessed the game (P=.034). The median behavioral intention to use LAKA was moderately positive and declined over time. Twenty patients played the game from start to finish. Behavioral change content was recognized and seen as potentially helpful by interview respondents who exposed themselves to the content of LAKA. Variation in the demand for applied gaming is generally explained by perceived enjoyment and effort and by individual differences in coping resources. An applied game can be offered as a feasible complementary intervention for more patients with complex chronic pain or fatigue complaints by embedding and delivering in alignment with patient experiences. Feasibility, effectiveness, and cost-effectiveness can be evaluated in a full-scale evaluation. New observations elicit areas of further research on the usage of computer-based interventions.

Assessment of progressively delayed prompts on guided skill learning in rats.

PubMed

Reid, Alliston K; Futch, Sara E; Ball, Katherine M; Knight, Aubrey G; Tucker, Martha

2017-03-01

We examined the controlling factors that allow a prompted skill to become autonomous in a discrete-trials implementation of Touchette's (1971) progressively delayed prompting procedure, but our subjects were rats rather than children with disabilities. Our prompted skill was a left-right lever-press sequence guided by two panel lights. We manipulated (a) the effectiveness of the guiding lights prompt and (b) the presence or absence of a progressively delayed prompt in four groups of rats. The less effective prompt yielded greater autonomy than the more effective prompt. The ability of the progressively delayed prompt procedure to produce behavioral autonomy depended upon characteristics of the obtained delay (trial duration) rather than on the pending prompt. Sequence accuracy was reliably higher in unprompted trials than in prompted trials, and this difference was maintained in the 2 groups that received no prompts but yielded equivalent trial durations. Overall sequence accuracy decreased systematically as trial duration increased. Shorter trials and their greater accuracy were correlated with higher overall reinforcement rates for faster responding. Waiting for delayed prompts (even if no actual prompt was provided) was associated with lower overall reinforcement rate by decreasing accuracy and by lengthening trials. These findings extend results from previous studies regarding the controlling factors in delayed prompting procedures applied to children with disabilities.

Design and pilot results of a mobile phone weight-loss application for women starting a meal replacement programme.

PubMed

Brindal, Emily; Hendrie, Gilly; Freyne, Jill; Coombe, Mac; Berkovsky, Shlomo; Noakes, Manny

2013-04-01

We developed and tested a mobile phone application (app) to support individuals embarking on a partial meal replacement programme (MRP). Overweight or obese women were randomly allocated to one of two study groups. The intervention group received an MRP Support app. The control group received a static app based on the information available with the MRP. A total of 58 adult women (Support n = 28; Control n = 30) participated in the 8-week trial. Their BMI was 26-43 kg/m 2 Usage data suggested that the intervention group were more engaged with using the app throughout the study period. Mixed modelling revealed that the difference in weight loss between the intervention and control groups (estimated mean, EM = 3.2% and 2.2% respectively) was not significant (P = 0.08). Objective data suggested that users of the Support app were more engaged than those using the control app. A total of 1098 prompts (54%) asking people in the intervention group to enter their meals were completed prior to the evening prompt. Women in the intervention group reported a greater increase in positive affect (i.e. mood) than those in the control group (EM = 0.48 and -0.01, respectively) (P = 0.012). At Week 8, those in the control group reported a greater decrease in the effort they were willing to put into staying on the diet than those who received the Support app (EM = -2.8 and -1.4, respectively) (P = 0.024). The Support app could be a useful adjunct to existing MRPs for psychological outcomes. © SAGE Publications Ltd, 2013.

Normative prompts reduce consumer food waste in restaurants.

PubMed

Stöckli, Sabrina; Dorn, Michael; Liechti, Stefan

2018-05-03

This field study demonstrates that prompts reduce food waste in a restaurant. Based on the behavioral change literature, it was hypothesized that (1) informational prompts encourage consumers to reduce food waste, and that (2) an informational prompt with a normative message is more effective than a prompt with only an informative message. The results were mixed. As expected, diners who were exposed to prompts asked to take away their leftovers more frequently than diners who were exposed to no prompts. However, prompts with an informative and normative message were no more powerful than prompts with only an informative message. Copyright © 2018 Elsevier Ltd. All rights reserved.

MRI or not to MRI! Should brain MRI be a routine investigation in children with autistic spectrum disorders?

PubMed

Zeglam, Adel M; Al-Ogab, Marwa F; Al-Shaftery, Thouraya

2015-09-01

To evaluate the routine usage of Magnetic Resonance Imaging (MRI) of brain and estimate the prevalence of brain abnormalities in children presenting to the Neurodevelopment Clinic of Al-Khadra Hospital (NDC-KH), Tripoli, Libya with autistic spectrum disorders (ASD). The records of all children with ASD presented to NDC-KH over 4-year period (from January 2009 to December 2012) were reviewed. All MRIs were acquired with a 1.5-T Philips (3-D T1, T2, FLAIR coronal and axial sequences). MRIs were reported to be normal, abnormal or no significant abnormalities by a consultant neuroradiologist. One thousand and seventy-five children were included in the study. Seven hundred and eighty-two children (72.7 %) had an MRI brain of whom 555 (71 %) were boys. 26 children (24 males and 2 females) (3.3 %) demonstrated MRI abnormalities (8 leukodystrophic changes, 4 periventricular leukomalacia, 3 brain atrophy, 2 tuberous sclerosis, 2 vascular changes, 1 pineoblastoma, 1 cerebellar angioma, 1 cerebellar hypoplasia, 3 agenesis of corpus callosum, 1 neuro-epithelial cyst). An unexpectedly high rate of MRI abnormalities was found in the first large series of clinical MRI investigations in children with autism. These results could contribute to further research into the pathogenesis of autistic spectrum disorder.

The short-term effects of a routine poisoning campaign on the movements and detectability of a social top-predator.

PubMed

Allen, Benjamin L; Engeman, Richard M; Leung, Luke K-P

2014-02-01

Top-predators can be important components of resilient ecosystems, but they are still controlled in many places to mitigate a variety of economic, environmental and/or social impacts. Lethal control is often achieved through the broad-scale application of poisoned baits. Understanding the direct and indirect effects of such lethal control on subsequent movements and behaviour of survivors is an important pre-requisite for interpreting the efficacy and ecological outcomes of top-predator control. In this study, we use GPS tracking collars to investigate the fine-scale and short-term movements of dingoes (Canis lupus dingo and other wild dogs) in response to a routine poison-baiting program as an example of how a common, social top-predator can respond (behaviourally) to moderate levels of population reduction. We found no consistent control-induced differences in home range size or location, daily distance travelled, speed of travel, temporal activity patterns or road/trail usage for the seven surviving dingoes we monitored immediately before and after a typical lethal control event. These data suggest that the spatial behaviour of surviving dingoes was not altered in ways likely to affect their detectability, and if control-induced changes in dingoes' ecological function did occur, these may not be related to altered spatial behaviour or movement patterns.

Opportunistic infection of Aspergillus and bacteria in captive Cape vultures (Gyps coprotheres)

PubMed Central

Chege, Stephen; Howlett, Judith; Al Qassimi, Majid; Toosy, Arshad; Kinne, Joerg; Obanda, Vincent

2013-01-01

Objective To describe clinical signs, pathology, diagnosis and treatment of Cape vultures in which Aspergillus fumigatus (A. fumigatus) and mixed species of bacteria were isolated. Methods Six Cape vultures sourced from South Africa for exhibition at Al Ain Zoo developed illness manifesting as anorexia, dyspnea, polyuria and lethargy. Three vultures died manifesting “pneumonia-like syndrome”. These three vultures were necropsied and gross lesions recorded, while organ tissues were collected for histopathology. Internal organs were swabbed for bacteriology and mycology. From live vultures, blood was collected for hematology and biochemistry, oropharyngeal and cloacal swabs were collected for mycology and bacteriology. Results A. fumigatus was isolated from the three dead vultures and two live ones that eventually survived. One of the dead vulture and two live vultures were co-infected with A. fumigatus and mixed species of bacteria that included Clostridium perfringens, Pseudomonas, Staphylococcus, Escherichia, Proteus, Enterococcus and Enterbacter. One of the Cape vulture and a Lappet-faced vulture, however, were free of Aspergillus or bacterial infections. At necropsy, intestinal hemorrhages were observed and the lungs were overtly congested with granulomas present on caudal air sac. Histopathological examinations demonstrated granulomatous lesions that were infiltrated by mononuclear cells and giant cells. Conclusions Aspergillosis is a persistent threat to captive birds and we recommend routine health assessments so that early diagnosis may prompt early treatment. It is likely that prompt prophylaxis by broad spectrum antibiotics and antifungals medication contributed to the survival of some of the vultures. PMID:23646305

Randomized trial of supplementary interviewing techniques to enhance recall of sexual partners in contact interviews.

PubMed

Brewer, Devon D; Potterat, John J; Muth, Stephen Q; Malone, Patricia Z; Montoya, Pamela; Green, David L; Rogers, Helen L; Cox, Patricia A

2005-03-01

People with multiple sex partners tend to forget a significant proportion when recalling them. Randomized trial of supplementary interviewing techniques during routine partner notification contact interviews for chlamydia, gonorrhea, and syphilis in Colorado Springs, CO. Cases with multiple sex partners in the last 3 months (n = 123) participated. Interviewers prompted nonspecifically and read back the list of elicited partners after cases recalled partners on their own. We then randomly assigned cases to receive 1 of 3 sets of recall cues: (1) an experimental set of cues consisting of locations where people meet partners, role relationships, network ties, and first letters of names; (2) another experimental set including common first names; and (3) control cues referring to individual characteristics (e.g., physical appearance). Nonspecific prompting and reading back the list each increased the number of additional partners elicited and located by 3% to 5% on average. On average, the combined location/role/letter/network cues elicited more additional partners (0.57) than did the first-name (0.29) and individual characteristics (0.28) cues. The location and first-name cues were the most effective in eliciting located partners. The supplementary techniques increased the number of new cases found by 12% and, importantly, identified branches of the sexual network that would not otherwise have been discovered. Elicitation of sex partners can be enhanced in contact interviews with simple interviewing techniques, resulting in improved network ascertainment and sexually transmitted disease case finding.

An e-health intervention designed to increase workday energy expenditure by reducing prolonged occupational sitting habits.

PubMed

Pedersen, Scott J; Cooley, Paul D; Mainsbridge, Casey

2014-01-01

Desk-based employees face multiple workplace health hazards such as insufficient physical activity and prolonged sitting. The objective of this study was to increase workday energy expenditure by interrupting prolonged occupational sitting time and introducing short-bursts of physical activity to employees' daily work habits. Over a 13-week period participants (n=17) in the intervention group were regularly exposed to a passive prompt delivered through their desktop computer that required them to stand up and engage in a short-burst of physical activity, while the control group (n=17) was not exposed to this intervention. Instead, the control group continued with their normal work routine. All participants completed a pre- and post- intervention survey to estimate workplace daily energy expenditure (calories). There was a significant 2 (Group) × 2 (Test) interaction, F (1, 32)=9.26, p < 0.05. The intervention group increased the calories expended during the workday from pre-test (M=866.29 ± 151.40) to post-test (M=1054.10 ± 393.24), whereas the control group decreased calories expended during the workday from pre-test (M=982.55 ± 315.66) to post-test (M=892.21 ± 255.36). An e-health intervention using a passive prompt was an effective mechanism for increasing employee work-related energy expenditure. Engaging employees in regular short-bursts of physical activity during the workday resulted in reduced sitting time, which may have long-term effects on the improvement of employee health.

Learning from instructional explanations: effects of prompts based on the active-constructive-interactive framework.

PubMed

Roelle, Julian; Müller, Claudia; Roelle, Detlev; Berthold, Kirsten

2015-01-01

Although instructional explanations are commonly provided when learners are introduced to new content, they often fail because they are not integrated into effective learning activities. The recently introduced active-constructive-interactive framework posits an effectiveness hierarchy in which interactive learning activities are at the top; these are then followed by constructive and active learning activities, respectively. Against this background, we combined instructional explanations with different types of prompts that were designed to elicit these learning activities and tested the central predictions of the active-constructive-interactive framework. In Experiment 1, N = 83 students were randomly assigned to one of four combinations of instructional explanations and prompts. To test the active < constructive learning hypothesis, the learners received either (1) complete explanations and engaging prompts designed to elicit active activities or (2) explanations that were reduced by inferences and inference prompts designed to engage learners in constructing the withheld information. Furthermore, in order to explore how interactive learning activities can be elicited, we gave the learners who had difficulties in constructing the prompted inferences adapted remedial explanations with either (3) unspecific engaging prompts or (4) revision prompts. In support of the active < constructive learning hypothesis, we found that the learners who received reduced explanations and inference prompts outperformed the learners who received complete explanations and engaging prompts. Moreover, revision prompts were more effective in eliciting interactive learning activities than engaging prompts. In Experiment 2, N = 40 students were randomly assigned to either (1) a reduced explanations and inference prompts or (2) a reduced explanations and inference prompts plus adapted remedial explanations and revision prompts condition. In support of the constructive < interactive learning hypothesis, the learners who received adapted remedial explanations and revision prompts as add-ons to reduced explanations and inference prompts acquired more conceptual knowledge.

Learning from Instructional Explanations: Effects of Prompts Based on the Active-Constructive-Interactive Framework

PubMed Central

Roelle, Julian; Müller, Claudia; Roelle, Detlev; Berthold, Kirsten

2015-01-01

Although instructional explanations are commonly provided when learners are introduced to new content, they often fail because they are not integrated into effective learning activities. The recently introduced active-constructive-interactive framework posits an effectiveness hierarchy in which interactive learning activities are at the top; these are then followed by constructive and active learning activities, respectively. Against this background, we combined instructional explanations with different types of prompts that were designed to elicit these learning activities and tested the central predictions of the active-constructive-interactive framework. In Experiment 1, N = 83 students were randomly assigned to one of four combinations of instructional explanations and prompts. To test the active < constructive learning hypothesis, the learners received either (1) complete explanations and engaging prompts designed to elicit active activities or (2) explanations that were reduced by inferences and inference prompts designed to engage learners in constructing the withheld information. Furthermore, in order to explore how interactive learning activities can be elicited, we gave the learners who had difficulties in constructing the prompted inferences adapted remedial explanations with either (3) unspecific engaging prompts or (4) revision prompts. In support of the active < constructive learning hypothesis, we found that the learners who received reduced explanations and inference prompts outperformed the learners who received complete explanations and engaging prompts. Moreover, revision prompts were more effective in eliciting interactive learning activities than engaging prompts. In Experiment 2, N = 40 students were randomly assigned to either (1) a reduced explanations and inference prompts or (2) a reduced explanations and inference prompts plus adapted remedial explanations and revision prompts condition. In support of the constructive < interactive learning hypothesis, the learners who received adapted remedial explanations and revision prompts as add-ons to reduced explanations and inference prompts acquired more conceptual knowledge. PMID:25853629

Design of the e-Vita diabetes mellitus study: effects and use of an interactive online care platform in patients with type 2 diabetes (e-VitaDM-1/ZODIAC-40)

PubMed Central

2014-01-01

Background Due to ongoing rise in need for care for people with chronic diseases and lagging increase in number of care providers, alternative forms of care provision and self-management support are needed. Empowering patients through an online care platform could help to improve patients’ self-management and reduce the burden on the healthcare system. Methods Access to laboratory results and educational modules on diabetes will be offered through a platform for subjects with type 2 diabetes mellitus treated in primary care. Differences in socio-demographic and clinical characteristics between subjects expressing interest vs. disinterest to use the platform will be explored. Platform usage will be tracked and compared. Patient satisfaction and quality of life will be measured by validated questionnaires and economic analyses will be performed. Discussion This study is designed to assess the feasibility of use of an online platform in routine primary healthcare for subjects with type 2 diabetes mellitus in the Netherlands, and to study effects of use of the platform on treatment satisfaction, quality of life and clinical parameters. Although providing access to a online platform is not a novel intervention, usage and effects have not yet been studied in this patient population. Trial registration Trial registration: NCT01570140. PMID:24593656

From Geometry to Diagnosis: Experiences of Geomatics in Structural Engineering

NASA Astrophysics Data System (ADS)

Riveiro, B.; Arias, P.; Armesto, J.; Caamaño, J. C.; Solla, M.

2012-07-01

Terrestrial photogrammetry and laser scanning are technologies that have been successfully used for metric surveying and 3D modelling in many different fields (archaeological and architectural documentation, industrial retrofitting, mining, structural monitoring, road surveying, etc.). In the case of structural applications, these techniques have been successfully applied to 3D modelling and sometimes monitoring; but they have not been sufficiently implemented to date, as routine tools in infrastructure management systems, in terms of automation of data processing and integration in the condition assessment procedures. In this context, this paper presents a series of experiences in the usage of terrestrial photogrammetry and laser scanning in the context of dimensional and structural evaluation of structures. These experiences are particularly focused on historical masonry structures, but modern prestressed concrete bridges are also investigated. The development of methodological procedures for data collection, and data integration in some cases, is tackled for each particular structure (with access limitations, geometrical configuration, range of measurement, etc.). The accurate geometrical information provided by both terrestrial techniques motivates the implementation of such results in the complex, and sometimes slightly approximated, geometric scene that is frequently used in structural analysis. In this sense, quantitative evaluating of the influence of real and accurate geometry in structural analysis results must be carried out. As main result in this paper, a series of experiences based on the usage of photogrammetric and laser scanning to structural engineering are presented.

Clinical diagnosis and typing of systemic amyloidosis in subcutaneous fat aspirates by mass spectrometry-based proteomics

PubMed Central

Vrana, Julie A.; Theis, Jason D.; Dasari, Surendra; Mereuta, Oana M.; Dispenzieri, Angela; Zeldenrust, Steven R.; Gertz, Morie A.; Kurtin, Paul J.; Grogg, Karen L.; Dogan, Ahmet

2014-01-01

Examination of abdominal subcutaneous fat aspirates is a practical, sensitive and specific method for the diagnosis of systemic amyloidosis. Here we describe the development and implementation of a clinical assay using mass spectrometry-based proteomics to type amyloidosis in subcutaneous fat aspirates. First, we validated the assay comparing amyloid-positive (n=43) and -negative (n=26) subcutaneous fat aspirates. The assay classified amyloidosis with 88% sensitivity and 96% specificity. We then implemented the assay as a clinical test, and analyzed 366 amyloid-positive subcutaneous fat aspirates in a 4-year period as part of routine clinical care. The assay had a sensitivity of 90%, and diverse amyloid types, including immunoglobulin light chain (74%), transthyretin (13%), serum amyloid A (%1), gelsolin (1%), and lysozyme (1%), were identified. Using bioinformatics, we identified a universal amyloid proteome signature, which has high sensitivity and specificity for amyloidosis similar to that of Congo red staining. We curated proteome databases which included variant proteins associated with systemic amyloidosis, and identified clonotypic immunoglobulin variable gene usage in immunoglobulin light chain amyloidosis, and the variant peptides in hereditary transthyretin amyloidosis. In conclusion, mass spectrometry-based proteomic analysis of subcutaneous fat aspirates offers a powerful tool for the diagnosis and typing of systemic amyloidosis. The assay reveals the underlying pathogenesis by identifying variable gene usage in immunoglobulin light chains and the variant peptides in hereditary amyloidosis. PMID:24747948

Music's Relevance for People Affected by Cancer: A Meta-Ethnography and Implications for Music Therapists.

PubMed

O'Callaghan, Clare C; McDermott, Fiona; Reid, Philippa; Michael, Natasha; Hudson, Peter; Zalcberg, John R; Edwards, Jane

2016-01-01

Evidence supports music-based oncologic support interventions including music therapy. By comparison, little is understood about music-based self-care. This meta-ethnography examined five published qualitative studies to extend understanding of music's relevance, including helpfulness, for people affected by cancer; including children, adolescents, and adults with cancer, carers, and the bereaved. To improve understanding of music's broad relevance for those affected by cancer. Meta-ethnography strategies informed the analysis. Five studies were synthesized that included 138 participants: 26 children and 28 parents of children with cancer; 12 adolescents and young adults with cancer; 52 adults with cancer; 12 carers; and 8 bereaved. Studies' category and thematic findings were compared and integrated into third-order interpretations, and a line of argument. Perspectives from the five studies that illuminated the line of argument were developed. Music usage can remain incidental, continue normally, and/or change because of cancer's harsh effects. Music can be a lifeline, support biopsychosocial and spiritual well-being, or become elusive, that is, difficult to experience. Music helps or intrudes because it extends self-awareness and social connections, and prompts play, memories, imageries, and legacies. Music therapists may help patients and carers to recover or extend music's helpful effects. Cancer care can be improved through offering music-based resources/services, which give cancer patients and carers opportunities to extend music usage for personal support and, for carers, to support patients. Music therapists can advocate for such resources and educate health professionals about assessing/recognizing when patients' and carers' changed music behaviors signify additional support needs. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Understanding usage of a hybrid website and smartphone app for weight management: a mixed-methods study.

PubMed

Morrison, Leanne G; Hargood, Charlie; Lin, Sharon Xiaowen; Dennison, Laura; Joseph, Judith; Hughes, Stephanie; Michaelides, Danius T; Johnston, Derek; Johnston, Marie; Michie, Susan; Little, Paul; Smith, Peter Wf; Weal, Mark J; Yardley, Lucy

2014-10-22

Advancements in mobile phone technology offer huge potential for enhancing the timely delivery of health behavior change interventions. The development of smartphone-based health interventions (apps) is a rapidly growing field of research, yet there have been few longitudinal examinations of how people experience and use these apps within their day-to-day routines, particularly within the context of a hybrid Web- and app-based intervention. This study used an in-depth mixed-methods design to examine individual variation in (1) impact on self-reported goal engagement (ie, motivation, self-efficacy, awareness, effort, achievement) of access to a weight management app (POWeR Tracker) when provided alongside a Web-based weight management intervention (POWeR) and (2) usage and views of POWeR Tracker. Thirteen adults were provided access to POWeR and were monitored over a 4-week period. Access to POWeR Tracker was provided in 2 alternate weeks (ie, weeks 1 and 3 or weeks 2 and 4). Participants' goal engagement was measured daily via self-report. Mixed effects models were used to examine change in goal engagement between the weeks when POWeR Tracker was and was not available and whether the extent of change in goal engagement varied between individual participants. Usage of POWeR and POWeR Tracker was automatically recorded for each participant. Telephone interviews were conducted and analyzed using inductive thematic analysis to further explore participants' experiences using POWeR and POWeR Tracker. Access to POWeR Tracker was associated with a significant increase in participants' awareness of their eating (β1=0.31, P=.04) and physical activity goals (β1=0.28, P=.03). The level of increase varied between individual participants. Usage data showed that participants used the POWeR website for similar amounts of time during the weeks when POWeR Tracker was (mean 29 minutes, SD 31 minutes) and was not available (mean 27 minutes, SD 33 minutes). POWeR Tracker was mostly accessed in short bursts (mean 3 minutes, SD 2 minutes) during convenient moments or moments when participants deemed the intervention content most relevant. The qualitative data indicated that nearly all participants agreed that it was more convenient to access information on-the-go via their mobiles compared to a computer. However, participants varied in their views and usage of the Web- versus app-based components and the informational versus tracking tools provided by POWeR Tracker. This study provides evidence that smartphones have the potential to improve individuals' engagement with their health-related goals when used as a supplement to an existing online intervention. The perceived convenience of mobile access to information does not appear to deter use of Web-based interventions or strengthen the impact of app access on goal engagement. A mixed-methods design enabled exploration of individual variation in daily usage of the app-based tools.

Understanding Usage of a Hybrid Website and Smartphone App for Weight Management: A Mixed-Methods Study

PubMed Central

Hargood, Charlie; Lin, Sharon Xiaowen; Dennison, Laura; Joseph, Judith; Hughes, Stephanie; Michaelides, Danius T; Johnston, Derek; Johnston, Marie; Michie, Susan; Little, Paul; Smith, Peter WF; Weal, Mark J; Yardley, Lucy

2014-01-01

Background Advancements in mobile phone technology offer huge potential for enhancing the timely delivery of health behavior change interventions. The development of smartphone-based health interventions (apps) is a rapidly growing field of research, yet there have been few longitudinal examinations of how people experience and use these apps within their day-to-day routines, particularly within the context of a hybrid Web- and app-based intervention. Objective This study used an in-depth mixed-methods design to examine individual variation in (1) impact on self-reported goal engagement (ie, motivation, self-efficacy, awareness, effort, achievement) of access to a weight management app (POWeR Tracker) when provided alongside a Web-based weight management intervention (POWeR) and (2) usage and views of POWeR Tracker. Methods Thirteen adults were provided access to POWeR and were monitored over a 4-week period. Access to POWeR Tracker was provided in 2 alternate weeks (ie, weeks 1 and 3 or weeks 2 and 4). Participants’ goal engagement was measured daily via self-report. Mixed effects models were used to examine change in goal engagement between the weeks when POWeR Tracker was and was not available and whether the extent of change in goal engagement varied between individual participants. Usage of POWeR and POWeR Tracker was automatically recorded for each participant. Telephone interviews were conducted and analyzed using inductive thematic analysis to further explore participants’ experiences using POWeR and POWeR Tracker. Results Access to POWeR Tracker was associated with a significant increase in participants’ awareness of their eating (β1=0.31, P=.04) and physical activity goals (β1=0.28, P=.03). The level of increase varied between individual participants. Usage data showed that participants used the POWeR website for similar amounts of time during the weeks when POWeR Tracker was (mean 29 minutes, SD 31 minutes) and was not available (mean 27 minutes, SD 33 minutes). POWeR Tracker was mostly accessed in short bursts (mean 3 minutes, SD 2 minutes) during convenient moments or moments when participants deemed the intervention content most relevant. The qualitative data indicated that nearly all participants agreed that it was more convenient to access information on-the-go via their mobiles compared to a computer. However, participants varied in their views and usage of the Web- versus app-based components and the informational versus tracking tools provided by POWeR Tracker. Conclusions This study provides evidence that smartphones have the potential to improve individuals’ engagement with their health-related goals when used as a supplement to an existing online intervention. The perceived convenience of mobile access to information does not appear to deter use of Web-based interventions or strengthen the impact of app access on goal engagement. A mixed-methods design enabled exploration of individual variation in daily usage of the app-based tools. PMID:25355131

Determinants of referral practices of clients by traditional birth attendants in Ilorin, Nigeria.

PubMed

Abodunrin, O L; Akande, T M; Musa, I O; Aderibigbe, S A

2010-06-01

A sizeable number of deliveries still take place with the assistance of Traditional Birth Attendants in Nigeria. This study aims to determine the factors that determine the referral practices of the TBAs in Ilorin of high risk and complicated pregnancies. This descriptive study was conducted among all the 162 registered TBAs in Ilorin that were traceable using pre-tested semi-structured interviewer-administered questionnaire. About 90%, whose source of skill acquisition was by inheritance did not refer their clients appropriately compared with 48% of those whose source of skill acquisition was through formal training (p<0.05). The more the numbers of trainings, the more appropriate the referral (p<0.05). Having supervisory visit by qualified personnel is associated with appropriate referral practices (p<0.05). Regular training and re-training of TBAs with routine monitoring and supportive supervision will promote prompt referral of high risk and complicated pregnancies and deliveries.

Overcoming environmental deterioration through defensive expenditures: field evidence from Bahía del Tóbari (Sonora, México) and implications for coastal impact assessment.

PubMed

Escofet, A; Bravo-Peña, L C

2007-08-01

The costs of the maneuvers that fishermen and shrimp farmers have to undertake in a coastal scenario where both the access to navigable waters and water quality have decreased were interpreted as defensive expenditures. Maneuvers were prompted by profound changes in water circulation and siltation mode imposed by major shifts in regional and local land-use patterns. In coastal scenarios under heavy land-based discharges and local geomorphic modifications, local users with little chance to move away may modify their routines in order to maintain existing levels of utility. The concept of defensive expenditures could be used to assess social responses to adverse changes in environmental and resource conditions, as a means to distinguish stages in which local sectors respond individually from qualitatively different stages in which intersectoral events are more conspicuous.

Laboratory practice guidelines for detecting and reporting JAK2 and MPL mutations in myeloproliferative neoplasms: a report of the Association for Molecular Pathology.

PubMed

Gong, Jerald Z; Cook, James R; Greiner, Timothy C; Hedvat, Cyrus; Hill, Charles E; Lim, Megan S; Longtine, Janina A; Sabath, Daniel; Wang, Y Lynn

2013-11-01

Recurrent mutations in JAK2 and MPL genes are genetic hallmarks of BCR-ABL1-negative myeloproliferative neoplasms. Detection of JAK2 and MPL mutations has been incorporated into routine diagnostic algorithms for these diseases. This Special Article summarizes results from a nationwide laboratory survey of JAK2 and MPL mutation analysis. Based on the current practice pattern and the literature, this Special Article provides recommendations and guidelines for laboratory practice for detection of mutations in the JAK2 and MPL genes, including clinical manifestations for prompting the mutation analysis, current and recommended methodologies for testing the mutations, and standardization for reporting the test results. This Special Article also points to future directions for genomic testing in BCR-ABL1-negative myeloproliferative neoplasms. Copyright © 2013 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

Waste cockle shell as natural catalyst for biodiesel production from jatropha oil

NASA Astrophysics Data System (ADS)

Hadi, Norulakmal Nor; Idrus, Nur Afini; Ghafar, Faridah; Salleh, Marmy Roshaidah Mohd

2017-12-01

Due to the increasing of industrialization and modernization of the world, the demand of petroleum has risen rapidly. The increasing demand for energy and environmental awareness has prompted many researches to embark on alternative fuel platforms that are environmentally acceptable. In this study, jatropha oil was used to produce biodiesel by a new transesterification routine in which cockle shell was used as source of heterogeneous catalyst. The investigation showed the catalyst that was calcined at temperature of 800 °C has the optimum capability to produce high yield. The highest yield of biodiesel production of 93.20 % were obtained by using 1.5 wt% of catalyst. The reaction was conducted at a temperature of 65 °C with the optimum methanol to oil ratio of 6:1. It was found that the physical properties of the biodiesel produced were significant to ASTM standard of fatty acid methyl ester (FAME).

Towards diagnostic markers for the psychoses.

PubMed

Lawrie, Stephen M; O'Donovan, Michael C; Saks, Elyn; Burns, Tom; Lieberman, Jeffrey A

2016-04-01

Psychotic disorders are currently grouped under broad phenomenological diagnostic rubrics. Researchers hope that progress in identifying aetiological mechanisms will ultimately enable more precise division of heterogeneous diagnoses into specific and valid subgroups. This goal has been an aim of psychiatry since the 19th century, when patients with general paresis were thought to have "insanity" similar to dementia praecox and manic depressive illness. Nowadays, the constructs of organic-induced and substance-induced psychotic disorder show that our diagnostic classification system already reflects, in part, aetiological factors. Most recently, gene copy number variation and autoimmunity have been associated with schizophrenia. We suggest how, on the basis of recent scientific advances, we can progress the identification of further putative subgroups and make the most of currently available interventions. Prompt diagnosis and treatment, and a more routine search for causes, could preserve function and improve outcome, and therefore be more acceptable to patients and carers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Electronic decision support for diagnostic imaging in a primary care setting

PubMed Central

Reed, Martin H

2011-01-01

Methods Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines. Results Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software. Conclusions Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow. PMID:21486884

Diagnosis of Dengue Infection Using Conventional and Biosensor Based Techniques

PubMed Central

Parkash, Om; Hanim Shueb, Rafidah

2015-01-01

Dengue is an arthropod-borne viral disease caused by four antigenically different serotypes of dengue virus. This disease is considered as a major public health concern around the world. Currently, there is no licensed vaccine or antiviral drug available for the prevention and treatment of dengue disease. Moreover, clinical features of dengue are indistinguishable from other infectious diseases such as malaria, chikungunya, rickettsia and leptospira. Therefore, prompt and accurate laboratory diagnostic test is urgently required for disease confirmation and patient triage. The traditional diagnostic techniques for the dengue virus are viral detection in cell culture, serological testing, and RNA amplification using reverse transcriptase PCR. This paper discusses the conventional laboratory methods used for the diagnosis of dengue during the acute and convalescent phase and highlights the advantages and limitations of these routine laboratory tests. Subsequently, the biosensor based assays developed using various transducers for the detection of dengue are also reviewed. PMID:26492265

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

Croft, Stephen; Favalli, Andrea

Here, we extend the familiar Bӧhnel point-model equations, which are routinely used to interpret neutron coincidence counting rates, by including the contribution of delayed neutrons. After developing the necessary equations we use them to show, by providing some numerical results, what the quantitative impact of neglecting delayed neutrons is across the full range of practical nuclear safeguards applications. The influence of delayed neutrons is predicted to be small for the types of deeply sub-critical assay problems which concern the nuclear safeguards community, smaller than uncertainties arising from other factors. This is most clearly demonstrated by considering the change in themore » effective (α,n)-to-spontaneous fission prompt-neutron ratio that the inclusion of delayed neutrons gives rise to. That the influence of delayed neutrons is small is fortunate, and our results justify the long standing practice of simply neglecting them in the analysis of field measurements.« less

'Miracle in Iowa': metaphor, analogy, and anachronism in the history of bioethics.

PubMed

Ferber, D S

2004-07-01

The term 'bioethics' is commonly associated with debates prompted by innovations in medical technology, yet the issues raised by bioethics are not that new. They concern the extent to which medicine and social morality exist in harmony or opposition--issues routinely addressed in the social history of medicine. This paper will argue that historical thinking, understood broadly, has a significant role to play in understanding relations between medicine and social morality, and therefore in contemporary bioethics. It explores past and present uses of metaphor and analogy in shaping perceptions of scientific innovation, and argues for the validity of apparently anachronistic thinking in our judgments of the past. The aims of this paper are ultimately pedagogical: to enable students to look at media reports about developments in medicine and biotechnology in order to problematise what are presented as the self-evident terms of current debate.

Analysing trends and forecasting malaria epidemics in Madagascar using a sentinel surveillance network: a web-based application.

PubMed

Girond, Florian; Randrianasolo, Laurence; Randriamampionona, Lea; Rakotomanana, Fanjasoa; Randrianarivelojosia, Milijaona; Ratsitorahina, Maherisoa; Brou, Télesphore Yao; Herbreteau, Vincent; Mangeas, Morgan; Zigiumugabe, Sixte; Hedje, Judith; Rogier, Christophe; Piola, Patrice

2017-02-13

The use of a malaria early warning system (MEWS) to trigger prompt public health interventions is a key step in adding value to the epidemiological data routinely collected by sentinel surveillance systems. This study describes a system using various epidemic thresholds and a forecasting component with the support of new technologies to improve the performance of a sentinel MEWS. Malaria-related data from 21 sentinel sites collected by Short Message Service are automatically analysed to detect malaria trends and malaria outbreak alerts with automated feedback reports. Roll Back Malaria partners can, through a user-friendly web-based tool, visualize potential outbreaks and generate a forecasting model. The system already demonstrated its ability to detect malaria outbreaks in Madagascar in 2014. This approach aims to maximize the usefulness of a sentinel surveillance system to predict and detect epidemics in limited-resource environments.

Relapsing Legionella pneumophila cellulitis: a case report and review of the literature.

PubMed

Han, Jennifer H; Nguyen, Josephine C; Harada, Shuko; Baddour, Larry M; Edelstein, Paul H

2010-12-01

Legionella spp. rarely cause soft tissue infections, with only a few cases reported and usually in the setting of immunocompromise. We report a case of L. pneumophila cellulitis, without pneumonia, in a 65-year-old immunocompromised woman. The patient had a history of interstitial lung disease and idiopathic thrombocytopenic purpura, for which she was receiving high-dose corticosteroids, and had recently experienced an episode of L. pneumophila cellulitis of the lower extremity, which responded to an extended course of levofloxacin. She was initially transferred to this institution for definitive workup of presumed B cell lymphoma and, during her hospital course, suffered a relapse of L. pneumophila-associated cellulitis that responded promptly to azithromycin. More unusual organisms such as Legionella spp. should be considered in the etiology of cellulitis, particularly in the setting of immunocompromise, in cases that are refractory to conventional antibiotics routinely administered for skin and soft tissue infections.

Perceptions of Pediatric Residents Regarding Counseling About Use of Social Networking Sites.

PubMed

Banker, Sumeet L; Fenick, Ada M; Qin, Li; Talwalkar, Jaideep S

2018-04-01

Increasing use of social networking sites (SNS) among youth prompted professional organizations to urge pediatricians to promote healthy media use. Electronic questionnaires were distributed to 76 pediatric residents at one academic center measuring attitudes, practices, and familiarity with SNS. Of 43 respondents (response rate = 57%), most reported personal SNS use (98%) and familiarity with SNS used by youth (72%), and 88% agreed that pediatricians should provide counseling on SNS use. Only 5% felt they had adequate training on SNS use in children, and just 26% felt comfortable advising families. Residents were less likely to discuss SNS use than general media use (19% vs 56%, P = .007). Media counseling was correlated with SNS counseling ( r = .38, P = .01). Pediatric residents recognize the importance of guiding families on SNS use, yet do not routinely provide counseling despite high levels of personal SNS use and familiarity. Focused training is necessary for pediatricians to prioritize practical guidance.

Acute hepatic decompensation precipitated by pregnancy-related catabolic stress: a rare mimic of acute liver failure.

PubMed

Sinclair, Marie; Ket, Shara; Testro, Adam; Gow, Paul J; Angus, Peter W

2014-02-01

Abnormal liver function tests are common in pregnancy; however, liver failure is rare. Pregnancy is a catabolic state that can precipitate illness in patients with underlying metabolic disorders. A 19-year-old woman presented at 14 weeks of gestation with an alanine transaminase of 2,252 international units/L (less than 30), an international normalized ratio of 6.9 (0.9-1.2), and an ammonia of 58 micromole/L (11-51 micromole/L). No cause was identified on routine investigations including liver biopsy. Biochemical and clinical deterioration prompted investigation for a metabolic disorder. Urinary orotic acid was elevated, consistent with the urea cycle disorder type 1 citrullinemia. Appropriate management (arginine supplementation and dietary protein restriction) led to rapid improvement and later delivery of a healthy neonate. This is an unusual presentation that reminds us of the importance of considering metabolic disorders during the catabolic stress of pregnancy.

Late myocardial ischemia with ST-segment elevation after negative dobutamine stress echocardiography in a patient with normal coronary arteries.

PubMed

Cabani, Enrico; Lattanzi, Fabio; Paci, Anna Maria; Pieroni, Andrea; Baria, Luca; Tommasi, Salvatore Mario De

2009-04-01

Late complications after pharmacological stress echocardiography are infrequent but potentially dreadful events. We report the case of a 80-year-old woman admitted to hospital for rest chest pain with trivial troponin increase, normal left ventricular function and no significant ECG changes. A dobutamine stress echocardiography was performed for diagnostic purpose, with a negative result. About 30 min after the end of dobutamine infusion, she developed ST-segment elevation in inferior leads associated with chest pain and left ventricular dyssynergy, promptly resolved by sublingual nitrates. Subsequently, angiography documented the absence of significant coronary stenoses. The following clinical course was uneventful. Transient myocardial ischemia was likely due to dobutamine-induced coronary spasm. The case emphasizes the utility of routine, long-lasting monitoring of patients after stress echocardiography, even if negative, to counteract possible late life-threatening complications.

Incidental gastric accessory spleen during laparoscopic sleeve gastrectomy.

PubMed

Almazeedi, Sulaiman; Alhaddad, Eliana; Al-Khithr, Talal; Alhunaidi, Mohammed

2017-01-01

Bariatric surgery has shown to produce the most predictable and tangible results for weight loss, with laparoscopic sleeve gastrectomy's being the most popular one of them. However, the occurrence of previously undiagnosed diseases can be encountered during bariatric operations. The work has been reported in line with the SCARE criteria. This is the case of a 54year old morbidly obese female, presenting to our hospital for a laparoscopic sleeve gastrectomy. During her procedure, it was discovered that she has an accessory spleen on the fundus of her stomach. The decision was made to resect it with the specimen of the stomach for histopathalogical examination. Incidental findings during routine bariatric surgery are a common occurance, and therefore prompt and effective intra-op management is key to the prognosis of the patient. Accessory spleens, although uncommon, tend to be asymptomatic. However, if undiagnosed, could present with dangerous consequences. Copyright © 2017. Published by Elsevier Ltd.

Using nerve transfer to restore prehension and grasp 12 years following spinal cord injury: a case report.

PubMed

Fox, Ida K; Novak, Christine B; Kahn, Lorna C; Mackinnon, Susan E; Ruvinskaya, Rimma; Juknis, Neringa

2018-01-01

Nerve transfers are used routinely for reconstruction of hand function following lower motor neuron lesions. In people with cervical spinal cord injury (SCI), this novel and alternate reconstruction option may be useful to restore prehension and grasp, and improve hand function. A 34-year-old male presented 12 years post-mid-cervical SCI. Pre-operative electrodiagnostic studies revealed intact lower motor neurons below the SCI level. He elected to undergo nerve transfer surgery to restore hand function. Intraoperative evaluation led to the transfer of a brachialis nerve to several median nerve recipient branches. Post surgery, he was discharged home and resumed activities of daily living. He achieved independent thumb and finger flexion function and continued to exhibit functional improvement at 4 years post surgery. These results should prompt referral for consideration of nerve transfer surgery-an exciting alternative to tendon transfer and neuroprostheses.

Silk-based biomaterials in biomedical textiles and fiber-based implants

PubMed Central

Li, Gang; Li, Yi; Chen, Guoqiang; He, Jihuan; Han, Yifan

2015-01-01

Biomedical textiles and fiber-based implants (BTFIs) have been in routine clinical use to facilitate healing for nearly five decades. Amongst the variety of biomaterials used, silk-based biomaterials (SBBs) have been widely used clinically viz. sutures for centuries and are being increasingly recognized as a prospective material for biomedical textiles. The ease of processing, controllable degradability, remarkable mechanical properties and biocompatibility have prompted the use of SBBs for various BTFIs for extracorporeal implants, soft tissue repair, healthcare/hygiene products and related needs. The present review focuses on BTFIs from the perspective of types and physical and biological properties, and this discussion is followed with an examination of the advantages and limitations of BTFIs from SBBs. The review covers progress in surface coatings, physical and chemical modifications of SBBs for BTFIs and identifies future needs and opportunities for the further development for BTFIs using SBBs. PMID:25772248

The Relationship between Stimulus and Response Prompts under Two Types of Programmed Presentations.

ERIC Educational Resources Information Center

Young, Jon I.; And Others

Prompts in concept classification normally occur on the stimulus, while in memorization tasks prompts customarily are given on the response. Opposite results have been obtained for these two tasks with excessive prompting. This study used English-Russian word pairs to compare stimulus prompts (underlining the English word) with response prompts in…

Interval Since Last HIV Test for Men and Women with Recent Risk for HIV Infection - United States, 2006-2016.

PubMed

Pitasi, Marc A; Delaney, Kevin P; Oraka, Emeka; Bradley, Heather; DiNenno, Elizabeth A; Brooks, John T; Prejean, Joseph

2018-06-22

Since 2006, CDC has recommended routine screening of all persons aged 13-64 years for human immunodeficiency virus (HIV) and at least annual rescreening of persons at higher risk (1). However, national surveillance data indicate that many persons at higher risk for HIV infection are not screened annually, and delays in diagnosis persist (2). CDC analyzed 2006-2016 data from the General Social Survey (GSS)* and estimated that only 39.6% of noninstitutionalized U.S. adults had ever tested for HIV. Among persons ever tested, the estimated median interval since last test was 1,080 days or almost 3 years. Only 62.2% of persons who reported HIV-related risk behaviors in the past 12 months were ever tested for HIV, and the median interval since last test in this group was 512 days (1.4 years). The percentage of persons ever tested and the interval since last test remained largely unchanged during 2006-2016. More frequent screening of persons with ongoing HIV risk is needed to achieve full implementation of CDC's screening recommendations and to prevent new infections. Integration of routine screening as standard clinical practice through existing strategies, such as electronic medical record prompts (3), or through new, innovative strategies might be needed to increase repeat screening of persons with ongoing risk.

Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

PubMed Central

Forbes, Lindsay J. L.; Forster, Alice S.; Dodd, Rachael H.; Tucker, Lorraine; Laming, Rachel; Sellars, Sarah; Patnick, Julietta; Ramirez, Amanda J.

2012-01-01

Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women. PMID:23213334

Statistical detection of geographic clusters of resistant Escherichia coli in a regional network with WHONET and SaTScan

PubMed Central

Park, Rachel; O'Brien, Thomas F.; Huang, Susan S.; Baker, Meghan A.; Yokoe, Deborah S.; Kulldorff, Martin; Barrett, Craig; Swift, Jamie; Stelling, John

2016-01-01

Objectives While antimicrobial resistance threatens the prevention, treatment, and control of infectious diseases, systematic analysis of routine microbiology laboratory test results worldwide can alert new threats and promote timely response. This study explores statistical algorithms for recognizing geographic clustering of multi-resistant microbes within a healthcare network and monitoring the dissemination of new strains over time. Methods Escherichia coli antimicrobial susceptibility data from a three-year period stored in WHONET were analyzed across ten facilities in a healthcare network utilizing SaTScan's spatial multinomial model with two models for defining geographic proximity. We explored geographic clustering of multi-resistance phenotypes within the network and changes in clustering over time. Results Geographic clustering identified from both latitude/longitude and non-parametric facility groupings geographic models were similar, while the latter was offers greater flexibility and generalizability. Iterative application of the clustering algorithms suggested the possible recognition of the initial appearance of invasive E. coli ST131 in the clinical database of a single hospital and subsequent dissemination to others. Conclusion Systematic analysis of routine antimicrobial resistance susceptibility test results supports the recognition of geographic clustering of microbial phenotypic subpopulations with WHONET and SaTScan, and iterative application of these algorithms can detect the initial appearance in and dissemination across a region prompting early investigation, response, and containment measures. PMID:27530311

Accurate differentiation of Mycobacterium chimaera from Mycobacterium intracellulare by MALDI-TOF MS analysis.

PubMed

Pranada, Arthur B; Witt, Ellen; Bienia, Michael; Kostrzewa, Markus; Timke, Markus

2017-05-01

The increasing number of infections caused by nontuberculous mycobacteria (NTM) has prompted the need for rapid and precise identification methods of these pathogens. Several studies report the applicability of MALDI-TOF mass spectrometry (MS) for identification of NTM. However, some closely related species have very similar spectral mass fingerprints, and until recently, Mycobacterium chimaera and M. intracellulare could not be separated from each other by MALDI-TOF MS. The conventional identification methods used in routine diagnostics have similar limitations. Recently, the differentiation of these two species within the Mycobacterium avium complex has become increasingly important due to reports of M. chimaera infections related to open heart surgery in Europe and in the USA. In this report, a method for the distinct differentiation of M. chimaera and M. intracellulare using a more detailed analysis of MALDI-TOF mass spectra is presented. Species-specific peaks could be identified and it was possible to assign all isolates (100 %) from reference strain collections as well as clinical isolates to the correct species. We have developed a model for the accurate identification of M. chimaera and M. intracellulare by MALDI-TOF MS. This approach has the potential for routine use in microbiology laboratories, as the model itself can be easily implemented into the software of the currently available systems by MALDI-TOF MS manufacturers.

Inhaled budesonide for the prevention of bronchopulmonary dysplasia.

PubMed

Bassler, Dirk

2017-10-01

Theoretically, administration of inhaled corticosteroids may allow for beneficial effects on the pulmonary system of infants with evolving or established bronchopulmonary dysplasia (BPD) with a lower risk of undesirable side effects compared to systemic corticosteroids. However, before deciding whether to use inhaled corticosteroids for BPD in routine clinical practice, the available randomized study data need to be considered. Currently published systematic reviews from the Cochrane Collaboration conclude that there is no role for inhaled corticosteroids in neither prevention nor treatment of BPD outside clinical trials. In contrast multiple observational studies indicate that a large number of preterm infants in Europe, North America and East Asia receive inhaled corticosteroids for this indication in routine clinical care. This discrepancy between evidence and practice prompted a large randomized controlled trial (RCT) investigating the role of inhaled budesonide for the prevention of BPD which was recently published and showed a significant reduction in the incidence of BPD. However, the primary outcome (a composite of death or BPD at 36 weeks postmenstrual age) was only of borderline significance as a result of a non-significant trend to increased mortality in the budesonide group. Results of the long-term follow up from this study should be considered when defining the future role of inhaled corticosteroids for BPD. Additionally, updated systematic reviews will help to determine whether the observed mortality difference between the two comparison groups represents truth or artifact.

Asthma education: different viewpoints elicited by qualitative and quantitative methods.

PubMed

Damon, Scott A; Tardif, Richard R

2015-04-01

This project began as a qualitative examination of how asthma education provided by health professionals could be improved. Unexpected qualitative findings regarding the use of Asthma Action Plans and the importance of insurance reimbursement for asthma education prompted further quantitative examination. Qualitative individual interviews were conducted with primary care physicians in private practice who routinely provide initial diagnoses of asthma and focus groups were conducted with other clinicians in private primary care practices who routinely provide asthma education. Using the DocStyles quantitative tool two questions regarding Asthma Action Plans and insurance reimbursement were asked of a representative sample of physicians and other clinicians. The utility of Asthma Action Plans was questioned in the 2012 qualitative study. Qualitative findings also raised questions regarding whether reimbursement is the barrier to asthma education for patients performed by medical professionals it is thought to be. 2013 quantitative findings show that the majority of clinicians see Asthma Action Plans as useful. The question of whether reimbursement is a barrier to providing asthma education to patients was not resolved by the quantitative data. The majority of clinicians see Asthma Action Plans as a useful tool for patient education. Clinicians had less clear opinions on whether the lack of defined reimbursement codes acted as a barrier to asthma education. The study also provided useful audience data for design of new asthma educational tools developed by CDC.

Pediatric pulmonary arterial hypertension and hyperthyroidism: a potentially fatal combination.

PubMed

Trapp, Christine M; Elder, Robert W; Gerken, Adrienne T; Sopher, Aviva B; Lerner, Shulamit; Aranoff, Gaya S; Rosenzweig, Erika B

2012-07-01

Patients with pulmonary arterial hypertension (PAH) who develop hyperthyroidism are at risk for acute cardiopulmonary decompensation and death. We present a series of eight idiopathic PAH/heritable PAH pediatric patients who developed hyperthyroidism between 1999 and 2011. Institutional Review Board approval was obtained; informed consent was waived due to the retrospective nature of the series. All eight patients were receiving iv epoprostenol; five of the eight patients presented with acute cardiopulmonary decompensation in the setting of hyperthyroidism. In the remaining three patients, hyperthyroidism was detected during routine screening of thyroid function tests. The one patient who underwent emergency thyroidectomy was the only survivor of those who presented in cardiopulmonary decline. Aggressive treatment of the hyperthyroid state, including emergency total thyroidectomy and escalation of targeted PAH therapy and β-blockade when warranted, may prove lifesaving in these patients. Prompt thyroidectomy or radioactive iodine ablation should be considered for clinically stable PAH patients with early and/or mild hyperthyroidism to avoid potentially life-threatening cardiopulmonary decompensation. Although the association between hyperthyroidism and PAH remains poorly understood, the potential impact of hyperthyroidism on the cardiopulmonary status of PAH patients must not be ignored. Hyperthyroidism must be identified early in this patient population to optimize intervention before acute decompensation. Thyroid function tests should be checked routinely in patients with PAH, particularly those on iv epoprostenol, and urgently in patients with acute decompensation or symptoms of hyperthyroidism.

Role of Clinical Presentations and Routine CSF Analysis in the Rapid Diagnosis of Acute Bacterial Meningitis in Cases of Negative Gram Stained Smears

PubMed Central

Fouad, Rabab; El-Kholy, Badawy; Yosry, Ayman

2014-01-01

Background and Aim. Bacterial meningitis is a lethal, disabling endemic disease needing prompt antibiotic management. Gram stained smears is rapid accurate method for diagnosis of bacterial meningitis. In cases of negative gram stained smears diagnosis is delayed till culture results. We aim to assess the role of clinical presentations and routine CSF analysis in the cost-effective rapid diagnosis of negative gram stained smears bacterial meningitis. Methods. Cross sectional study including 623 acute meningitis patients divided into two groups: bacterial meningitis and nonbacterial meningitis groups. The clinical presentations, systemic inflammatory parameters, and CSF analysis were evaluated and compared in both groups. Results. Altered conscious level, localizing neurological signs, Kernig's and Brudzinski's signs together with peripheral leucocytosis (>10.000/mm3), high CRP (>6) together with high CSF protein (>50 gl/dL), CSF neutrophilic count (≥50% of total CSF leucocytic count), and low CSF glucose level (<45 gm/dL) and CSF/serum glucose ≤0.6 were significantly diagnostic in bacterial meningitis patients. From the significant CSF analysis variables CSF protein carried the higher accuracy of diagnosis 78% with sensitivity 88% and specificity 72%. Conclusions. High CSF protein (>50 mg/dL) together with plasma inflammatory markers and CSF cytochemical parameters can diagnose bacterial meningitis in gram stain negative smear till culture results. PMID:24803939

Rational case management of malaria with a rapid diagnostic test, Paracheck Pf®, in antenatal health care in Bangui, Central African Republic.

PubMed

Manirakiza, Alexandre; Serdouma, Eugène; Heredeïbona, Luc Salva; Djalle, Djibrine; Madji, Nestor; Moyen, Methode; Soula, Georges; Le Faou, Alain; Delmont, Jean

2012-06-26

Both treatment and prevention strategies are recommended by the World Health Organization for the control of malaria during pregnancy in tropical areas. The aim of this study was to assess use of a rapid diagnostic test for prompt management of malaria in pregnancy in Bangui, Central African Republic. A cohort of 76 pregnant women was screened systematically for malaria with ParacheckPf® at each antenatal visit. The usefulness of the method was analysed by comparing the number of malaria episodes requiring treatment in the cohort with the number of prescriptions received by another group of pregnant women followed-up in routine antenatal care. In the cohort group, the proportion of positive ParacheckPf® episodes during antenatal clinics visits was 13.8%, while episodes of antimalarial prescriptions in the group which was followed-up routinely by antenatal personnel was estimated at 26.3%. Hence, the relative risk of the cohort for being prescribed an antimalarial drug was 0.53. Therefore, the attributable fraction of presumptive treatment avoided by systematic screening with ParacheckPf® was 47%. Use of a rapid diagnostic test is useful, affordable and easy for adequate treatment of malaria in pregnant women. More powerful studies of the usefulness of introducing the test into antenatal care are needed in all heath centres in the country and in other tropical areas.

Periodic Email Prompts to Re-Use an Internet-Delivered Computer-Tailored Lifestyle Program: Influence of Prompt Content and Timing

PubMed Central

de Vries, Hein; Candel, Math; van de Kar, Angelique; van Osch, Liesbeth

2013-01-01

Background Adherence to Internet-delivered lifestyle interventions using multiple tailoring is suboptimal. Therefore, it is essential to invest in proactive strategies, such as periodic email prompts, to boost re-use of the intervention. Objective This study investigated the influence of content and timing of a single email prompt on re-use of an Internet-delivered computer-tailored (CT) lifestyle program. Methods A sample of municipality employees was invited to participate in the program. All participants who decided to use the program received an email prompting them to revisit the program. A 2×3 (content × timing) design was used to test manipulations of prompt content and timing. Depending on the study group participants were randomly assigned to, they received either a prompt containing standard content (an invitation to revisit the program), or standard content plus a preview of new content placed on the program website. Participants received this prompt after 2, 4, or 6 weeks. In addition to these 6 experimental conditions, a control condition was included consisting of participants who did not receive an additional email prompt. Clicks on the uniform resource locator (URL) provided in the prompt and log-ins to the CT program were objectively monitored. Logistic regression analyses were conducted to determine whether prompt content and/or prompt timing predicted clicking on the URL and logging in to the CT program. Results Of all program users (N=240), 206 participants received a subsequent email prompting them to revisit the program. A total of 53 participants (25.7%) who received a prompt reacted to this prompt by clicking on the URL, and 25 participants (12.1%) actually logged in to the program. There was a main effect of prompt timing; participants receiving an email prompt 2 weeks after their first visit clicked on the URL significantly more often compared with participants that received the prompt after 4 weeks (odds ratio [OR] 3.069, 95% CI 1.392-6.765, P=.005) and after 6 weeks (OR 4.471, 95% CI 1.909-10.471, P=.001). Furthermore, participants who received an email prompt 2 weeks after their first visit logged in to the program significantly more often compared to participants receiving the prompt after 6 weeks (OR 16.356, 95% CI 2.071-129.196, P=.008). A trend was observed with regard to prompt content. Participants receiving a prompt with additional content were more likely to log in to the program compared to participants who received a standard prompt. However, this result was not statistically significant (OR 2.286, 95% CI 0.892-5.856, P=.09). Conclusions The key findings suggest that boosting revisits to a CT program benefits most from relatively short prompt timing. Furthermore, a preview of new website content may be added to a standard prompt to further increase its effectiveness in persuading people to log in to the program. PMID:23363466

Periodic email prompts to re-use an internet-delivered computer-tailored lifestyle program: influence of prompt content and timing.

PubMed

Schneider, Francine; de Vries, Hein; Candel, Math; van de Kar, Angelique; van Osch, Liesbeth

2013-01-31

Adherence to Internet-delivered lifestyle interventions using multiple tailoring is suboptimal. Therefore, it is essential to invest in proactive strategies, such as periodic email prompts, to boost re-use of the intervention. This study investigated the influence of content and timing of a single email prompt on re-use of an Internet-delivered computer-tailored (CT) lifestyle program. A sample of municipality employees was invited to participate in the program. All participants who decided to use the program received an email prompting them to revisit the program. A 2×3 (content × timing) design was used to test manipulations of prompt content and timing. Depending on the study group participants were randomly assigned to, they received either a prompt containing standard content (an invitation to revisit the program), or standard content plus a preview of new content placed on the program website. Participants received this prompt after 2, 4, or 6 weeks. In addition to these 6 experimental conditions, a control condition was included consisting of participants who did not receive an additional email prompt. Clicks on the uniform resource locator (URL) provided in the prompt and log-ins to the CT program were objectively monitored. Logistic regression analyses were conducted to determine whether prompt content and/or prompt timing predicted clicking on the URL and logging in to the CT program. Of all program users (N=240), 206 participants received a subsequent email prompting them to revisit the program. A total of 53 participants (25.7%) who received a prompt reacted to this prompt by clicking on the URL, and 25 participants (12.1%) actually logged in to the program. There was a main effect of prompt timing; participants receiving an email prompt 2 weeks after their first visit clicked on the URL significantly more often compared with participants that received the prompt after 4 weeks (odds ratio [OR] 3.069, 95% CI 1.392-6.765, P=.005) and after 6 weeks (OR 4.471, 95% CI 1.909-10.471, P=.001). Furthermore, participants who received an email prompt 2 weeks after their first visit logged in to the program significantly more often compared to participants receiving the prompt after 6 weeks (OR 16.356, 95% CI 2.071-129.196, P=.008). A trend was observed with regard to prompt content. Participants receiving a prompt with additional content were more likely to log in to the program compared to participants who received a standard prompt. However, this result was not statistically significant (OR 2.286, 95% CI 0.892-5.856, P=.09). The key findings suggest that boosting revisits to a CT program benefits most from relatively short prompt timing. Furthermore, a preview of new website content may be added to a standard prompt to further increase its effectiveness in persuading people to log in to the program.

The use of picture prompts and prompt delay to teach receptive labeling.

PubMed

Vedora, Joseph; Barry, Tiffany

2016-12-01

The current study extended research on picture prompts by using them with a progressive prompt delay to teach receptive labeling of pictures to 2 teenagers with autism. The procedure differed from prior research because the auditory stimulus was not presented or was presented only once during the picture-prompt condition. The results indicated that the combination of picture prompts and prompt delay was effective, although 1 participant required a procedural modification. © 2016 Society for the Experimental Analysis of Behavior.

Efficacy and effectiveness of tumour necrosis factor inhibitors in the treatment of rheumatoid arthritis in randomized controlled trials and routine clinical practice.

PubMed

Aaltonen, Kalle J; Ylikylä, Suvi; Tuulikki Joensuu, Jaana; Isomäki, Pia; Pirilä, Laura; Kauppi, Markku; Rannio, Tuomas; Eklund, Kari; Blom, Marja; Nordström, Dan

2017-05-01

Efficacy of TNF inhibitors in the treatment of RA assessed in randomized controlled trials (RCTs) may not be fully comparable to routine care owing to the stringent inclusion criteria. The objective of this study was to observe the effectiveness of TNF inhibitors in real-world patients and assess the patients' potential eligibility for the RCTs. RA patients starting a TNF-inhibitor treatment between 2004 and 2014 were identified from the National Register for Biologic Treatment in Finland, which is a longitudinal observational cohort study. Effectiveness was measured using the ACR and EULAR response criteria and by studying the proportion of patients reaching DAS28 remission. The patients' baseline characteristics were compared against the inclusion criteria of 27 RCTs. EULAR moderate and good treatment responses at 6 months were achieved by 69 and 40% of the users of the first TNF inhibitor, respectively. ACR20, ACR50 and ACR70 responses were reached by 48, 27 and 13%, respectively. DAS28 remission was reached by 47%. Only 7.6-44% of the patients would have been potentially eligible for the RCTs. The eligible patients had better treatment responses compared with the non-eligible patients. Different TNF inhibitors were mostly equipotent, but the usage of MTX co-therapy had a major influence on treatment response. Only a small proportion of patients would have been eligible for RCTs, and the efficacy of TNF inhibitors assessed in them cannot be generalized directly into Finnish routine health care. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Herbal medicine for adults with asthma: A systematic review.

PubMed

Shergis, Johannah L; Wu, Lei; Zhang, Anthony L; Guo, Xinfeng; Lu, Chuanjian; Xue, Charlie C

2016-08-01

Many people with asthma use herbal medicines to help reduce symptoms and improve asthma control. To update the systematic review and meta-analysis of randomised controlled trials of herbal medicine for adult asthma. Nine English and Chinese databases were searched (PubMed, Embase, CINAHL, CENTRAL, AMED, CBM, CNKI, CQVIP, Wanfang). Herbal medicines combined with routine pharmacotherapies compared with the same pharmacotherapies alone or placebo. Cochrane Risk of Bias Tool and GRADE Summary of Findings tables were used to evaluate methodological quality. Twenty-nine (29) studies involving 3,001 participants were included. Herbal interventions used multi-ingredients such as licorice root, crow-dipper, astragali, and angelica. Compared with routine pharmacotherapies alone, herbal medicines as add-on therapy improved lung function (FEV1: MD 7.81%, 95% CI 5.79, 9.83, I(2) = 63%; PEFR: MD 65.14 L/min, 95% CI 58.87, 71.41, I(2) = 21%); asthma control (MD 2.47 points, 95% CI 1.64, 3.29, I(2) = 55%); reduced salbutamol usage (MD -1.14 puffs/day, 95% CI -2.20, -0.09, I(2) = 92%); and reduced acute asthma exacerbations over one year (MD -1.20, 95% CI -1.82, -0.58, one study). Compared with placebo plus pharmacotherapies herbal medicines as add-on therapy improved lung function (FEV1: MD 15.83%, 95% CI 13.54, 18.12 and PEFR: MD 55.20 L/min, 95% CI 33.41, 76.99). Other outcomes were not reported in these placebo studies. Included studies were low to moderate quality. Adverse events were rare. Herbal medicines combined with routine pharmacotherapies improved asthma outcomes greater than pharmacotherapies alone. Included studies did not blind participants therefore more studies that address such weaknesses are warranted.

What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials.

PubMed

Kotronoulas, Grigorios; Kearney, Nora; Maguire, Roma; Harrow, Alison; Di Domenico, David; Croy, Suzanne; MacGillivray, Stephen

2014-05-10

The systematic use of patient-reported outcome measures (PROMs) has been advocated as an effective way to standardize cancer practice. Yet, the question of whether PROMs can lead to actual improvements in the quality of patient care remains under debate. This review examined whether inclusion of PROM in routine clinical practice is associated with improvements in patient outcomes, processes of care, and health service outcomes during active anticancer treatment. A systematic review of five electronic databases (Medline, EMBASE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], PsycINFO, and Psychology and Behavioral Sciences Collection [PBSC]) was conducted from database inception to May 2012 to locate randomized and nonrandomized controlled trials of patients receiving active anticancer treatment or supportive care irrespective of type of cancer. Based on prespecified eligibility criteria, we included 26 articles that reported on 24 unique controlled trials. Wide variability in the design and use of interventions delivered, outcomes evaluated, and cancer- and modality-specific context was apparent. Health service outcomes were only scarcely included as end points. Overall, the number of statistically significant findings were limited and PROMs' intervention effect sizes were predominantly small-to-moderate. The routine use of PROMs increases the frequency of discussion of patient outcomes during consultations. In some studies, PROMs are associated with improved symptom control, increased supportive care measures, and patient satisfaction. Additional effort is required to ensure patient adherence, as well as additional support to clinicians who will respond to patient concerns and issues, with clear system guidelines in place to guide their responses. More research is required to support PROM cost-benefit in terms of patient safety, clinician burden, and health services usage.

Statistical analysis of water-quality data containing multiple detection limits II: S-language software for nonparametric distribution modeling and hypothesis testing

USGS Publications Warehouse

Lee, L.; Helsel, D.

2007-01-01

Analysis of low concentrations of trace contaminants in environmental media often results in left-censored data that are below some limit of analytical precision. Interpretation of values becomes complicated when there are multiple detection limits in the data-perhaps as a result of changing analytical precision over time. Parametric and semi-parametric methods, such as maximum likelihood estimation and robust regression on order statistics, can be employed to model distributions of multiply censored data and provide estimates of summary statistics. However, these methods are based on assumptions about the underlying distribution of data. Nonparametric methods provide an alternative that does not require such assumptions. A standard nonparametric method for estimating summary statistics of multiply-censored data is the Kaplan-Meier (K-M) method. This method has seen widespread usage in the medical sciences within a general framework termed "survival analysis" where it is employed with right-censored time-to-failure data. However, K-M methods are equally valid for the left-censored data common in the geosciences. Our S-language software provides an analytical framework based on K-M methods that is tailored to the needs of the earth and environmental sciences community. This includes routines for the generation of empirical cumulative distribution functions, prediction or exceedance probabilities, and related confidence limits computation. Additionally, our software contains K-M-based routines for nonparametric hypothesis testing among an unlimited number of grouping variables. A primary characteristic of K-M methods is that they do not perform extrapolation and interpolation. Thus, these routines cannot be used to model statistics beyond the observed data range or when linear interpolation is desired. For such applications, the aforementioned parametric and semi-parametric methods must be used.

Knowledge about acetaminophen toxicity among emergency department visitors.

PubMed

Chen, Lee; Schneider, Sandra; Wax, Paul

2002-12-01

Overdoses of acetaminophen are an increasingly common cause of acute liver failure. This study examines knowledge about acetaminophen therapeutic usage and toxicity among emergency department visitors. Adult visitors in an urban/suburban emergency department waiting room was surveyed with a questionnaire; 103/138 (75%) approached completed the questionnaire. 18% of the subjects believed the maximum daily acetaminophen dose is > or = 5 g. When asked to identify acetaminophen-containing products, only 13% chose Percocet and 6% Vicodin Motrin was the medication respondents most frequently believed to contain acetaminophen. 52% did not know acetaminophen toxicity causes liver damage. No statistically significant differences existed with regard to sex, race and age; more female subjects routinely inform doctors about their acetaminophen use compared to males (64% vs 30%). Some study subjects have very limited knowledge regarding therapeutic use of acetaminophen and its toxicity.

Using high-order polynomial basis in 3-D EM forward modeling based on volume integral equation method

NASA Astrophysics Data System (ADS)

Kruglyakov, Mikhail; Kuvshinov, Alexey

2018-05-01

3-D interpretation of electromagnetic (EM) data of different origin and scale becomes a common practice worldwide. However, 3-D EM numerical simulations (modeling)—a key part of any 3-D EM data analysis—with realistic levels of complexity, accuracy and spatial detail still remains challenging from the computational point of view. We present a novel, efficient 3-D numerical solver based on a volume integral equation (IE) method. The efficiency is achieved by using a high-order polynomial (HOP) basis instead of the zero-order (piecewise constant) basis that is invoked in all routinely used IE-based solvers. We demonstrate that usage of the HOP basis allows us to decrease substantially the number of unknowns (preserving the same accuracy), with corresponding speed increase and memory saving.

Dental DNA fingerprinting in identification of human remains

PubMed Central

Girish, KL; Rahman, Farzan S; Tippu, Shoaib R

2010-01-01

The recent advances in molecular biology have revolutionized all aspects of dentistry. DNA, the language of life yields information beyond our imagination, both in health or disease. DNA fingerprinting is a tool used to unravel all the mysteries associated with the oral cavity and its manifestations during diseased conditions. It is being increasingly used in analyzing various scenarios related to forensic science. The technical advances in molecular biology have propelled the analysis of the DNA into routine usage in crime laboratories for rapid and early diagnosis. DNA is an excellent means for identification of unidentified human remains. As dental pulp is surrounded by dentin and enamel, which forms dental armor, it offers the best source of DNA for reliable genetic type in forensic science. This paper summarizes the recent literature on use of this technique in identification of unidentified human remains. PMID:21731342

DU Processing Efficiency and Reclamation: Plasma Arc Melting

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

Imhoff, Seth D.; Aikin, Jr., Robert M.; Swenson, Hunter

The work described here corresponds to one piece of a larger effort to increase material usage efficiency during DU processing operations. In order to achieve this goal, multiple technologies and approaches are being tested. These technologies occupy a spectrum of technology readiness levels (TRLs). Plasma arc melting (PAM) is one of the technologies being investigated. PAM utilizes a high temperature plasma to melt materials. Depending on process conditions, there are potential opportunities for recycling and material reclamation. When last routinely operational, the LANL research PAM showed extremely promising results for recycling and reclamation of DU and DU alloys. The currentmore » TRL is lower due to machine idleness for nearly two decades, which has proved difficult to restart. This report describes the existing results, promising techniques, and the process of bringing this technology back to readiness at LANL.« less

Beta agonists in livestock feed: status, health concerns, and international trade.

PubMed

Centner, T J; Alvey, J C; Stelzleni, A M

2014-09-01

Since the U.S. Food and Drug Administration approved ractopamine hydrochloride and zilpaterol hydrochloride in animal feeds, usage of those compounds has been a topic of worldwide debate. Ractopamine and zilpaterol are β-adrenergic agonists used as veterinary drugs to increase weight gain in certain animals raised for food. The Joint FAO/WHO Expert Committee on Food Additives (JECFA) established maximum residue limits for ractopamine, which were adopted by the Codex Alimentarius Commission (Codex). No maximum residue limits for zilpaterol have been adopted by JECFA, and new reports of animal mobility issues confront the use of this feed additive. However, many countries disagree with the Codex standards and are restricting or banning meat products containing β agonists. The bans by major importers of U.S. meat products have prompted some to advocate that the United States use the World Trade Organization dispute settlement body. This paper looks at the developments to provide a fuller accounting of what the issues may mean to U.S. firms selling meat products containing residues of β agonists.

GPU-accelerated low-latency real-time searches for gravitational waves from compact binary coalescence

NASA Astrophysics Data System (ADS)

Liu, Yuan; Du, Zhihui; Chung, Shin Kee; Hooper, Shaun; Blair, David; Wen, Linqing

2012-12-01

We present a graphics processing unit (GPU)-accelerated time-domain low-latency algorithm to search for gravitational waves (GWs) from coalescing binaries of compact objects based on the summed parallel infinite impulse response (SPIIR) filtering technique. The aim is to facilitate fast detection of GWs with a minimum delay to allow prompt electromagnetic follow-up observations. To maximize the GPU acceleration, we apply an efficient batched parallel computing model that significantly reduces the number of synchronizations in SPIIR and optimizes the usage of the memory and hardware resource. Our code is tested on the CUDA ‘Fermi’ architecture in a GTX 480 graphics card and its performance is compared with a single core of Intel Core i7 920 (2.67 GHz). A 58-fold speedup is achieved while giving results in close agreement with the CPU implementation. Our result indicates that it is possible to conduct a full search for GWs from compact binary coalescence in real time with only one desktop computer equipped with a Fermi GPU card for the initial LIGO detectors which in the past required more than 100 CPUs.

Hepatotoxicity induced by methimazole in a previously healthy patient.

PubMed

Gallelli, Luca; Staltari, Orietta; Palleria, Caterina; De Sarro, Giovambattista; Ferraro, Maria

2009-09-01

We report a case of hepatotoxicity induced by methimazole treatment in a patient affected by hyperthyroidism. A 54-year-old man, presented to our observation for palpitations, excessive sweating, weakness, heat intolerance and weight loss. On physical examination, his blood pressure was 140/90 mmHg and heart beat was 100/min regular. He had mild tremors and left exophthalmos. Laboratory test revealed a significant increase in serum thyroid hormone levels with a decrease in thyroid stimulating hormone levels. A diagnosis of hyperthyroidism was made and he began treatment with methimazole (30 mg/day). Fourteen days later, he returned for the development of scleral icterus, followed by dark urine, and abdominal pain in the right upper quadrant. Laboratory examinations and liver biopsy performed a diagnosis of cholestatic hepatitis, secondary to methimazole usage. Methimazole was promptly withdrawn and cholestyramine, ursodeoxycholic acid, and chlorpheniramine were given. After five days, abdominal pain resolved and laboratory parameters returned to normal. Naranjo probability scale indicated a probable relationship between hepatotoxicity and methimazole therapy. In conclusion physicians should be aware the risk of hepatotoxicity related with methimazole.

Adverse consequences of neonatal antibiotic exposure.

PubMed

Cotten, Charles M

2016-04-01

Antibiotics have not only saved lives and improved outcomes, but they also influence the evolving microbiome. This review summarizes reports on neonatal infections and variation in antibiotic utilization, discusses the emergence of resistant organisms, and presents data from human neonates and animal models demonstrating the impact of antibiotics on the microbiome, and how microbiome alterations impact health. The importance of antibiotic stewardship is also discussed. Infections increase neonatal morbidity and mortality. Furthermore, the clinical presentation of infections can be subtle, prompting clinicians to empirically start antibiotics when infection is a possibility. Antibiotic-resistant infections are a growing problem. Cohort studies have identified extensive center variations in antibiotic usage and associations between antibiotic exposures and outcomes. Studies of antibiotic-induced microbiome alterations and downstream effects on the developing immune system have increased our understanding of the mechanisms underlying the associations between antibiotics and adverse outcomes. The emergence of resistant microorganisms and recent evidence linking antibiotic practice variations with health outcomes has led to the initiation of antibiotic stewardship programs. The review encourages practitioners to assess local antibiotic use with regard to local microbiology, and to adopt steps to reduce infections and use antibiotics wisely.

[Update on epidemiology, pathophysiology, diagnosis and treatment of malignant pleural mesothelioma].

PubMed

Gopar-Nieto, Rodrigo; Cabello-López, Alejandro; Juárez-Pérez, Cuauhtémoc Arturo; Haro-García, Luis Cuauhtémoc; Jiménez-Ramírez, Carmina; Aguilar-Madrid, Guadalupe

2016-01-01

Malignant pleural mesothelioma is an occupational tumor caused by asbestos exposure. In Mexico, as asbestos usage is not prohibited, an increase in the number of cases is expected. Asbestos exposure is ubiquitous due to the great amount of products in which it is present. Its carcinogenicity is caused as the inhaled asbestos fibers cannot be eliminated by macrophages and, thus, they travel to the pleura through lymphatic pathways, producing a persistent inflammatory response. Diagnosis approach includes occupational history, along with clinical signs and symptoms, and paraclinical studies, such as pleural fluid cytology, chest x-rays, computed tomography, magnetic resonance imaging, and biopsy with immunohistochemistry. The main differential diagnosis is lung adenocarcinoma. Regarding the treatment of this tumor, it mainly comprises palliative care, even though chemotherapy, radiotherapy, and, in selected cases, surgical treatments have been used. There is an urgent need for general physicians and specialists to identify asbestos exposure, in order to make a timely diagnosis. Research is necessary to develop screening and prompt diagnostic tools, along with an epidemiological surveillance program for the workers and the general population exposed to asbestos.

Cherenkov and scintillation light separation on the TheiaR &D experiment

NASA Astrophysics Data System (ADS)

Caravaca, Javier; Land, Benjamin

2016-03-01

Identifying by separate the scintillation and Cherenkov light produced in a scintillation medium enables outstanding capabilities for future particle detectors, being the most relevant: allowing particle directionality information in a low energy threshold detector and improved particle identification. The TheiaR &D experiment uses an array of small and fast photomultipliers (PMTs) and state-of-the-art electronics to demonstrate the reconstruction of a Cherenkov ring in a scintillation medium, based on the number of produced photoelectrons and the timing information. A charged particle ionizing a scintillation medium produces a prompt Cherenkov cone and late isotropic scintillation light, typically delayed by <1ns. The fast response of our PMTs and DAQ provides a precision well below the ns level, making possible the time separation. Furthermore, the usage of the new developed water-based liquid scintillators (WBLS) provides a medium with a tunable Cherenkov/Scintillation light yield ratio, enhancing the visibility of the dimer Cherenkov light in presence of the scintillation light. Description of the experiment, details of the analysis and preliminary results of the first months of running will be discussed.

CRISPR-engineered genome editing for the next generation neurological disease modeling.

PubMed

Feng, Weijun; Liu, Hai-Kun; Kawauchi, Daisuke

2018-02-02

Neurological disorders often occur because of failure of proper brain development and/or appropriate maintenance of neuronal circuits. In order to understand roles of causative factors (e.g. genes, cell types) in disease development, generation of solid animal models has been one of straight-forward approaches. Recent next generation sequencing studies on human patient-derived clinical samples have identified various types of recurrent mutations in individual neurological diseases. While these discoveries have prompted us to evaluate impact of mutated genes on these neurological diseases, a feasible but flexible genome editing tool had remained to be developed. An advance of genome editing technology using the clustered regularly interspaced short palindromic repeats (CRISPR) with the CRISPR-associated protein (Cas) offers us a tremendous potential to create a variety of mutations in the cell, leading to "next generation" disease models carrying disease-associated mutations. We will here review recent progress of CRISPR-based brain disease modeling studies and discuss future requirement to tackle current difficulties in usage of these technologies. Copyright © 2017 Elsevier Inc. All rights reserved.

Contraception counselling of female soldiers in primary healthcare facilities.

PubMed

Crabb, Sarah L

2015-06-01

Effectiveness of barrier and oral contraceptive pills is dependent on daily adherence and consistency that cannot always be guaranteed by military lifestyle. Long-acting reversible contraceptive (LARC) methods could provide a good alternative to guarantee effective contraception in unpredictable scenarios, and recent studies have suggested they could provide wider non-contraceptive benefits. LARC has been proven to be more cost effective than the combined oral contraceptive pill. The National Institute of Health and Care Excellence (NICE) has released guidelines on contraception provision to ensure all women receive the contraception method that is most appropriate to the individual. A retrospective audit of 105 sets of primary healthcare notes of serving female soldiers was assessed to establish contraceptive choices and whether appropriate information had been provided within the last year of their last consultation. 100% had seen a healthcare provider capable of providing contraceptive advice in the last year. 69% documented as using some form of non-surgical contraception versus 58% quoted as national usage. 21% were using some form of LARC versus 8% national usage. 66% of eligible women had not had LARC discussed with them, and of these 50% did not have any contraceptive usage documented. Among other consultations, 41% had had a medical within the year period, of which over half had no documented contraceptive status. As military healthcare providers, we have more exposure to our patients than NHS equivalents and this small study suggests there is an increased demand for contraception. Contraceptive choice counselling should be a mandatory part of routine initial medicals. If the situation demands a medical for any other reason, a documented contraception status should form an important part of the risk assessment process. 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.

Meta-analysis of warmed versus standard temperature CO2 insufflation for laparoscopic cholecystectomy.

PubMed

Hakeem, Abdul R; Birks, Theodore; Azeem, Qasim; Di Franco, Filippo; Gergely, Szabolcs; Harris, Adrian M

2016-06-01

There is conflicting evidence for the use of warmed, humidified carbon dioxide (CO2) for creating pneumoperitoneum during laparoscopic cholecystectomy. Few studies have reported less post-operative pain and analgesic requirement when warmed CO2 was used. This systematic review and meta-analysis aims to analyse the literature on the use of warmed CO2 in comparison to standard temperature CO2 during laparoscopic cholecystectomy. Systematic review and meta-analysis carried out in line with the PRISMA guidelines. Primary outcomes of interest were post-operative pain at 6 h, day 1 and day 2 following laparoscopic cholecystectomy. Secondary outcomes were analgesic usage and drop in intra-operative core body temperature. Standard Mean Difference (SMD) was calculated for continuous variables. Six randomised controlled trials (RCTs) met the inclusion criteria (n = 369). There was no significant difference in post-operative pain at 6 h [3 RCTs; SMD = -0.66 (-1.33, 0.02) (Z = 1.89) (P = 0.06)], day 1 [4 RCTs; SMD = -0.51 (-1.47, 0.44) (Z = 1.05) (P = 0.29)] and day 2 [2 RCTs; SMD = -0.96 (-2.30, 0.37) (Z = 1.42) (P = 0.16)] between the warmed CO2 and standard CO2 group. There was no difference in analgesic usage between the two groups, but pooled analysis was not possible. Two RCTs reported significant drop in intra-operative core body temperature, but there were no adverse events related to this. This review showed no difference in post-operative pain and analgesic requirements between the warmed and standard CO2 insufflation during laparoscopic cholecystectomy. Currently there is not enough high quality evidence to suggest routine usage of warmed CO2 for creating pneumoperitoneum during laparoscopic cholecystectomy. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Dental unit water lines decontamination with the aid of nanotechnology.

PubMed

Paramashivaiah, Rashmi; Prabhuji, M L V; Narayanan, Roopalakshmi

2016-01-01

This article reviews the issue of dental unit waterline (DUWL) contamination which affects all the clinical and hospital settings. The contaminating microorganisms commonly isolated from these settings and the most pathogenic among them have serious consequences. Over the years several measures are inculcated for decontamination of water, their advantages and shortcomings have been addressed. Options using nanotechnology which are available in the market are described briefly. A manual and electronic search was conducted. Google and PubMed were searched for relevant material from studies up to 2013. Medical Subject Headings words looked for were "Nanotechnology," "Water purification," and "Biofilms." Reviewed findings were summarized by topic, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for reporting. Seventy articles were shortlisted for articles pertaining to our topic of discussion. A systematic approach was followed by two independent reviewers and included eligibility criteria for study inclusion, data extraction, data synthesis, and drawing of conclusion. Dental waterline contamination is widespread in any type of dental setting having serious implications on clinicians and patients alike, especially elderly and immune-compromised. Hence, international bodies like center for disease and control and American Dental Association have come up with stringent measures for maintenance of water quality. A gamut of procedures has been tried to overcome this problem ranging from chlorinated products, water filters to the usage of distilled water. The use of nanoemulsions, nanofilters, nanomembranes, etc., and their applicability for routine usage is discussed. Biofilm formation in DUWLs is inevitable with the subsequent release of part of microbiota into the otherwise sterile dental settings. These consequences can be quite serious on clinicians and dental patients. Though conventional measures in water decontamination have been partly successful, the quest for more foolproof methods has led to the use of latest technology, i.e., nanotechnology. The most practical option has to be chosen based on the ease of their usage.

Factors relating to usage patterns of amalgam and resin composite for posterior restorations--a prospective analysis.

PubMed

Khalaf, Mai E; Alomari, Qasem D; Omar, Ridwaan

2014-07-01

This study prospectively analyzed the use of amalgam and resin composite posterior restorations placed by general dentists in relation to dentist, patient and cavity factors. One thousand posterior restorations placed by a representative sample of general dentists working in the Ministry of Health (MOH), Kuwait, during routine clinical practice were included. Information about the restorations was recorded using a survey questionnaire. Descriptive statistics and multivariate logistic regression analysis were used to determine the factors associated with the use of amalgam versus tooth coloured restoratives. Dentists chose amalgam for 30.8% of the 1000 restorations. Dentists with longer work experience (>15 years) were more likely to choose amalgam (OR=2.61, 95% CI=1.06, 6.40). Younger dentists (≤30 years) were less likely to choose amalgam (OR=0. 45, 95% CI=0.26, 0.77). Amalgam was more likely to be chosen for patients with poor oral hygiene (OR=1.58, 95% CI=1.08, 2.32) and a higher number (≥4) of restorations (OR=1.44, 95% CI=1.07, 1.94) with large cavity sizes (OR=6.33, 95% CI=3.88, 10.32). Tooth-coloured restorations were more likely to be chosen for cavities of smaller sizes. The use of resin composite materials as the dominant choice among dentists in Kuwait reflects the trend worldwide. Nevertheless, clinicians still find a use for amalgam in posterior load-bearing teeth and in the high-caries risk population. The findings give insight into factors influencing material usage under different clinical conditions and provides information about the perceived deficiencies or shortcomings of resin composite materials in a general dental practice setting. This information can be useful for identifying perceived barriers to the usage of newer restorative materials and finding ways to overcome them. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using simple technology to prompt multistep tasks in the home for people with dementia: An exploratory study comparing prompting formats.

PubMed

Boyd, Hazel C; Evans, Nina M; Orpwood, Roger D; Harris, Nigel D

2017-05-01

Objectives To investigate the relative effectiveness of different prompts for people with dementia during multistep tasks in the home, to inform prompting technology design. Methods Nine pairs of participants (one with dementia and a partner or relative) participated at home. The participants with mild to moderate dementia (5M/4F, aged 73-86 years) functioned at the Planned or Exploratory levels of the Pool Activity Level instrument. A touchscreen computer displayed different prompts during two set tasks: "card-and-envelope" and "CD player." The trials were scored to establish the relative effectiveness of the prompts. Individual tasks were also explored. Results Text and audio prompts were each more effective than video or picture prompts for a card-and-envelope task, but this was not seen in a CD player task. The differences may be related to the type of actions within the tasks; the card-and-envelope actions were easier to convey verbally; the CD player actions lent themselves to visual prompts. Conclusions Designers of technology-based prompts for people with dementia should consider that the effectiveness of different prompts is likely to be task dependent. Familiar, unambiguous language can increase the success of tailored prompts. There are significant practical challenges associated with choosing and deconstructing everyday tasks at home.

Tools to overcome potential barriers to chlamydia screening in general practice: Qualitative evaluation of the implementation of a complex intervention.

PubMed

Ricketts, Ellie J; Francischetto, Elaine O'Connell; Wallace, Louise M; Hogan, Angela; McNulty, Cliodna A M

2016-03-22

Chlamydia trachomatis remains a significant public health problem. We used a complex intervention, with general practice staff, consisting of practice based workshops, posters, computer prompts and testing feedback and feedback to increase routine chlamydia screening tests in under 25 year olds in South West England. We aimed to evaluate how intervention components were received by staff and to understand what determined their implementation into ongoing practice. We used face-to-face and telephone individual interviews with 29 general practice staff analysed thematically within a Normalisation Process Theory Framework which explores: 1. Coherence (if participants understand the purpose of the intervention); 2. Cognitive participation (engagement with and implementation of the intervention); 3. Collective action (work actually undertaken that drives the intervention forwards); 4. Reflexive monitoring (assessment of the impact of the intervention). Our results showed coherence as all staff including receptionists understood the purpose of the training was to make them aware of the value of chlamydia screening tests and how to increase this in their general practice. The training was described by nearly all staff as being of high quality and responsible for creating a shared understanding between staff of how to undertake routine chlamydia screening. Cognitive participation in many general practice staff teams was demonstrated through their engagement by meeting after the training to discuss implementation, which confirmed the role of each staff member and the use of materials. However several participants still felt unable to discuss chlamydia in many consultations or described sexual health as low priority among colleagues. National targets were considered so high for some general practice staff that they didn't engage with the screening intervention. Collective action work undertaken to drive the intervention included use of computer prompts which helped staff remember to make the offer, testing rate feedback and having a designated lead. Ensuring patients collected samples when still in the general practice was not attained in most general practices. Reflexive monitoring showed positive feedback from patients and other staff about the value of screening, and feedback about the general practices testing rates helped sustain activity. A complex intervention including interactive workshops, materials to help implementation and feedback can help chlamydia screening testing increase in general practices.

Babies Living Safe & Smokefree: randomized controlled trial of a multilevel multimodal behavioral intervention to reduce low-income children's tobacco smoke exposure.

PubMed

Collins, Bradley N; Lepore, Stephen J

2017-03-14

Addressing children's tobacco smoke exposure (TSE) remains a public health priority. However, there is low uptake and ineffectiveness of treatment, particularly in low-income populations that face numerous challenges to smoking behavior change. A multilevel intervention combining system-level health messaging and advice about TSE delivered at community clinics that disseminate the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), combined with nicotine replacement and intensive multimodal, individual-level behavioral intervention may improve TSE control efforts in such high-risk populations. This trial uses a randomized two-group design with three measurement points: baseline, 3-month and 12-month follow-up. The primary outcome is bioverified child TSE; the secondary outcome is bioverified maternal quit status. Smoking mothers of children less than 6 years old are recruited from WIC clinics. All participants receive WIC system-level intervention based on the "Ask, Advise, Refer (AAR)" best practices guidelines for pediatrics clinics. It includes training all WIC staff about the importance of maternal tobacco control; and detailing clinics with AAR intervention prompts in routine work flow to remind WIC nutrition counselors to ask all mothers about child TSE, advise about TSE harms and benefits of protection, and refer smokers to cessation services. After receiving the system intervention, mothers are randomized to receive 3 months of additional treatment or an attention control intervention: (1) The multimodal behavioral intervention (MBI) treatment includes telephone counseling sessions about child TSE reduction and smoking cessation, provision of nicotine replacement therapy, a mobile app to support cessation efforts, and multimedia text messages about TSE and smoking cessation; (2) The attention control intervention offers equivalent contact as the MBI and includes nutrition-focused telephone counseling, mobile app, and multimedia text messages about improving nutrition. The control condition also receives a referral to the state smoking cessation quitline. This study tests an innovative community-based, multilevel and integrated multimodal approach to reducing child TSE in a vulnerable, low-income population. The approach is sustainable and has potential for wide reach because WIC can integrate the tobacco intervention prompts into routine workflow and refer smokers to free evidence-based behavioral counseling interventions, such as state quitlines. Clinicaltrials.gov NCT02602288 . Registered 9 November 2015.

eHealth System for Collecting and Utilizing Patient Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) Among Cancer Patients: Mixed Methods Approach to Evaluate Feasibility and Acceptability.

PubMed

Girgis, Afaf; Durcinoska, Ivana; Levesque, Janelle V; Gerges, Martha; Sandell, Tiffany; Arnold, Anthony; Delaney, Geoff P

2017-10-02

Despite accumulating evidence indicating that collecting patient-reported outcomes (PROs) and transferring results to the treating health professional in real time has the potential to improve patient well-being and cancer outcomes, this practice is not widespread. The aim of this study was to test the feasibility and acceptability of PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care), a newly developed electronic health (eHealth) system that facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research. We developed an eHealth system in consultation with content-specific expert advisory groups and tested it with patients receiving treatment or follow-up care in two hospitals in New South Wales, Australia, over a 3-month period. Participants were recruited in clinic and completed self-report Web-based assessments either just before their upcoming clinical consultation or every 4 weeks if in follow-up care. A mixed methods approach was used to evaluate feasibility and acceptability of PROMPT-Care; data collected throughout the study informed the accuracy and completeness of data transfer procedures, and extent of missing data was determined from participants' assessments. Patients participated in cognitive interviews while completing their first assessment and completed evaluation surveys and interviews at study-end to assess system acceptability and usefulness of patient self-management resources, and oncology staff were interviewed at study-end to determine the acceptability and perceived usefulness of real-time PRO reporting. A total of 42 patients consented to the study; 7 patients were withdrawn before starting the intervention primarily because of changes in eligibility. Overall, 35 patients (13 on treatment and 22 in follow-up) completed 67 assessments during the study period. Mean completeness of patient-reported data was 93%, with 100% accuracy of data transfer. Ten patients completed cognitive interviews, 28 completed evaluation surveys, and 14 completed evaluation interviews at study-end. PROMPT-Care patient acceptability was high-100% (28/28) reported the time to complete the Web-based assessments (average 15 min) as about right, most willing to answer more questions (79%, 22/28 yes), 96% (27/28) found the Web-based assessment easier or same as completing a paper copy, and they valued the self-management resources . Oncology staff (n=5) also reported high acceptability and potential feasibility of the system. Patients and oncology staff found the PROMPT-Care system to be highly acceptable, and the results suggest that it would be feasible to implement it into an oncology setting. Suggested modifications to the patient assessment survey, clinician access to the reports, and system requirements will be made as part of the next stage of large-scale testing and future implementation of the system as part of routine care. Australian New Zealand Clinical Trials Registry ACTRN1261500135294; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369299&isReview=true (Archived by WebCite at http://www.webcitation.org/6lzylG5A0). ©Afaf Girgis, Ivana Durcinoska, Janelle V Levesque, Martha Gerges, Tiffany Sandell, Anthony Arnold, Geoff P Delaney, The PROMPT-Care Program Group. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.10.2017.

Prompting methods affect the accuracy of children's school lunch recalls.

PubMed

Baxter, S D; Thompson, W O; Davis, H C

2000-08-01

To evaluate the feasibility of implementing 3 specific prompting methods among students in the first and fourth grades (mean age = 7.2 and 10.1 years, respectively), to validate recall accuracy of first- and fourth-grade students against observation, to develop a single measure of inaccuracy that cumulated errors in reporting food items and amounts without allowing underreporting and overreporting to cancel each other, and to establish information regarding the measure of inaccuracy for use in future studies. Children were interviewed the morning after they were observed eating lunch provided by the school. Interviews included free recall, nonsuggestive prompted recall, and specific prompted recall (either preference, food category, or visual). Ninety-six children (48 students per grade) were studied--32 per the specific prompting method--stratified by grade, sex, and ethnicity (African-American or white). Specific prompting method was randomly assigned to children within strata. Food items were categorized and weighted as: combination entree = 2, condiments = 1/3, and other = 1. To calculate inaccuracy of recall, absolute differences between amounts reported and observed eaten were calculated for each item and then multiplied by each item's weight; these values were then summed across all items for each child. Inaccuracy of recall was determined before specific prompting and after specific prompting and for the difference (inaccuracy after specific prompting minus inaccuracy before specific prompting). Before specific prompting, median inaccuracy was 2.7 servings for the 48 first-grade students and 1.7 servings for the 48 fourth-grade students. The median difference in inaccuracy from before to after specific prompting was 0 for both grades. Specific prompting increased recall accuracy for 9 first-graders and 12 fourth-graders, but decreased recall accuracy for 21 first-graders and 7 fourth-graders, and did not change recall accuracy for 18 first-graders and 29 fourth-graders. Among children whose recall accuracy increased after specific prompting, 5 first-graders and 8 fourth-graders received prompting for food category. Among first-grade students, specific prompting (either preference, food category, or visual) may hurt more than help recall accuracy. Among fourth-grade students, prompting for food category yields small gains in recall accuracy with minimal losses. Validation studies are needed with larger sample sizes to determine prompting methods that produce more accurate dietary recalls from children of various socioeconomic status groups, other racial/ethnic groups, and at other meals.

Using simple technology to prompt multistep tasks in the home for people with dementia: An exploratory study comparing prompting formats

PubMed Central

Evans, Nina M; Orpwood, Roger D; Harris, Nigel D

2015-01-01

Objectives To investigate the relative effectiveness of different prompts for people with dementia during multistep tasks in the home, to inform prompting technology design. Methods Nine pairs of participants (one with dementia and a partner or relative) participated at home. The participants with mild to moderate dementia (5M/4F, aged 73–86 years) functioned at the Planned or Exploratory levels of the Pool Activity Level instrument. A touchscreen computer displayed different prompts during two set tasks: “card-and-envelope” and “CD player.” The trials were scored to establish the relative effectiveness of the prompts. Individual tasks were also explored. Results Text and audio prompts were each more effective than video or picture prompts for a card-and-envelope task, but this was not seen in a CD player task. The differences may be related to the type of actions within the tasks; the card-and-envelope actions were easier to convey verbally; the CD player actions lent themselves to visual prompts. Conclusions Designers of technology-based prompts for people with dementia should consider that the effectiveness of different prompts is likely to be task dependent. Familiar, unambiguous language can increase the success of tailored prompts. There are significant practical challenges associated with choosing and deconstructing everyday tasks at home. PMID:26428634

Examination of a Regressive Prompt-Delay Procedure for Improving Sight-Word Reading

ERIC Educational Resources Information Center

Daly, Edward J., III.; Hess, Polly M.; Sommerhalder, Mackenzie; Strong, Whitney; Johnsen, Mallory; O'Connor, Maureen A.; Young, Nicholas D.

2016-01-01

The current two-experiment study examined the effects of a regressive prompt-delay procedure on sight-word reading of four elementary school students. In contrast to traditional progressive prompt-delay procedures in which the latency of prompts is increased, the regressive prompt-delay latency is decreased over time. Data indicate that…

Investigating the Effect of Discussion Prompts on Knowledge Construction

ERIC Educational Resources Information Center

Howell, Ginger S.

2014-01-01

The purpose of this study was to examine the effect of Andrews' (1980) three structured divergent prompt designs (Playground prompt, Brainstorm prompt, and Focal prompt) on knowledge construction. Sixty-five online graduate participants at a university in a South Atlantic state were a part of the study. Students' posts were analyzed using the…

Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement.

PubMed

Doyle, Cathal; Howe, Cathy; Woodcock, Thomas; Myron, Rowan; Phekoo, Karen; McNicholas, Chris; Saffer, Jessica; Bell, Derek

2013-10-26

The implementation of evidence-based treatments to deliver high-quality care is essential to meet the healthcare demands of aging populations. However, the sustainable application of recommended practice is difficult to achieve and variable outcomes well recognised. The NHS Institute for Innovation and Improvement Sustainability Model (SM) was designed to help healthcare teams recognise determinants of sustainability and take action to embed new practice in routine care. This article describes a formative evaluation of the application of the SM by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL). Data from project teams' responses to the SM and formal reviews was used to assess acceptability of the SM and the extent to which it prompted teams to take action. Projects were classified as 'engaged,' 'partially engaged' and 'non-engaged.' Quarterly survey feedback data was used to explore reasons for variation in engagement. Score patterns were compared against formal review data and a 'diversity of opinion' measure was derived to assess response variance over time. Of the 19 teams, six were categorized as 'engaged,' six 'partially engaged,' and seven as 'non-engaged.' Twelve teams found the model acceptable to some extent. Diversity of opinion reduced over time. A minority of teams used the SM consistently to take action to promote sustainability but for the majority SM use was sporadic. Feedback from some team members indicates difficulty in understanding and applying the model and negative views regarding its usefulness. The SM is an important attempt to enable teams to systematically consider determinants of sustainability, provide timely data to assess progress, and prompt action to create conditions for sustained practice. Tools such as these need to be tested in healthcare settings to assess strengths and weaknesses and findings disseminated to aid development. This study indicates the SM provides a potentially useful approach to measuring teams' views on the likelihood of sustainability and prompting action. Securing engagement of teams with the SM was challenging and redesign of elements may need to be considered. Capacity building and facilitation appears necessary for teams to effectively deploy the SM.

Observed assertive and intrusive maternal feeding behaviors increase child adiposity123

PubMed Central

Ozbeki, Tina N; Appugliese, Danielle P; Kaciroti, Niko; Corwyn, Robert F; Bradley, Robert H

2012-01-01

Background: Few studies have examined observed maternal feeding behaviors and their potential association with child adiposity. The association between maternal prompting to eat and child adiposity has been inconsistent. Objectives: This study sought to identify factors associated with maternal feeding behaviors and to test the hypothesis that more maternal prompts to eat, more assertive prompts, and more intrusiveness are associated with greater child adiposity. Design: Children (n = 1218) and their mothers were videotaped eating a standardized snack at ages 15, 24, and 36 mo. Maternal prompts to eat, the percentage of prompts that were assertive, and intrusiveness were coded. Adjusted regression analyses evaluated predictors of prompts, the percentage of assertive prompts, and intrusiveness and the relation of each of these factors with child adiposity (weight-for-length z score at 15 mo and BMI z score at 24 and 36 mo) after control for the child's race-ethnicity and sex, family income-to-needs ratio, and maternal education, weight status, and depressive symptoms. Results: At 36 mo, mothers gave an average of 9.3 prompts; 61% of prompts were assertive, and 48% of mothers were intrusive. Lower maternal education and minority race-ethnicity were associated with a greater percentage of assertive prompts and intrusiveness. A greater percentage of assertive prompts and intrusiveness, but not total prompts, was associated with higher child adiposity. Conclusions: Assertive prompting and an intrusive style had small but significant associations with greater child adiposity. Future work should focus on maternal motivations for assertive and intrusive feeding styles and mechanisms through which these feeding styles might increase child adiposity. PMID:22277552

Engaging Young Students in Scientific Investigations: Prompting for Meaningful Reflection

ERIC Educational Resources Information Center

Wilson, Travis; Perry, Michelle; Anderson, Carolyn J.; Grosshandler, Dean

2012-01-01

This study examined the verbal prompts a tutor used to promote reflection and young students' responses to these prompts. Seven children (ages 8-12) participated in 260 min of one-on-one tutoring to learn scientific concepts related to gear movement; the tutor spontaneously provided these students with 763 prompts for reflection. Prompts reliably…

The Use of Picture Prompts and Prompt Delay to Teach Receptive Labeling

ERIC Educational Resources Information Center

Vedora, Joseph; Barry, Tiffany

2016-01-01

The current study extended research on picture prompts by using them with a progressive prompt delay to teach receptive labeling of pictures to 2 teenagers with autism. The procedure differed from prior research because the auditory stimulus was not presented or was presented only once during the picture-prompt condition. The results indicated…

A Comparison of Two Prompting Procedures for Teaching Basic Skills to Children with Autism

ERIC Educational Resources Information Center

Fentress, Genevieve M.; Lerman, Dorothea C.

2012-01-01

We compared two prompting techniques that are commonly used to teach individuals with autism. In the "most-to-least" (MTL) prompting condition, the therapist initially delivered the most intrusive prompt necessary to achieve a correct response. Prompts were gradually faded across subsequent trials, while errors resulted in the provision of…

Autonomous indoor wayfinding for individuals with cognitive impairments

PubMed Central

2010-01-01

Background A challenge to individuals with cognitive impairments in wayfinding is how to remain oriented, recall routines, and travel in unfamiliar areas in a way relying on limited cognitive capacity. While people without disabilities often use maps or written directions as navigation tools or for remaining oriented, this cognitively-impaired population is very sensitive to issues of abstraction (e.g. icons on maps or signage) and presents the designer with a challenge to tailor navigation information specific to each user and context. Methods This paper describes an approach to providing distributed cognition support of travel guidance for persons with cognitive disabilities. A solution is proposed based on passive near-field RFID tags and scanning PDAs. A prototype is built and tested in field experiments with real subjects. The unique strength of the system is the ability to provide unique-to-the-user prompts that are triggered by context. The key to the approach is to spread the context awareness across the system, with the context being flagged by the RFID tags and the appropriate response being evoked by displaying the appropriate path guidance images indexed by the intersection of specific end-user and context ID embedded in RFID tags. Results We found that passive RFIDs generally served as good context for triggering navigation prompts, although individual differences in effectiveness varied. The results of controlled experiments provided more evidence with regard to applicabilities of the proposed autonomous indoor wayfinding method. Conclusions Our findings suggest that the ability to adapt indoor wayfinding devices for appropriate timing of directions and standing orientation will be particularly important. PMID:20840786

Application of a framework to assess the usefulness of alternative sepsis criteria

PubMed Central

Seymour, Christopher W.; Coopersmith, Craig M.; Deutschman, Clifford S; Gesten, Foster; Klompas, Michael; Levy, Mitchell; Martin, Gregory S.; Osborn, Tiffany M.; Rhee, Chanu; Warren, David; Watson, R. Scott; Angus, Derek C.

2016-01-01

The current definition for sepsis is life-threatening, acute organ dysfunction secondary to a dysregulated host response to infection. Criteria to operationalize this definition can be judged by 6 domains of usefulness (reliability; content, construct and criterion validity, measurement burden, and timeliness). The relative importance of these 6 domains depends on the intended purpose for the criteria (clinical care, basic and clinical research, surveillance, or quality improvement (QI) and audit). For example, criteria for clinical care should have high content and construct validity, timeliness, and low measurement burden to facilitate prompt care. Criteria for surveillance or QI/audit place greater emphasis on reliability across individuals and sites and lower emphasis on timeliness. Criteria for clinical trials require timeliness to ensure prompt enrollment and reasonable reliability but can tolerate high measurement burden. Basic research also tolerates high measurement burden and may not need stability over time. In an illustrative case study, we compared examples of criteria designed for clinical care, surveillance and QI/audit among 396,241 patients admitted to 12 academic and community hospitals in an integrated health system. Case rates differed 4-fold and mortality 3-fold. Predictably, clinical care criteria, which emphasized timeliness and low burden and therefore used vital signs and routine laboratory tests, had the highest case identification with lowest mortality. QI /audit criteria, which emphasized reliability and criterion validity, used discharge information and had the lowest case identification with highest mortality. Using this framework to identify the purpose and apply domains of usefulness can help with the evaluation of existing sepsis diagnostic criteria and provide a roadmap for future work. PMID:26901560

Severe methemoglobinemia complicating topical benzocaine use during endoscopy in a toddler: a case report and review of the literature.

PubMed

Dahshan, Ahmed; Donovan, G Kevin

2006-04-01

Severe methemoglobinemia resulting from the use of topical benzocaine has been reported in adults as a rare complication. Here we report a case of severe acquired methemoglobinemia resulting from topical use of benzocaine spray during diagnostic upper gastrointestinal endoscopy in a 3-year-old boy with repeated episodes of hematemesis 3 weeks posttonsillectomy. He developed marked cyanosis and became increasingly agitated immediately after completion of his unremarkable endoscopic procedure, which was performed under intravenous sedation. He did not respond to maximum supplemental oxygen and had increased respiratory effort. His pulse oximetry dropped to 85%, but simultaneous arterial blood-gas analysis showed marked hypoxemia (Po2 = 29%) and severe methemoglobinemia (methemoglobin = 39%). His cyanosis and altered mental status promptly resolved after intravenous administration of methylene blue. In patients with methemoglobinemia, pulse oximetry tends to overestimate the actual oxygen saturation and is not entirely reliable. Posttonsillectomy bleeding is a rare but occasionally serious complication that could occur weeks after the surgery, although it more commonly occurs within the first few days. Physicians should remain aware of the possibility of its late onset. This case illustrates the severity of acquired methemoglobinemia that may result from even small doses of topical benzocaine and highlights the fact that prompt treatment of the disorder can be life saving. We question the rationale for routine use of topical anesthetic spray for sedated upper gastrointestinal endoscopy in children. By bringing the attention of pediatricians to this rare but serious complication, we hope that it will result in its improved recognition and possible prevention.

Use of sexual risk assessment and feedback at intake to promote counselor awareness of subsequent client risk behavior during early treatment.

PubMed

Hartzler, Bryan; Beadnell, Blair; Calsyn, Donald A

2014-08-01

Sexual risk is an important, oft-neglected area in addiction treatment. This report examines computerized sexual risk assessment and client feedback at intake as means of enhancing counselor awareness of client risk behavior during early treatment, as well as any clinical impact of that counselor awareness. In 2009-2011, new clients at both opiate treatment and drug-free treatment programs endorsed in a computer-assisted assessment at intake 90-day retrospective indices for: being sexually active, having multiple partners, having sex under drug influence, and inconsistently using condoms. Clients were randomly assigned in a 2:1 ratio to receive or not receive a personal feedback report, and those receiving a report chose if a counselor copy was also distributed. Ninety days later, retained clients (N = 79) repeated the assessment and their counselors concurrently reported perceptions of recent client risk behavior. Based on client reports, pretreatment risk behaviors were prevalent among men and women and remained so during treatment. A general linear model revealed greater counselor awareness of subsequent client risk behavior with mutual distribution of intake feedback reports to client and counselor, and at the opiate treatment program. A repeated-measures analysis of variance indicated that counselor awareness did not predict change in temporally stable patterns of sexual risk behavior. CONCLUSIONS/IMPORTANCE: Findings document that computerized intake assessment of sexual risk and mutually distributed feedback reports prompt greater counselor awareness of clients' subsequent risk behavior. Future research is needed to determine how best to prepare counselors to use such awareness to effectively prompt risk reduction in routine care.

Application of a Framework to Assess the Usefulness of Alternative Sepsis Criteria.

PubMed

Seymour, Christopher W; Coopersmith, Craig M; Deutschman, Clifford S; Gesten, Foster; Klompas, Michael; Levy, Mitchell; Martin, Gregory S; Osborn, Tiffany M; Rhee, Chanu; Warren, David K; Watson, R Scott; Angus, Derek C

2016-03-01

The current definition of sepsis is life-threatening, acute organ dysfunction secondary to a dysregulated host response to infection. Criteria to operationalize this definition can be judged by six domains of usefulness (reliability, content, construct and criterion validity, measurement burden, and timeliness). The relative importance of these six domains depends on the intended purpose for the criteria (clinical care, basic and clinical research, surveillance, or quality improvement [QI] and audit). For example, criteria for clinical care should have high content and construct validity, timeliness, and low measurement burden to facilitate prompt care. Criteria for surveillance or QI/audit place greater emphasis on reliability across individuals and sites and lower emphasis on timeliness. Criteria for clinical trials require timeliness to ensure prompt enrollment and reasonable reliability but can tolerate high measurement burden. Basic research also tolerates high measurement burden and may not need stability over time. In an illustrative case study, we compared examples of criteria designed for clinical care, surveillance and QI/audit among 396,241 patients admitted to 12 academic and community hospitals in an integrated health system. Case rates differed four-fold and mortality three-fold. Predictably, clinical care criteria, which emphasized timeliness and low burden and therefore used vital signs and routine laboratory tests, had the greater case identification with lowest mortality. QI/audit criteria, which emphasized reliability and criterion validity, used discharge information and had the lowest case identification with highest mortality. Using this framework to identify the purpose and apply domains of usefulness can help with the evaluation of existing sepsis diagnostic criteria and provide a roadmap for future work.

Headache and neuropsychic disorders in the puerperium: a case report with suspected deficiency of urea cycle enzymes.

PubMed

Tonini, Maria Clara; Bignamini, V; Mattioli, M

2011-05-01

An enzymatic abnormality of the urea cycle is a metabolic disorder occasionally seen in adults, but particularly in the puerperium. The main risk is acute hyperammoniemic encephalopathy, leading to psychosis, coma and even death if not diagnosed promptly and treated appropriately. Headache is frequent in the puerperium normally manifesting between 3 and 6 days after delivery. We describe here a 39-year-old woman, who 3 days after delivery presented diffuse tension-type headache and depression, followed by behavioral disorders, psychomotor agitation, epileptic seizures, and finally coma 2 days later. Pregnancy and normal delivery: routine blood chemistry findings, CT scan, MR imaging, angio-MR of the brain, and lumbar puncture were normal. EEG when seizures started, it showed diffuse slowing, as in the case of metabolic encephalopathy. This led us to assay blood ammonia, which was high at >400 mmol. Liver function and abdominal US were normal; hence, we suspected a urea cycle enzymatic abnormality, and requested for genetic tests. These confirmed a congenital primary metabolic deficiency of arginine succinate synthetase, with high citrullinemia (type II, adult form). Dialysis was started promptly, with initially iv arginine, then orally, plus medical therapy for the hyperammoniemia and a low protein diet; plasma ammonia dropped swiftly to normal, and her state of consciousness gradually improved until all the clinical symptoms had resolved. Ammonia assay should always be considered in the first few days of the puerperium in women with headache and behavioral disorders, to exclude an inborn deficiency of the urea cycle, which may have gone unnoticed until then.

Internet-delivered treatment for older adults with anxiety and depression: implementation of the Wellbeing Plus Course in routine clinical care and comparison with research trial outcomes

PubMed Central

Staples, Lauren G.; Fogliati, Vincent J.; Dear, Blake F.; Nielssen, Olav

2016-01-01

Background The Wellbeing Plus Course is an internet-delivered psychological intervention for older adults with anxiety or depression. Aims To compare the effectiveness of the Wellbeing Plus Course in a public health setting (clinic group) with its efficacy in a randomised controlled trial (research group). Method Participants (n=949) were Australian adults aged 60 and above. Primary outcome measures were the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7). Results Initial symptom severity was higher in the clinic group and course completion was lower. Both groups showed significant symptom reductions at post-treatment and were satisfied with the treatment. Results were maintained at 3-month follow-up. Within-group symptom changes were comparable between settings; there were no between-group differences on primary outcomes or satisfaction. Conclusions The Wellbeing Plus Course is as effective and acceptable in routine clinical care, as it is in controlled research trials. Declaration of interest N.T. and B.F.D developed the Wellbeing Plus Course but derived no financial benefit from it. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27703794

Antifungal treatment in haematological and oncological patients: Need for quality assessment in routine care.

PubMed

Lachenmayr, Sarah J; Berking, Sophie; Horns, Heidi; Strobach, Dorothea; Ostermann, Helmut; Berger, Karin

2018-03-25

Invasive fungal infections in haematological and oncological patients have a major impact on morbidity, mortality and treatment costs. Therefore, rational use of antifungal agents is important for optimal patient care and resource use. The study's objective was to analyse antifungal usage in a German tertiary teaching hospital, department of haematology and oncology, to evaluate quality of antifungal treatment and to assess the need for an antifungal stewardship programme. This retrospective observational study included patients ≥18 years receiving systemic antifungals for prophylaxis or therapy of invasive fungal infection between January and June 2016. Appropriateness of antifungal prescriptions was evaluated in accordance with guidelines of the German Society of Haematology and Oncology (DGHO) and drug labelling. In total, 104/1278 (8.1%) patients received antifungals. One hundred seventy-one antifungals were prescribed: 48 for prophylaxis, 104 for empirical and 19 for targeted therapy. In 127 (74.3%) prescriptions, indication was appropriate, and in 132 (77.2%), choice of drug. Antifungals were correctly dosed in 131 prescriptions (76.6%). Thirty-four antifungals (20.0%) were co-administrated with interacting drugs (5 mild to moderate, 29 severe interactions). Results of this analysis demonstrate that use of systemic antifungals in routine care differs in a substantial number of patients from guideline and labelling recommendations. To optimise antifungal use, the implementation of antifungal stewardship programmes seems to be justified. © 2018 Blackwell Verlag GmbH.

Conventional sunscreen application does not lead to sufficient body coverage.

PubMed

Jovanovic, Z; Schornstein, T; Sutor, A; Neufang, G; Hagens, R

2017-10-01

This study aimed to assess sunscreen application habits and relative body coverage after single whole body application. Fifty-two healthy volunteers were asked to use the test product once, following their usual sunscreen application routine. Standardized UV photographs, which were evaluated by Image Analysis, were conducted before and immediately after product application to evaluate relative body coverage. In addition to these procedures, the volunteers completed an online self-assessment questionnaire to assess sunscreen usage habits. After product application, the front side showed significantly less non-covered skin (4.35%) than the backside (17.27%) (P = 0.0000). Females showed overall significantly less non-covered skin (8.98%) than males (13.16%) (P = 0.0381). On the backside, females showed significantly less non-covered skin (13.57%) (P = 0.0045) than males (21.94%), while on the front side, this difference between females (4.14%) and males (4.53%) was not significant. In most cases, the usual sunscreen application routine does not provide complete body coverage even though an extra light sunscreen with good absorption properties was used. On average, 11% of the body surface was not covered by sunscreen at all. Therefore, appropriate consumer education is required to improve sunscreen application and to warrant effective sun protection. © 2017 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Considering student choice when selecting instructional strategies: a comparison of three prompting systems.

PubMed

Taber-Doughty, Teresa

2005-01-01

Three secondary age students with moderate intellectual disabilities learned to use the system of least prompts, a self-operated picture prompting system, and a self-operated auditory prompting system to use a copy machine and a debit machine. Both the effectiveness and efficiency of these prompting systems were compared. Additionally, student preference of instructional method was examined. The results demonstrated that each prompting system was effective and efficient with varying students when skill acquisition and duration of task performance were measured. All students demonstrated increased independence in completing both tasks. This study found that the preferred prompting systems were more effective in terms of both skill acquisition and duration for completing tasks for students.

Comparison of Everyday and Every-Fourth-Day Probe Sessions with the Simultaneous Prompting Procedure

ERIC Educational Resources Information Center

Reichow, Brian; Wolery, Mark

2009-01-01

Simultaneous prompting is a response-prompting procedure requiring two daily sessions: an instructional session in which a controlling prompt is provided on all trials, and a probe session in which no prompt is provided on any trials. In this study, two schedules of conducting the probe sessions (daily vs. every fourth day) were compared using the…

Comparison of Most-to-Least to Error Correction for Teaching Receptive Labelling for Two Children Diagnosed with Autism

ERIC Educational Resources Information Center

Leaf, Justin B.; Alcalay, Aditt; Leaf, Jeremy A.; Tsuji, Kathleen; Kassardjian, Alyne; Dale, Stephanie; McEachin, John; Taubman, Mitchell; Leaf, Ronald

2016-01-01

Prompting systems are guidelines of when to provide learners with prompts and when to fade prompts. Today, there are several prompting systems implemented to teach receptive labeling to individuals diagnosed with autism spectrum disorders and other disabilities. This study compared most-to-least prompting to an error correction procedure involving…

The Effects of Prompts and a Group-Oriented Contingency on Out-of-School Physical Activity in Elementary School-Aged Students

ERIC Educational Resources Information Center

Hastie, Peter A.; van der Mars, Hans; Layne, Todd; Wadsworth, Danielle

2012-01-01

This study examined the effectiveness of three conditions in which 48 fourth-grade students were prompted to be physically active out of school. Using an alternating treatments design (Cooper, Heron, & Heward, 2007) the three intervention conditions included: (a) Baseline: No prompting of students, (b) Teacher Prompts: Verbal prompt to…

APAtrap: identification and quantification of alternative polyadenylation sites from RNA-seq data.

PubMed

Ye, Congting; Long, Yuqi; Ji, Guoli; Li, Qingshun Quinn; Wu, Xiaohui

2018-06-01

Alternative polyadenylation (APA) has been increasingly recognized as a crucial mechanism that contributes to transcriptome diversity and gene expression regulation. As RNA-seq has become a routine protocol for transcriptome analysis, it is of great interest to leverage such unprecedented collection of RNA-seq data by new computational methods to extract and quantify APA dynamics in these transcriptomes. However, research progress in this area has been relatively limited. Conventional methods rely on either transcript assembly to determine transcript 3' ends or annotated poly(A) sites. Moreover, they can neither identify more than two poly(A) sites in a gene nor detect dynamic APA site usage considering more than two poly(A) sites. We developed an approach called APAtrap based on the mean squared error model to identify and quantify APA sites from RNA-seq data. APAtrap is capable of identifying novel 3' UTRs and 3' UTR extensions, which contributes to locating potential poly(A) sites in previously overlooked regions and improving genome annotations. APAtrap also aims to tally all potential poly(A) sites and detect genes with differential APA site usages between conditions. Extensive comparisons of APAtrap with two other latest methods, ChangePoint and DaPars, using various RNA-seq datasets from simulation studies, human and Arabidopsis demonstrate the efficacy and flexibility of APAtrap for any organisms with an annotated genome. Freely available for download at https://apatrap.sourceforge.io. liqq@xmu.edu.cn or xhuister@xmu.edu.cn. Supplementary data are available at Bioinformatics online.

Systematic review of use of β-blockers in sepsis.

PubMed

Chacko, Cyril Jacob; Gopal, Shameer

2015-01-01

We proposed a review of present literature and systematic analysis of present literature to summarize the evidence on the use of β-blockers on the outcome of a patient with severe sepsis and septic shock. Medline, EMBASE, Cochrane Library were searched from 1946 to December 2013. The bibliography of all relevant articles was hand searched. Full-text search of the grey literature was done through the medical institution database. The database search identified a total of 1241 possible studies. The citation list was hand searched by both the authors. A total of 9 studies were identified. Most studies found a benefit from β-blocker administration in sepsis. This included improved heart rate (HR) control, decreased mortality and improvement in acid-base parameters. Chronic β-blocker usage in sepsis was also associated with improved mortality. The administration of β-blockers during sepsis was associated with better control of HR. The methodological quality of all the included studies, however, was poor. There is insufficient evidence to justify the routine use of β-blockers in sepsis. A large adequately powered multi-centered randomized controlled clinical trial is required to address the question on the efficacy of β-blocker usage in sepsis. This trial should also consider a number of important questions including the choice of β-blocker used, optimal dosing, timing of intervention, duration of intervention and discontinuation of the drug. Until such time based on the available evidence, there is no place for the use of β-blockers in sepsis in current clinical practice.

Rapid Bioavailability and Disposition protocol: A novel higher throughput approach to assess pharmacokinetics and steady-state brain distribution with reduced animal usage.

PubMed

Fu, Tingting; Gao, Ruina; Scott-Stevens, Paul; Chen, Yan; Zhang, Chalmers; Wang, Jianfei; Summerfield, Scott; Liu, Houfu; Sahi, Jasminder

2018-05-29

Besides routine pharmacokinetic (PK) parameters, unbound brain-to-blood concentration ratio (K p,uu ) is an index particularly crucial in drug discovery for central nervous system (CNS) indications. Despite advantages of K p,uu from steady state after constant intravenous (i.v.) infusion compared with one- or multiple time points after transient dosing, it is seldom obtained for compound optimization in early phase of CNS drug discovery due to requirement of prerequisite PK data to inform the study design. Here, we designed a novel rat in vivo PK protocol, dubbed as Rapid Bioavailability and Disposition (RBD), which combined oral (p.o.) dosing and i.v. infusion to obtain steady-state brain penetration, along with blood clearance, oral exposure and oral bioavailability for each discovery compound, within a 24 hour in-life experiment and only a few (e.g., 3) animals. Protocol validity was verified through simulations with a range of PK parameters in compartmental models as well as data comparison for nine compounds with distinct PK profiles. PK parameters (K p,brain , CL b and oral AUC) measured from the RBD protocol for all compounds, were within two-fold and/or statistically similar to those derived from conventional i.v./p.o. crossover PK studies. Our data clearly indicates that the RBD protocol offers reliable and reproducible data over a wide range of PK properties, with reduced turnaround time and animal usage. Copyright © 2017. Published by Elsevier B.V.

Taking clickers to the next level: a contingent teaching model

NASA Astrophysics Data System (ADS)

Stewart, Sepideh; Stewart, Wayne

2013-12-01

Over the past decade, many researchers have discussed the effectiveness of clickers and their potential to change the way we teach and interact with students. Although most of the literature revolves around elementary usage of clickers, the deeper questions of how to integrate this technology into teaching are largely unanswered. In this paper, we present an implementation of a teaching model in a third year undergraduate Bayesian statistics class. The model is based on Schoenfeld's interactive teaching routine and it is enhanced by Draper and Brown's contingent teaching and Beatty et al.'s Question Driven Instruction (QDI) and the use of clickers. It illustrates a teaching paradigm which is flexible, contingent to students' needs, makes use of the most up to date information from students' feedback via clickers and benefits from the teacher's decision making at appropriate moments. We will discuss the pedagogical implications of this model in teaching.

BCYCLIC: A parallel block tridiagonal matrix cyclic solver

NASA Astrophysics Data System (ADS)

Hirshman, S. P.; Perumalla, K. S.; Lynch, V. E.; Sanchez, R.

2010-09-01

A block tridiagonal matrix is factored with minimal fill-in using a cyclic reduction algorithm that is easily parallelized. Storage of the factored blocks allows the application of the inverse to multiple right-hand sides which may not be known at factorization time. Scalability with the number of block rows is achieved with cyclic reduction, while scalability with the block size is achieved using multithreaded routines (OpenMP, GotoBLAS) for block matrix manipulation. This dual scalability is a noteworthy feature of this new solver, as well as its ability to efficiently handle arbitrary (non-powers-of-2) block row and processor numbers. Comparison with a state-of-the art parallel sparse solver is presented. It is expected that this new solver will allow many physical applications to optimally use the parallel resources on current supercomputers. Example usage of the solver in magneto-hydrodynamic (MHD), three-dimensional equilibrium solvers for high-temperature fusion plasmas is cited.

Design of a Variational Multiscale Method for Turbulent Compressible Flows

NASA Technical Reports Server (NTRS)

Diosady, Laslo Tibor; Murman, Scott M.

2013-01-01

A spectral-element framework is presented for the simulation of subsonic compressible high-Reynolds-number flows. The focus of the work is maximizing the efficiency of the computational schemes to enable unsteady simulations with a large number of spatial and temporal degrees of freedom. A collocation scheme is combined with optimized computational kernels to provide a residual evaluation with computational cost independent of order of accuracy up to 16th order. The optimized residual routines are used to develop a low-memory implicit scheme based on a matrix-free Newton-Krylov method. A preconditioner based on the finite-difference diagonalized ADI scheme is developed which maintains the low memory of the matrix-free implicit solver, while providing improved convergence properties. Emphasis on low memory usage throughout the solver development is leveraged to implement a coupled space-time DG solver which may offer further efficiency gains through adaptivity in both space and time.

Workload and casemix in Cape Town emergency departments.

PubMed

Wallis, Lee A; Twomey, Michele

2007-12-01

Little is known about the nature of patients presenting to emergency departments (EDs) in South Africa. This study aimed to provide evidence on ED usage in Cape Town by studying patients at four community health centre (CHC) EDs, with details of the severity of their presentation and their disposal. A total of 16,392 patients presented in this 8-week prospective observational study, and 15,681 were included in the descriptive data analysis. One-quarter were children. There were clear and predictable peaks in attendance after 1600 hr and at weekends, with a steady stream of patients presenting overnight. Case severity was evenly distributed between emergency, urgent and routine care. Nearly 10% of patients were referred on to a higher level of care. The data from this study present a model for staffing and resource allocation. It has implications for the provision of emergency care in CHC EDs.

Software design for analysis of multichannel intracardial and body surface electrocardiograms.

PubMed

Potse, Mark; Linnenbank, André C; Grimbergen, Cornelis A

2002-11-01

Analysis of multichannel ECG recordings (body surface maps (BSMs) and intracardial maps) requires special software. We created a software package and a user interface on top of a commercial data analysis package (MATLAB) by a combination of high-level and low-level programming. Our software was created to satisfy the needs of a diverse group of researchers. It can handle a large variety of recording configurations. It allows for interactive usage through a fast and robust user interface, and batch processing for the analysis of large amounts of data. The package is user-extensible, includes routines for both common and experimental data processing tasks, and works on several computer platforms. The source code is made intelligible using software for structured documentation and is available to the users. The package is currently used by more than ten research groups analysing ECG data worldwide.

Semi-Supervised Approach to Monitoring Clinical Depressive Symptoms in Social Media

PubMed Central

Yazdavar, Amir Hossein; Al-Olimat, Hussein S.; Ebrahimi, Monireh; Bajaj, Goonmeet; Banerjee, Tanvi; Thirunarayan, Krishnaprasad; Pathak, Jyotishman; Sheth, Amit

2017-01-01

With the rise of social media, millions of people are routinely expressing their moods, feelings, and daily struggles with mental health issues on social media platforms like Twitter. Unlike traditional observational cohort studies conducted through questionnaires and self-reported surveys, we explore the reliable detection of clinical depression from tweets obtained unobtrusively. Based on the analysis of tweets crawled from users with self-reported depressive symptoms in their Twitter profiles, we demonstrate the potential for detecting clinical depression symptoms which emulate the PHQ-9 questionnaire clinicians use today. Our study uses a semi-supervised statistical model to evaluate how the duration of these symptoms and their expression on Twitter (in terms of word usage patterns and topical preferences) align with the medical findings reported via the PHQ-9. Our proactive and automatic screening tool is able to identify clinical depressive symptoms with an accuracy of 68% and precision of 72%. PMID:29707701

Cardio-oncology: the Nuclear Option.

PubMed

Alvarez, Jorge A; Russell, Raymond R

2017-04-01

Cardio-oncology focuses increased effort to decrease cancer treatment-related cardiotoxicity while continuing to improve outcomes. We sought to synthesize the latest in nuclear cardiology as it pertains to the assessment of left ventricular function in preventative guidelines and comparison to other modalities, novel molecular markers of pre-clinical cardiotoxicity, and its role in cardiac amyloid diagnosis. Planar ERNA (equilibrium radionuclide angiocardiography) provides a reliable and proven means of monitoring and preventing anthracycline cardiotoxicity, and SPECT ERNA using solid-state gamma cameras may provide reproducible assessments of left ventricular function with reduced radiation exposure. While certain chemotherapeutics have vascular side effects, the use of stress perfusion imaging has still not been adequately studied for routine use. Similarly, markers of apoptosis, inflammation, and sympathetic nerve dysfunction are promising, but are still not ready for uniform usage. SPECT tracers can assist in nonbiopsy diagnosis of cardiac amyloid. Nuclear cardiology is a significant contributor to the multimodality approach to cardio-oncology.

Ultrasonic imaging: safety considerations

PubMed Central

ter Haar, Gail

2011-01-01

Modern ultrasound imaging for diagnostic purposes has a wide range of applications. It is used in obstetrics to monitor the progress of pregnancy, in oncology to visualize tumours and their response to treatment, and, in cardiology, contrast-enhanced studies are used to investigate heart function and physiology. An increasing use of diagnostic ultrasound is to provide the first photograph for baby's album—in the form of a souvenir or keepsake scan that might be taken as part of a routine investigation, or during a visit to an independent high-street ‘boutique’. It is therefore important to ensure that any benefit accrued from these applications outweighs any accompanying risk, and to evaluate the existing ultrasound bio-effect and epidemiology literature with this in mind. This review considers the existing laboratory and epidemiological evidence about the safety of diagnostic ultrasound and puts it in the context of current clinical usage. PMID:22866238

The role of increased exposure to transfer-of-stimulus-control procedures on the acquisition of intraverbal behavior.

PubMed

Coon, Jared T; Miguel, Caio F

2012-01-01

Studies that have compared the effectiveness of differing prompt types to teach intraverbal responses have yielded mixed results, suggesting that individuals' reinforcement histories with prompt types may influence which prompt will be most effective. The purpose of this study was to test whether programmed increases in exposure to specific prompt types would produce concomitant increases in the acquisition rate of intraverbal responding. We compared acquisition rates among 4 typically developing preschool-aged children when taught via either echoic or tact prompts following exposure training with 1 prompt type. For all participants, the prompt method most recently used to teach intraverbal responses required fewer trials to teach new intraverbal responses compared to a prompt method that had not been used recently. The results are discussed in terms of the effects of reinforcement history on the acquisition of verbal behavior.

THE ROLE OF INCREASED EXPOSURE TO TRANSFER-OF-STIMULUS-CONTROL PROCEDURES ON THE ACQUISITION OF INTRAVERBAL BEHAVIOR

PubMed Central

Coon, Jared T.; Miguel, Caio F.

2012-01-01

Studies that have compared the effectiveness of differing prompt types to teach intraverbal responses have yielded mixed results, suggesting that individuals' reinforcement histories with prompt types may influence which prompt will be most effective. The purpose of this study was to test whether programmed increases in exposure to specific prompt types would produce concomitant increases in the acquisition rate of intraverbal responding. We compared acquisition rates among 4 typically developing preschool-aged children when taught via either echoic or tact prompts following exposure training with 1 prompt type. For all participants, the prompt method most recently used to teach intraverbal responses required fewer trials to teach new intraverbal responses compared to a prompt method that had not been used recently. The results are discussed in terms of the effects of reinforcement history on the acquisition of verbal behavior. PMID:23322924

Video prompting versus other instruction strategies for persons with Alzheimer's disease.

PubMed

Perilli, Viviana; Lancioni, Giulio E; Hoogeveen, Frans; Caffó, Alessandro; Singh, Nirbhay; O'Reilly, Mark; Sigafoos, Jeff; Cassano, Germana; Oliva, Doretta

2013-06-01

Two studies assessed the effectiveness of video prompting as a strategy to support persons with mild and moderate Alzheimer's disease in performing daily activities. In study I, video prompting was compared to an existing strategy relying on verbal instructions. In study II, video prompting was compared to another existing strategy relying on static pictorial cues. Video prompting and the other strategies were counterbalanced across tasks and participants and compared within alternating treatments designs. Video prompting was effective in all participants. Similarly effective were the other 2 strategies, and only occasional differences between the strategies were reported. Two social validation assessments showed that university psychology students and graduates rated the patients' performance with video prompting more favorably than their performance with the other strategies. Video prompting may be considered a valuable alternative to the other strategies to support daily activities in persons with Alzheimer's disease.

Promoting Engagement With a Digital Health Intervention (HeLP-Diabetes) Using Email and Text Message Prompts: Mixed-Methods Study

PubMed Central

Modrow, Kerstin; Hamilton, Fiona; Pal, Kingshuk; Ross, Jamie

2017-01-01

Background Engagement with digital health interventions (DHIs) may be regarded as a prerequisite for the intervention to achieve positive health or behavior change outcomes. One method employed to promote engagement is the use of prompts such as emails and text messages. However, little is known about the characteristics of prompts that promote engagement. This study explored the association between the content and delivery mode of prompts and the users’ engagement with HeLP-Diabetes (Healthy Living for People with type 2 Diabetes), a DHI that aimed to promote self-management in adults with type 2 diabetes. Objective The objective of this study was to identify the characteristics of prompts, specifically the content and delivery mode, which were associated with increased engagement. Methods This was a mixed-methods study. Email and text message prompts were sent to the registered users of HeLP-Diabetes. Use of the intervention was recorded and examined to identify which email and text message prompts were associated with subsequent visits to the DHI. Characteristics of prompts that were identified as particularly effective or ineffective were explored through think-aloud interviews with the participants. Results Of a total of 39 email prompts, 49% (19/39) prompts showed a significant association with subsequent visits to the DHI. However, none of the text message prompts were associated with subsequent visits to the DHI. Furthermore, think-aloud interviews were carried out with 6 experienced participants with type 2 diabetes. The findings suggest that these participants preferred email prompts that were clear, relatively short, and empowering; used nondirective advice; included health professional references; were visually appealing; and contained news and updates. Conclusions The findings of this study contribute to the existing evidence supporting the role of email prompts in promoting and maintaining engagement with DHIs. This study described the content of prompts that may be engaging. However, the results should be interpreted with caution, as prompts may be context-specific interventions and the results may not be generalizable across other DHIs or other types of interventions targeting self-management of type 2 diabetes. PMID:28829328

Pediatric Pulmonary Arterial Hypertension and Hyperthyroidism: A Potentially Fatal Combination

PubMed Central

Trapp, Christine M.; Elder, Robert W.; Gerken, Adrienne T.; Sopher, Aviva B.; Lerner, Shulamit; Rosenzweig, Erika B.

2012-01-01

Context: Patients with pulmonary arterial hypertension (PAH) who develop hyperthyroidism are at risk for acute cardiopulmonary decompensation and death. Cases and Setting: We present a series of eight idiopathic PAH/heritable PAH pediatric patients who developed hyperthyroidism between 1999 and 2011. Institutional Review Board approval was obtained; informed consent was waived due to the retrospective nature of the series. All eight patients were receiving iv epoprostenol; five of the eight patients presented with acute cardiopulmonary decompensation in the setting of hyperthyroidism. In the remaining three patients, hyperthyroidism was detected during routine screening of thyroid function tests. The one patient who underwent emergency thyroidectomy was the only survivor of those who presented in cardiopulmonary decline. Evidence Synthesis: Aggressive treatment of the hyperthyroid state, including emergency total thyroidectomy and escalation of targeted PAH therapy and β-blockade when warranted, may prove lifesaving in these patients. Prompt thyroidectomy or radioactive iodine ablation should be considered for clinically stable PAH patients with early and/or mild hyperthyroidism to avoid potentially life-threatening cardiopulmonary decompensation. Conclusions: Although the association between hyperthyroidism and PAH remains poorly understood, the potential impact of hyperthyroidism on the cardiopulmonary status of PAH patients must not be ignored. Hyperthyroidism must be identified early in this patient population to optimize intervention before acute decompensation. Thyroid function tests should be checked routinely in patients with PAH, particularly those on iv epoprostenol, and urgently in patients with acute decompensation or symptoms of hyperthyroidism. PMID:22622024

Surveillance of emerging drugs of abuse in Hong Kong: validation of an analytical tool.

PubMed

Tang, Magdalene H Y; Ching, C K; Tse, M L; Ng, Carol; Lee, Caroline; Chong, Y K; Wong, Watson; Mak, Tony W L

2015-04-01

To validate a locally developed chromatography-based method to monitor emerging drugs of abuse whilst performing regular drug testing in abusers. Cross-sectional study. Eleven regional hospitals, seven social service units, and a tertiary level clinical toxicology laboratory in Hong Kong. A total of 972 drug abusers and high-risk individuals were recruited from acute, rehabilitation, and high-risk settings between 1 November 2011 and 31 July 2013. A subset of the participants was of South Asian ethnicity. In total, 2000 urine or hair specimens were collected. Proof of concept that surveillance of emerging drugs of abuse can be performed whilst conducting routine drug of abuse testing in patients. The method was successfully applied to 2000 samples with three emerging drugs of abuse detected in five samples: PMMA (paramethoxymethamphetamine), TFMPP [1-(3-trifluoromethylphenyl)piperazine], and methcathinone. The method also detected conventional drugs of abuse, with codeine, methadone, heroin, methamphetamine, and ketamine being the most frequently detected drugs. Other findings included the observation that South Asians had significantly higher rates of using opiates such as heroin, methadone, and codeine; and that ketamine and cocaine had significantly higher detection rates in acute subjects compared with the rehabilitation population. This locally developed analytical method is a valid tool for simultaneous surveillance of emerging drugs of abuse and routine drug monitoring of patients at minimal additional cost and effort. Continued, proactive surveillance and early identification of emerging drugs will facilitate prompt clinical, social, and legislative management.

Prophylactic antibiotics in acute pancreatitis: endless debate.

PubMed

Mourad, M M; Evans, Rpt; Kalidindi, V; Navaratnam, R; Dvorkin, L; Bramhall, S R

2017-02-01

INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis. RESULTS Mixed evidence was found to support and refute the role of prophylactic antibiotics in acute pancreatitis. Most studies have failed to demonstrate much benefit from its routine use. Data from our unit suggested little benefit of their routine use, and showed that the mortality of those treated with antibiotics was significantly higher compared with those not treated with antibiotics (9% vs 0%, respectively, P = 0.043). In addition, the antibiotic group had significantly higher morbidity (36% vs 5%, respectively, P = 0.002). CONCLUSIONS Antibiotics should be used in patients who develop sepsis, infected necrosis-related systemic inflammatory response syndrome, multiple organ dysfunction syndrome or pancreatic and extra-pancreatic infection. Despite the many other factors that should be considered, prompt antibiotic therapy is recommended once inflammatory markers are raised, to prevent secondary pancreatic infection. Unfortunately, there remain many unanswered questions regarding the indications for antibiotic administration and the patients who benefit from antibiotic treatment in acute pancreatitis.

Rational case management of malaria with a rapid diagnostic test, Paracheck Pf®, in antenatal health care in Bangui, Central African Republic

PubMed Central

2012-01-01

Background Both treatment and prevention strategies are recommended by the World Health Organization for the control of malaria during pregnancy in tropical areas. The aim of this study was to assess use of a rapid diagnostic test for prompt management of malaria in pregnancy in Bangui, Central African Republic. Methods A cohort of 76 pregnant women was screened systematically for malaria with ParacheckPf® at each antenatal visit. The usefulness of the method was analysed by comparing the number of malaria episodes requiring treatment in the cohort with the number of prescriptions received by another group of pregnant women followed-up in routine antenatal care. Results In the cohort group, the proportion of positive ParacheckPf® episodes during antenatal clinics visits was 13.8%, while episodes of antimalarial prescriptions in the group which was followed-up routinely by antenatal personnel was estimated at 26.3%. Hence, the relative risk of the cohort for being prescribed an antimalarial drug was 0.53. Therefore, the attributable fraction of presumptive treatment avoided by systematic screening with ParacheckPf® was 47%. Conclusions Use of a rapid diagnostic test is useful, affordable and easy for adequate treatment of malaria in pregnant women. More powerful studies of the usefulness of introducing the test into antenatal care are needed in all heath centres in the country and in other tropical areas. PMID:22734602

FTIR spectroscopy in medical mycology: applications to the differentiation and typing of Candida.

PubMed

Toubas, Dominique; Essendoubi, Mohammed; Adt, Isabelle; Pinon, Jean-Michel; Manfait, Michel; Sockalingum, Ganesh D

2007-03-01

The incidence of fungal infections, in particular candidiasis and aspergillosis, has considerably increased during the last three decades. This is mainly due to advances in medical treatments and technologies. In high risk patients (e.g. in haematology or intensive care), the prognosis of invasive candidiasis is relatively poor. Therefore, a rapid and correct identification of the infectious agent is important for an efficient and prompt therapy. Most clinical laboratories rely on conventional identification methods that are based on morphological, physiological and nutritional characteristics. However, these have their limitations because they are time-consuming and not always very accurate. Moreover, molecular methods may be required to determine the genetic relationship between the infectious strains, for instance in Candida outbreaks. In addition, the latter methods require time, expensive consumables and highly trained staff to be performed adequately. In this study, we have applied the FTIR spectroscopic approach to different situations encountered in routine mycological diagnosis. We show the potentials of this phenotypic approach, used in parallel with routine identification methods, for the differentiation of 3 frequently encountered Candida species (C. albicans, C. glabrata and C. krusei) by using both suspensions and microcolonies. This approach, developed for an early discrimination, may help in the initial choice of antifungal treatment. Furthermore, we demonstrate the feasibility of the method for intraspecies comparison (typing) of 3 Candida species (C. albicans, C. glabrata and C. parapsilosis), particularly when an outbreak is suspected.

Can cardiovascular magnetic resonance prompt early cardiovascular/rheumatic treatment in autoimmune rheumatic diseases? Current practice and future perspectives.

PubMed

Mavrogeni, Sophie I; Sfikakis, Petros P; Dimitroulas, Theodoros; Koutsogeorgopoulou, Loukia; Katsifis, Gikas; Markousis-Mavrogenis, George; Kolovou, Genovefa; Kitas, George D

2018-06-01

Life expectancy in autoimmune rheumatic diseases (ARDs) remains lower compared to the general population, due to various comoborbidities. Cardiovascular disease (CVD) represents the main contributor to premature mortality. Conventional and biologic disease-modifying antirheumatic drugs (DMARDs) have considerably improved long-term outcomes in ARDs not only by suppressing systemic inflammation but also by lowering CVD burden. Regarding atherosclerotic disease prevention, EULAR has recommended tight disease control accompanied by regular assessment of traditional CVD risk factors and lifestyle changes. However, this approach, although rational and evidence-based, does not account for important issues such as myocardial inflammation and the long asymptomatic period that usually proceeds clinical manifestations of CVD disease in ARDs before or after the diagnosis of systemic disease. Cardiovascular magnetic resonance (CMR) can offer reliable, reproducible and operator independent information regarding myocardial inflammation, ischemia and fibrosis. Some studies suggest a role for CMR in the risk stratification of ARDs and demonstrate that oedema/fibrosis visualisation with CMR may have the potential to inform cardiac and rheumatic treatment modification in ARDs with or without abnormal routine cardiac evaluation. In this review, we discuss how CMR findings could influence anti-rheumatic treatment decisions targeting optimal control of both systemic and myocardial inflammation irrespective of clinical manifestations of cardiac disease. CMR can provide a different approach that is very promising for risk stratification and treatment modification; however, further studies are needed before the inclusion of CMR in the routine evaluation and treatment of patients with ARDs.

It's all about the children: a participant-driven photo-elicitation study of Mexican-origin mothers' food choices

PubMed Central

2011-01-01

Background There is a desperate need to address diet-related chronic diseases in Mexican-origin women, particularly for those in border region colonias (Mexican settlements) and other new destination communities in rural and non-rural areas of the U.S. Understanding the food choices of mothers, who lead food and health activities in their families, provides one way to improve health outcomes in Mexican-origin women and their children. This study used a visual method, participant-driven photo-elicitation, and grounded theory in a contextual study of food choices from the perspectives of Mexican-origin mothers. Methods Teams of trained promotoras (female community health workers from the area) collected all data in Spanish. Ten Mexican-origin mothers living in colonias in Hidalgo County, TX completed a creative photography assignment and an in-depth interview using their photographs as visual prompts and examples. English transcripts were coded inductively by hand, and initial observations emphasized the salience of mothers' food practices in their routine care-giving. This was explored further by coding transcripts in the qualitative data analysis software Atlas.ti. Results An inductive conceptual framework was created to provide context for understanding mothers' daily practices and their food practices in particular. Three themes emerged from the data: 1) a mother's primary orientation was toward her children; 2) leveraging resources to provide the best for her children; and 3) a mother's daily food practices kept her children happy, healthy, and well-fed. Results offer insight into the intricate meanings embedded in Mexican-origin mothers' routine food choices. Conclusions This paper provides a new perspective for understanding food choice through the eyes of mothers living in the colonias of South Texas -- one that emphasizes the importance of children in their routine food practices and the resilience of the mothers themselves. Additional research is needed to better understand mothers' perspectives and food practices with larger samples of women and among other socioeconomic groups. PMID:21943081

Use of flexible ureteroscopy in the clinical practice for the treatment of renal stones: results from a large European survey conducted by the EAU Young Academic Urologists-Working Party on Endourology and Urolithiasis.

PubMed

Sanguedolce, F; Liatsikos, E; Verze, P; Hruby, S; Breda, A; Beatty, J D; Knoll, T

2014-08-01

Treatment of renal stones using flexible ureteroscopy (fURS) is increasingly common despite the poor evidence in literature supporting its use and indications. With this study, we wanted to investigate the current use and indication of fURS for the treatment of renal stones in the clinical practice across the European countries. A survey was conducted using an emailed questionnaire consisting of 21 items; 2,894 recipients were selected via the EAU membership database. The questionnaires were collected through the SurveyMonkey system and the data were processed with the SPSS statistical package. Frequencies, cross tabs and Pearson correlation coefficients were applied as appropriate. 1,168 questionnaires were collected (response rate 40.4%). fURS was performed in 72.9% of the respondents' institutions, and 54.2% of the respondents were performing the procedure. For 95% of the users, fURS was considered first-line treatment, for stone of lower pole stone (45.9%) and <1 cm (44.2%) and 2 cm (43.8%) in size. The ureteral access sheaths were used routinely by more than 70% of the respondents. Lower pole stone repositioning technique was routinely performed by 45.9% of the surgeons. After fragmentation, 47.2% of the responders preferred to retrieve only the bigger fragments. At the end of fURS, lower volume surgeons were more likely to place routinely a double-J stent (p = 0.001). Higher volume surgeons estimated a higher durability of devices, both optical and digital ones (p < 0.001), and were more prone to consider fURS cost-effective when compared to other treatment modalities (p < 0.001). fURS is widely used for the treatment of renal stones and its use and indication can vary according to the age and surgeons' case volume. Higher volume surgeons are more prompt to extend international guidelines indications and to consider the technology cost-effective.

Variability in Accreditation Council for Graduate Medical Education Resident Case Log System practices among orthopaedic surgery residents.

PubMed

Salazar, Dane; Schiff, Adam; Mitchell, Erika; Hopkinson, William

2014-02-05

The Accreditation Council for Graduate Medical Education (ACGME) Resident Case Log System is designed to be a reflection of residents' operative volume and an objective measure of their surgical experience. All operative procedures and manipulations in the operating room, Emergency Department, and outpatient clinic are to be logged into the Resident Case Log System. Discrepancies in the log volumes between residents and residency programs often prompt scrutiny. However, it remains unclear if such disparities truly represent differences in operative experiences or if they are reflections of inconsistent logging practices. The purpose of this study was to investigate individual recording practices among orthopaedic surgery residents prior to August 1, 2011. Orthopaedic surgery residents received a questionnaire on case log practices that was distributed through the Council of Orthopaedic Residency Directors list server. Respondents were asked to respond anonymously about recording practices in different clinical settings as well as types of cases routinely logged. Hypothetical scenarios of common orthopaedic procedures were presented to investigate the differences in the Current Procedural Terminology codes utilized. Two hundred and ninety-eight orthopaedic surgery residents completed the questionnaire; 37% were fifth-year residents, 22% were fourth-year residents, 18% were third-year residents, 15% were second-year residents, and 8% were first-year residents. Fifty-six percent of respondents reported routinely logging procedures performed in the Emergency Department or urgent care setting. Twenty-two percent of participants routinely logged procedures in the clinic or outpatient setting, 20% logged joint injections, and only 13% logged casts or splints applied in the office setting. There was substantial variability in the Current Procedural Terminology codes selected for the seven clinical scenarios. There has been a lack of standardization in case-logging practices among orthopaedic surgery residents prior to August 1, 2011. ACGME case log data prior to this date may not be a reliable measure of residents' procedural experience.

From Efficacy to Effectiveness and Beyond: What Next for Brief Interventions in Primary Care?

PubMed Central

O’Donnell, Amy; Wallace, Paul; Kaner, Eileen

2014-01-01

Background: Robust evidence supports the effectiveness of screening and brief alcohol interventions in primary healthcare. However, lack of understanding about their “active ingredients” and concerns over the extent to which current approaches remain faithful to their original theoretical roots has led some to demand a cautious approach to future roll-out pending further research. Against this background, this paper provides a timely overview of the development of the brief alcohol intervention evidence base to assess the extent to which it has achieved the four key levels of intervention research: efficacy, effectiveness, implementation, and demonstration. Methods: Narrative overview based on (1) the results of a review of systematic reviews and meta-analyses of the effectiveness of brief alcohol intervention in primary healthcare and (2) synthesis of the findings of key additional primary studies on the improvement and evaluation of brief alcohol intervention implementation in routine primary healthcare. Results: The brief intervention field seems to constitute an almost perfect example of the evaluation of a complex intervention. Early evaluations of screening and brief intervention approaches included more tightly controlled efficacy trials and have been followed by more pragmatic trials of effectiveness in routine clinical practice. Most recently, attention has shifted to dissemination, implementation, and wider-scale roll-out. However, delivery in routine primary health remains inconsistent, with an identified knowledge gap around how to successfully embed brief alcohol intervention approaches in mainstream care, and as yet unanswered questions concerning what specific intervention component prompt the positive changes in alcohol consumption. Conclusion: Both the efficacy and effectiveness of brief alcohol interventions have been comprehensively demonstrated, and intervention effects seem replicable and stable over time, and across different study contexts. Thus, while unanswered questions remain, given the positive evidence amassed to date, research efforts should maintain a continued focus on promoting sustained implementation of screening and brief alcohol intervention approaches in primary care to ensure that those who might benefit from screening and brief alcohol interventions actually receive such support. PMID:25221524

Similar Prompts May Not Be Similar in the Performance They Elicit: Examining Fluency, Complexity, Accuracy, and Lexis in Narratives from Five Picture Prompts

ERIC Educational Resources Information Center

de Jong, Nel; Vercellotti, Mary Lou

2016-01-01

Only a few characteristics of picture-based narrative prompts have been studied to determine what features affect task performance. Thus, it is not easy to identify equivalent narrative prompts or identify features that are impactful. Tavakoli and Foster (2008) and Tavakoli (2009) examined the impact of prompt on the language produced by English…

Age trajectories of everyday cognition in African American and White older adults under prompted and unprompted conditions

PubMed Central

Thomas, Kelsey R.; Marsiske, Michael

2016-01-01

We investigated how race and verbal prompting interacted with age to predict age trajectories on a performance-based measure of everyday cognition. African American (n = 727) and White (n = 2052) older adults from the ACTIVE clinical trial were given the Observed Tasks of Daily Living (OTDL; a performance-based measure of medication management/finances/telephone use) at baseline and 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said “I don't know” or did not respond, they received a standardised verbal prompt, which served only as a cue to initiate the first step. At each occasion, unprompted (sum of items correct without prompting) and prompted (sum of correct prompted and unprompted items) scores were derived for each participant. Mixed effects models for change were used to determine the age trajectories of OTDL performance by race. When not prompted, African Americans demonstrated more rapid decline in OTDL performance than Whites, especially after age 80. When prompted, both groups had improved performance and evinced shallower decline, although African Americans continued to demonstrate a slightly more rapid decline. Simple prompting attenuated age-related changes of African Americans and Whites on a measure of everyday cognition. Prompting may be especially helpful for older African Americans. PMID:26480946

Age trajectories of everyday cognition in African American and White older adults under prompted and unprompted conditions.

PubMed

Thomas, Kelsey R; Marsiske, Michael

2017-06-01

We investigated how race and verbal prompting interacted with age to predict age trajectories on a performance-based measure of everyday cognition. African American (n = 727) and White (n = 2052) older adults from the ACTIVE clinical trial were given the Observed Tasks of Daily Living (OTDL; a performance-based measure of medication management/finances/telephone use) at baseline and 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said "I don't know" or did not respond, they received a standardised verbal prompt, which served only as a cue to initiate the first step. At each occasion, unprompted (sum of items correct without prompting) and prompted (sum of correct prompted and unprompted items) scores were derived for each participant. Mixed effects models for change were used to determine the age trajectories of OTDL performance by race. When not prompted, African Americans demonstrated more rapid decline in OTDL performance than Whites, especially after age 80. When prompted, both groups had improved performance and evinced shallower decline, although African Americans continued to demonstrate a slightly more rapid decline. Simple prompting attenuated age-related changes of African Americans and Whites on a measure of everyday cognition. Prompting may be especially helpful for older African Americans.

Do Email and Mobile Phone Prompts Stimulate Primary School Children to Reuse an Internet-Delivered Smoking Prevention Intervention?

PubMed Central

Mercken, Liesbeth; Crutzen, Rik; Willems, Paul; de Vries, Hein; Oenema, Anke

2014-01-01

Background Improving the use (eg, initial visit and revisits) of Internet-delivered interventions to promote healthy lifestyles such as non-smoking is one of the largest challenges in the field of eHealth. Prompts have shown to be effective in stimulating reuse of Internet-delivered interventions among adults and adolescents. However, evidence concerning effectiveness of prompts to promote reuse of a website among children is still scarce. Objective The aim of this study is to investigate (1) whether prompts are effective in promoting reuse of an intervention website containing information on smoking prevention for children, (2) whether the content of the prompt is associated with its effect in terms of reuse, and (3) whether there are differences between children who do or do not respond to prompts. Methods The sample of this cluster-randomized study consisted of 1124 children (aged 10-11 years) from 108 Dutch primary schools, who were assigned to the experimental group of an Internet-delivered smoking prevention intervention study. All participants completed a Web-based questionnaire on factors related to (non-)smoking. Schools were randomized to a no-prompt group (n=50) or a prompt group (n=58). All children could revisit the intervention website, but only the children in the prompt group received email and SMS prompts to revisit the website. Those prompt messages functioned as a teaser to stimulate reuse of the intervention website. Reuse of the website was objectively tracked by means of a server registration system. Repeated measures analysis of variance and linear regression analysis were performed to assess the effects of prompts on website reuse and to identify individual characteristics of participants who reuse the intervention website. Results Children in the prompt group reused the intervention website significantly more often compared to children in the no-prompt group (B=1.56, P<.001). Prompts announcing new animated videos (F 1,1122=9.33, P=.002) and games about (non-)smoking on the website (F 1,1122=8.28, P=.004) resulted in most reuse of the website. Within the prompt group, children with a low socioeconomic status (SES) reused the intervention website more often (B=2.19, P<.001) than children of high SES (B=0.93, P=.005). Conclusions Prompts can stimulate children to reuse an intervention website aimed at smoking prevention. Prompts showed, furthermore, to stimulate children of a low SES slightly more to reuse an intervention website, which is often a difficult target group in terms of stimulating participation. However, the number of revisits was quite low, which requires further study into how prompts can be optimized in terms of content and frequency to improve the number of revisits. Trial Registration Netherlands Trial Register Number: NTR3116; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3116 (Archived by WebCite at http://www.webcitation.org/6O0wQYuPI). PMID:24642082

Do email and mobile phone prompts stimulate primary school children to reuse an Internet-delivered smoking prevention intervention?

PubMed

Cremers, Henricus-Paul; Mercken, Liesbeth; Crutzen, Rik; Willems, Paul; de Vries, Hein; Oenema, Anke

2014-03-18

Improving the use (eg, initial visit and revisits) of Internet-delivered interventions to promote healthy lifestyles such as non-smoking is one of the largest challenges in the field of eHealth. Prompts have shown to be effective in stimulating reuse of Internet-delivered interventions among adults and adolescents. However, evidence concerning effectiveness of prompts to promote reuse of a website among children is still scarce. The aim of this study is to investigate (1) whether prompts are effective in promoting reuse of an intervention website containing information on smoking prevention for children, (2) whether the content of the prompt is associated with its effect in terms of reuse, and (3) whether there are differences between children who do or do not respond to prompts. The sample of this cluster-randomized study consisted of 1124 children (aged 10-11 years) from 108 Dutch primary schools, who were assigned to the experimental group of an Internet-delivered smoking prevention intervention study. All participants completed a Web-based questionnaire on factors related to (non-)smoking. Schools were randomized to a no-prompt group (n=50) or a prompt group (n=58). All children could revisit the intervention website, but only the children in the prompt group received email and SMS prompts to revisit the website. Those prompt messages functioned as a teaser to stimulate reuse of the intervention website. Reuse of the website was objectively tracked by means of a server registration system. Repeated measures analysis of variance and linear regression analysis were performed to assess the effects of prompts on website reuse and to identify individual characteristics of participants who reuse the intervention website. Children in the prompt group reused the intervention website significantly more often compared to children in the no-prompt group (B=1.56, P<.001). Prompts announcing new animated videos (F1,1122=9.33, P=.002) and games about (non-)smoking on the website (F1,1122=8.28, P=.004) resulted in most reuse of the website. Within the prompt group, children with a low socioeconomic status (SES) reused the intervention website more often (B=2.19, P<.001) than children of high SES (B=0.93, P=.005). Prompts can stimulate children to reuse an intervention website aimed at smoking prevention. Prompts showed, furthermore, to stimulate children of a low SES slightly more to reuse an intervention website, which is often a difficult target group in terms of stimulating participation. However, the number of revisits was quite low, which requires further study into how prompts can be optimized in terms of content and frequency to improve the number of revisits. Netherlands Trial Register Number: NTR3116; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3116 (Archived by WebCite at http://www.webcitation.org/6O0wQYuPI).

Measurement of the differential cross-sections of prompt and non-prompt production of J / ψ and ψ (2S) in pp collisions at √s = 7 and 8 TeV with the ATLAS detector

DOE PAGES

Aad, G.; Abbott, B.; Abdallah, J.; ...

2016-05-20

The production rates of prompt and non-prompt J/ψ and ψ(2S) mesons in their dimuon decay modes are measured using 2.1 and 11.4 fb -1 of data collected with the ATLAS experiment at the Large Hadron Collider, in proton–proton collisions at √s=7 and 8 respectively. Production cross-sections for prompt as well as non-prompt sources, ratios of ψ(2S) to J/ψ production, and the fractions of non-prompt production for J/ψ and ψ(2S) are measured as a function of meson transverse momentum and rapidity. Lastly, the measurements are compared to theoretical predictions.

A question prompt list for patients with advanced cancer in the final year of life: development and cross-cultural evaluation.

PubMed

Walczak, Adam; Mazer, Benjamin; Butow, Phyllis N; Tattersall, Martin H N; Clayton, Josephine M; Davidson, Patricia M; Young, Jane; Ladwig, Susan; Epstein, Ronald M

2013-09-01

Clinicians and patients find prognosis and end-of-life care discussions challenging. Misunderstanding one's prognosis can contribute to poor decision-making and end-of-life quality of life. A question prompt list (booklet of questions patients can ask clinicians) targeting these issues may help overcome communication barriers. None exists for end-of-life discussions outside the palliative care setting. To develop/pilot a question prompt list facilitating discussion/planning of end-of-life care for oncology patients with advanced cancer from Australia and the United States and to explore acceptability, perceived benefits/challenges of using the question prompt list, suggestions for improvements and the necessity of country-specific adaptations. An expert panel developed a question prompt list targeting prognosis and end-of-life issues. Australian/US semi-structured interviews and one focus group elicited feedback about the question prompt list. Transcribed data were analysed using qualitative methods. Thirty-four patients with advanced cancer (15 Australian/19 US) and 13 health professionals treating such patients (7 Australian/6 US) from two Australian and one US cancer centre participated. Most endorsed the entire question prompt list, though a minority queried the utility/appropriateness of some questions. Analysis identified four global themes: (1) reinforcement of known benefits of question prompt lists, (2) appraisal of content and suggestions for further developments, (3) perceived benefits and challenges in using the question prompt list and (4) contrasts in Australian/US feedback. These contrasts necessitated distinct Australian/US final versions of the question prompt list. Participants endorsed the question prompt list as acceptable and useful. Feedback resulted in two distinct versions of the question prompt list, accommodating differences between Australian and US approaches to end-of-life discussions, highlighting the appropriateness of tailoring communication aides to individual populations.

Low energy prompt gamma-ray tests of a large volume BGO detector.

PubMed

Naqvi, A A; Kalakada, Zameer; Al-Anezi, M S; Raashid, M; Khateeb-ur-Rehman; Maslehuddin, M; Garwan, M A

2012-01-01

Tests of a large volume Bismuth Germinate (BGO) detector were carried out to detect low energy prompt gamma-rays from boron and cadmium-contaminated water samples using a portable neutron generator-based Prompt Gamma Neutron Activation Analysis (PGNAA) setup. Inspite of strong interference between the sample- and the detector-associated prompt gamma-rays, an excellent agreement has been observed between the experimental and calculated yields of the prompt gamma-rays, indicating successful application of the large volume BGO detector in the PGNAA analysis of bulk samples using low energy prompt gamma-rays. Copyright © 2011 Elsevier Ltd. All rights reserved.

Randomized Trial Evaluating Ranibizumab Plus Prompt or Deferred Laser or Triamcinolone Plus Prompt Laser for Diabetic Macular Edema

PubMed Central

Elman, Michael J.; Aiello, Lloyd Paul; Beck, Roy W.; Bressler, Neil M.; Bressler, Susan B.; Edwards, Allison R.; Ferris, Frederick L.; Friedman, Scott M.; Glassman, Adam R.; Miller, Kellee M.; Scott, Ingrid U.; Stockdale, Cynthia R.; Sun, Jennifer K.

2010-01-01

Objective Evaluate intravitreal 0.5 mg ranibizumab or 4 mg triamcinolone combined with focal/grid laser compared with focal/grid laser alone for treatment of diabetic macular edema (DME). Design Multicenter, randomized clinical trial. Participants A total of 854 study eyes of 691 participants with visual acuity (approximate Snellen equivalent) of 20/32 to 20/320 and DME involving the fovea. Methods Eyes were randomized to sham injection + prompt laser (n=293), 0.5 mg ranibizumab + prompt laser (n=187), 0.5 mg ranibizumab + deferred (≥24 weeks) laser (n=188), or 4 mg triamcinolone + prompt laser (n=186). Retreatment followed an algorithm facilitated by a web-based, real-time data-entry system. Main Outcome Measures Best-corrected visual acuity and safety at 1 year. Results The 1-year mean change (±standard deviation) in the visual acuity letter score from baseline was significantly greater in the ranibizumab + prompt laser group (+9±11, P<0.001) and ranibizumab + deferred laser group (+9±12, P<0.001) but not in the triamcinolone + prompt laser group (+4±13, P=0.31) compared with the sham + prompt laser group (+3±13). Reduction in mean central subfield thickness in the triamcinolone + prompt laser group was similar to both ranibizumab groups and greater than in the sham + prompt laser group. In the subset of pseudophakic eyes at baseline (n=273), visual acuity improvement in the triamcinolone + prompt laser group appeared comparable to that in the ranibizumab groups. No systemic events attributable to study treatment were apparent. Three eyes (0.8%) had injection-related endophthalmitis in the ranibizumab groups, whereas elevated intraocular pressure and cataract surgery were more frequent in the triamcinolone + prompt laser group. Two-year visual acuity outcomes were similar to 1-year outcomes. Conclusions Intravitreal ranibizumab with prompt or deferred laser is more effective through at least 1 year compared with prompt laser alone for the treatment of DME involving the central macula. Ranibizumab as applied in this study, although uncommonly associated with endophthalmitis, should be considered for patients with DME and characteristics similar to those in this clinical trial. In pseudophakic eyes, intravitreal triamcinolone + prompt laser seems more effective than laser alone but frequently increases the risk of intraocular pressure elevation. PMID:20427088

Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema.

PubMed

Elman, Michael J; Aiello, Lloyd Paul; Beck, Roy W; Bressler, Neil M; Bressler, Susan B; Edwards, Allison R; Ferris, Frederick L; Friedman, Scott M; Glassman, Adam R; Miller, Kellee M; Scott, Ingrid U; Stockdale, Cynthia R; Sun, Jennifer K

2010-06-01

Evaluate intravitreal 0.5 mg ranibizumab or 4 mg triamcinolone combined with focal/grid laser compared with focal/grid laser alone for treatment of diabetic macular edema (DME). Multicenter, randomized clinical trial. A total of 854 study eyes of 691 participants with visual acuity (approximate Snellen equivalent) of 20/32 to 20/320 and DME involving the fovea. Eyes were randomized to sham injection + prompt laser (n=293), 0.5 mg ranibizumab + prompt laser (n=187), 0.5 mg ranibizumab + deferred (> or =24 weeks) laser (n=188), or 4 mg triamcinolone + prompt laser (n=186). Retreatment followed an algorithm facilitated by a web-based, real-time data-entry system. Best-corrected visual acuity and safety at 1 year. The 1-year mean change (+/-standard deviation) in the visual acuity letter score from baseline was significantly greater in the ranibizumab + prompt laser group (+9+/-11, P<0.001) and ranibizumab + deferred laser group (+9+/-12, P<0.001) but not in the triamcinolone + prompt laser group (+4+/-13, P=0.31) compared with the sham + prompt laser group (+3+/-13). Reduction in mean central subfield thickness in the triamcinolone + prompt laser group was similar to both ranibizumab groups and greater than in the sham + prompt laser group. In the subset of pseudophakic eyes at baseline (n=273), visual acuity improvement in the triamcinolone + prompt laser group appeared comparable to that in the ranibizumab groups. No systemic events attributable to study treatment were apparent. Three eyes (0.8%) had injection-related endophthalmitis in the ranibizumab groups, whereas elevated intraocular pressure and cataract surgery were more frequent in the triamcinolone + prompt laser group. Two-year visual acuity outcomes were similar to 1-year outcomes. Intravitreal ranibizumab with prompt or deferred laser is more effective through at least 1 year compared with prompt laser alone for the treatment of DME involving the central macula. Ranibizumab as applied in this study, although uncommonly associated with endophthalmitis, should be considered for patients with DME and characteristics similar to those in this clinical trial. In pseudophakic eyes, intravitreal triamcinolone + prompt laser seems more effective than laser alone but frequently increases the risk of intraocular pressure elevation. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Comprehensive overview of the Point-by-Point model of prompt emission in fission

NASA Astrophysics Data System (ADS)

Tudora, A.; Hambsch, F.-J.

2017-08-01

The investigation of prompt emission in fission is very important in understanding the fission process and to improve the quality of evaluated nuclear data required for new applications. In the last decade remarkable efforts were done for both the development of prompt emission models and the experimental investigation of the properties of fission fragments and the prompt neutrons and γ-ray emission. The accurate experimental data concerning the prompt neutron multiplicity as a function of fragment mass and total kinetic energy for 252Cf(SF) and 235 ( n, f) recently measured at JRC-Geel (as well as other various prompt emission data) allow a consistent and very detailed validation of the Point-by-Point (PbP) deterministic model of prompt emission. The PbP model results describe very well a large variety of experimental data starting from the multi-parametric matrices of prompt neutron multiplicity ν (A,TKE) and γ-ray energy E_{γ}(A,TKE) which validate the model itself, passing through different average prompt emission quantities as a function of A ( e.g., ν(A), E_{γ}(A), < ɛ > (A) etc.), as a function of TKE ( e.g., ν (TKE), E_{γ}(TKE)) up to the prompt neutron distribution P (ν) and the total average prompt neutron spectrum. The PbP model does not use free or adjustable parameters. To calculate the multi-parametric matrices it needs only data included in the reference input parameter library RIPL of IAEA. To provide average prompt emission quantities as a function of A, of TKE and total average quantities the multi-parametric matrices are averaged over reliable experimental fragment distributions. The PbP results are also in agreement with the results of the Monte Carlo prompt emission codes FIFRELIN, CGMF and FREYA. The good description of a large variety of experimental data proves the capability of the PbP model to be used in nuclear data evaluations and its reliability to predict prompt emission data for fissioning nuclei and incident energies for which the experimental information is completely missing. The PbP treatment can also provide input parameters of the improved Los Alamos model with non-equal residual temperature distributions recently reported by Madland and Kahler, especially for fissioning nuclei without any experimental information concerning the prompt emission.

Prompting Kids To Write.

ERIC Educational Resources Information Center

Mathena, Traci Johnson

2000-01-01

Middle school teacher describes a framework that gives inexperienced, anxious writers the confidence to write. The process, called doing prompts, stems from analyzing prompts or writing assignments that outline the topic for a piece of writing. The process involves analyzing the prompt being called for, completing a graphic organizer, composing…

Monte Carlo simulation of prompt γ-ray emission in proton therapy using a specific track length estimator

NASA Astrophysics Data System (ADS)

El Kanawati, W.; Létang, J. M.; Dauvergne, D.; Pinto, M.; Sarrut, D.; Testa, É.; Freud, N.

2015-10-01

A Monte Carlo (MC) variance reduction technique is developed for prompt-γ emitters calculations in proton therapy. Prompt-γ emitted through nuclear fragmentation reactions and exiting the patient during proton therapy could play an important role to help monitoring the treatment. However, the estimation of the number and the energy of emitted prompt-γ per primary proton with MC simulations is a slow process. In order to estimate the local distribution of prompt-γ emission in a volume of interest for a given proton beam of the treatment plan, a MC variance reduction technique based on a specific track length estimator (TLE) has been developed. First an elemental database of prompt-γ emission spectra is established in the clinical energy range of incident protons for all elements in the composition of human tissues. This database of the prompt-γ spectra is built offline with high statistics. Regarding the implementation of the prompt-γ TLE MC tally, each proton deposits along its track the expectation of the prompt-γ spectra from the database according to the proton kinetic energy and the local material composition. A detailed statistical study shows that the relative efficiency mainly depends on the geometrical distribution of the track length. Benchmarking of the proposed prompt-γ TLE MC technique with respect to an analogous MC technique is carried out. A large relative efficiency gain is reported, ca. 105.

A citizen science approach to optimising computer aided detection (CAD) in mammography

NASA Astrophysics Data System (ADS)

Ionescu, Georgia V.; Harkness, Elaine F.; Hulleman, Johan; Astley, Susan M.

2018-03-01

Computer aided detection (CAD) systems assist medical experts during image interpretation. In mammography, CAD systems prompt suspicious regions which help medical experts to detect early signs of cancer. This is a challenging task and prompts may appear in regions that are actually normal, whilst genuine cancers may be missed. The effect prompting has on readers performance is not fully known. In order to explore the effects of prompting errors, we have created an online game (Bat Hunt), designed for non-experts, that mirrors mammographic CAD. This allows us to explore a wider parameter space. Users are required to detect bats in images of flocks of birds, with image difficulty matched to the proportions of screening mammograms in different BI-RADS density categories. Twelve prompted conditions were investigated, along with unprompted detection. On average, players achieved a sensitivity of 0.33 for unprompted detection, and sensitivities of 0.75, 0.83, and 0.92 respectively for 70%, 80%, and 90% of targets prompted, regardless of CAD specificity. False prompts distract players from finding unprompted targets if they appear in the same image. Player performance decreases when the number of false prompts increases, and increases proportionally with prompting sensitivity. Median lowest d' was for unprompted condition (1.08) and the highest for sensitivity 90% and 0.5 false prompts per image (d'=4.48).

Measurement of the differential cross-sections of prompt and non-prompt production of [Formula: see text] and [Formula: see text] in pp collisions at [Formula: see text] and 8 TeV with the ATLAS detector.

PubMed

Aad, G; Abbott, B; Abdallah, J; Abdinov, O; Aben, R; Abolins, M; AbouZeid, O S; Abramowicz, H; Abreu, H; Abreu, R; Abulaiti, Y; Acharya, B S; Adamczyk, L; Adams, D L; Adelman, J; Adomeit, S; Adye, T; Affolder, A A; Agatonovic-Jovin, T; Agricola, J; Aguilar-Saavedra, J A; Ahlen, S P; Ahmadov, F; Aielli, G; Akerstedt, H; Åkesson, T P A; Akimov, A V; Alberghi, G L; Albert, J; Albrand, S; Alconada Verzini, M J; Aleksa, M; Aleksandrov, I N; Alexa, C; Alexander, G; Alexopoulos, T; Alhroob, M; Alimonti, G; Alio, L; Alison, J; Alkire, S P; Allbrooke, B M M; Allport, P P; Aloisio, A; Alonso, A; Alonso, F; Alpigiani, C; Altheimer, A; Alvarez Gonzalez, B; Álvarez Piqueras, D; Alviggi, M G; Amadio, B T; Amako, K; Amaral Coutinho, Y; Amelung, C; Amidei, D; Amor Dos Santos, S P; Amorim, A; Amoroso, S; Amram, N; Amundsen, G; Anastopoulos, C; Ancu, L S; Andari, N; Andeen, T; Anders, C F; Anders, G; Anders, J K; Anderson, K J; Andreazza, A; Andrei, V; Angelidakis, S; Angelozzi, I; Anger, P; Angerami, A; Anghinolfi, F; Anisenkov, A V; Anjos, N; Annovi, A; Antonelli, M; Antonov, A; Antos, J; Anulli, F; Aoki, M; Aperio Bella, L; Arabidze, G; Arai, Y; Araque, J P; Arce, A T H; Arduh, F A; Arguin, J-F; Argyropoulos, S; Arik, M; Armbruster, A J; Arnaez, O; Arnal, V; Arnold, H; Arratia, M; Arslan, O; Artamonov, A; Artoni, G; Asai, S; Asbah, N; Ashkenazi, A; Åsman, B; Asquith, L; Assamagan, K; Astalos, R; Atkinson, M; Atlay, N B; Augsten, K; Aurousseau, M; Avolio, G; Axen, B; Ayoub, M K; Azuelos, G; Baak, M A; Baas, A E; Baca, M J; Bacci, C; Bachacou, H; Bachas, K; Backes, M; Backhaus, M; Bagiacchi, P; Bagnaia, P; Bai, Y; Bain, T; Baines, J T; Baker, O K; Baldin, E M; Balek, P; Balestri, T; Balli, F; Balunas, W K; Banas, E; Banerjee, Sw; Bannoura, A A E; Bansil, H S; Barak, L; Barberio, E L; Barberis, D; Barbero, M; Barillari, T; Barisonzi, M; Barklow, T; Barlow, N; Barnes, S L; Barnett, B M; Barnett, R M; Barnovska, Z; Baroncelli, A; Barone, G; Barr, A J; Barreiro, F; Barreiro Guimarães da Costa, J; Bartoldus, R; Barton, A E; Bartos, P; Basalaev, A; Bassalat, A; Basye, A; Bates, R L; Batista, S J; Batley, J R; Battaglia, M; Bauce, M; Bauer, F; Bawa, H S; Beacham, J B; Beattie, M D; Beau, T; Beauchemin, P H; Beccherle, R; Bechtle, P; Beck, H P; Becker, K; Becker, M; Beckingham, M; Becot, C; Beddall, A J; Beddall, A; Bednyakov, V A; Bee, C P; Beemster, L J; Beermann, T A; Begel, M; Behr, J K; Belanger-Champagne, C; Bell, W H; Bella, G; Bellagamba, L; Bellerive, A; Bellomo, M; Belotskiy, K; Beltramello, O; Benary, O; Benchekroun, D; Bender, M; Bendtz, K; Benekos, N; Benhammou, Y; Benhar Noccioli, E; Benitez Garcia, J A; Benjamin, D P; Bensinger, J R; Bentvelsen, S; Beresford, L; Beretta, M; Berge, D; Bergeaas Kuutmann, E; Berger, N; Berghaus, F; Beringer, J; Bernard, C; Bernard, N R; Bernius, C; Bernlochner, F U; Berry, T; Berta, P; Bertella, C; Bertoli, G; Bertolucci, F; Bertsche, C; Bertsche, D; Besana, M I; Besjes, G J; Bessidskaia Bylund, O; Bessner, M; Besson, N; Betancourt, C; Bethke, S; Bevan, A J; Bhimji, W; Bianchi, R M; Bianchini, L; Bianco, M; Biebel, O; Biedermann, D; Bieniek, S P; Biglietti, M; Bilbao De Mendizabal, J; Bilokon, H; Bindi, M; Binet, S; Bingul, A; Bini, C; Biondi, S; Bjergaard, D M; Black, C W; Black, J E; Black, K M; Blackburn, D; Blair, R E; Blanchard, J-B; Blanco, J E; Blazek, T; Bloch, I; Blocker, C; Blum, W; Blumenschein, U; Bobbink, G J; Bobrovnikov, V S; Bocchetta, S S; Bocci, A; Bock, C; Boehler, M; Bogaerts, J A; Bogavac, D; Bogdanchikov, A G; Bohm, C; Boisvert, V; Bold, T; Boldea, V; Boldyrev, A S; Bomben, M; Bona, M; Boonekamp, M; Borisov, A; Borissov, G; Borroni, S; Bortfeldt, J; Bortolotto, V; Bos, K; Boscherini, D; Bosman, M; Boudreau, J; Bouffard, J; Bouhova-Thacker, E V; Boumediene, D; Bourdarios, C; Bousson, N; Boveia, A; Boyd, J; Boyko, I R; Bozic, I; Bracinik, J; Brandt, A; Brandt, G; Brandt, O; Bratzler, U; Brau, B; Brau, J E; Braun, H M; Brazzale, S F; Breaden Madden, W D; Brendlinger, K; Brennan, A J; Brenner, L; Brenner, R; Bressler, S; Bristow, K; Bristow, T M; Britton, D; Britzger, D; Brochu, F M; Brock, I; Brock, R; Bronner, J; Brooijmans, G; Brooks, T; Brooks, W K; Brosamer, J; Brost, E; Brown, J; Bruckman de Renstrom, P A; Bruncko, D; Bruneliere, R; Bruni, A; Bruni, G; Bruschi, M; Bruscino, N; Bryngemark, L; Buanes, T; Buat, Q; Buchholz, P; Buckley, A G; Buda, S I; Budagov, I A; Buehrer, F; Bugge, L; Bugge, M K; Bulekov, O; Bullock, D; Burckhart, H; Burdin, S; Burgard, C D; Burghgrave, B; Burke, S; Burmeister, I; Busato, E; Büscher, D; Büscher, V; Bussey, P; Butler, J M; Butt, A I; Buttar, C M; Butterworth, J M; Butti, P; Buttinger, W; Buzatu, A; Buzykaev, A R; Cabrera Urbán, S; Caforio, D; Cairo, V M; Cakir, O; Calace, N; Calafiura, P; Calandri, A; Calderini, G; Calfayan, P; Caloba, L P; Calvet, D; Calvet, S; Camacho Toro, R; Camarda, S; Camarri, P; Cameron, D; Caminal Armadans, R; Campana, S; Campanelli, M; Campoverde, A; Canale, V; Canepa, A; Cano Bret, M; Cantero, J; Cantrill, R; Cao, T; Capeans Garrido, M D M; Caprini, I; Caprini, M; Capua, M; Caputo, R; Cardarelli, R; Cardillo, F; Carli, T; Carlino, G; Carminati, L; Caron, S; Carquin, E; Carrillo-Montoya, G D; Carter, J R; Carvalho, J; Casadei, D; Casado, M P; Casolino, M; Castaneda-Miranda, E; Castelli, A; Castillo Gimenez, V; Castro, N F; Catastini, P; Catinaccio, A; Catmore, J R; Cattai, A; Caudron, J; Cavaliere, V; Cavalli, D; Cavalli-Sforza, M; Cavasinni, V; Ceradini, F; Cerio, B C; Cerny, K; Cerqueira, A S; Cerri, A; Cerrito, L; Cerutti, F; Cerv, M; Cervelli, A; Cetin, S A; Chafaq, A; Chakraborty, D; Chalupkova, I; Chang, P; Chapman, J D; Charlton, D G; Chau, C C; Chavez Barajas, C A; Cheatham, S; Chegwidden, A; Chekanov, S; Chekulaev, S V; Chelkov, G A; Chelstowska, M A; Chen, C; Chen, H; Chen, K; Chen, L; Chen, S; Chen, X; Chen, Y; Cheng, H C; Cheng, Y; Cheplakov, A; Cheremushkina, E; Cherkaoui El Moursli, R; Chernyatin, V; Cheu, E; Chevalier, L; Chiarella, V; Chiarelli, G; Chiodini, G; Chisholm, A S; Chislett, R T; Chitan, A; Chizhov, M V; Choi, K; Chouridou, S; Chow, B K B; Christodoulou, V; Chromek-Burckhart, D; Chudoba, J; Chuinard, A J; Chwastowski, J J; Chytka, L; Ciapetti, G; Ciftci, A K; Cinca, D; Cindro, V; Cioara, I A; Ciocio, A; Cirotto, F; Citron, Z H; Ciubancan, M; Clark, A; Clark, B L; Clark, P J; Clarke, R N; Cleland, W; Clement, C; Coadou, Y; Cobal, M; Coccaro, A; Cochran, J; Coffey, L; Cogan, J G; Colasurdo, L; Cole, B; Cole, S; Colijn, A P; Collot, J; Colombo, T; Compostella, G; Conde Muiño, P; Coniavitis, E; Connell, S H; Connelly, I A; Consorti, V; Constantinescu, S; Conta, C; Conti, G; Conventi, F; Cooke, M; Cooper, B D; Cooper-Sarkar, A M; Cornelissen, T; Corradi, M; Corriveau, F; Corso-Radu, A; Cortes-Gonzalez, A; Cortiana, G; Costa, G; Costa, M J; Costanzo, D; Côté, D; Cottin, G; Cowan, G; Cox, B E; Cranmer, K; Cree, G; Crépé-Renaudin, S; Crescioli, F; Cribbs, W A; Crispin Ortuzar, M; Cristinziani, M; Croft, V; Crosetti, G; Cuhadar Donszelmann, T; Cummings, J; Curatolo, M; Cúth, J; Cuthbert, C; Czirr, H; Czodrowski, P; D'Auria, S; D'Onofrio, M; Da Cunha Sargedas De Sousa, M J; Da Via, C; Dabrowski, W; Dafinca, A; Dai, T; Dale, O; Dallaire, F; Dallapiccola, C; Dam, M; Dandoy, J R; Dang, N P; Daniells, A C; Danninger, M; Dano Hoffmann, M; Dao, V; Darbo, G; Darmora, S; Dassoulas, J; Dattagupta, A; Davey, W; David, C; Davidek, T; Davies, E; Davies, M; Davison, P; Davygora, Y; Dawe, E; Dawson, I; Daya-Ishmukhametova, R K; De, K; de Asmundis, R; De Benedetti, A; De Castro, S; De Cecco, S; De Groot, N; de Jong, P; De la Torre, H; De Lorenzi, F; De Pedis, D; De Salvo, A; De Sanctis, U; De Santo, A; De Vivie De Regie, J B; Dearnaley, W J; Debbe, R; Debenedetti, C; Dedovich, D V; Deigaard, I; Del Peso, J; Del Prete, T; Delgove, D; Deliot, F; Delitzsch, C M; Deliyergiyev, M; Dell'Acqua, A; Dell'Asta, L; Dell'Orso, M; Della Pietra, M; Della Volpe, D; Delmastro, M; Delsart, P A; Deluca, C; DeMarco, D A; Demers, S; Demichev, M; Demilly, A; Denisov, S P; Derendarz, D; Derkaoui, J E; Derue, F; Dervan, P; Desch, K; Deterre, C; Deviveiros, P O; Dewhurst, A; Dhaliwal, S; Di Ciaccio, A; Di Ciaccio, L; Di Domenico, A; Di Donato, C; Di Girolamo, A; Di Girolamo, B; Di Mattia, A; Di Micco, B; Di Nardo, R; Di Simone, A; Di Sipio, R; Di Valentino, D; Diaconu, C; Diamond, M; Dias, F A; Diaz, M A; Diehl, E B; Dietrich, J; Diglio, S; Dimitrievska, A; Dingfelder, J; Dita, P; Dita, S; Dittus, F; Djama, F; Djobava, T; Djuvsland, J I; do Vale, M A B; Dobos, D; Dobre, M; Doglioni, C; Dohmae, T; Dolejsi, J; Dolezal, Z; Dolgoshein, B A; Donadelli, M; Donati, S; Dondero, P; Donini, J; Dopke, J; Doria, A; Dova, M T; Doyle, A T; Drechsler, E; Dris, M; Dubreuil, E; Duchovni, E; Duckeck, G; Ducu, O A; Duda, D; Dudarev, A; Duflot, L; Duguid, L; Dührssen, M; Dunford, M; Duran Yildiz, H; Düren, M; Durglishvili, A; Duschinger, D; Dyndal, M; Eckardt, C; Ecker, K M; Edgar, R C; Edson, W; Edwards, N C; Ehrenfeld, W; Eifert, T; Eigen, G; Einsweiler, K; Ekelof, T; El Kacimi, M; Ellert, M; Elles, S; Ellinghaus, F; Elliot, A A; Ellis, N; Elmsheuser, J; Elsing, M; Emeliyanov, D; Enari, Y; Endner, O C; Endo, M; Erdmann, J; Ereditato, A; Ernis, G; Ernst, J; Ernst, M; Errede, S; Ertel, E; Escalier, M; Esch, H; Escobar, C; Esposito, B; Etienvre, A I; Etzion, E; Evans, H; Ezhilov, A; Fabbri, L; Facini, G; Fakhrutdinov, R M; Falciano, S; Falla, R J; Faltova, J; Fang, Y; Fanti, M; Farbin, A; Farilla, A; Farooque, T; Farrell, S; Farrington, S M; Farthouat, P; Fassi, F; Fassnacht, P; Fassouliotis, D; Faucci Giannelli, M; Favareto, A; Fayard, L; Federic, P; Fedin, O L; Fedorko, W; Feigl, S; Feligioni, L; Feng, C; Feng, E J; Feng, H; Fenyuk, A B; Feremenga, L; Fernandez Martinez, P; Fernandez Perez, S; Ferrando, J; Ferrari, A; Ferrari, P; Ferrari, R; Ferreira de Lima, D E; Ferrer, A; Ferrere, D; Ferretti, C; Ferretto Parodi, A; Fiascaris, M; Fiedler, F; Filipčič, A; Filipuzzi, M; Filthaut, F; Fincke-Keeler, M; Finelli, K D; Fiolhais, M C N; Fiorini, L; Firan, A; Fischer, A; Fischer, C; Fischer, J; Fisher, W C; Fitzgerald, E A; Flaschel, N; Fleck, I; Fleischmann, P; Fleischmann, S; Fletcher, G T; Fletcher, G; Fletcher, R R M; Flick, T; Floderus, A; Flores Castillo, L R; Flowerdew, M J; Formica, A; Forti, A; Fournier, D; Fox, H; Fracchia, S; Francavilla, P; Franchini, M; Francis, D; Franconi, L; Franklin, M; Frate, M; Fraternali, M; Freeborn, D; French, S T; Friedrich, F; Froidevaux, D; Frost, J A; Fukunaga, C; Fullana Torregrosa, E; Fulsom, B G; Fusayasu, T; Fuster, J; Gabaldon, C; Gabizon, O; Gabrielli, A; Gabrielli, A; Gach, G P; Gadatsch, S; Gadomski, S; Gagliardi, G; Gagnon, P; Galea, C; Galhardo, B; Gallas, E J; Gallop, B J; Gallus, P; Galster, G; Gan, K K; Gao, J; Gao, Y; Gao, Y S; Garay Walls, F M; Garberson, F; García, C; García Navarro, J E; Garcia-Sciveres, M; Gardner, R W; Garelli, N; Garonne, V; Gatti, C; Gaudiello, A; Gaudio, G; Gaur, B; Gauthier, L; Gauzzi, P; Gavrilenko, I L; Gay, C; Gaycken, G; Gazis, E N; Ge, P; Gecse, Z; Gee, C N P; Geich-Gimbel, Ch; Geisler, M P; Gemme, C; Genest, M H; Gentile, S; George, M; George, S; Gerbaudo, D; Gershon, A; Ghasemi, S; Ghazlane, H; Giacobbe, B; Giagu, S; Giangiobbe, V; Giannetti, P; Gibbard, B; Gibson, S M; Gilchriese, M; Gillam, T P S; Gillberg, D; Gilles, G; Gingrich, D M; Giokaris, N; Giordani, M P; Giorgi, F M; Giorgi, F M; Giraud, P F; Giromini, P; Giugni, D; Giuliani, C; Giulini, M; Gjelsten, B K; Gkaitatzis, S; Gkialas, I; Gkougkousis, E L; Gladilin, L K; Glasman, C; Glatzer, J; Glaysher, P C F; Glazov, A; Goblirsch-Kolb, M; Goddard, J R; Godlewski, J; Goldfarb, S; Golling, T; Golubkov, D; Gomes, A; Gonçalo, R; Goncalves Pinto Firmino Da Costa, J; Gonella, L; González de la Hoz, S; Gonzalez Parra, G; Gonzalez-Sevilla, S; Goossens, L; Gorbounov, P A; Gordon, H A; Gorelov, I; Gorini, B; Gorini, E; Gorišek, A; Gornicki, E; Goshaw, A T; Gössling, C; Gostkin, M I; Goujdami, D; Goussiou, A G; Govender, N; Gozani, E; Grabas, H M X; Graber, L; Grabowska-Bold, I; Gradin, P O J; Grafström, P; Grahn, K-J; Gramling, J; Gramstad, E; Grancagnolo, S; Gratchev, V; Gray, H M; Graziani, E; Greenwood, Z D; Grefe, C; Gregersen, K; Gregor, I M; Grenier, P; Griffiths, J; Grillo, A A; Grimm, K; Grinstein, S; Gris, Ph; Grivaz, J-F; Grohs, J P; Grohsjean, A; Gross, E; Grosse-Knetter, J; Grossi, G C; Grout, Z J; Guan, L; Guenther, J; Guescini, F; Guest, D; Gueta, O; Guido, E; Guillemin, T; Guindon, S; Gul, U; Gumpert, C; Guo, J; Guo, Y; Gupta, S; Gustavino, G; Gutierrez, P; Gutierrez Ortiz, N G; Gutschow, C; Guyot, C; Gwenlan, C; Gwilliam, C B; Haas, A; Haber, C; Hadavand, H K; Haddad, N; Haefner, P; Hageböck, S; Hajduk, Z; Hakobyan, H; Haleem, M; Haley, J; Hall, D; Halladjian, G; Hallewell, G D; Hamacher, K; Hamal, P; Hamano, K; Hamilton, A; Hamity, G N; Hamnett, P G; Han, L; Hanagaki, K; Hanawa, K; Hance, M; Hanke, P; Hanna, R; Hansen, J B; Hansen, J D; Hansen, M C; Hansen, P H; Hara, K; Hard, A S; Harenberg, T; Hariri, F; Harkusha, S; Harrington, R D; Harrison, P F; Hartjes, F; Hasegawa, M; Hasegawa, Y; Hasib, A; Hassani, S; Haug, S; Hauser, R; Hauswald, L; Havranek, M; Hawkes, C M; Hawkings, R J; Hawkins, A D; Hayashi, T; Hayden, D; Hays, C P; Hays, J M; Hayward, H S; Haywood, S J; Head, S J; Heck, T; Hedberg, V; Heelan, L; Heim, S; Heim, T; Heinemann, B; Heinrich, L; Hejbal, J; Helary, L; Hellman, S; Hellmich, D; Helsens, C; Henderson, J; Henderson, R C W; Heng, Y; Hengler, C; Henkelmann, S; Henrichs, A; Henriques Correia, A M; Henrot-Versille, S; Herbert, G H; Hernández Jiménez, Y; Herrberg-Schubert, R; Herten, G; Hertenberger, R; Hervas, L; Hesketh, G G; Hessey, N P; Hetherly, J W; Hickling, R; Higón-Rodriguez, E; Hill, E; Hill, J C; Hiller, K H; Hillier, S J; Hinchliffe, I; Hines, E; Hinman, R R; Hirose, M; Hirschbuehl, D; Hobbs, J; Hod, N; Hodgkinson, M C; Hodgson, P; Hoecker, A; Hoeferkamp, M R; Hoenig, F; Hohlfeld, M; Hohn, D; Holmes, T R; Homann, M; Hong, T M; Hooft van Huysduynen, L; Hopkins, W H; Horii, Y; Horton, A J; Hostachy, J-Y; Hou, S; Hoummada, A; Howard, J; Howarth, J; Hrabovsky, M; Hristova, I; Hrivnac, J; Hryn'ova, T; Hrynevich, A; Hsu, C; Hsu, P J; Hsu, S-C; Hu, D; Hu, Q; Hu, X; Huang, Y; Hubacek, Z; Hubaut, F; Huegging, F; Huffman, T B; Hughes, E W; Hughes, G; Huhtinen, M; Hülsing, T A; Huseynov, N; Huston, J; Huth, J; Iacobucci, G; Iakovidis, G; Ibragimov, I; Iconomidou-Fayard, L; Ideal, E; Idrissi, Z; Iengo, P; Igonkina, O; Iizawa, T; Ikegami, Y; Ikeno, M; Ilchenko, Y; Iliadis, D; Ilic, N; Ince, T; Introzzi, G; Ioannou, P; Iodice, M; Iordanidou, K; Ippolito, V; Irles Quiles, A; Isaksson, C; Ishino, M; Ishitsuka, M; Ishmukhametov, R; Issever, C; Istin, S; Iturbe Ponce, J M; Iuppa, R; Ivarsson, J; Iwanski, W; Iwasaki, H; Izen, J M; Izzo, V; Jabbar, S; Jackson, B; Jackson, M; Jackson, P; Jaekel, M R; Jain, V; Jakobs, K; Jakobsen, S; Jakoubek, T; Jakubek, J; Jamin, D O; Jana, D K; Jansen, E; Jansky, R; Janssen, J; Janus, M; Jarlskog, G; Javadov, N; Javůrek, T; Jeanty, L; Jejelava, J; Jeng, G-Y; Jennens, D; Jenni, P; Jentzsch, J; Jeske, C; Jézéquel, S; Ji, H; Jia, J; Jiang, Y; Jiggins, S; Jimenez Pena, J; Jin, S; Jinaru, A; Jinnouchi, O; Joergensen, M D; Johansson, P; Johns, K A; Jon-And, K; Jones, G; Jones, R W L; Jones, T J; Jongmanns, J; Jorge, P M; Joshi, K D; Jovicevic, J; Ju, X; Jung, C A; Jussel, P; Juste Rozas, A; Kaci, M; Kaczmarska, A; Kado, M; Kagan, H; Kagan, M; Kahn, S J; Kajomovitz, E; Kalderon, C W; Kama, S; Kamenshchikov, A; Kanaya, N; Kaneti, S; Kantserov, V A; Kanzaki, J; Kaplan, B; Kaplan, L S; Kapliy, A; Kar, D; Karakostas, K; Karamaoun, A; Karastathis, N; Kareem, M J; Karentzos, E; Karnevskiy, M; Karpov, S N; Karpova, Z M; Karthik, K; Kartvelishvili, V; Karyukhin, A N; Kashif, L; Kass, R D; Kastanas, A; Kataoka, Y; Kato, C; Katre, A; Katzy, J; Kawagoe, K; Kawamoto, T; Kawamura, G; Kazama, S; Kazanin, V F; Keeler, R; Kehoe, R; Keller, J S; Kempster, J J; Keoshkerian, H; Kepka, O; Kerševan, B P; Kersten, S; Keyes, R A; Khalil-Zada, F; Khandanyan, H; Khanov, A; Kharlamov, A G; Khoo, T J; Khovanskiy, V; Khramov, E; Khubua, J; Kido, S; Kim, H Y; Kim, S H; Kim, Y K; Kimura, N; Kind, O M; King, B T; King, M; King, S B; Kirk, J; Kiryunin, A E; Kishimoto, T; Kisielewska, D; Kiss, F; Kiuchi, K; Kivernyk, O; Kladiva, E; Klein, M H; Klein, M; Klein, U; Kleinknecht, K; Klimek, P; Klimentov, A; Klingenberg, R; Klinger, J A; Klioutchnikova, T; Kluge, E-E; Kluit, P; Kluth, S; Knapik, J; Kneringer, E; Knoops, E B F G; Knue, A; Kobayashi, A; Kobayashi, D; Kobayashi, T; Kobel, M; Kocian, M; Kodys, P; Koffas, T; Koffeman, E; Kogan, L A; Kohlmann, S; Kohout, Z; Kohriki, T; Koi, T; Kolanoski, H; Koletsou, I; Komar, A A; Komori, Y; Kondo, T; Kondrashova, N; Köneke, K; König, A C; Kono, T; Konoplich, R; Konstantinidis, N; Kopeliansky, R; Koperny, S; Köpke, L; Kopp, A K; Korcyl, K; Kordas, K; Korn, A; Korol, A A; Korolkov, I; Korolkova, E V; Kortner, O; Kortner, S; Kosek, T; Kostyukhin, V V; Kotov, V M; Kotwal, A; Kourkoumeli-Charalampidi, A; Kourkoumelis, C; Kouskoura, V; Koutsman, A; Kowalewski, R; Kowalski, T Z; Kozanecki, W; Kozhin, A S; Kramarenko, V A; Kramberger, G; Krasnopevtsev, D; Krasny, M W; Krasznahorkay, A; Kraus, J K; Kravchenko, A; Kreiss, S; Kretz, M; Kretzschmar, J; Kreutzfeldt, K; Krieger, P; Krizka, K; Kroeninger, K; Kroha, H; Kroll, J; Kroseberg, J; Krstic, J; Kruchonak, U; Krüger, H; Krumnack, N; Kruse, A; Kruse, M C; Kruskal, M; Kubota, T; Kucuk, H; Kuday, S; Kuehn, S; Kugel, A; Kuger, F; Kuhl, A; Kuhl, T; Kukhtin, V; Kukla, R; Kulchitsky, Y; Kuleshov, S; Kuna, M; Kunigo, T; Kupco, A; Kurashige, H; Kurochkin, Y A; Kus, V; Kuwertz, E S; Kuze, M; Kvita, J; Kwan, T; Kyriazopoulos, D; La Rosa, A; La Rosa Navarro, J L; La Rotonda, L; Lacasta, C; Lacava, F; Lacey, J; Lacker, H; Lacour, D; Lacuesta, V R; Ladygin, E; Lafaye, R; Laforge, B; Lagouri, T; Lai, S; Lambourne, L; Lammers, S; Lampen, C L; Lampl, W; Lançon, E; Landgraf, U; Landon, M P J; Lang, V S; Lange, J C; Lankford, A J; Lanni, F; Lantzsch, K; Lanza, A; Laplace, S; Lapoire, C; Laporte, J F; Lari, T; Lasagni Manghi, F; Lassnig, M; Laurelli, P; Lavrijsen, W; Law, A T; Laycock, P; Lazovich, T; Le Dortz, O; Le Guirriec, E; Le Menedeu, E; LeBlanc, M; LeCompte, T; Ledroit-Guillon, F; Lee, C A; Lee, S C; Lee, L; Lefebvre, G; Lefebvre, M; Legger, F; Leggett, C; Lehan, A; Lehmann Miotto, G; Lei, X; Leight, W A; Leisos, A; Leister, A G; Leite, M A L; Leitner, R; Lellouch, D; Lemmer, B; Leney, K J C; Lenz, T; Lenzi, B; Leone, R; Leone, S; Leonidopoulos, C; Leontsinis, S; Leroy, C; Lester, C G; Levchenko, M; Levêque, J; Levin, D; Levinson, L J; Levy, M; Lewis, A; Leyko, A M; Leyton, M; Li, B; Li, H; Li, H L; Li, L; Li, L; Li, S; Li, X; Li, Y; Liang, Z; Liao, H; Liberti, B; Liblong, A; Lichard, P; Lie, K; Liebal, J; Liebig, W; Limbach, C; Limosani, A; Lin, S C; Lin, T H; Linde, F; Lindquist, B E; Linnemann, J T; Lipeles, E; Lipniacka, A; Lisovyi, M; Liss, T M; Lissauer, D; Lister, A; Litke, A M; Liu, B; Liu, D; Liu, H; Liu, J; Liu, J B; Liu, K; Liu, L; Liu, M; Liu, M; Liu, Y; Livan, M; Lleres, A; Llorente Merino, J; Lloyd, S L; Lo Sterzo, F; Lobodzinska, E; Loch, P; Lockman, W S; Loebinger, F K; Loevschall-Jensen, A E; Loew, K M; Loginov, A; Lohse, T; Lohwasser, K; Lokajicek, M; Long, B A; Long, J D; Long, R E; Looper, K A; Lopes, L; Lopez Mateos, D; Lopez Paredes, B; Lopez Paz, I; Lorenz, J; Lorenzo Martinez, N; Losada, M; Lösel, P J; Lou, X; Lounis, A; Love, J; Love, P A; Lu, N; Lubatti, H J; Luci, C; Lucotte, A; Luedtke, C; Luehring, F; Lukas, W; Luminari, L; Lundberg, O; Lund-Jensen, B; Lynn, D; Lysak, R; Lytken, E; Ma, H; Ma, L L; Maccarrone, G; Macchiolo, A; Macdonald, C M; Maček, B; Machado Miguens, J; Macina, D; Madaffari, D; Madar, R; Maddocks, H J; Mader, W F; Madsen, A; Maeda, J; Maeland, S; Maeno, T; Maevskiy, A; Magradze, E; Mahboubi, K; Mahlstedt, J; Maiani, C; Maidantchik, C; Maier, A A; Maier, T; Maio, A; Majewski, S; Makida, Y; Makovec, N; Malaescu, B; Malecki, Pa; Maleev, V P; Malek, F; Mallik, U; Malon, D; Malone, C; Maltezos, S; Malyshev, V M; Malyukov, S; Mamuzic, J; Mancini, G; Mandelli, B; Mandelli, L; Mandić, I; Mandrysch, R; Maneira, J; Manfredini, A; Manhaes de Andrade Filho, L; Manjarres Ramos, J; Mann, A; Manousakis-Katsikakis, A; Mansoulie, B; Mantifel, R; Mantoani, M; Mapelli, L; March, L; Marchiori, G; Marcisovsky, M; Marino, C P; Marjanovic, M; Marley, D E; Marroquim, F; Marsden, S P; Marshall, Z; Marti, L F; Marti-Garcia, S; Martin, B; Martin, T A; Martin, V J; Martin Dit Latour, B; Martinez, M; Martin-Haugh, S; Martoiu, V S; Martyniuk, A C; Marx, M; Marzano, F; Marzin, A; Masetti, L; Mashimo, T; Mashinistov, R; Masik, J; Maslennikov, A L; Massa, I; Massa, L; Mastrandrea, P; Mastroberardino, A; Masubuchi, T; Mättig, P; Mattmann, J; Maurer, J; Maxfield, S J; Maximov, D A; Mazini, R; Mazza, S M; Mazzaferro, L; Mc Goldrick, G; Mc Kee, S P; McCarn, A; McCarthy, R L; McCarthy, T G; McCubbin, N A; McFarlane, K W; Mcfayden, J A; Mchedlidze, G; McMahon, S J; McPherson, R A; Medinnis, M; Meehan, S; Mehlhase, S; Mehta, A; Meier, K; Meineck, C; Meirose, B; Mellado Garcia, B R; Meloni, F; Mengarelli, A; Menke, S; Meoni, E; Mercurio, K M; Mergelmeyer, S; Mermod, P; Merola, L; Meroni, C; Merritt, F S; Messina, A; Metcalfe, J; Mete, A S; Meyer, C; Meyer, C; Meyer, J-P; Meyer, J; Meyer Zu Theenhausen, H; Middleton, R P; Miglioranzi, S; Mijović, L; Mikenberg, G; Mikestikova, M; Mikuž, M; Milesi, M; Milic, A; Miller, D W; Mills, C; Milov, A; Milstead, D A; Minaenko, A A; Minami, Y; Minashvili, I A; Mincer, A I; Mindur, B; Mineev, M; Ming, Y; Mir, L M; Mitani, T; Mitrevski, J; Mitsou, V A; Miucci, A; Miyagawa, P S; Mjörnmark, J U; Moa, T; Mochizuki, K; Mohapatra, S; Mohr, W; Molander, S; Moles-Valls, R; Monden, R; Mönig, K; Monini, C; Monk, J; Monnier, E; Montejo Berlingen, J; Monticelli, F; Monzani, S; Moore, R W; Morange, N; Moreno, D; Moreno Llácer, M; Morettini, P; Mori, D; Morii, M; Morinaga, M; Morisbak, V; Moritz, S; Morley, A K; Mornacchi, G; Morris, J D; Mortensen, S S; Morton, A; Morvaj, L; Mosidze, M; Moss, J; Motohashi, K; Mount, R; Mountricha, E; Mouraviev, S V; Moyse, E J W; Muanza, S; Mudd, R D; Mueller, F; Mueller, J; Mueller, R S P; Mueller, T; Muenstermann, D; Mullen, P; Mullier, G A; Murillo Quijada, J A; Murray, W J; Musheghyan, H; Musto, E; Myagkov, A G; Myska, M; Nachman, B P; Nackenhorst, O; Nadal, J; Nagai, K; Nagai, R; Nagai, Y; Nagano, K; Nagarkar, A; Nagasaka, Y; Nagata, K; Nagel, M; Nagy, E; Nairz, A M; Nakahama, Y; Nakamura, K; Nakamura, T; Nakano, I; Namasivayam, H; Naranjo Garcia, R F; Narayan, R; Narrias Villar, D I; Naumann, T; Navarro, G; Nayyar, R; Neal, H A; Nechaeva, P Yu; Neep, T J; Nef, P D; Negri, A; Negrini, M; Nektarijevic, S; Nellist, C; Nelson, A; Nemecek, S; Nemethy, P; Nepomuceno, A A; Nessi, M; Neubauer, M S; Neumann, M; Neves, R M; Nevski, P; Newman, P R; Nguyen, D H; Nickerson, R B; Nicolaidou, R; Nicquevert, B; Nielsen, J; Nikiforou, N; Nikiforov, A; Nikolaenko, V; Nikolic-Audit, I; Nikolopoulos, K; Nilsen, J K; Nilsson, P; Ninomiya, Y; Nisati, A; Nisius, R; Nobe, T; Nodulman, L; Nomachi, M; Nomidis, I; Nooney, T; Norberg, S; Nordberg, M; Novgorodova, O; Nowak, S; Nozaki, M; Nozka, L; Ntekas, K; Nunes Hanninger, G; Nunnemann, T; Nurse, E; Nuti, F; O'Brien, B J; O'grady, F; O'Neil, D C; O'Shea, V; Oakham, F G; Oberlack, H; Obermann, T; Ocariz, J; Ochi, A; Ochoa, I; Ochoa-Ricoux, J P; Oda, S; Odaka, S; Ogren, H; Oh, A; Oh, S H; Ohm, C C; Ohman, H; Oide, H; Okamura, W; Okawa, H; Okumura, Y; Okuyama, T; Olariu, A; Olivares Pino, S A; Oliveira Damazio, D; Oliver Garcia, E; Olszewski, A; Olszowska, J; Onofre, A; Onogi, K; Onyisi, P U E; Oram, C J; Oreglia, M J; Oren, Y; Orestano, D; Orlando, N; Oropeza Barrera, C; Orr, R S; Osculati, B; Ospanov, R; Otero Y Garzon, G; Otono, H; Ouchrif, M; Ould-Saada, F; Ouraou, A; Oussoren, K P; Ouyang, Q; Ovcharova, A; Owen, M; Owen, R E; Ozcan, V E; Ozturk, N; Pachal, K; Pacheco Pages, A; Padilla Aranda, C; Pagáčová, M; Pagan Griso, S; Paganis, E; Paige, F; Pais, P; Pajchel, K; Palacino, G; Palestini, S; Palka, M; Pallin, D; Palma, A; Pan, Y B; Panagiotopoulou, E St; Pandini, C E; Panduro Vazquez, J G; Pani, P; Panitkin, S; Pantea, D; Paolozzi, L; Papadopoulou, Th D; Papageorgiou, K; Paramonov, A; Paredes Hernandez, D; Parker, M A; Parker, K A; Parodi, F; Parsons, J A; Parzefall, U; Pasqualucci, E; Passaggio, S; Pastore, F; Pastore, Fr; Pásztor, G; Pataraia, S; Patel, N D; Pater, J R; Pauly, T; Pearce, J; Pearson, B; Pedersen, L E; Pedersen, M; Pedraza Lopez, S; Pedro, R; Peleganchuk, S V; Pelikan, D; Penc, O; Peng, C; Peng, H; Penning, B; Penwell, J; Perepelitsa, D V; Perez Codina, E; Pérez García-Estañ, M T; Perini, L; Pernegger, H; Perrella, S; Peschke, R; Peshekhonov, V D; Peters, K; Peters, R F Y; Petersen, B A; Petersen, T C; Petit, E; Petridis, A; Petridou, C; Petroff, P; Petrolo, E; Petrucci, F; Pettersson, N E; Pezoa, R; Phillips, P W; Piacquadio, G; Pianori, E; Picazio, A; Piccaro, E; Piccinini, M; Pickering, M A; Piegaia, R; Pignotti, D T; Pilcher, J E; Pilkington, A D; Pin, A W J; Pina, J; Pinamonti, M; Pinfold, J L; Pingel, A; Pires, S; Pirumov, H; Pitt, M; Pizio, C; Plazak, L; Pleier, M-A; Pleskot, V; Plotnikova, E; Plucinski, P; Pluth, D; Poettgen, R; Poggioli, L; Pohl, D; Polesello, G; Poley, A; Policicchio, A; Polifka, R; Polini, A; Pollard, C S; Polychronakos, V; Pommès, K; Pontecorvo, L; Pope, B G; Popeneciu, G A; Popovic, D S; Poppleton, A; Pospisil, S; Potamianos, K; Potrap, I N; Potter, C J; Potter, C T; Poulard, G; Poveda, J; Pozdnyakov, V; Pralavorio, P; Pranko, A; Prasad, S; Prell, S; Price, D; Price, L E; Primavera, M; Prince, S; Proissl, M; Prokofiev, K; Prokoshin, F; Protopapadaki, E; Protopopescu, S; Proudfoot, J; Przybycien, M; Ptacek, E; Puddu, D; Pueschel, E; Puldon, D; Purohit, M; Puzo, P; Qian, J; Qin, G; Qin, Y; Quadt, A; Quarrie, D R; Quayle, W B; Queitsch-Maitland, M; Quilty, D; Raddum, S; Radeka, V; Radescu, V; Radhakrishnan, S K; Radloff, P; Rados, P; Ragusa, F; Rahal, G; Rajagopalan, S; Rammensee, M; Rangel-Smith, C; Rauscher, F; Rave, S; Ravenscroft, T; Raymond, M; Read, A L; Readioff, N P; Rebuzzi, D M; Redelbach, A; Redlinger, G; Reece, R; Reeves, K; Rehnisch, L; Reichert, J; Reisin, H; Relich, M; Rembser, C; Ren, H; Renaud, A; Rescigno, M; Resconi, S; Rezanova, O L; Reznicek, P; Rezvani, R; Richter, R; Richter, S; Richter-Was, E; Ricken, O; Ridel, M; Rieck, P; Riegel, C J; Rieger, J; Rifki, O; Rijssenbeek, M; Rimoldi, A; Rinaldi, L; Ristić, B; Ritsch, E; Riu, I; Rizatdinova, F; Rizvi, E; Robertson, S H; Robichaud-Veronneau, A; Robinson, D; Robinson, J E M; Robson, A; Roda, C; Roe, S; Røhne, O; Rolli, S; Romaniouk, A; Romano, M; Romano Saez, S M; Romero Adam, E; Rompotis, N; Ronzani, M; Roos, L; Ros, E; Rosati, S; Rosbach, K; Rose, P; Rosendahl, P L; Rosenthal, O; Rossetti, V; Rossi, E; Rossi, L P; Rosten, J H N; Rosten, R; Rotaru, M; Roth, I; Rothberg, J; Rousseau, D; Royon, C R; Rozanov, A; Rozen, Y; Ruan, X; Rubbo, F; Rubinskiy, I; Rud, V I; Rudolph, C; Rudolph, M S; Rühr, F; Ruiz-Martinez, A; Rurikova, Z; Rusakovich, N A; Ruschke, A; Russell, H L; Rutherfoord, J P; Ruthmann, N; Ryabov, Y F; Rybar, M; Rybkin, G; Ryder, N C; Saavedra, A F; Sabato, G; Sacerdoti, S; Saddique, A; Sadrozinski, H F-W; Sadykov, R; Safai Tehrani, F; Saha, P; Sahinsoy, M; Saimpert, M; Saito, T; Sakamoto, H; Sakurai, Y; Salamanna, G; Salamon, A; Salazar Loyola, J E; Saleem, M; Salek, D; Sales De Bruin, P H; Salihagic, D; Salnikov, A; Salt, J; Salvatore, D; Salvatore, F; Salvucci, A; Salzburger, A; Sammel, D; Sampsonidis, D; Sanchez, A; Sánchez, J; Sanchez Martinez, V; Sandaker, H; Sandbach, R L; Sander, H G; Sanders, M P; Sandhoff, M; Sandoval, C; Sandstroem, R; Sankey, D P C; Sannino, M; Sansoni, A; Santoni, C; Santonico, R; Santos, H; Santoyo Castillo, I; Sapp, K; Sapronov, A; Saraiva, J G; Sarrazin, B; Sasaki, O; Sasaki, Y; Sato, K; Sauvage, G; Sauvan, E; Savage, G; Savard, P; Sawyer, C; Sawyer, L; Saxon, J; Sbarra, C; Sbrizzi, A; Scanlon, T; Scannicchio, D A; Scarcella, M; Scarfone, V; Schaarschmidt, J; Schacht, P; Schaefer, D; Schaefer, R; Schaeffer, J; Schaepe, S; Schaetzel, S; Schäfer, U; Schaffer, A C; Schaile, D; Schamberger, R D; Scharf, V; Schegelsky, V A; Scheirich, D; Schernau, M; Schiavi, C; Schillo, C; Schioppa, M; Schlenker, S; Schmieden, K; Schmitt, C; Schmitt, S; Schmitt, S; Schneider, B; Schnellbach, Y J; Schnoor, U; Schoeffel, L; Schoening, A; Schoenrock, B D; Schopf, E; Schorlemmer, A L S; Schott, M; Schouten, D; Schovancova, J; Schramm, S; Schreyer, M; Schroeder, C; Schuh, N; Schultens, M J; Schultz-Coulon, H-C; Schulz, H; Schumacher, M; Schumm, B A; Schune, Ph; Schwanenberger, C; Schwartzman, A; Schwarz, T A; Schwegler, Ph; Schweiger, H; Schwemling, Ph; Schwienhorst, R; Schwindling, J; Schwindt, T; Sciacca, F G; Scifo, E; Sciolla, G; Scuri, F; Scutti, F; Searcy, J; Sedov, G; Sedykh, E; Seema, P; Seidel, S C; Seiden, A; Seifert, F; Seixas, J M; Sekhniaidze, G; Sekhon, K; Sekula, S J; Seliverstov, D M; Semprini-Cesari, N; Serfon, C; Serin, L; Serkin, L; Serre, T; Sessa, M; Seuster, R; Severini, H; Sfiligoj, T; Sforza, F; Sfyrla, A; Shabalina, E; Shamim, M; Shan, L Y; Shang, R; Shank, J T; Shapiro, M; Shatalov, P B; Shaw, K; Shaw, S M; Shcherbakova, A; Shehu, C Y; Sherwood, P; Shi, L; Shimizu, S; Shimmin, C O; Shimojima, M; Shiyakova, M; Shmeleva, A; Shoaleh Saadi, D; Shochet, M J; Shojaii, S; Shrestha, S; Shulga, E; Shupe, M A; Shushkevich, S; Sicho, P; Sidebo, P E; Sidiropoulou, O; Sidorov, D; Sidoti, A; Siegert, F; Sijacki, Dj; Silva, J; Silver, Y; Silverstein, S B; Simak, V; Simard, O; Simic, Lj; Simion, S; Simioni, E; Simmons, B; Simon, D; Sinervo, P; Sinev, N B; Sioli, M; Siragusa, G; Sisakyan, A N; Sivoklokov, S Yu; Sjölin, J; Sjursen, T B; Skinner, M B; Skottowe, H P; Skubic, P; Slater, M; Slavicek, T; Slawinska, M; Sliwa, K; Smakhtin, V; Smart, B H; Smestad, L; Smirnov, S Yu; Smirnov, Y; Smirnova, L N; Smirnova, O; Smith, M N K; Smith, R W; Smizanska, M; Smolek, K; Snesarev, A A; Snidero, G; Snyder, S; Sobie, R; Socher, F; Soffer, A; Soh, D A; Sokhrannyi, G; Solans Sanchez, C A; Solar, M; Solc, J; Soldatov, E Yu; Soldevila, U; Solodkov, A A; Soloshenko, A; Solovyanov, O V; Solovyev, V; Sommer, P; Song, H Y; Soni, N; Sood, A; Sopczak, A; Sopko, B; Sopko, V; Sorin, V; Sosa, D; Sosebee, M; Sotiropoulou, C L; Soualah, R; Soukharev, A M; South, D; Sowden, B C; Spagnolo, S; Spalla, M; Spangenberg, M; Spanò, F; Spearman, W R; Sperlich, D; Spettel, F; Spighi, R; Spigo, G; Spiller, L A; Spousta, M; Spreitzer, T; Denis, R D St; Stabile, A; Staerz, S; Stahlman, J; Stamen, R; Stamm, S; Stanecka, E; Stanek, R W; Stanescu, C; Stanescu-Bellu, M; Stanitzki, M M; Stapnes, S; Starchenko, E A; Stark, J; Staroba, P; Starovoitov, P; Staszewski, R; Steinberg, P; Stelzer, B; Stelzer, H J; Stelzer-Chilton, O; Stenzel, H; Stewart, G A; Stillings, J A; Stockton, M C; Stoebe, M; Stoicea, G; Stolte, P; Stonjek, S; Stradling, A R; Straessner, A; Stramaglia, M E; Strandberg, J; Strandberg, S; Strandlie, A; Strauss, E; Strauss, M; Strizenec, P; Ströhmer, R; Strom, D M; Stroynowski, R; Strubig, A; Stucci, S A; Stugu, B; Styles, N A; Su, D; Su, J; Subramaniam, R; Succurro, A; Suchek, S; Sugaya, Y; Suk, M; Sulin, V V; Sultansoy, S; Sumida, T; Sun, S; Sun, X; Sundermann, J E; Suruliz, K; Susinno, G; Sutton, M R; Suzuki, S; Svatos, M; Swiatlowski, M; Sykora, I; Sykora, T; Ta, D; Taccini, C; Tackmann, K; Taenzer, J; Taffard, A; Tafirout, R; Taiblum, N; Takai, H; Takashima, R; Takeda, H; Takeshita, T; Takubo, Y; Talby, M; Talyshev, A A; Tam, J Y C; Tan, K G; Tanaka, J; Tanaka, R; Tanaka, S; Tannenwald, B B; Tannoury, N; Tapprogge, S; Tarem, S; Tarrade, F; Tartarelli, G F; Tas, P; Tasevsky, M; Tashiro, T; Tassi, E; Tavares Delgado, A; Tayalati, Y; Taylor, F E; Taylor, G N; Taylor, P T E; Taylor, W; Teischinger, F A; Teixeira-Dias, P; Temming, K K; Temple, D; Ten Kate, H; Teng, P K; Teoh, J J; Tepel, F; Terada, S; Terashi, K; Terron, J; Terzo, S; Testa, M; Teuscher, R J; Theveneaux-Pelzer, T; Thomas, J P; Thomas-Wilsker, J; Thompson, E N; Thompson, P D; Thompson, R J; Thompson, A S; Thomsen, L A; Thomson, E; Thomson, M; Thun, R P; Tibbetts, M J; Ticse Torres, R E; Tikhomirov, V O; Tikhonov, Yu A; Timoshenko, S; Tiouchichine, E; Tipton, P; Tisserant, S; Todome, K; Todorov, T; Todorova-Nova, S; Tojo, J; Tokár, S; Tokushuku, K; Tollefson, K; Tolley, E; Tomlinson, L; Tomoto, M; Tompkins, L; Toms, K; Torrence, E; Torres, H; Torró Pastor, E; Toth, J; Touchard, F; Tovey, D R; Trefzger, T; Tremblet, L; Tricoli, A; Trigger, I M; Trincaz-Duvoid, S; Tripiana, M F; Trischuk, W; Trocmé, B; Troncon, C; Trottier-McDonald, M; Trovatelli, M; True, P; Truong, L; Trzebinski, M; Trzupek, A; Tsarouchas, C; Tseng, J C-L; Tsiareshka, P V; Tsionou, D; Tsipolitis, G; Tsirintanis, N; Tsiskaridze, S; Tsiskaridze, V; Tskhadadze, E G; Tsukerman, I I; Tsulaia, V; Tsuno, S; Tsybychev, D; Tudorache, A; Tudorache, V; Tuna, A N; Tupputi, S A; Turchikhin, S; Turecek, D; Turra, R; Turvey, A J; Tuts, P M; Tykhonov, A; Tylmad, M; Tyndel, M; Ueda, I; Ueno, R; Ughetto, M; Ugland, M; Ukegawa, F; Unal, G; Undrus, A; Unel, G; Ungaro, F C; Unno, Y; Unverdorben, C; Urban, J; Urquijo, P; Urrejola, P; Usai, G; Usanova, A; Vacavant, L; Vacek, V; Vachon, B; Valderanis, C; Valencic, N; Valentinetti, S; Valero, A; Valery, L; Valkar, S; Valladolid Gallego, E; Vallecorsa, S; Valls Ferrer, J A; Van Den Wollenberg, W; Van Der Deijl, P C; van der Geer, R; van der Graaf, H; van Eldik, N; van Gemmeren, P; Van Nieuwkoop, J; van Vulpen, I; van Woerden, M C; Vanadia, M; Vandelli, W; Vanguri, R; Vaniachine, A; Vannucci, F; Vardanyan, G; Vari, R; Varnes, E W; Varol, T; Varouchas, D; Vartapetian, A; Varvell, K E; Vazeille, F; Vazquez Schroeder, T; Veatch, J; Veloce, L M; Veloso, F; Velz, T; Veneziano, S; Ventura, A; Ventura, D; Venturi, M; Venturi, N; Venturini, A; Vercesi, V; Verducci, M; Verkerke, W; Vermeulen, J C; Vest, A; Vetterli, M C; Viazlo, O; Vichou, I; Vickey, T; Vickey Boeriu, O E; Viehhauser, G H A; Viel, S; Vigne, R; Villa, M; Villaplana Perez, M; Vilucchi, E; Vincter, M G; Vinogradov, V B; Vivarelli, I; Vives Vaque, F; Vlachos, S; Vladoiu, D; Vlasak, M; Vogel, M; Vokac, P; Volpi, G; Volpi, M; von der Schmitt, H; von Radziewski, H; von Toerne, E; Vorobel, V; Vorobev, K; Vos, M; Voss, R; Vossebeld, J H; Vranjes, N; Vranjes Milosavljevic, M; Vrba, V; Vreeswijk, M; Vuillermet, R; Vukotic, I; Vykydal, Z; Wagner, P; Wagner, W; Wahlberg, H; Wahrmund, S; Wakabayashi, J; Walder, J; Walker, R; Walkowiak, W; Wang, C; Wang, F; Wang, H; Wang, H; Wang, J; Wang, J; Wang, K; Wang, R; Wang, S M; Wang, T; Wang, T; Wang, X; Wanotayaroj, C; Warburton, A; Ward, C P; Wardrope, D R; Washbrook, A; Wasicki, C; Watkins, P M; Watson, A T; Watson, I J; Watson, M F; Watts, G; Watts, S; Waugh, B M; Webb, S; Weber, M S; Weber, S W; Webster, J S; Weidberg, A R; Weinert, B; Weingarten, J; Weiser, C; Weits, H; Wells, P S; Wenaus, T; Wengler, T; Wenig, S; Wermes, N; Werner, M; Werner, P; Wessels, M; Wetter, J; Whalen, K; Wharton, A M; White, A; White, M J; White, R; White, S; Whiteson, D; Wickens, F J; Wiedenmann, W; Wielers, M; Wienemann, P; Wiglesworth, C; Wiik-Fuchs, L A M; Wildauer, A; Wilkens, H G; Williams, H H; Williams, S; Willis, C; Willocq, S; Wilson, A; Wilson, J A; Wingerter-Seez, I; Winklmeier, F; Winter, B T; Wittgen, M; Wittkowski, J; Wollstadt, S J; Wolter, M W; Wolters, H; Wosiek, B K; Wotschack, J; Woudstra, M J; Wozniak, K W; Wu, M; Wu, M; Wu, S L; Wu, X; Wu, Y; Wyatt, T R; Wynne, B M; Xella, S; Xu, D; Xu, L; Yabsley, B; Yacoob, S; Yakabe, R; Yamada, M; Yamaguchi, D; Yamaguchi, Y; Yamamoto, A; Yamamoto, S; Yamanaka, T; Yamauchi, K; Yamazaki, Y; Yan, Z; Yang, H; Yang, H; Yang, Y; Yao, W-M; Yasu, Y; Yatsenko, E; Yau Wong, K H; Ye, J; Ye, S; Yeletskikh, I; Yen, A L; Yildirim, E; Yorita, K; Yoshida, R; Yoshihara, K; Young, C; Young, C J S; Youssef, S; Yu, D R; Yu, J; Yu, J M; Yu, J; Yuan, L; Yuen, S P Y; Yurkewicz, A; Yusuff, I; Zabinski, B; Zaidan, R; Zaitsev, A M; Zalieckas, J; Zaman, A; Zambito, S; Zanello, L; Zanzi, D; Zeitnitz, C; Zeman, M; Zemla, A; Zeng, Q; Zengel, K; Zenin, O; Ženiš, T; Zerwas, D; Zhang, D; Zhang, F; Zhang, H; Zhang, J; Zhang, L; Zhang, R; Zhang, X; Zhang, Z; Zhao, X; Zhao, Y; Zhao, Z; Zhemchugov, A; Zhong, J; Zhou, B; Zhou, C; Zhou, L; Zhou, L; Zhou, M; Zhou, N; Zhu, C G; Zhu, H; Zhu, J; Zhu, Y; Zhuang, X; Zhukov, K; Zibell, A; Zieminska, D; Zimine, N I; Zimmermann, C; Zimmermann, S; Zinonos, Z; Zinser, M; Ziolkowski, M; Živković, L; Zobernig, G; Zoccoli, A; Zur Nedden, M; Zurzolo, G; Zwalinski, L

2016-01-01

The production rates of prompt and non-prompt [Formula: see text] and [Formula: see text] mesons in their dimuon decay modes are measured using 2.1 and 11.4 fb[Formula: see text] of data collected with the ATLAS experiment at the Large Hadron Collider, in proton-proton collisions at [Formula: see text] and 8 respectively. Production cross-sections for prompt as well as non-prompt sources, ratios of [Formula: see text] to [Formula: see text] production, and the fractions of non-prompt production for [Formula: see text] and [Formula: see text] are measured as a function of meson transverse momentum and rapidity. The measurements are compared to theoretical predictions.

Study protocol for Chronic Obstructive Pulmonary Disease-Sitting and ExacerbAtions Trial (COPD-SEAT): a randomised controlled feasibility trial of a home-based self-monitoring sedentary behaviour intervention

PubMed Central

Orme, Mark; Weedon, Amie; Esliger, Dale; Saukko, Paula; Morgan, Mike; Steiner, Michael; Downey, John; Singh, Sally; Sherar, Lauren

2016-01-01

Introduction An acute exacerbation of chronic obstructive pulmonary disease (COPD) marks a critical life event, which can lower patient quality of life and ability to perform daily activities. Patients with COPD tend to lead inactive and highly sedentary lifestyles, which may contribute to reductions in functional capacity. Targeting sedentary behaviour (SB) may be more attainable than exercise (at a moderate-to-vigorous intensity) for behaviour change in patients following an exacerbation. This study aims to evaluate the feasibility and acceptability of a 2-week at-home intervention providing education and self-monitoring to reduce prolonged periods of SB in patients with COPD discharged following an acute exacerbation. Methods and analysis Patients will be randomised into 1 of 3 conditions: usual care (control), education or education+feedback. The education group will receive information and suggestions about reducing long periods of sitting. The education+feedback group will receive real-time feedback on their sitting time, stand-ups and step count at home through an inclinometer linked to a smart device app. The inclinometer will also provide vibration prompts to encourage movement when the wearer has been sedentary for too long. Data will be collected during hospital admission and 2 weeks after discharge. Qualitative interviews will be conducted with patients in the intervention groups to explore patient experiences. Interviews with healthcare staff will also be conducted. All data will be collected January to August 2016. The primary outcomes are feasibility and acceptability, which will be assessed by qualitative interviews, uptake and drop-out rates, reasons for refusing the intervention, compliance, app usage and response to vibration prompts. Ethics and dissemination The research ethics committee East Midlands Leicester-Central has provided ethical approval for the conduct of this study. The results of the study will be disseminated through appropriate conference proceedings and peer-reviewed journals. Trial registration number ISRCTN13790881; Pre-results. PMID:27697880

A Probe Intermix Procedure for Fading Response Prompts.

ERIC Educational Resources Information Center

Billingsley, Felix F.

1987-01-01

A prompt fading method was employed to teach an eight-year-old student with severe behavior disorders the self-paced use of a functional behavior (requesting rather than grabbing food items). Initial pairing of prompts and natural cues was followed by a mix of prompted and probe (unprompted) trials. (Author/JW)

Review of Video Prompting Studies for Persons with Developmental Disabilities

ERIC Educational Resources Information Center

Banda, Devender R.; Dogoe, Maud S.; Matuszny, Rose Marie

2011-01-01

We reviewed 18 video prompting studies that were conducted with persons with developmental disabilities. Results across the studies indicate that video prompting is a viable method for improving various domestic, vocational, and independent living skills. In addition, video prompting strategies facilitated maintenance and generalization of learned…

Home therapy with continuous infusion of factor VIII after minor surgery or serious haemorrhage.

PubMed

Varon, D; Schulman, S; Bashari, D; Martinowitz, U

1996-10-01

Administration of factor VIII (F VIII) concentrates by continuous infusion is now routinely used at several haemophilia centers but almost exclusively for hospitalized patients. We evaluated various aspects of home therapy with continuous infusion of an immunoaffinity purified F VIII concentrate (Monoclate P®, Armour) in patients who would normally have been treated with high doses in bolus injections or with continuous infusion as in-patients. Twenty haemophilia A patients, eight after minor surgery and 12 for serious haemorrhage, received continuous infusion with undiluted F VIII by a minipump for a mean of 0.9 days in the hospital, followed by 3.3 days at home. Infusion bags were exchanged every 2.5 days. No haemorrhagic complications occurred, and five haemorrhages that had been resistant to treatment with bolus injections responded promptly to the continuous infusion. There were no technical problems and patient compliance and acceptance was good. We find this mode of therapy safe, efficacious and convenient for the patients as well as for the staff.

Acute Symptomatic Seizures Caused by Electrolyte Disturbances

PubMed Central

Nardone, Raffaele; Brigo, Francesco

2016-01-01

In this narrative review we focus on acute symptomatic seizures occurring in subjects with electrolyte disturbances. Quite surprisingly, despite its clinical relevance, this issue has received very little attention in the scientific literature. Electrolyte abnormalities are commonly encountered in clinical daily practice, and their diagnosis relies on routine laboratory findings. Acute and severe electrolyte imbalances can manifest with seizures, which may be the sole presenting symptom. Seizures are more frequently observed in patients with sodium disorders (especially hyponatremia), hypocalcemia, and hypomagnesemia. They do not entail a diagnosis of epilepsy, but are classified as acute symptomatic seizures. EEG has little specificity in differentiating between various electrolyte disturbances. The prominent EEG feature is slowing of the normal background activity, although other EEG findings, including various epileptiform abnormalities may occur. An accurate and prompt diagnosis should be established for a successful management of seizures, as rapid identification and correction of the underlying electrolyte disturbance (rather than an antiepileptic treatment) are of crucial importance in the control of seizures and prevention of permanent brain damage. PMID:26754778

Identification of impaired hearing in early childhood.

PubMed Central

Wong, D; Shah, C P

1979-01-01

Although the incidence of congenital deafness is high, routine neonatal screening for this problem is not practised, and early identification of congenital or early acquired deafness is relatively rare. Delaying therapy until a child is 3 or more years old severely limits speech development, language acquisition and learning. The commonest causes of delay in diagnosis are the refusal of physicians to listen to the parents' observations, their failure to screen children for hearing and speech problems, and their reluctance to arrange prompt referral for audiologic assessment. Diagnostic delay occurs even though half the children who have impaired hearing are known to be at increased risk. A plea is made for the setting up of a register of infants known to be at risk for impaired hearing. First-contact physicians should be alert to the possibility of hearing problems, particularly in children at high risk. Screening methods for use by nonspecialist practitioners are outlined. Images p535-a p536-a p540-a PMID:387194

Research with Pregnant Women: New Insights on Legal Decision-Making

PubMed Central

Mastroianni, Anna C.; Henry, Leslie Meltzer; Robinson, David; Bailey, Theodore; Faden, Ruth R.; Little, Margaret O.; Lyerly, Anne Drapkin

2017-01-01

Although pregnant women rely on medical interventions to treat and prevent a wide variety of health conditions, they are frequently excluded or underrepresented in clinical research. The resulting dearth of pregnancy-specific evidence to guide clinical decisionmaking routinely exposes pregnant women, and their future offspring, to risk of uncertain harms for uncertain benefits. The two legal factors regularly cited as obstacles to such research are the federal regulatory scheme and fear of liability. This article reveals a far more nuanced and complex view of the legal context. First, legal professionals may—at any time from product conception to marketing—influence decisions about research with pregnant women. Second, factors not previously articulated in the literature may prompt legal professionals to slow or halt such research. They include: financial interests, regulatory ambiguity, obstacles to risk management, and site-specific laws unrelated to research. Any efforts to promote the ethical inclusion of pregnant women in research must acknowledge the role of legal decisionmakers and address their professional concerns. PMID:28543423

Postdural puncture headache

PubMed Central

2017-01-01

Postdural puncture headache (PDPH) is a common complication after inadvertent dural puncture. Risks factors include female sex, young age, pregnancy, vaginal delivery, low body mass index, and being a non-smoker. Needle size, design, and the technique used also affect the risk. Because PDPH can be incapacitating, prompt diagnosis and treatment are mandatory. A diagnostic hallmark of PDPH is a postural headache that worsens with sitting or standing, and improves with lying down. Conservative therapies such as bed rest, hydration, and caffeine are commonly used as prophylaxis and treatment for this condition; however, no substantial evidence supports routine bed rest and aggressive hydration. An epidural blood patch is the most effective treatment option for patients with unsuccessful conservative management. Various other prophylactic and treatment interventions have been suggested. However, due to a lack of conclusive evidence supporting their use, the potential benefits of such interventions should be weighed carefully against the risks. This article reviews the current literature on the diagnosis, risk factors, pathophysiology, prevention, and treatment of PDPH. PMID:28367283

Tuberculous brain abscess and subdural empyema in an immunocompetent child: Significance of AFB staining in aspirated pus

PubMed Central

Vijayakumar, B.; Sarin, K.; Mohan, Girija

2012-01-01

Tuberculous brain abscess and subdural empyema are extremely rare manifestations of central nervous system tuberculosis. Here, we report a case of an 11-year-old immunocompetent child who developed temporal lobe abscess and subdural empyema following chronic otitis media. A right temporal craniotomy was performed and the abscess was excised. The Ziehl Nielsen staining of the aspirated pus from the temporal lobe abscess yielded acid fast bacilli. Prompt administration of antituberculous treatment resulted in complete recovery of the child. Even though the subdural abscess was not drained, we presume that to be of tubercular aetiology. Ours is probably the first case of brain abscess and subdural empyema due to Mycobacterium tuberculosis reported in the same child. This case is being reported because of its rarity and to stress the importance of routine staining for tubercle bacilli in all cases of brain abscess, especially in endemic areas, as it is difficult to differentiate tuberculous from pyogenic abscess clinically as well as histopathologically. PMID:22566728

Tuberculous brain abscess and subdural empyema in an immunocompetent child: Significance of AFB staining in aspirated pus.

PubMed

Vijayakumar, B; Sarin, K; Mohan, Girija

2012-04-01

Tuberculous brain abscess and subdural empyema are extremely rare manifestations of central nervous system tuberculosis. Here, we report a case of an 11-year-old immunocompetent child who developed temporal lobe abscess and subdural empyema following chronic otitis media. A right temporal craniotomy was performed and the abscess was excised. The Ziehl Nielsen staining of the aspirated pus from the temporal lobe abscess yielded acid fast bacilli. Prompt administration of antituberculous treatment resulted in complete recovery of the child. Even though the subdural abscess was not drained, we presume that to be of tubercular aetiology. Ours is probably the first case of brain abscess and subdural empyema due to Mycobacterium tuberculosis reported in the same child. This case is being reported because of its rarity and to stress the importance of routine staining for tubercle bacilli in all cases of brain abscess, especially in endemic areas, as it is difficult to differentiate tuberculous from pyogenic abscess clinically as well as histopathologically.

METALLURGICAL PROGRAMS: CALCULATION OF MASS FROM VOLUME, DENSITY OF MIXTURES, AND CONVERSION OF ATOMIC TO WEIGHT PERCENT

NASA Technical Reports Server (NTRS)

Degroh, H.

1994-01-01

The Metallurgical Programs include three simple programs which calculate solutions to problems common to metallurgical engineers and persons making metal castings. The first program calculates the mass of a binary ideal (alloy) given the weight fractions and densities of the pure components and the total volume. The second program calculates the densities of a binary ideal mixture. The third program converts the atomic percentages of a binary mixture to weight percentages. The programs use simple equations to assist the materials staff with routine calculations. The Metallurgical Programs are written in Microsoft QuickBASIC for interactive execution and have been implemented on an IBM PC-XT/AT operating MS-DOS 2.1 or higher with 256K bytes of memory. All instructions needed by the user appear as prompts as the software is used. Data is input using the keyboard only and output is via the monitor. The Metallurgical programs were written in 1987.

Furanodiene Induces Extrinsic and Intrinsic Apoptosis in Doxorubicin-Resistant MCF-7 Breast Cancer Cells via NF-κB-Independent Mechanism.

PubMed

Zhong, Zhang-Feng; Yu, Hai-Bing; Wang, Chun-Ming; Qiang, Wen-An; Wang, Sheng-Peng; Zhang, Jin-Ming; Yu, Hua; Cui, Liao; Wu, Tie; Li, De-Qiang; Wang, Yi-Tao

2017-01-01

Chemotherapy is used as a primary approach in cancer treatment after routine surgery. However, chemo-resistance tends to occur when chemotherapy is used clinically, resulting in poor prognosis and recurrence. Currently, Chinese medicine may provide insight into the design of new therapies to overcome chemo-resistance. Furanodiene, as a heat-sensitive sesquiterpene, is isolated from the essential oil of Rhizoma Curcumae . Even though mounting evidence claiming that furanodiene possesses anti-cancer activities in various types of cancers, the underlying mechanisms against chemo-resistant cancer are not fully clear. Our study found that furanodiene could display anti-cancer effects by inhibiting cell viability, inducing cell cytotoxicity, and suppressing cell proliferation in doxorubicin-resistant MCF-7 breast cancer cells. Furthermore, furanodiene preferentially causes apoptosis by interfering with intrinsic/extrinsic-dependent and NF-κB-independent pathways in doxorubicin-resistant MCF-7 cells. These observations also prompt that furanodiene may be developed as a promising natural product for multidrug-resistant cancer therapy in the future.

Human Herpesvirus-6 cytopathic inclusions: an exceptional and recognizable finding on skin biopsy during HHV6 reactivation after autologous stem-cell transplantation.

PubMed

Roux, Jennifer; Battistella, Maxime; Fornecker, Luc; Legoff, Jérôme; Deau, Bénédicte; Houhou, Nadira; Bouaziz, Jean-David; Thieblemont, Catherine; Janin, Anne

2012-08-01

Skin rash are common in immunocompromised patients, particularly after bone marrow transplantation. Human herpes virus 6 (HHV6) reactivation is often suspected, but its clinical presentation and the routine laboratory tests may be unspecific, thus leading to late diagnosis. In this case, we report specific intralymphocytic cytopathic inclusions on skin biopsy as a sign of systemic HHV6 reactivation. A 56-year-old patient presented progressive erythroderma and fever occurring after autologous hematopoietic stem-cell transplantation for mantle cell lymphoma. The skin biopsy showed a perivascular infiltrate of medium-to-large lymphocytes with irregular nuclei containing a large central basophilic inclusion surrounded by a clear halo. High levels of HHV-6 genomic in skin biopsy confirm HHV-6-induced cytopathic effect. The clinical course improved with intravenous foscavir. The specific histopathological findings encountered in this case are exceptional but recognizable, and along with HHV-6 DNA detection allow a prompt recognition of HHV6 skin rash.

Use of Selamectin and Moxidectin in the Treatment of Mouse Fur Mites

PubMed Central

Mook, Deborah M; Benjamin, Kimberly A

2008-01-01

A breeding colony consisting of 250 different strains of mice was treated with the topical acaricide selamectin for the mouse fur mite Myocoptes musculinus, with no apparent ill effect, suggesting that this drug is safe for use in mice. To further evaluate their efficacy in treating Myocoptes spp., we compared selamectin with another acaricide, moxidectin, in a controlled manner. Infested mice were treated with selamectin or moxidectin at the time of cage change, and a subset of mice was retreated 10 d later. Mice underwent routine cellophane tape examination of the pelage for 1 y. Although no adult mites were found in any group at 1 mo after treatment, egg casings were found in the selamectin treatment group as late as 6 mo after treatment, prompting concern about its effectiveness. Moxidectin used in combination with cage changing was effective in eradicating mites, with mice negative for traces of mites on cellophane tape examination of the pelage from months 2 through 12 after treatment. PMID:18459708

Tetanus Immunity Gaps in Children 5–14 Years and Men ≥ 15 Years of Age Revealed by Integrated Disease Serosurveillance in Kenya, Tanzania, and Mozambique

PubMed Central

Scobie, Heather M.; Patel, Minal; Martin, Diana; Mkocha, Harran; Njenga, Sammy M.; Odiere, Maurice R.; Pelletreau, Sonia; Priest, Jeffrey W.; Thompson, Ricardo; Won, Kimberly Y.; Lammie, Patrick J.

2017-01-01

Recent tetanus cases associated with male circumcision in Eastern and Southern Africa (ESA) prompted an examination of tetanus immunity by age and sex using multiplex serologic data from community surveys in three ESA countries during 2012–2013. Tetanus seroprotection was lower among children 5–14 years versus 1–4 years of age in Kenya (66% versus 90%) and Tanzania (66% versus 89%), but not in Mozambique (91% versus 88%), where children receive two booster doses in school. Among males ≥ 15 years of age, tetanus seroprotection was lower than females in Kenya (45% versus 96%), Tanzania (28% versus 94%), and Mozambique (64% versus 90%). Tetanus immunity from infant vaccination doses wanes over time, and only women of reproductive age routinely receive booster doses. To prevent immunity gaps in older children, adolescents, and adult men, a life-course vaccination strategy is needed to provide the three recommended tetanus booster doses. PMID:27920395

Atypical mycobacterial infection presenting as persistent skin lesion in a patient with ulcerative colitis.

PubMed

Bamias, Giorgos; Daikos, George L; Siakavellas, Spyros I; Kaltsa, Garyfallia; Smilakou, Stavroula; Katsogridakis, Ioannis; Vafiadis-Zouboulis, Irene; Ladas, Spiros D

2011-01-01

Immunosuppressive drugs are commonly used for the treatment of inflammatory bowel disease. Patients receiving immunosuppressants are susceptible to a variety of infections with opportunistic pathogens. We present a case of skin infection with Mycobacterium chelonae in a 60-year-old Caucasian woman with ulcerative colitis who had been treated with corticosteroids and azathioprine. The disease manifested with fever and rash involving the right leg. Infliximab was administered due to a presumptive diagnosis of pyoderma gangrenosum, leading to worsening of the clinical syndrome and admission to our hospital. Routine cultures from various sites were all negative. However, Ziehl-Neelsen staining of pus from the lesions revealed acid-fast bacilli, and culture yielded a rapidly growing mycobacterium further identified as M. chelonae. The patient responded to a clarithromycin-based regimen. Clinicians should be aware of skin lesions caused by atypical mycobacteria in immunocompromised patients with inflammatory bowel disease. Furthermore, they should be able to thoroughly investigate and promptly treat these conditions.

Lack of SLC2A1 (glucose transporter 1) mutations in 30 Italian patients with alternating hemiplegia of childhood.

PubMed

De Grandis, Elisa; Stagnaro, Michela; Biancheri, Roberta; Giannotta, Melania; Gobbi, Giuseppe; Traverso, Monica; Veneselli, Edvige; Zara, Federico

2013-07-01

Alternating hemiplegia of childhood is a rare, predominantly sporadic disorder. Diagnosis is clinical, and little is known about genetics. Glucose transporter 1 deficiency syndrome shares with alternating hemiplegia of childhood paroxysmal and nonparoxysmal symptoms. The aim of the study was to investigate glucose transporter 1 mutations in 30 Italian patients. Genetic material was analyzed by DNA amplification and glucose transporter 1 region sequencing. Mutational analysis findings of the SLC2A1 gene were negative in all patients. The pattern of movement disorders was reviewed. Interictal dystonia and multiple paroxysmal events were typical of alternating hemiplegia of childhood. In conclusion, alternating hemiplegia of childhood is a heterogeneous clinical condition, and although glucose transporter 1 deficiency can represent an undiagnosed cause of this disorder, mutational analysis is not routinely recommended. Alternatively, a careful clinical analysis and the 3-O-methyl-D-glucose uptake test can allow prompt identification of a subgroup of patients with alternating hemiplegia of childhood treatable with a ketogenic diet.

Enhancing Surveillance and Diagnostics in Anthrax-Endemic Countries

PubMed Central

Salzer, Johanna S.; Traxler, Rita M.; Hendricks, Katherine A.; Kadzik, Melissa E.; Marston, Chung K.; Kolton, Cari B.; Stoddard, Robyn A.; Hoffmaster, Alex R.; Bower, William A.; Walke, Henry T.

2017-01-01

Naturally occurring anthrax disproportionately affects the health and economic welfare of poor, rural communities in anthrax-endemic countries. However, many of these countries have limited anthrax prevention and control programs. Effective prevention of anthrax outbreaks among humans is accomplished through routine livestock vaccination programs and prompt response to animal outbreaks. The Centers for Disease Control and Prevention uses a 2-phase framework when providing technical assistance to partners in anthrax-endemic countries. The first phase assesses and identifies areas for improvement in existing human and animal surveillance, laboratory diagnostics, and outbreak response. The second phase provides steps to implement improvements to these areas. We describe examples of implementing this framework in anthrax-endemic countries. These activities are at varying stages of completion; however, the public health impact of these initiatives has been encouraging. The anthrax framework can be extended to other zoonotic diseases to build on these efforts, improve human and animal health, and enhance global health security. PMID:29155651

Field Worker Evaluation of Dengue Vector Surveillance Methods: Factors That Determine Perceived Ease, Difficulty, Value, and Time Effectiveness in Australia and Malaysia.

PubMed

Azil, Aishah H; Ritchie, Scott A; Williams, Craig R

2015-10-01

This qualitative study aimed to describe field worker perceptions, evaluations of worth, and time costs of routine dengue vector surveillance methods in Cairns (Australia), Kuala Lumpur and Petaling District (Malaysia). In Cairns, the BG-Sentinel trap is a favored method for field workers because of its user-friendliness, but is not as cost-efficient as the sticky ovitrap. In Kuala Lumpur, the Mosquito Larvae Trapping Device is perceived as a solution for the inaccessibility of premises to larval surveys. Nonetheless, the larval survey method is retained in Malaysia for prompt detection of dengue vectors. For dengue vector surveillance to be successful, there needs to be not only technical, quantitative evaluations of method performance but also an appreciation of how amenable field workers are to using particular methods. Here, we report novel field worker perceptions of dengue vector surveillance methods in addition to time analysis for each method. © 2014 APJPH.

Peripartum Cardiomyopathy: Moving Towards a More Central Role of Genetics#

PubMed Central

Cemin, Roberto; Janardhanan, Rajesh; Donazzan, Luca; Daves, Massimo

2013-01-01

Peripartum cardiomyopathy (PCM) is a relatively rare disease with potentially devasting consequences requiring prompt identification and correct treatment. Overall prognosis is good in majority of the cases, although some patients may progress to irreversible heart failure. Early diagnosis is important and effective treatment reduces mortality rates and increases the chance of complete recovery of ventricular systolic function. The aetiology and pathogenesis seems to be multifactorial and poorly understood, with the available literature rather conflicting. In recent years, there has been increased interest in the role played by genetic predisposition in the development of PCM. It probably develops as a result of a complex interaction of pregnancy-associated factors and genetic factors and recently there have been many observations pointing out the central role played by a genetic predisposition. The direct and indirect observations on genetic susceptibility may offer new insights into the pathogenesis of PCM. However, larger studies are needed before advising routine genetic testing in these patients. PMID:23909634

Salmon caviar-induced anaphylactic shock.

PubMed

Flais, Michael J; Kim, Susan S; Harris, Kathleen E; Greenberger, Paul A

2004-01-01

Foods, particularly shellfish and nuts, are commonly implicated as causes of anaphylaxis. Salmon caviar, to our knowledge, is an exceedingly rare cause of anaphylactic shock. This study describes a patient who experienced anaphylactic shock on her initial ingestion of caviar. Skin testing and inhibition assays using the enzyme-linked immunosorbent assay were performed. On the percutaneous test, the patient had a 7 x 9 mm/15 x 55 mm wheal/ erythema reaction to caviar liquid. Caviar liquid caused 68, 73, and 73% inhibition of immunoglobulin E (IgE) binding at concentrations of 0.01, 0.1, and 1.0 mg/mL in an enzyme-linked immunosorbent assay, respectively. There was no evidence for IgE antibodies that could be demonstrated to bind to the caviar eggs. Despite using both metoprolol and lisinopril, the patient responded promptly to subcutaneous epinephrine. This report indicates that an IgE-mediated response occurred after caviar ingestion. Although she experienced anaphylactic shock, the patient recovered quickly after epinephrine administration despite routine use of a 3-adrenergic blocker and angiotensin-converting enzyme inhibitor.

Availability, usage, and factors affecting usage of electrophysical agents by physical therapists: a regional cross-sectional survey

PubMed Central

Abe, Yuichi; Goh, Ah-Cheng; Miyoshi, Kei

2016-01-01

[Purpose] The aim of this study was to investigate the availability, usage, and factors affecting usage of electrophysical agents by physical therapists in Nagano Prefecture, Japan. [Subjects and Methods] Questionnaires were sent to all 1,571 physical therapists working in 245 institutions within Nagano Prefecture. A total of 1,110 questionnaires were returned, out of which 1,099 (70%) questionnaires containing valid responses were analyzed. Frequencies and percentages were calculated for 22 modalities with regards to availability, usage, rate of usage, and confidence level in usage. Factors affecting usage and the relationship between rate of usage and confidence level (Spearman’s rho) were also determined. [Results] The top three responses for the various outcome measures were as follows: (1) hot packs (88%), low frequency stimulators (76%), and ultrasound (68%) for availability; (2) hot packs (72%), ultrasound (61%), and cold packs (59%) for usage; (3) hot packs (75%), cold spray (49%), and ultrasound (44%) for confidence in usage; and (4) equipment availability (80%), past experience (79%), and research evidence (78%) for factors affecting usage. There was a significant positive relationship between confidence and usage for all modalities, except for ultraviolet radiation, iontophoresis, and magnetic field. [Conclusion] Usage was strongly correlated with confidence, with the top three used modalities also being the ones with the highest confidence in usage. PMID:27942126

A comprehensive overview of exosomes as drug delivery vehicles - endogenous nanocarriers for targeted cancer therapy.

PubMed

Johnsen, Kasper Bendix; Gudbergsson, Johann Mar; Skov, Martin Najbjerg; Pilgaard, Linda; Moos, Torben; Duroux, Meg

2014-08-01

Exosomes denote a class of secreted nanoparticles defined by size, surface protein and lipid composition, and the ability to carry RNA and proteins. They are important mediators of intercellular communication and regulators of the cellular niche, and their altered characteristics in many diseases, such as cancer, suggest them to be important both for diagnostic and therapeutic purposes, prompting the idea of using exosomes as drug delivery vehicles, especially for gene therapy. This review covers the current status of evidence presented in the field of exosome-based drug delivery systems. Components for successful exosome-based drug delivery, such as choice of donor cell, therapeutic cargo, use of targeting peptide, loading method and administration route are highlighted and discussed with a general focus pertaining to the results obtained in models of different cancer types. In addition, completed and on-going clinical trials are described, evaluating exosome-based therapies for the treatment of different cancer types. Due to their endogenous origin, exosome-based drug delivery systems may have advantages in the treatment of cancer, but their design needs further refinement to justify their usage on the clinical scale. Copyright © 2014 Elsevier B.V. All rights reserved.

UBIQUITOUS POLLUTANTS FROM CUMULATIVE ...

EPA Pesticide Factsheets

The occurrence of pharmaceuticals and personal care products (PPCPS) as environmental pollutants is a multifaceted issue whose scope continues to become better delineated since the escalation of concerted attention beginning in the 1980s. PPCPs typically occur as trace environmental pollutants (primarily in surface but also in ground waters) as a result of their widespread, continuous, combined usage in a broad range of human and veterinary therapeutic activities and practices. With respect to the risk-assessment paradigm, the growing body of published work has focused primarily on the origin and occurrence of these substances. Comparatively less is known about human and ecological exposure, and even less about the known or even potential hazards associated with exposure to these anthropogenic substances, many of which are highly bioactive. The continually growing, worldwide importance of freshwater resources underscores the need for ensuring that any aggregate or cumulative impacts on water supplies and resultant potential for human or ecological exposure be minimized. This has prompted the more recent investigations on waste treatment processes for one of the major sources of environmental disposition, namely sewage. Despite the paucity of health effects data for long-term, simultaneous exposure to multiple xenobiotics (particularly PPCPS) at low doses (a major toxicological issue that can be described by the

PERSONAL-PRACTICES POLLUTANTS: UBIETY, UBIQUITY ...

EPA Pesticide Factsheets

The occurrence of pharmaceuticals and personal care products (PPCPS) as environmental pollutants is a multifaceted issue whose scope continues to become better delineated with the escalation of attention that began in the 1980s. PPCPs typically occur as trace environmental pollutants (primarily in surface but also in ground waters) as a result of their widespread, continuous, combined usage in a broad range of human and veterinary therapeutic activities and practices. With respect to the risk-assessment paradigm, the growing body of published work has focused primarily on the origin and occurrence of these substances. Comparatively less is known about human and ecological exposure, and even less about the known or even potential hazards associated with exposure to these anthropogenic substances, many of which are highly bioactive.The continually growing, worldwide importance of freshwater resources underscores the need for ensuring that any aggregate impacts on water supplies and resultant potential for human or ecological cumulative exposure be minimized. This has prompted the more recent investigations on waste treatment processes for one of the major sources of environmental disposition, namely sewage. Despite the paucity of health effects data for long-term, simultaneous exposure to multiple xenobiotics (particularly PPCPS) at low doses (a major toxicological issue that can be described by the

Revisiting doxycycline in pregnancy and early childhood--time to rebuild its reputation?

PubMed

Cross, Ruby; Ling, Clare; Day, Nicholas P J; McGready, Rose; Paris, Daniel H

2016-01-01

Doxycycline is highly effective, inexpensive with a broad therapeutic spectrum and exceptional bioavailability. However these benefits have been overshadowed by its classification alongside the tetracyclines - class D drugs, contraindicated in pregnancy and in children under 8 years of age. Doxycycline-treatable diseases are emerging as leading causes of undifferentiated febrile illness in Southeast Asia. For example scrub typhus and murine typhus have an unusually severe impact on pregnancy outcomes, and current mortality rates for scrub typhus reach 12-13% in India and Thailand. The emerging evidence for these important doxycycline-treatable diseases prompted us to revisit doxycycline usage in pregnancy and childhood. A systematic review of the available literature on doxycycline use in pregnant women and children revealed a safety profile of doxycycline that differed significantly from that of tetracycline; no correlation between the use of doxycycline and teratogenic effects during pregnancy or dental staining in children was found. The change of the US FDA pregnancy classification scheme to an evidence-based approach will enable adequate evaluation of doxycycline in common tropical illnesses and in vulnerable populations in clinical treatment trials, dosage-optimization pharmacokinetic studies and for the empirical treatment of undifferentiated febrile illnesses, especially in pregnant women and children.

Role of mobile health in the care of culturally and linguistically diverse US populations.

PubMed

Tirado, Miguel

2011-01-01

Emerging trends in the health-related use of cell phones include the proliferation of mobile health applications for the care and monitoring of patients with chronic diseases and the rise in cell phone usage by Latinos and African Americans in the United States. This article reviews public policy in four areas with the goal of improving the care of patients belonging to culturally and linguistically diverse populations: 1) mobile health service access and the physician's duty of care, 2) affordability of and reimbursement for health related services via mobile phone, 3) protocols for mobile health enabled patient health data collection and distribution, and 4) cultural and linguistic appropriateness of health related messages delivered via cell phone. The review demonstrates the need for policy changes that would allow for reimbursement of both synchronous and asynchronous patient-provider communication, subsidize broadband access for lower-income patients, introduce standards for confidentiality of health data transmitted via cell phone as well as amplify existing cultural and linguistic standards to encompass mobile communication, and consider widespread public accessibility when certifying new technologies as "medical devices." Federal and state governments must take prompt action to ensure that the benefits of mobile health are accessible to all Americans.

Enhancing Student Explanations of Evolution: Comparing Elaborating and Competing Theory Prompts

ERIC Educational Resources Information Center

Donnelly, Dermot F.; Namdar, Bahadir; Vitale, Jonathan M.; Lai, Kevin; Linn, Marcia C.

2016-01-01

In this study, we explore how two different prompt types within an online computer-based inquiry learning environment enhance 392 7th grade students' explanations of evolution with three teachers. In the "elaborating" prompt condition, students are prompted to write explanations that support the accepted theory of evolution. In the…

Comparison of Self-Prompting of Cooking Skills via Picture-Based Cookbooks and Video Recipes

ERIC Educational Resources Information Center

Mechling, Linda C.; Stephens, Erin

2009-01-01

This investigation compared the use of static picture prompting, in a cookbook format, and video prompting to self-prompt four students with moderate intellectual disabilities to independently complete multi-step cooking tasks. An adapted alternating treatments design (AATD) with baseline, alternating treatments, and final treatment condition, was…

Prompting in Web-Based Environments: Supporting Self-Monitoring and Problem Solving Skills in College Students

ERIC Educational Resources Information Center

Kauffman, Douglas F.; Ge, Xun; Xie, Kui; Chen, Ching-Huei

2008-01-01

This study explored Metacognition and how automated instructional support in the form of problem-solving and self-reflection prompts influenced students' capacity to solve complex problems in a Web-based learning environment. Specifically, we examined the independent and interactive effects of problem-solving prompts and reflection prompts on…

A Comparison of Flexible Prompt Fading and Constant Time Delay for Five Children with Autism

ERIC Educational Resources Information Center

Soluaga, Doris; Leaf, Justin B.; Taubman, Mitchell; McEachin, John; Leaf, Ron

2008-01-01

Given the increasing rates of autism, identifying prompting procedures that can assist in the development of more optimal learning opportunities for this population is critical. Extensive empirical research exists supporting the effectiveness of various prompting strategies. Constant time delay (CTD) is a highly implemented prompting procedure…

Responses to different types of inquiry prompts: college students' discourse, performance, and perceptions of group work in an engineering class

NASA Astrophysics Data System (ADS)

Balgopal, Meena M.; Casper, Anne Marie A.; Atadero, Rebecca A.; Rambo-Hernandez, Karen E.

2017-08-01

Working in small groups to solve problems is an instructional strategy that allows university students in science, technology, engineering, and mathematics disciplines the opportunity to practice interpersonal and professional skills while gaining and applying discipline-specific content knowledge. Previous research indicates that not all group work prompts result in the same experiences for students. In this study we posed two types of prompts (guided and open) to undergraduate engineering students in a statics course as they participated in group work projects. We measured student discourse, student performance, and perceptions of group work. We found that guided prompts were associated with higher-level discourse and higher performance (project scores) than open prompts. Students engaged in guided prompts were more likely to discuss distribution of labour and design/calculation details of their projects than when students responded to open prompts. We posit that guided prompts, which more clearly articulate expectations of students, help students determine how to divide tasks amongst themselves and, subsequently, jump to higher levels of discourse.

Naturalistic Assessment of Everyday Activities and Prompting Technologies in Mild Cognitive Impairment

PubMed Central

Seelye, Adriana M.; Schmitter-Edgecombe, Maureen; Cook, Diane J.; Crandall, Aaron

2014-01-01

Older adults with mild cognitive impairment (MCI) often have difficulty performing complex instrumental activities of daily living (IADLs), which are critical to independent living. In this study, amnestic multi-domain MCI (N = 29), amnestic single-domain MCI (N = 18), and healthy older participants (N = 47) completed eight scripted IADLs (e.g., cook oatmeal on the stove) in a smart apartment testbed. We developed and experimented with a graded hierarchy of technology-based prompts to investigate both the amount of prompting and type of prompts required to assist individuals with MCI in completing the activities. When task errors occurred, progressive levels of assistance were provided, starting with the lowest level needed to adjust performance. Results showed that the multi-domain MCI group made more errors and required more prompts than the single-domain MCI and healthy older adult groups. Similar to the other two groups, the multi-domain MCI group responded well to the indirect prompts and did not need a higher level of prompting to get back on track successfully with the tasks. Need for prompting assistance was best predicted by verbal memory abilities in multi-domain amnestic MCI. Participants across groups indicated that they perceived the prompting technology to be very helpful. PMID:23351284

A Fuzzy Logic Prompting Mechanism Based on Pattern Recognition and Accumulated Activity Effective Index Using a Smartphone Embedded Sensor.

PubMed

Liu, Chung-Tse; Chan, Chia-Tai

2016-08-19

Sufficient physical activity can reduce many adverse conditions and contribute to a healthy life. Nevertheless, inactivity is prevalent on an international scale. Improving physical activity is an essential concern for public health. Reminders that help people change their health behaviors are widely applied in health care services. However, timed-based reminders deliver periodic prompts suffer from flexibility and dependency issues which may decrease prompt effectiveness. We propose a fuzzy logic prompting mechanism, Accumulated Activity Effective Index Reminder (AAEIReminder), based on pattern recognition and activity effective analysis to manage physical activity. AAEIReminder recognizes activity levels using a smartphone-embedded sensor for pattern recognition and analyzing the amount of physical activity in activity effective analysis. AAEIReminder can infer activity situations such as the amount of physical activity and days spent exercising through fuzzy logic, and decides whether a prompt should be delivered to a user. This prompting system was implemented in smartphones and was used in a short-term real-world trial by seventeenth participants for validation. The results demonstrated that the AAEIReminder is feasible. The fuzzy logic prompting mechanism can deliver prompts automatically based on pattern recognition and activity effective analysis. AAEIReminder provides flexibility which may increase the prompts' efficiency.

Characterizing Periodic Messaging Interventions Across Health Behaviors and Media: Systematic Review

PubMed Central

Fuentes, Laura W; Cohen, Joanna E

2014-01-01

Background Periodic prompts serve as tools for health behavior interventions to encourage and maintain behavior changes. Past literature reviews have examined periodic messages targeting specific behaviors (smoking, physical activity, diet, etc) or media (telephone, email, face-to-face, newsletter, etc) and have found them to be effective in impacting health behavior in the short term. Objective Our goal was to review the literature related to periodic messaging and prompts in order to explore typical characteristics, assess the role of prompt timing, identify common theoretical models used, and identify characteristics associated with the effectiveness of periodic prompts. Methods Electronic searches of PubMed, PsycINFO, CINAHL, and Web of Science were conducted in October 2012 and May 2013. Database search terms included variant terms for periods, prompts, interventions, media, and health behaviors. Results Forty-two of the 55 included research articles found that prompts resulted in significant positive behavioral outcomes for participants. Prompts were delivered via text messages, email, mailed communications, and in a few instances via phone. Generally, the provision of feedback and specific strategies to accomplish behavior change appears to be important for the success of periodic prompts. Rationale for prompt timing was rarely provided, although some studies did organize message content around days of the week or times perceived to be high risk for particular behaviors. Smoking cessation interventions tended to be organized around quit date. Among studies using theoretical models to inform their interventions, the transtheoretical model was most common. Conclusions Periodic messaging interventions yield positive results for short-term health behavior changes. Interventions including feedback and prompts that included strategies were more likely to report significantly positive outcomes. Work remains to better understand elements that make periodic prompts successful and whether they are effective in producing long-term outcomes. PMID:24667840

Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.

PubMed

Bauer, Nerissa S; Carroll, Aaron E; Saha, Chandan; Downs, Stephen M

2016-04-01

Clinicians at our institution typically respond to about half of the prompts they are given by the clinic's computer decision support system (CDSS). We sought to examine factors associated with clinician response to CDSS prompts as part of a larger, ongoing quality improvement effort to optimize CDSS use. We examined patient, prompt, and clinician characteristics associated with clinician response to decision support prompts from the Child Health Improvement through Computer Automation (CHICA) system. We asked pediatricians who were nonusers of CHICA to rate decision support topics as "easy" or "not easy" to discuss with patients and their guardians. We analyzed these ratings and data, from July 1, 2009 to January 29, 2013, utilizing a hierarchical regression model, to determine whether factors such as comfort with the prompt topic and the length of the user's experience with CHICA contribute to user response rates. We examined 414 653 prompts from 22 260 patients. The length of time a clinician had been using CHICA was associated with an increase in their prompt response rate. Clinicians were more likely to respond to topics rated as "easy" to discuss. The position of the prompt on the page, clinician gender, and the patient's age, race/ethnicity, and preferred language were also predictive of prompt response rate. This study highlights several factors associated with clinician prompt response rates that could be generalized to other health information technology applications, including the clinician's length of exposure to the CDSS, the prompt's position on the page, and the clinician's comfort with the prompt topic. Incorporating continuous quality improvement efforts when designing and implementing health information technology may ensure that its use is optimized. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Short message service prompts for skills practice in Internet-delivered cognitive behaviour therapy for chronic pain - are they feasible and effective?

PubMed

Gandy, M; Fogliati, V J; Terides, M D; Johnston, L; Nicholson Perry, K; Newall, C; Titov, N; Dear, B F

2016-09-01

Patients face numerous challenges adopting skills taught within pain self-management programmes. The present study reports the acceptability and preliminary outcomes of supplementing an Internet-delivered cognitive behavioural therapy (iCBT) course for chronic pain, the Pain Course, with brief automated short message service (SMS) prompts that encourage skills practice. Participants were recruited from the Waitlist Control Group of a large randomized controlled trial and provided access to the Pain Course over 8 weeks, with the addition of SMS prompts. Fifteen SMS prompts were created to encourage the use of self-management skills during the course. Participants were sent one random SMS prompt each business day. The acceptability of the SMS was assessed and clinical outcomes of participants who received prompts (n = 56) compared with a historical group who previously received the course without prompts (n = 139). SMS prompts were rated highly with 85% reporting them to be very helpful or helpful and that they would recommend them to others. Clinical improvements for those receiving SMS, at post-treatment and 3-month follow-up (disability, d = 0.44; 0.58; anxiety d = 0.50; 0.51; depression, d = 0.78; 0.79 and average pain d = 0.49; 0.54), were consistent with participant who had received the course previously without SMS (ps >0.05). Brief automated SMS prompts were an acceptable adjunct to iCBT for chronic pain but did not result in any additional clinical benefit. Further research is needed to systematically evaluate the potential of SMS prompts to increase skills practice and facilitate treatment outcomes. WHAT DOES THIS STUDY ADD?: Automated short message service (SMS) messages are an acceptable means of prompting skills practice during iCBT for chronic pain. SMS prompts did not improve clinical outcomes of an established clinician-supported iCBT programme. © 2016 European Pain Federation - EFIC®

Effectiveness of Prompts on Fourth-Grade Children's Dietary Recall Accuracy Depends on Retention Interval and Varies by Gender.

PubMed

Baxter, Suzanne D; Smith, Albert F; Hitchcock, David B; Guinn, Caroline H; Royer, Julie A; Collins, Kathleen L; Smith, Alyssa L; Puryear, Megan P; Vaadi, Kate K; Finney, Christopher J; Miller, Patricia H

2015-09-01

Dietary recall accuracy is related to retention interval (RI) (i.e., time between to-be-reported meals and the interview), and possibly to prompts. To the best of our knowledge, no study has evaluated their combined effect. The combined influence of RI and prompts on children's recall accuracy was investigated in this study. Two RIs [short (prior-24-h recall obtained in afternoon) and long (previous-day recall obtained in morning)] were crossed with 4 prompts [forward (distant-to-recent), meal-name (breakfast, lunch, etc.), open (no instructions), and reverse (recent-to-distant)], creating 8 conditions. Fourth-grade children (n = 480; 50% girls) were randomly selected from consenting children at 10 schools in 4 districts in a southern state during 3 school years (2011-2012, 2012-2013, and 2013-2014). Each child was observed eating school-provided breakfast and lunch, and interviewed one time under 1 of the 8 conditions. Condition assignment was constrained so that each had 60 children (30 girls). Accuracy measures were food-item omission and intrusion rates, and energy correspondence rate and inflation ratio. For each measure, linear models determined effects of RI, prompt, gender, and interactions (2-way, 3-way); race/ethnicity, school year, and district were control variables. RI (P values < 0.015) and prompt (P values < 0.005) were significant for all 4 accuracy measures. RI × prompt (P values < 0.001) was significant for 3 accuracy measures (not intrusion rate). Prompt × gender (P = 0.005) was significant for omission rate. RI × prompt × gender was significant for intrusion rate and inflation ratio (P values < 0.001). For the short vs. long RI across prompts and genders, accuracy was better by 33-50% for each accuracy measure. To obtain the most accurate recalls possible from children, studies should be designed to use a short rather than long RI. Prompts affect children's recall accuracy, although the effectiveness of different prompts depends on RI and varies by gender: at a short RI, the choice of prompts has little systematic effect on accuracy, whereas at a long RI, reverse prompts may elicit the most accurate recalls. © 2015 American Society for Nutrition.

What impact does written information about fatigue have on patients with autoimmune rheumatic diseases? Findings from a qualitative study.

PubMed

Hart, Ruth I; Ng, Wan-Fai; Newton, Julia L; Hackett, Katie L; Lee, Richard P; Thompson, Ben

2017-09-01

Although fatigue is a common symptom for people with rheumatic diseases, limited support is available. This study explored the impact of written information about fatigue, focusing on a booklet, Fatigue and arthritis. Thirteen patients with rheumatic disease and fatigue were recruited purposively from a rheumatology outpatient service. They were interviewed before and after receiving the fatigue booklet. Two patients, plus six professionals with relevant interests, participated in a focus group. Transcripts were analysed thematically and a descriptive summary was produced. Interviewees consistently reported that fatigue made life more challenging, and none had previously received any support to manage it. Reflecting on the booklet, most said that it had made a difference to how they thought about fatigue, and that this had been valuable. Around half also said that it had affected, or would affect, how they managed fatigue. No one reported any impact on fatigue itself. Comments from interviewees and focus group members alike suggested that the research process may have contributed to the changes in thought and behaviour reported. Its key contributions appear to have been: clarifying the booklet's relevance; prompting reflection on current management; and introducing accountability. This study indicated that written information can make a difference to how people think about fatigue and may also prompt behaviour change. However, context appeared to be important: it seems likely that the research process played a part and that the impact of the booklet may have been less if read in isolation. Aspects of the research appearing to facilitate impact could be integrated into routine care, providing a pragmatic (relatively low-cost) response to an unmet need. © 2016 The Authors Musculoskeletal Care Published by John Wiley & Sons Ltd.

Increasing incidence of malaria in children despite insecticide-treated bed nets and prompt anti-malarial therapy in Tororo, Uganda

PubMed Central

2012-01-01

Background The burden of malaria has decreased in parts of Africa following the scaling up of control interventions. However, similar data are limited from high transmission settings. Methods A cohort of 100 children, aged six weeks to 10 months of age, were enrolled in an area of high malaria transmission intensity and followed through 48 months of age. Children were given a long-lasting insecticide-treated bed net (LLIN) at enrolment and received all care, including monthly blood smears and treatment with artemisinin-based combination therapy (ACT) for uncomplicated malaria, at a dedicated clinic. The incidence of malaria was estimated by passive surveillance and associations between malaria incidence and age, calendar time and season were measured using generalized estimating equations. Results Reported compliance with LLINs was 98% based on monthly routine evaluations. A total of 1,633 episodes of malaria were observed, with a median incidence of 5.3 per person-year (PPY). There were only six cases of complicated malaria, all single convulsions. Malaria incidence peaked at 6.5 PPY at 23 months of age before declining to 3.5 PPY at 48 months. After adjusting for age and season, the risk of malaria increased by 52% from 2008 to 2011 (RR 1.52, 95% CI 1.10-2.09). Asymptomatic parasitaemia was uncommon (monthly prevalence <10%) and rarely observed prior to 24 months of age. Conclusions In Tororo, despite provision of LLINs and prompt treatment with ACT, the incidence of malaria is very high and appears to be rising. Additional malaria control interventions in high transmission settings are likely needed. Trial registration Current Controlled Trials Identifier NCT00527800 PMID:23273022

The New Portable Transcutaneous Electrical Nerve Stimulation Device Was Efficacious in the Control of Primary Dysmenorrhea Cramp Pain.

PubMed

Lauretti, Gabriela R; Oliveira, Raquel; Parada, Flavia; Mattos, Anita L

2015-08-01

Transcutaneous electrical nerve stimulation (TENS) is an established method for pain relief in dysmenorrhea. A feasible advantage would be the study of a portable device. The purpose of the study was to evaluate the effectiveness and safety of a new portable TENS device (TANYX®) for menstruation cramps. Forty women were evaluated in a double-blind, prospective, randomized fashion, divided into sham and active groups. TENS was applied medially at the suprapubic region, for 30-min duration at eight-hour intervals, up to seven days. The placebo group (PG) received sham device. The TENS group (TG) applied an active 85 Hz frequency TENS. Efficacy measures were pain relief evaluated on a visual analog scale (VAS) and diclofenac intake, and quality of life represented by: 1) capacity to get out of the bed, 2) food or drink intake, 3) missing routine daily activities such as work or school, and 4) quality of sleep. The active TENS device induced a prompt onset of pain relief in a strictly segmental manner nearby the dermatomes where the TENS was applied at the skin, and there was a drop in mean pain score from 8 to 2 cm (p < 0.001). Diclofenac consumption was also significantly reduced (p < 0.01), compared with the PG. Quality of life improved significantly in TG when compared with PG (p < 0.05). Three months after the beginning of the study, 14/20 of the women were still using the active device regularly. No adverse effects were observed. The portable, disposable, active TENS device induced a prompt onset of pain relief and improved the quality of life, without adverse effects, in patients with painful cramps associated with dysmenorrhea. © 2015 International Neuromodulation Society.

Pathways to diagnosis: a qualitative study of the experiences and emotional reactions of parents of children diagnosed with type 1 diabetes.

PubMed

Rankin, David; Harden, Jeni; Waugh, Norman; Noyes, Kathryn; Barnard, Katharine D; Stephen, John; Robertson, Kenneth J; Bath, Louise; Robertson, Linda; Lawton, Julia

2014-12-01

The aim of this study was to explore from parents' perspectives the circumstances and events which led to their child being diagnosed with type 1 diabetes (T1D). The objective was to understand reasons for delays in seeking treatment and parents' emotional reactions to diagnosis so others can be better informed and supported in future. In-depth interviews with 54 parents of children (aged ≤12 yr) with T1D were conducted. Data analysis used an inductive, thematic approach. Parents described a 'prompt' and a 'delayed' pathway to their child being diagnosed. Parents who considered the diagnosis to be 'prompt' reported how they, or other people, had recognized their child had developed symptoms of T1D which resulted in a rapid presentation to health care professionals. In contrast, parents who perceived their child's diagnosis to be 'delayed' did not recognize signs of T1D and attributed their child's deteriorating health to other conditions, being out of routines and/or their stage of development. These parents often only sought medical help when symptoms became extreme. All parents were distressed by their child's diagnosis; however, parents in the 'delayed' pathway expressed unresolved feelings of guilt, particularly when their child was diagnosed with diabetic ketoacidosis. Parents' and other people's knowledge about T1D can affect the duration between onset of their child's symptoms and diagnosis. Campaigns to raise awareness should ensure that parents are made aware of symptoms and that T1D can develop during childhood. Health care professionals could discuss with parents the events preceding their child's diagnosis to better determine their emotional support needs. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Fast multipurpose Monte Carlo simulation for proton therapy using multi- and many-core CPU architectures.

PubMed

Souris, Kevin; Lee, John Aldo; Sterpin, Edmond

2016-04-01

Accuracy in proton therapy treatment planning can be improved using Monte Carlo (MC) simulations. However the long computation time of such methods hinders their use in clinical routine. This work aims to develop a fast multipurpose Monte Carlo simulation tool for proton therapy using massively parallel central processing unit (CPU) architectures. A new Monte Carlo, called MCsquare (many-core Monte Carlo), has been designed and optimized for the last generation of Intel Xeon processors and Intel Xeon Phi coprocessors. These massively parallel architectures offer the flexibility and the computational power suitable to MC methods. The class-II condensed history algorithm of MCsquare provides a fast and yet accurate method of simulating heavy charged particles such as protons, deuterons, and alphas inside voxelized geometries. Hard ionizations, with energy losses above a user-specified threshold, are simulated individually while soft events are regrouped in a multiple scattering theory. Elastic and inelastic nuclear interactions are sampled from ICRU 63 differential cross sections, thereby allowing for the computation of prompt gamma emission profiles. MCsquare has been benchmarked with the gate/geant4 Monte Carlo application for homogeneous and heterogeneous geometries. Comparisons with gate/geant4 for various geometries show deviations within 2%-1 mm. In spite of the limited memory bandwidth of the coprocessor simulation time is below 25 s for 10(7) primary 200 MeV protons in average soft tissues using all Xeon Phi and CPU resources embedded in a single desktop unit. MCsquare exploits the flexibility of CPU architectures to provide a multipurpose MC simulation tool. Optimized code enables the use of accurate MC calculation within a reasonable computation time, adequate for clinical practice. MCsquare also simulates prompt gamma emission and can thus be used also for in vivo range verification.

Discipline in early childhood.

PubMed

Howard, B J

1991-12-01

As pediatricians we have an opportunity and a responsibility to guide parents in the structure of discipline they set up for their children. The major goals of this structure are to help children develop a sense of being both lovable and capable. To feel lovable a child needs an enduring responsive relationship that conveys positive regard. Attending to children promptly, giving individual time daily, acknowledging positive behaviors, and ignoring minor transgressions all help them feel valued. Active listening without judgment demonstrates acceptance of children's feelings. Talking to children without labels or generalizations but with specific feedback about their actions and with congruent emotional tone is respectful and promotes self-esteem. Children also deserve assistance with transitions, thanks, and apologies as appropriate. To feel (and become) capable, children need a consistent structure of routines, good models, respectful instruction, and progressive expectations so that they have an ongoing experience of success. To grow as individuals they need opportunities to make choices relevant to their interests and role-taking opportunities to gain perspective on social interaction. Praise and rewards motivate as well as instruct children, but they also need to experience consequences to their actions. Natural consequences are optimal but parents also need to design logical consequences that are graded, related, prompt, and reasonable for a child's misbehaviors. Consequences are most effective when given after only one request, exactly as clearly promised by the adult involved without interference by others. Time out is one of the most effective consequences for young children when used properly. Physical punishment has multiple negative effects on a child's development, especially if used noncontingently. Intrapersonal and family factors predispose parents to predictable problems in establishing healthy discipline. Pediatricians can play an important role in promoting the emotional development of children by anticipating, guiding, and counseling families about discipline as well as referring them effectively.

Can We Identify Parents Who Do Not Verbally Share Concerns for Their Children's Development?

PubMed

Eremita, Matthew; Semancik, Eileen; Lerer, Trudy; Dworkin, Paul H

2017-04-01

We aimed to identify characteristics of parents who do not voice developmental concerns when prompted by their children's nurse and/or primary care provider (PCP), despite reporting concerns on parent-completed questionnaires. We reviewed 376 medical records of children seen for a 9-month well-child visit in an urban pediatric clinic between September 2011 and December 2012 for sociodemographic variables hypothesized to affect parents' sharing of developmental concerns: the child's birth order and gender; parents' education level, employment, relationship status, and primary language; and family size and racial/ethnic background. The target population was parents who reported concerns on the Parents' Evaluation of Developmental Status (PEDS), a routinely administered, parent-completed screening questionnaire. We subdivided parents who reported concerns on the PEDS (N = 86) based on whether they voiced developmental concerns when prompted by their children's nurse and/or PCP. Two-sided Fisher's exact tests and logistic regression evaluated the relationship between sociodemographic variables and parents' voicing of developmental concerns. Only parent education approached significance, as parents with less than a high school education (

Evaluation of Multiple-Alternative Prompts during Tact Training

ERIC Educational Resources Information Center

Leaf, Justin B.; Townley-Cochran, Donna; Mitchell, Erin; Milne, Christine; Alcalay, Aditt; Leaf, Jeremy; Leaf, Ron; Taubman, Mitch; McEachin, John; Oppenheim-Leaf, Misty L.

2016-01-01

This study compared 2 methods of fading prompts while teaching tacts to 3 individuals who had been diagnosed with autism spectrum disorder (ASD). The 1st method involved use of an echoic prompt and prompt fading. The 2nd method involved providing multiple-alternative answers and fading by increasing the difficulty of the discrimination. An adapted…

77 FR 76624 - Prompt Payment Interest Rate; Contract Disputes Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... DEPARTMENT OF THE TREASURY Fiscal Service Prompt Payment Interest Rate; Contract Disputes Act... beginning January 1, 2013, and ending on June 30, 2013, the prompt payment interest rate is 1-3/8 per centum... Prompt Payment Act, 31 U.S.C. 3902(a), provide for the calculation of interest due on claims at the rate...

45 CFR 235.70 - Prompt notice to child support or Medicaid agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Prompt notice to child support or Medicaid agency... Medicaid agency. (a) A State plan under title IV-A of the Social Security Act must provide for prompt.... Prompt notice must also include all relevant information as prescribed by the State medicaid agency for...

Constructing Student Knowledge in the Online Classroom: The Effectiveness of Focal Prompts

ERIC Educational Resources Information Center

Howell, Ginger S.; LaCour, Misty M.; McGlawn, Penny A.

2017-01-01

The purpose of this study was to examine the effect of three Structured Divergent discussion board prompt designs on knowledge construction in a graduate online course. According to Andrews (1980), the form of the question affects the extent of the response within a discussion. The Playground prompt, the Brainstorming prompt, and the Focal prompt…

Determination of pharmaceutical compounds in surface- and ground-water samples by solid-phase extraction and high-performance liquid chromatography-electrospray ionization mass spectrometry

USGS Publications Warehouse

Cahill, J.D.; Furlong, E.T.; Burkhardt, M.R.; Kolpin, D.; Anderson, L.G.

2004-01-01

Commonly used prescription and over-the-counter pharmaceuticals are possibly present in surface- and ground-water samples at ambient concentrations less than 1 μg/L. In this report, the performance characteristics of a combined solid-phase extraction isolation and high-performance liquid chromatography–electrospray ionization mass spectrometry (HPLC–ESI-MS) analytical procedure for routine determination of the presence and concentration of human-health pharmaceuticals are described. This method was developed and used in a recent national reconnaissance of pharmaceuticals in USA surface waters. The selection of pharmaceuticals evaluated for this method was based on usage estimates, resulting in a method that contains compounds from diverse chemical classes, which presents challenges and compromises when applied as a single routine analysis. The method performed well for the majority of the 22 pharmaceuticals evaluated, with recoveries greater than 60% for 12 pharmaceuticals. The recoveries of angiotensin-converting enzyme inhibitors, a histamine (H2) receptor antagonist, and antihypoglycemic compound classes were less than 50%, but were retained in the method to provide information describing the potential presence of these compounds in environmental samples and to indicate evidence of possible matrix enhancing effects. Long-term recoveries, evaluated from reagent-water fortifications processed over 2 years, were similar to initial method performance. Method detection limits averaged 0.022 μg/L, sufficient for expected ambient concentrations. Compound-dependent matrix effects on HPLC/ESI-MS analysis, including enhancement and suppression of ionization, were observed as a 20–30% increase in measured concentrations for three compounds and greater than 50% increase for two compounds. Changing internal standard and more frequent ESI source maintenance minimized matrix effects. Application of the method in the national survey demonstrates that several pharmaceuticals are routinely detected at 0.010–0.100 μg/L concentrations.

Operating room sound level hazards for patients and physicians.

PubMed

Fritsch, Michael H; Chacko, Chris E; Patterson, Emily B

2010-07-01

Exposure to certain new surgical instruments and operating room devices during procedures could cause hearing damage to patients and personnel. Surgical instruments and related equipment generate significant sound levels during routine usage. Both patients and physicians are exposed to these levels during the operative cases, many of which can last for hours. The noise loads during cases are cumulative. Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) standards are inconsistent in their appraisals of potential damage. Implications of the newer power instruments are not widely recognized. Bruel and Kjaer sound meter spectral recordings for 20 major instruments from 5 surgical specialties were obtained at the ear levels for the patient and the surgeon between 32 and 20 kHz. Routinely used instruments generated sound levels as high as 131 dB. Patient and operator exposures differed. There were unilateral dominant exposures. Many instruments had levels that became hazardous well within the length of an average surgical procedure. The OSHA and NIOSH systems gave contradicting results when applied to individual instruments and types of cases. Background noise, especially in its intermittent form, was also of significant nature. Some patients and personnel have additional predisposing physiologic factors. Instrument noise levels for average length surgical cases may exceed OSHA and NIOSH recommendations for hearing safety. Specialties such as Otolaryngology, Orthopedics, and Neurosurgery use instruments that regularly exceed limits. General operating room noise also contributes to overall personnel exposures. Innovative countermeasures are suggested.

The XChemExplorer graphical workflow tool for routine or large-scale protein-ligand structure determination.

PubMed

Krojer, Tobias; Talon, Romain; Pearce, Nicholas; Collins, Patrick; Douangamath, Alice; Brandao-Neto, Jose; Dias, Alexandre; Marsden, Brian; von Delft, Frank

2017-03-01

XChemExplorer (XCE) is a data-management and workflow tool to support large-scale simultaneous analysis of protein-ligand complexes during structure-based ligand discovery (SBLD). The user interfaces of established crystallographic software packages such as CCP4 [Winn et al. (2011), Acta Cryst. D67, 235-242] or PHENIX [Adams et al. (2010), Acta Cryst. D66, 213-221] have entrenched the paradigm that a `project' is concerned with solving one structure. This does not hold for SBLD, where many almost identical structures need to be solved and analysed quickly in one batch of work. Functionality to track progress and annotate structures is essential. XCE provides an intuitive graphical user interface which guides the user from data processing, initial map calculation, ligand identification and refinement up until data dissemination. It provides multiple entry points depending on the need of each project, enables batch processing of multiple data sets and records metadata, progress and annotations in an SQLite database. XCE is freely available and works on any Linux and Mac OS X system, and the only dependency is to have the latest version of CCP4 installed. The design and usage of this tool are described here, and its usefulness is demonstrated in the context of fragment-screening campaigns at the Diamond Light Source. It is routinely used to analyse projects comprising 1000 data sets or more, and therefore scales well to even very large ligand-design projects.

Incidence and molecular characterization of Glucose-6-Phosphate Dehydrogenase deficiency among neonates for newborn screening in Chaozhou, China.

PubMed

Yang, H; Wang, Q; Zheng, L; Zhan, X-F; Lin, M; Lin, F; Tong, X; Luo, Z-Y; Huang, Y; Yang, L-Y

2015-06-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is highly prevalent in southern China. The aim of this study is to assess the extent of this disease in Chinese neonates and determine its molecular characteristics using a novel molecular screening method. A total of 2500 neonates were routinely screened for G6PD deficiency using a modified fluorescent spot test (FST). PCR-high-resolution melting (HRM) analysis was then used for the molecular assay. The overall incidence of G6PD deficiency was 2.68% in our study cohort. Frequency in male population was 3.22% (44 neonates of 1365 male neonates), and in female population was 2.03% (23 neonates of 1135 female neonates). Of the 67 newborns suspected to be G6PD deficient based on FST (44 males, 23 females), 58 of 67 (87%) were detected with gene alterations. Seven kinds of mutations [c.95A>G, c.392G>T, c.493A>G, c.871G>A, c.1360C>T, c.1376G>T, and c.1388G>A] were identified by HRM analysis. Routine newborn screening in Chaozhou, China with a relatively high prevalence of G6PD deficiency is justified and meets the World Health Organization recommendation. The usage of molecular diagnosis can favor the detection of heterozygotes which can be a supplement to regular newborn screening and useful for premarital and prenatal diagnosis for G6PD deficiency. © 2014 John Wiley & Sons Ltd.

An introduction to implementation science for the non-specialist.

PubMed

Bauer, Mark S; Damschroder, Laura; Hagedorn, Hildi; Smith, Jeffrey; Kilbourne, Amy M

2015-09-16

The movement of evidence-based practices (EBPs) into routine clinical usage is not spontaneous, but requires focused efforts. The field of implementation science has developed to facilitate the spread of EBPs, including both psychosocial and medical interventions for mental and physical health concerns. The authors aim to introduce implementation science principles to non-specialist investigators, administrators, and policymakers seeking to become familiar with this emerging field. This introduction is based on published literature and the authors' experience as researchers in the field, as well as extensive service as implementation science grant reviewers. Implementation science is "the scientific study of methods to promote the systematic uptake of research findings and other EBPs into routine practice, and, hence, to improve the quality and effectiveness of health services." Implementation science is distinct from, but shares characteristics with, both quality improvement and dissemination methods. Implementation studies can be either assess naturalistic variability or measure change in response to planned intervention. Implementation studies typically employ mixed quantitative-qualitative designs, identifying factors that impact uptake across multiple levels, including patient, provider, clinic, facility, organization, and often the broader community and policy environment. Accordingly, implementation science requires a solid grounding in theory and the involvement of trans-disciplinary research teams. The business case for implementation science is clear: As healthcare systems work under increasingly dynamic and resource-constrained conditions, evidence-based strategies are essential in order to ensure that research investments maximize healthcare value and improve public health. Implementation science plays a critical role in supporting these efforts.

A prospective randomized trial of tapered-cuff endotracheal tubes with intermittent subglottic suctioning in preventing ventilator-associated pneumonia in critically ill patients.

PubMed

Mahmoodpoor, Ata; Hamishehkar, Hadi; Hamidi, Masoud; Shadvar, Kamran; Sanaie, Sarvin; Golzari, Samad Ej; Khan, Zahid Hussain; Nader, Nader D

2017-04-01

Endotracheal tube placement is necessary for the control of the airway in patients who are mechanically ventilated. However, prolonged duration of endotracheal tube placement contributes to the development of ventilator-associated pneumonias (VAPs). The aim of this study was to evaluate whether subglottic suctioning using TaperGuard EVAC tubes was effective in decreasing the frequency of VAP. A total of 276 mechanically ventilated patients for more than 72 hours were randomly assigned to group E (EVAC tube) and group C (conventional tube). All patients received routine care including VAP prevention measures during their intensive care unit stay. In group E, subglottic suctioning was performed every 6 hours. Outcome variables included incidence VAP, intensive care unit length of stay, and mortality. Frequency of intraluminal suction, mechanical ventilation-free days, reintubation, the ratio of arterial oxygen partial pressure to fractional inspired oxygen and mortality rate were similar between the 2 groups (P > .05). The mean cuff pressure in group E was significantly less than that in group C (P < .001). Ventilator-associated pneumonia was significantly less in group E compared with group C (P = .015). The use of intermittent subglottic secretion suctioning was associated with a significant decrease in the incidence of the VAP in critically ill patients. However, larger multicenter trials are required to arrive at a concrete decision on routine usage of TaperGuard tubes in critical care settings. Published by Elsevier Inc.

Improving maternity care using a personal health record: study protocol for a stepped-wedge, randomised, controlled trial.

PubMed

Groenen, Carola J M; Faber, Marjan J; Kremer, Jan A M; Vandenbussche, Frank P H A; van Duijnhoven, Noortje T L

2016-04-16

A personal health record (PHR) is an online application through which individuals can access, manage, and share their health information in a private, secure, and confidential environment. Personal health records empower patients, facilitate collaboration among healthcare professionals, and improve health outcomes. Given these anticipated positive effects, we want to implement a PHR, named MyPregn@ncy, in a Dutch maternity care setting and to evaluate its effects in routine care. This paper presents the study protocol. The effects of implementing a PHR in maternity care on patients and professionals will be identified in a stepped-wedge, cluster-randomised, controlled trial. The study will be performed in the region of Nijmegen, a Dutch area with an average of 4,500 births a year and more than 230 healthcare professionals involved in maternity care. Data analyses will describe the effects of MyPregn@ncy on health outcomes in maternity care, quality of care from the patients' perspectives, and collaboration among healthcare professionals. Additionally, a process evaluation of the implementation of MyPregn@ncy will be performed. Data will be collected using data from the Dutch perinatal registry, questionnaires, interviews, and log data. The study is expected to yield new information about the effects, strengths, possibilities, and challenges to the implementation and usage of a PHR in routine maternal care settings. Results may lead to new insights and improvements in the quality of maternal and perinatal care. Netherlands Trial Register: NTR4063.

The XChemExplorer graphical workflow tool for routine or large-scale protein–ligand structure determination

PubMed Central

Krojer, Tobias; Talon, Romain; Pearce, Nicholas; Douangamath, Alice; Brandao-Neto, Jose; Dias, Alexandre; Marsden, Brian

2017-01-01

XChemExplorer (XCE) is a data-management and workflow tool to support large-scale simultaneous analysis of protein–ligand complexes during structure-based ligand discovery (SBLD). The user interfaces of established crystallo­graphic software packages such as CCP4 [Winn et al. (2011 ▸), Acta Cryst. D67, 235–242] or PHENIX [Adams et al. (2010 ▸), Acta Cryst. D66, 213–221] have entrenched the paradigm that a ‘project’ is concerned with solving one structure. This does not hold for SBLD, where many almost identical structures need to be solved and analysed quickly in one batch of work. Functionality to track progress and annotate structures is essential. XCE provides an intuitive graphical user interface which guides the user from data processing, initial map calculation, ligand identification and refinement up until data dissemination. It provides multiple entry points depending on the need of each project, enables batch processing of multiple data sets and records metadata, progress and annotations in an SQLite database. XCE is freely available and works on any Linux and Mac OS X system, and the only dependency is to have the latest version of CCP4 installed. The design and usage of this tool are described here, and its usefulness is demonstrated in the context of fragment-screening campaigns at the Diamond Light Source. It is routinely used to analyse projects comprising 1000 data sets or more, and therefore scales well to even very large ligand-design projects. PMID:28291762

A novel enterovirus and parechovirus multiplex one-step real-time PCR-validation and clinical experience.

PubMed

Nielsen, Alex Christian Yde; Böttiger, Blenda; Midgley, Sofie Elisabeth; Nielsen, Lars Peter

2013-11-01

As the number of new enteroviruses and human parechoviruses seems ever growing, the necessity for updated diagnostics is relevant. We have updated an enterovirus assay and combined it with a previously published assay for human parechovirus resulting in a multiplex one-step RT-PCR assay. The multiplex assay was validated by analysing the sensitivity and specificity of the assay compared to the respective monoplex assays, and a good concordance was found. Furthermore, the enterovirus assay was able to detect 42 reference strains from all 4 species, and an additional 9 genotypes during panel testing and routine usage. During 15 months of routine use, from October 2008 to December 2009, we received and analysed 2187 samples (stool samples, cerebrospinal fluids, blood samples, respiratory samples and autopsy samples) were tested, from 1546 patients and detected enteroviruses and parechoviruses in 171 (8%) and 66 (3%) of the samples, respectively. 180 of the positive samples could be genotyped by PCR and sequencing and the most common genotypes found were human parechovirus type 3, echovirus 9, enterovirus 71, Coxsackievirus A16, and echovirus 25. During 2009 in Denmark, both enterovirus and human parechovirus type 3 had a similar seasonal pattern with a peak during the summer and autumn. Human parechovirus type 3 was almost invariably found in children less than 4 months of age. In conclusion, a multiplex assay was developed allowing simultaneous detection of 2 viruses, which can cause similar clinical symptoms. Copyright © 2013 Elsevier B.V. All rights reserved.

The influence of prophylactic proton pump inhibitor treatment on the development of symptomatic marginal ulceration in Roux-en-Y gastric bypass patients: a historic cohort study.

PubMed

Coblijn, Usha K; Lagarde, Sjoerd M; de Castro, Steve M M; Kuiken, Sjoerd D; van Tets, Willem F; van Wagensveld, Bart A

2016-02-01

Marginal ulceration at the gastrojejunostomy is a serious complication after laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) and occurs in 1%-16% of patients. Proton pump inhibitors (PPIs) might lower the occurrence of these ulcers. The aim of the present study was to evaluate the effect of 6 months prophylactic usage of PPIs on the development of marginal ulceration and compare this with a historic patient control group. A single institution cohort at a bariatric center of excellence, The Sint Lucas Andreas Zienkenhuis, Amsterdam A consecutive database of patients who underwent LRYGB from November 2007 to September 2012 in a single institution was retrospectively reviewed. From August 2011, patients received a standard dose of pantozol 40 mg once daily directly postoperatively for 6 months. No standard PPI prophylaxis was administered before August 2011, and the patients not using PPIs in this historic cohort served as the control group. A total of 610 patients underwent LRYGB, of which 128 patients (21.0%) underwent revisional surgery. Postoperative PPIs were administered in the intervention group of 337 patients, compared with the historic control group consisting of 273 patients. Six patients (1.2%) who received postoperative PPIs versus 20 patients (7.3 %) in the historic control group developed marginal ulceration (P = .001). Patients using proton pump inhibitors developed fewer gastrointestinal complaints postoperatively (P< .001). Routine usage of PPIs reduced the occurrence of marginal ulceration after LRYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Health information exchange usage in emergency departments and clinics: the who, what, and why.

PubMed

Johnson, Kevin B; Unertl, Kim M; Chen, Qingxia; Lorenzi, Nancy M; Nian, Hui; Bailey, James; Frisse, Mark

2011-01-01

Health information exchange (HIE) systems are being developed across the nation. Understanding approaches taken by existing successful exchanges can help new exchange efforts determine goals and plan implementations. The goal of this study was to explore characteristics of use and users of a successful regional HIE. We used a mixed-method analysis, consisting of cross-sectional audit log data, semi-structured interviews, and direct observation in a sample of emergency departments and ambulatory safety net clinics actively using HIE. For each site, we measured overall usage trends, user logon statistics, and data types accessed by users. We also assessed reasons for use and outcomes of use. Overall, users accessed HIE for 6.8% of all encounters, with higher rates of access for repeat visits, for patients with comorbidities, for patients known to have data in the exchange, and at sites providing HIE access to both nurses and physicians. Discharge summaries and test reports were the most frequently accessed data in the exchange. Providers consistently noted retrieving additional history, preventing repeat tests, comparing new results to retrieved results, and avoiding hospitalizations as a consequence of HIE access. HIE use in emergency departments and ambulatory clinics was focused on patients where missing information was believed to be present in the exchange and was related to factors including the roles of people with access, the setting, and other site-specific issues that impacted the overall breadth of routine system use. These data should form an important foundation as other sites embark upon HIE implementation.

Effectiveness of Static Pictures vs. Video Prompting for Teaching Functional Life Skills to Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Kellems, Ryan O.; Frandsen, Kaitlyn; Cardon, Teresa A.; Knight, Katie; Andersen, Margaret

2018-01-01

This study compared the effectiveness of static picture prompting to video prompting when used as precursors for teaching daily living and motor skills to three individuals with autism spectrum disorders. The video prompting intervention was delivered on an iPad. Participants learned three out of six different tasks, which included throwing a ball…

An Evaluation of Constant Time Delay and Simultaneous Prompting Procedures in Skill Acquisition for Young Children with Autism

ERIC Educational Resources Information Center

Brandt, Julie A. Ackerlund; Weinkauf, Sara; Zeug, Nicole; Klatt, Kevin P.

2016-01-01

Previous research has shown that various prompting procedures are effective in teaching skills to children and adults with developmental disabilities. Simultaneous prompting includes proving a prompt immediately following an instruction; whereas constant time-delay procedures include a set time delay (i.e., 5 s or 10 s) prior to delivering a…

A Prompting Procedure for Increasing Sales in a Small Pet Store

ERIC Educational Resources Information Center

Milligan, Jacqueline; Hantula, Donald A.

2006-01-01

A simple prompting procedure involving index cards was used to increase suggestive selling by the owner/operator of a small pet grooming business. Over a year of baseline data revealed that no sales prompts were given and few pet products were sold. When the owner was prompted by an index card to ask customers if they wanted to purchase pet…

Evaluating the Effects of a Video Prompt in a System of Least Prompts Procedure

ERIC Educational Resources Information Center

Smith, Katie A.; Ayres, Kevin M.; Mechling, Linda C.; Alexander, Jennifer L.; Mataras, Theologia K.; Shepley, Sally B.

2015-01-01

The purpose of this study was to evaluate the effects of a system of least prompts procedure with a video prompt serving as the model in teaching office tasks to three high school students with moderate intellectual disability. A multiple probe across behaviors design replicated across participants was used to evaluate the intervention. The…

An Analysis of Modifications to the Three-Step Guided Compliance Procedure Necessary to Achieve Compliance among Preschool Children

ERIC Educational Resources Information Center

Wilder, David A.; Myers, Kristin; Fischetti, Anthony; Leon, Yanerys; Nicholson, Katie; Allison, Janelle

2012-01-01

After a 3-step guided compliance procedure (vocal prompt, vocal plus model prompt, vocal prompt plus physical guidance) did not increase compliance, we evaluated 2 modifications with 4 preschool children who exhibited noncompliance. The first modification consisted of omission of the model prompt, and the second modification consisted of omitting…

Exploring the Impacts of Cognitive and Metacognitive Prompting on Students' Scientific Inquiry Practices Within an E-Learning Environment

NASA Astrophysics Data System (ADS)

Zhang, Wen-Xin; Hsu, Ying-Shao; Wang, Chia-Yu; Ho, Yu-Ting

2015-02-01

This study explores the effects of metacognitive and cognitive prompting on the scientific inquiry practices of students with various levels of initial metacognition. Two junior high school classes participated in this study. One class, the experimental group (n = 26), which received an inquiry-based curriculum with a combination of cognitive and metacognitive prompts, was compared to the other class, the comparison group (n = 25), which received only cognitive prompts in the same curriculum. Data sources included a test of inquiry practices, a questionnaire of metacognition, and worksheets. The results showed that the mixed cognitive and metacognitive prompts had significant impacts on the students' inquiry practices, especially their planning and analyzing abilities. Furthermore, the mixed prompts appeared to have a differential effect on those students with lower level metacognition, who showed significant improvement in their inquiry abilities. A combination of cognitive and metacognitive prompts during an inquiry cycle was found to promote students' inquiry practices.

Measurement of χ c1 and χ c2 production with = 7 TeV pp collisions at ATLAS

NASA Astrophysics Data System (ADS)

Aad, G.; Abajyan, T.; Abbott, B.; Abdallah, J.; Khalek, S. Abdel; Abdinov, O.; Aben, R.; Abi, B.; Abolins, M.; AbouZeid, O. S.; Abramowicz, H.; Abreu, H.; Abulaiti, Y.; Acharya, B. S.; Adamczyk, L.; Adams, D. L.; Addy, T. N.; Adelman, J.; Adomeit, S.; Adye, T.; Aefsky, S.; Agatonovic-Jovin, T.; Aguilar-Saavedra, J. A.; Agustoni, M.; Ahlen, S. P.; Ahmad, A.; Ahmadov, F.; Aielli, G.; Åkesson, T. P. A.; Akimoto, G.; Akimov, A. V.; Alam, M. A.; Albert, J.; Albrand, S.; Verzini, M. J. Alconada; Aleksa, M.; Aleksandrov, I. N.; Alessandria, F.; Alexa, C.; Alexander, G.; Alexandre, G.; Alexopoulos, T.; Alhroob, M.; Aliev, M.; Alimonti, G.; Alio, L.; Alison, J.; Allbrooke, B. M. M.; Allison, L. J.; Allport, P. P.; Allwood-Spiers, S. E.; Almond, J.; Aloisio, A.; Alon, R.; Alonso, A.; Alonso, F.; Altheimer, A.; Gonzalez, B. Alvarez; Alviggi, M. G.; Amako, K.; Coutinho, Y. Amaral; Amelung, C.; Ammosov, V. V.; Santos, S. P. Amor Dos; Amorim, A.; Amoroso, S.; Amram, N.; Amundsen, G.; Anastopoulos, C.; Ancu, L. S.; Andari, N.; Andeen, T.; Anders, C. F.; Anders, G.; Anderson, K. J.; Andreazza, A.; Andrei, V.; Anduaga, X. S.; Angelidakis, S.; Anger, P.; Angerami, A.; Anghinolfi, F.; Anisenkov, A. V.; Anjos, N.; Annovi, A.; Antonaki, A.; Antonelli, M.; Antonov, A.; Antos, J.; Anulli, F.; Aoki, M.; Bella, L. Aperio; Apolle, R.; Arabidze, G.; Aracena, I.; Arai, Y.; Arce, A. T. H.; Arfaoui, S.; Arguin, J.-F.; Argyropoulos, S.; Arik, E.; Arik, M.; Armbruster, A. J.; Arnaez, O.; Arnal, V.; Arslan, O.; Artamonov, A.; Artoni, G.; Asai, S.; Asbah, N.; Ask, S.; Åsman, B.; Asquith, L.; Assamagan, K.; Astalos, R.; Astbury, A.; Atkinson, M.; Atlay, N. B.; Auerbach, B.; Auge, E.; Augsten, K.; Aurousseau, M.; Avolio, G.; Azuelos, G.; Azuma, Y.; Baak, M. A.; Bacci, C.; Bach, A. M.; Bachacou, H.; Bachas, K.; Backes, M.; Backhaus, M.; Mayes, J. Backus; Badescu, E.; Bagiacchi, P.; Bagnaia, P.; Bai, Y.; Bailey, D. C.; Bain, T.; Baines, J. T.; Baker, O. K.; Baker, S.; Balek, P.; Balli, F.; Banas, E.; Banerjee, Sw.; Banfi, D.; Bangert, A.; Bansal, V.; Bansil, H. S.; Barak, L.; Baranov, S. P.; Barber, T.; Barberio, E. L.; Barberis, D.; Barbero, M.; Barillari, T.; Barisonzi, M.; Barklow, T.; Barlow, N.; Barnett, B. M.; Barnett, R. M.; Baroncelli, A.; Barone, G.; Barr, A. J.; Barreiro, F.; da Costa, J. Barreiro Guimarães; Bartoldus, R.; Barton, A. E.; Bartos, P.; Bartsch, V.; Bassalat, A.; Basye, A.; Bates, R. L.; Batkova, L.; Batley, J. R.; Battistin, M.; Bauer, F.; Bawa, H. S.; Beau, T.; Beauchemin, P. H.; Beccherle, R.; Bechtle, P.; Beck, H. P.; Becker, K.; Becker, S.; Beckingham, M.; Beddall, A. J.; Beddall, A.; Bedikian, S.; Bednyakov, V. A.; Bee, C. P.; Beemster, L. J.; Beermann, T. A.; Begel, M.; Behr, K.; Belanger-Champagne, C.; Bell, P. J.; Bell, W. H.; Bella, G.; Bellagamba, L.; Bellerive, A.; Bellomo, M.; Belloni, A.; Beloborodova, O. L.; Belotskiy, K.; Beltramello, O.; Benary, O.; Benchekroun, D.; Bendtz, K.; Benekos, N.; Benhammou, Y.; Noccioli, E. Benhar; Garcia, J. A. Benitez; Benjamin, D. P.; Bensinger, J. R.; Benslama, K.; Bentvelsen, S.; Berge, D.; Kuutmann, E. Bergeaas; Berger, N.; Berghaus, F.; Berglund, E.; Beringer, J.; Bernard, C.; Bernat, P.; Bernhard, R.; Bernius, C.; Bernlochner, F. U.; Berry, T.; Berta, P.; Bertella, C.; Bertolucci, F.; Besana, M. I.; Besjes, G. J.; Bessidskaia, O.; Besson, N.; Bethke, S.; Bhimji, W.; Bianchi, R. M.; Bianchini, L.; Bianco, M.; Biebel, O.; Bieniek, S. P.; Bierwagen, K.; Biesiada, J.; Biglietti, M.; De Mendizabal, J. Bilbao; Bilokon, H.; Bindi, M.; Binet, S.; Bingul, A.; Bini, C.; Bittner, B.; Black, C. W.; Black, J. E.; Black, K. M.; Blackburn, D.; Blair, R. E.; Blanchard, J.-B.; Blazek, T.; Bloch, I.; Blocker, C.; Blum, W.; Blumenschein, U.; Bobbink, G. J.; Bobrovnikov, V. S.; Bocchetta, S. S.; Bocci, A.; Boddy, C. R.; Boehler, M.; Boek, J.; Boek, T. T.; Boelaert, N.; Bogaerts, J. A.; Bogdanchikov, A. G.; Bogouch, A.; Bohm, C.; Bohm, J.; Boisvert, V.; Bold, T.; Boldea, V.; Boldyrev, A. S.; Bolnet, N. M.; Bomben, M.; Bona, M.; Boonekamp, M.; Bordoni, S.; Borer, C.; Borisov, A.; Borissov, G.; Borri, M.; Borroni, S.; Bortfeldt, J.; Bortolotto, V.; Bos, K.; Boscherini, D.; Bosman, M.; Boterenbrood, H.; Bouchami, J.; Boudreau, J.; Bouhova-Thacker, E. V.; Boumediene, D.; Bourdarios, C.; Bousson, N.; Boutouil, S.; Boveia, A.; Boyd, J.; Boyko, I. R.; Bozovic-Jelisavcic, I.; Bracinik, J.; Branchini, P.; Brandt, A.; Brandt, G.; Brandt, O.; Bratzler, U.; Brau, B.; Brau, J. E.; Braun, H. M.; Brazzale, S. F.; Brelier, B.; Brendlinger, K.; Brenner, R.; Bressler, S.; Bristow, T. M.; Britton, D.; Brochu, F. M.; Brock, I.; Brock, R.; Broggi, F.; Bromberg, C.; Bronner, J.; Brooijmans, G.; Brooks, T.; Brooks, W. K.; Brosamer, J.; Brost, E.; Brown, G.; Brown, J.; de Renstrom, P. A. Bruckman; Bruncko, D.; Bruneliere, R.; Brunet, S.; Bruni, A.; Bruni, G.; Bruschi, M.; Bryngemark, L.; Buanes, T.; Buat, Q.; Bucci, F.; Buchholz, P.; Buckingham, R. M.; Buckley, A. G.; Buda, S. I.; Budagov, I. A.; Budick, B.; Buehrer, F.; Bugge, L.; Bugge, M. K.; Bulekov, O.; Bundock, A. C.; Bunse, M.; Burckhart, H.; Burdin, S.; Burgess, T.; Burghgrave, B.; Burke, S.; Burmeister, I.; Busato, E.; Büscher, V.; Bussey, P.; Buszello, C. P.; Butler, B.; Butler, J. M.; Butt, A. I.; Buttar, C. M.; Butterworth, J. M.; Buttinger, W.; Buzatu, A.; Byszewski, M.; Urbán, S. Cabrera; Caforio, D.; Cakir, O.; Calafiura, P.; Calderini, G.; Calfayan, P.; Calkins, R.; Caloba, L. P.; Caloi, R.; Calvet, D.; Calvet, S.; Toro, R. Camacho; Camarri, P.; Cameron, D.; Caminada, L. M.; Armadans, R. Caminal; Campana, S.; Campanelli, M.; Canale, V.; Canelli, F.; Canepa, A.; Cantero, J.; Cantrill, R.; Cao, T.; Garrido, M. D. M. Capeans; Caprini, I.; Caprini, M.; Capua, M.; Caputo, R.; Cardarelli, R.; Carli, T.; Carlino, G.; Carminati, L.; Caron, S.; Carquin, E.; Carrillo-Montoya, G. D.; Carter, A. A.; Carter, J. R.; Carvalho, J.; Casadei, D.; Casado, M. P.; Caso, C.; Castaneda-Miranda, E.; Castelli, A.; Gimenez, V. Castillo; Castro, N. F.; Catastini, P.; Catinaccio, A.; Catmore, J. R.; Cattai, A.; Cattani, G.; Caughron, S.; Cavaliere, V.; Cavalli, D.; Cavalli-Sforza, M.; Cavasinni, V.; Ceradini, F.; Cerio, B.; Cerny, K.; Cerqueira, A. S.; Cerri, A.; Cerrito, L.; Cerutti, F.; Cervelli, A.; Cetin, S. A.; Chafaq, A.; Chakraborty, D.; Chalupkova, I.; Chan, K.; Chang, P.; Chapleau, B.; Chapman, J. D.; Charfeddine, D.; Charlton, D. G.; Chavda, V.; Barajas, C. A. Chavez; Cheatham, S.; Chekanov, S.; Chekulaev, S. V.; Chelkov, G. A.; Chelstowska, M. A.; Chen, C.; Chen, H.; Chen, K.; Chen, L.; Chen, S.; Chen, X.; Chen, Y.; Cheng, Y.; Cheplakov, A.; El Moursli, R. Cherkaoui; Chernyatin, V.; Cheu, E.; Chevalier, L.; Chiarella, V.; Chiefari, G.; Childers, J. T.; Chilingarov, A.; Chiodini, G.; Chisholm, A. S.; Chislett, R. T.; Chitan, A.; Chizhov, M. V.; Chouridou, S.; Chow, B. K. B.; Christidi, I. A.; Chromek-Burckhart, D.; Chu, M. L.; Chudoba, J.; Ciapetti, G.; Ciftci, A. K.; Ciftci, R.; Cinca, D.; Cindro, V.; Ciocio, A.; Cirilli, M.; Cirkovic, P.; Citron, Z. H.; Citterio, M.; Ciubancan, M.; Clark, A.; Clark, P. J.; Clarke, R. N.; Cleland, W.; Clemens, J. C.; Clement, B.; Clement, C.; Coadou, Y.; Cobal, M.; Coccaro, A.; Cochran, J.; Coelli, S.; Coffey, L.; Cogan, J. G.; Coggeshall, J.; Colas, J.; Cole, B.; Cole, S.; Colijn, A. P.; Collins-Tooth, C.; Collot, J.; Colombo, T.; Colon, G.; Compostella, G.; Muiño, P. Conde; Coniavitis, E.; Conidi, M. C.; Connelly, I. A.; Consonni, S. M.; Consorti, V.; Constantinescu, S.; Conta, C.; Conti, G.; Conventi, F.; Cooke, M.; Cooper, B. D.; Cooper-Sarkar, A. M.; Cooper-Smith, N. J.; Copic, K.; Cornelissen, T.; Corradi, M.; Corriveau, F.; Corso-Radu, A.; Cortes-Gonzalez, A.; Cortiana, G.; Costa, G.; Costa, M. J.; Costanzo, D.; Côté, D.; Cottin, G.; Courneyea, L.; Cowan, G.; Cox, B. E.; Cranmer, K.; Cree, G.; Crépé-Renaudin, S.; Crescioli, F.; Ortuzar, M. Crispin; Cristinziani, M.; Crosetti, G.; Cuciuc, C.-M.; Almenar, C. Cuenca; Donszelmann, T. Cuhadar; Cummings, J.; Curatolo, M.; Cuthbert, C.; Czirr, H.; Czodrowski, P.; Czyczula, Z.; D'Auria, S.; D'Onofrio, M.; D'Orazio, A.; Da Cunha Sargedas De Sousa, M. J.; Da Via, C.; Dabrowski, W.; Dafinca, A.; Dai, T.; Dallaire, F.; Dallapiccola, C.; Dam, M.; Daniells, A. C.; Hoffmann, M. Dano; Dao, V.; Darbo, G.; Darlea, G. L.; Darmora, S.; Dassoulas, J. A.; Davey, W.; David, C.; Davidek, T.; Davies, E.; Davies, M.; Davignon, O.; Davison, A. R.; Davygora, Y.; Dawe, E.; Dawson, I.; Daya-Ishmukhametova, R. K.; De, K.; de Asmundis, R.; De Castro, S.; De Cecco, S.; de Graat, J.; De Groot, N.; de Jong, P.; De La Taille, C.; De la Torre, H.; De Lorenzi, F.; De Nooij, L.; De Pedis, D.; De Salvo, A.; De Sanctis, U.; De Santo, A.; De Vivie De Regie, J. B.; De Zorzi, G.; Dearnaley, W. J.; Debbe, R.; Debenedetti, C.; Dechenaux, B.; Dedovich, D. V.; Degenhardt, J.; Del Peso, J.; Del Prete, T.; Delemontex, T.; Deliot, F.; Deliyergiyev, M.; Dell'Acqua, A.; Dell'Asta, L.; Della Pietra, M.; della Volpe, D.; Delmastro, M.; Delsart, P. A.; Deluca, C.; Demers, S.; Demichev, M.; Demilly, A.; Demirkoz, B.; Denisov, S. P.; Derendarz, D.; Derkaoui, J. E.; Derue, F.; Dervan, P.; Desch, K.; Deviveiros, P. O.; Dewhurst, A.; DeWilde, B.; Dhaliwal, S.; Dhullipudi, R.; Di Ciaccio, A.; Di Ciaccio, L.; Di Domenico, A.; Di Donato, C.; Di Girolamo, A.; Di Girolamo, B.; Di Mattia, A.; Di Micco, B.; Di Nardo, R.; Di Simone, A.; Di Sipio, R.; Di Valentino, D.; Diaz, M. A.; Diehl, E. B.; Dietrich, J.; Dietzsch, T. A.; Diglio, S.; Yagci, K. Dindar; Dingfelder, J.; Dionisi, C.; Dita, P.; Dita, S.; Dittus, F.; Djama, F.; Djobava, T.; do Vale, M. A. B.; Wemans, A. Do Valle; Doan, T. K. O.; Dobos, D.; Dobson, E.; Dodd, J.; Doglioni, C.; Doherty, T.; Dohmae, T.; Dolejsi, J.; Dolezal, Z.; Dolgoshein, B. A.; Donadelli, M.; Donati, S.; Dondero, P.; Donini, J.; Dopke, J.; Doria, A.; Anjos, A. Dos; Dotti, A.; Dova, M. T.; Doyle, A. T.; Dris, M.; Dubbert, J.; Dube, S.; Dubreuil, E.; Duchovni, E.; Duckeck, G.; Ducu, O. A.; Duda, D.; Dudarev, A.; Dudziak, F.; Duflot, L.; Duguid, L.; Dührssen, M.; Dunford, M.; Yildiz, H. Duran; Düren, M.; Dwuznik, M.; Ebke, J.; Edson, W.; Edwards, C. A.; Edwards, N. C.; Ehrenfeld, W.; Eifert, T.; Eigen, G.; Einsweiler, K.; Eisenhandler, E.; Ekelof, T.; El Kacimi, M.; Ellert, M.; Elles, S.; Ellinghaus, F.; Ellis, K.; Ellis, N.; Elmsheuser, J.; Elsing, M.; Emeliyanov, D.; Enari, Y.; Endner, O. C.; Endo, M.; Engelmann, R.; Erdmann, J.; Ereditato, A.; Eriksson, D.; Ernis, G.; Ernst, J.; Ernst, M.; Ernwein, J.; Errede, D.; Errede, S.; Ertel, E.; Escalier, M.; Esch, H.; Escobar, C.; Curull, X. Espinal; Esposito, B.; Etienne, F.; Etienvre, A. I.; Etzion, E.; Evangelakou, D.; Evans, H.; Fabbri, L.; Facini, G.; Fakhrutdinov, R. M.; Falciano, S.; Fang, Y.; Fanti, M.; Farbin, A.; Farilla, A.; Farooque, T.; Farrell, S.; Farrington, S. M.; Farthouat, P.; Fassi, F.; Fassnacht, P.; Fassouliotis, D.; Fatholahzadeh, B.; Favareto, A.; Fayard, L.; Federic, P.; Fedin, O. L.; Fedorko, W.; Fehling-Kaschek, M.; Feligioni, L.; Feng, C.; Feng, E. J.; Feng, H.; Fenyuk, A. B.; Fernando, W.; Ferrag, S.; Ferrando, J.; Ferrara, V.; Ferrari, A.; Ferrari, P.; Ferrari, R.; de Lima, D. E. Ferreira; Ferrer, A.; Ferrere, D.; Ferretti, C.; Parodi, A. Ferretto; Fiascaris, M.; Fiedler, F.; Filipčič, A.; Filipuzzi, M.; Filthaut, F.; Fincke-Keeler, M.; Finelli, K. D.; Fiolhais, M. C. N.; Fiorini, L.; Firan, A.; Fischer, J.; Fisher, M. J.; Fitzgerald, E. A.; Flechl, M.; Fleck, I.; Fleischmann, P.; Fleischmann, S.; Fletcher, G. T.; Fletcher, G.; Flick, T.; Floderus, A.; Castillo, L. R. Flores; Bustos, A. C. Florez; Flowerdew, M. J.; Martin, T. Fonseca; Formica, A.; Forti, A.; Fortin, D.; Fournier, D.; Fox, H.; Francavilla, P.; Franchini, M.; Franchino, S.; Francis, D.; Franklin, M.; Franz, S.; Fraternali, M.; Fratina, S.; French, S. T.; Friedrich, C.; Friedrich, F.; Froidevaux, D.; Frost, J. A.; Fukunaga, C.; Torregrosa, E. Fullana; Fulsom, B. G.; Fuster, J.; Gabaldon, C.; Gabizon, O.; Gabrielli, A.; Gabrielli, A.; Gadatsch, S.; Gadfort, T.; Gadomski, S.; Gagliardi, G.; Gagnon, P.; Galea, C.; Galhardo, B.; Gallas, E. J.; Gallo, V.; Gallop, B. J.; Gallus, P.; Galster, G.; Gan, K. K.; Gandrajula, R. P.; Gao, J.; Gao, Y. S.; Walls, F. M. Garay; Garberson, F.; García, C.; Navarro, J. E. García; Garcia-Sciveres, M.; Gardner, R. W.; Garelli, N.; Garonne, V.; Gatti, C.; Gaudio, G.; Gaur, B.; Gauthier, L.; Gauzzi, P.; Gavrilenko, I. L.; Gay, C.; Gaycken, G.; Gazis, E. N.; Ge, P.; Gecse, Z.; Gee, C. N. P.; Geerts, D. A. A.; Geich-Gimbel, Ch.; Gellerstedt, K.; Gemme, C.; Gemmell, A.; Genest, M. H.; Gentile, S.; George, M.; George, S.; Gerbaudo, D.; Gershon, A.; Ghazlane, H.; Ghodbane, N.; Giacobbe, B.; Giagu, S.; Giangiobbe, V.; Giannetti, P.; Gianotti, F.; Gibbard, B.; Gibson, S. M.; Gilchriese, M.; Gillam, T. P. S.; Gillberg, D.; Gillman, A. R.; Gingrich, D. M.; Giokaris, N.; Giordani, M. P.; Giordano, R.; Giorgi, F. M.; Giovannini, P.; Giraud, P. F.; Giugni, D.; Giuliani, C.; Giunta, M.; Gjelsten, B. K.; Gkialas, I.; Gladilin, L. K.; Glasman, C.; Glatzer, J.; Glazov, A.; Glonti, G. L.; Goblirsch-Kolb, M.; Goddard, J. R.; Godfrey, J.; Godlewski, J.; Goeringer, C.; Goldfarb, S.; Golling, T.; Golubkov, D.; Gomes, A.; Fajardo, L. S. Gomez; Gonçalo, R.; Da Costa, J. Goncalves Pinto Firmino; Gonella, L.; de la Hoz, S. González; Parra, G. Gonzalez; Silva, M. L. Gonzalez; Gonzalez-Sevilla, S.; Goodson, J. J.; Goossens, L.; Gorbounov, P. A.; Gordon, H. A.; Gorelov, I.; Gorfine, G.; Gorini, B.; Gorini, E.; Gorišek, A.; Gornicki, E.; Goshaw, A. T.; Gössling, C.; Gostkin, M. I.; Gouighri, M.; Goujdami, D.; Goulette, M. P.; Goussiou, A. G.; Goy, C.; Gozpinar, S.; Grabas, H. M. X.; Graber, L.; Grabowska-Bold, I.; Grafström, P.; Grahn, K.-J.; Gramling, J.; Gramstad, E.; Grancagnolo, F.; Grancagnolo, S.; Grassi, V.; Gratchev, V.; Gray, H. M.; Gray, J. A.; Graziani, E.; Grebenyuk, O. G.; Greenwood, Z. D.; Gregersen, K.; Gregor, I. M.; Grenier, P.; Griffiths, J.; Grigalashvili, N.; Grillo, A. A.; Grimm, K.; Grinstein, S.; Gris, Ph.; Grishkevich, Y. V.; Grivaz, J.-F.; Grohs, J. P.; Grohsjean, A.; Gross, E.; Grosse-Knetter, J.; Grossi, G. C.; Groth-Jensen, J.; Grout, Z. J.; Grybel, K.; Guescini, F.; Guest, D.; Gueta, O.; Guicheney, C.; Guido, E.; Guillemin, T.; Guindon, S.; Gul, U.; Gumpert, C.; Gunther, J.; Guo, J.; Gupta, S.; Gutierrez, P.; Ortiz, N. G. Gutierrez; Gutschow, C.; Guttman, N.; Guyot, C.; Gwenlan, C.; Gwilliam, C. B.; Haas, A.; Haber, C.; Hadavand, H. K.; Haefner, P.; Hageboeck, S.; Hajduk, Z.; Hakobyan, H.; Haleem, M.; Hall, D.; Halladjian, G.; Hamacher, K.; Hamal, P.; Hamano, K.; Hamer, M.; Hamilton, A.; Hamilton, S.; Han, L.; Hanagaki, K.; Hanawa, K.; Hance, M.; Hanke, P.; Hansen, J. R.; Hansen, J. B.; Hansen, J. D.; Hansen, P. H.; Hansson, P.; Hara, K.; Hard, A. S.; Harenberg, T.; Harkusha, S.; Harper, D.; Harrington, R. D.; Harris, O. M.; Harrison, P. F.; Hartjes, F.; Harvey, A.; Hasegawa, S.; Hasegawa, Y.; Hassani, S.; Haug, S.; Hauschild, M.; Hauser, R.; Havranek, M.; Hawkes, C. M.; Hawkings, R. J.; Hawkins, A. D.; Hayashi, T.; Hayden, D.; Hays, C. P.; Hayward, H. S.; Haywood, S. J.; Head, S. J.; Heck, T.; Hedberg, V.; Heelan, L.; Heim, S.; Heinemann, B.; Heisterkamp, S.; Hejbal, J.; Helary, L.; Heller, C.; Heller, M.; Hellman, S.; Hellmich, D.; Helsens, C.; Henderson, J.; Henderson, R. C. W.; Henrichs, A.; Correia, A. M. Henriques; Henrot-Versille, S.; Hensel, C.; Herbert, G. H.; Hernandez, C. M.; Jiménez, Y. Hernández; Herrberg-Schubert, R.; Herten, G.; Hertenberger, R.; Hervas, L.; Hesketh, G. G.; Hessey, N. P.; Hickling, R.; Higón-Rodriguez, E.; Hill, J. C.; Hiller, K. H.; Hillert, S.; Hillier, S. J.; Hinchliffe, I.; Hines, E.; Hirose, M.; Hirschbuehl, D.; Hobbs, J.; Hod, N.; Hodgkinson, M. C.; Hodgson, P.; Hoecker, A.; Hoeferkamp, M. R.; Hoffman, J.; Hoffmann, D.; Hofmann, J. I.; Hohlfeld, M.; Holmes, T. R.; Hong, T. M.; van Huysduynen, L. Hooft; Hostachy, J.-Y.; Hou, S.; Hoummada, A.; Howard, J.; Howarth, J.; Hrabovsky, M.; Hristova, I.; Hrivnac, J.; Hryn'ova, T.; Hsu, P. J.; Hsu, S.-C.; Hu, D.; Hu, X.; Huang, Y.; Hubacek, Z.; Hubaut, F.; Huegging, F.; Huettmann, A.; Huffman, T. B.; Hughes, E. W.; Hughes, G.; Huhtinen, M.; Hülsing, T. A.; Hurwitz, M.; Huseynov, N.; Huston, J.; Huth, J.; Iacobucci, G.; Iakovidis, G.; Ibragimov, I.; Iconomidou-Fayard, L.; Idarraga, J.; Ideal, E.; Iengo, P.; Igonkina, O.; Iizawa, T.; Ikegami, Y.; Ikematsu, K.; Ikeno, M.; Iliadis, D.; Ilic, N.; Inamaru, Y.; Ince, T.; Ioannou, P.; Iodice, M.; Iordanidou, K.; Ippolito, V.; Quiles, A. Irles; Isaksson, C.; Ishino, M.; Ishitsuka, M.; Ishmukhametov, R.; Issever, C.; Istin, S.; Ivashin, A. V.; Iwanski, W.; Iwasaki, H.; Izen, J. M.; Izzo, V.; Jackson, B.; Jackson, J. N.; Jackson, M.; Jackson, P.; Jaekel, M. R.; Jain, V.; Jakobs, K.; Jakobsen, S.; Jakoubek, T.; Jakubek, J.; Jamin, D. O.; Jana, D. K.; Jansen, E.; Jansen, H.; Janssen, J.; Janus, M.; Jared, R. C.; Jarlskog, G.; Jeanty, L.; Jeng, G.-Y.; Plante, I. Jen-La; Jennens, D.; Jenni, P.; Jentzsch, J.; Jeske, C.; Jézéquel, S.; Jha, M. K.; Ji, H.; Ji, W.; Jia, J.; Jiang, Y.; Belenguer, M. Jimenez; Jin, S.; Jinaru, A.; Jinnouchi, O.; Joergensen, M. D.; Joffe, D.; Johansson, K. E.; Johansson, P.; Johns, K. A.; Jon-And, K.; Jones, G.; Jones, R. W. L.; Jones, T. J.; Jorge, P. M.; Joshi, K. D.; Jovicevic, J.; Ju, X.; Jung, C. A.; Jungst, R. M.; Jussel, P.; Rozas, A. Juste; Kaci, M.; Kaczmarska, A.; Kadlecik, P.; Kado, M.; Kagan, H.; Kagan, M.; Kajomovitz, E.; Kalinin, S.; Kama, S.; Kanaya, N.; Kaneda, M.; Kaneti, S.; Kanno, T.; Kantserov, V. A.; Kanzaki, J.; Kaplan, B.; Kapliy, A.; Kar, D.; Karakostas, K.; Karastathis, N.; Karnevskiy, M.; Karpov, S. N.; Karthik, K.; Kartvelishvili, V.; Karyukhin, A. N.; Kashif, L.; Kasieczka, G.; Kass, R. D.; Kastanas, A.; Kataoka, Y.; Katre, A.; Katzy, J.; Kaushik, V.; Kawagoe, K.; Kawamoto, T.; Kawamura, G.; Kazama, S.; Kazanin, V. F.; Kazarinov, M. Y.; Keeler, R.; Keener, P. T.; Kehoe, R.; Keil, M.; Keller, J. S.; Keoshkerian, H.; Kepka, O.; Kerševan, B. P.; Kersten, S.; Kessoku, K.; Keung, J.; Khalil-zada, F.; Khandanyan, H.; Khanov, A.; Kharchenko, D.; Khodinov, A.; Khomich, A.; Khoo, T. J.; Khoriauli, G.; Khoroshilov, A.; Khovanskiy, V.; Khramov, E.; Khubua, J.; Kim, H.; Kim, S. H.; Kimura, N.; Kind, O.; King, B. T.; King, M.; King, R. S. B.; King, S. B.; Kirk, J.; Kiryunin, A. E.; Kishimoto, T.; Kisielewska, D.; Kitamura, T.; Kittelmann, T.; Kiuchi, K.; Kladiva, E.; Klein, M.; Klein, U.; Kleinknecht, K.; Klimek, P.; Klimentov, A.; Klingenberg, R.; Klinger, J. A.; Klinkby, E. B.; Klioutchnikova, T.; Klok, P. F.; Kluge, E.-E.; Kluit, P.; Kluth, S.; Kneringer, E.; Knoops, E. B. F. G.; Knue, A.; Kobayashi, T.; Kobel, M.; Kocian, M.; Kodys, P.; Koenig, S.; Koevesarki, P.; Koffas, T.; Koffeman, E.; Kogan, L. A.; Kohlmann, S.; Kohout, Z.; Kohriki, T.; Koi, T.; Kolanoski, H.; Koletsou, I.; Koll, J.; Komar, A. A.; Komori, Y.; Kondo, T.; Köneke, K.; König, A. C.; Kono, T.; Konoplich, R.; Konstantinidis, N.; Kopeliansky, R.; Koperny, S.; Köpke, L.; Kopp, A. K.; Korcyl, K.; Kordas, K.; Korn, A.; Korol, A. A.; Korolkov, I.; Korolkova, E. V.; Korotkov, V. A.; Kortner, O.; Kortner, S.; Kostyukhin, V. V.; Kotov, S.; Kotov, V. M.; Kotwal, A.; Kourkoumelis, C.; Kouskoura, V.; Koutsman, A.; Kowalewski, R.; Kowalski, T. Z.; Kozanecki, W.; Kozhin, A. S.; Kral, V.; Kramarenko, V. A.; Kramberger, G.; Krasny, M. W.; Krasznahorkay, A.; Kraus, J. K.; Kravchenko, A.; Kreiss, S.; Kretzschmar, J.; Kreutzfeldt, K.; Krieger, N.; Krieger, P.; Kroeninger, K.; Kroha, H.; Kroll, J.; Kroseberg, J.; Krstic, J.; Kruchonak, U.; Krüger, H.; Kruker, T.; Krumnack, N.; Krumshteyn, Z. V.; Kruse, A.; Kruse, M. C.; Kruskal, M.; Kubota, T.; Kuday, S.; Kuehn, S.; Kugel, A.; Kuhl, T.; Kukhtin, V.; Kulchitsky, Y.; Kuleshov, S.; Kuna, M.; Kunkle, J.; Kupco, A.; Kurashige, H.; Kurata, M.; Kurochkin, Y. A.; Kurumida, R.; Kus, V.; Kuwertz, E. S.; Kuze, M.; Kvita, J.; Kwee, R.; La Rosa, A.; La Rotonda, L.; Labarga, L.; Lablak, S.; Lacasta, C.; Lacava, F.; Lacey, J.; Lacker, H.; Lacour, D.; Lacuesta, V. R.; Ladygin, E.; Lafaye, R.; Laforge, B.; Lagouri, T.; Lai, S.; Laier, H.; Laisne, E.; Lambourne, L.; Lampen, C. L.; Lampl, W.; Lançon, E.; Landgraf, U.; Landon, M. P. J.; Lang, V. S.; Lange, C.; Lankford, A. J.; Lanni, F.; Lantzsch, K.; Lanza, A.; Laplace, S.; Lapoire, C.; Laporte, J. F.; Lari, T.; Larner, A.; Lassnig, M.; Laurelli, P.; Lavorini, V.; Lavrijsen, W.; Laycock, P.; Le, B. T.; Le Dortz, O.; Le Guirriec, E.; Le Menedeu, E.; LeCompte, T.; Ledroit-Guillon, F.; Lee, C. A.; Lee, H.; Lee, J. S. H.; Lee, S. C.; Lee, L.; Lefebvre, G.; Lefebvre, M.; Legger, F.; Leggett, C.; Lehan, A.; Lehmacher, M.; Miotto, G. Lehmann; Lei, X.; Leister, A. G.; Leite, M. A. L.; Leitner, R.; Lellouch, D.; Lemmer, B.; Lendermann, V.; Leney, K. J. C.; Lenz, T.; Lenzen, G.; Lenzi, B.; Leone, R.; Leonhardt, K.; Leontsinis, S.; Leroy, C.; Lessard, J.-R.; Lester, C. G.; Lester, C. M.; Levêque, J.; Levin, D.; Levinson, L. J.; Lewis, A.; Lewis, G. H.; Leyko, A. M.; Leyton, M.; Li, B.; Li, B.; Li, H.; Li, H. L.; Li, S.; Li, X.; Liang, Z.; Liao, H.; Liberti, B.; Lichard, P.; Lie, K.; Liebal, J.; Liebig, W.; Limbach, C.; Limosani, A.; Limper, M.; Lin, S. C.; Linde, F.; Lindquist, B. E.; Linnemann, J. T.; Lipeles, E.; Lipniacka, A.; Lisovyi, M.; Liss, T. M.; Lissauer, D.; Lister, A.; Litke, A. M.; Liu, B.; Liu, D.; Liu, J. B.; Liu, K.; Liu, L.; Liu, M.; Liu, M.; Liu, Y.; Livan, M.; Livermore, S. S. A.; Lleres, A.; Merino, J. Llorente; Lloyd, S. L.; Sterzo, F. Lo; Lobodzinska, E.; Loch, P.; Lockman, W. S.; Loddenkoetter, T.; Loebinger, F. K.; Loevschall-Jensen, A. E.; Loginov, A.; Loh, C. W.; Lohse, T.; Lohwasser, K.; Lokajicek, M.; Lombardo, V. P.; Long, J. D.; Long, R. E.; Lopes, L.; Mateos, D. Lopez; Paredes, B. Lopez; Lorenz, J.; Martinez, N. Lorenzo; Losada, M.; Loscutoff, P.; Losty, M. J.; Lou, X.; Lounis, A.; Love, J.; Love, P. A.; Lowe, A. J.; Lu, F.; Lubatti, H. J.; Luci, C.; Lucotte, A.; Ludwig, D.; Ludwig, I.; Luehring, F.; Lukas, W.; Luminari, L.; Lund, E.; Lundberg, J.; Lundberg, O.; Lund-Jensen, B.; Lungwitz, M.; Lynn, D.; Lysak, R.; Lytken, E.; Ma, H.; Ma, L. L.; Maccarrone, G.; Macchiolo, A.; Maček, B.; Miguens, J. Machado; Macina, D.; Mackeprang, R.; Madar, R.; Madaras, R. J.; Maddocks, H. J.; Mader, W. F.; Madsen, A.; Maeno, M.; Maeno, T.; Magnoni, L.; Magradze, E.; Mahboubi, K.; Mahlstedt, J.; Mahmoud, S.; Mahout, G.; Maiani, C.; Maidantchik, C.; Maio, A.; Majewski, S.; Makida, Y.; Makovec, N.; Mal, P.; Malaescu, B.; Malecki, Pa.; Maleev, V. P.; Malek, F.; Mallik, U.; Malon, D.; Malone, C.; Maltezos, S.; Malyshev, V. M.; Malyukov, S.; Mamuzic, J.; Mandelli, L.; Mandić, I.; Mandrysch, R.; Maneira, J.; Manfredini, A.; de Andrade Filho, L. Manhaes; Ramos, J. A. Manjarres; Mann, A.; Manning, P. M.; Manousakis-Katsikakis, A.; Mansoulie, B.; Mantifel, R.; Mapelli, L.; March, L.; Marchand, J. F.; Marchese, F.; Marchiori, G.; Marcisovsky, M.; Marino, C. P.; Marques, C. N.; Marroquim, F.; Marshall, Z.; Marti, L. F.; Marti-Garcia, S.; Martin, B.; Martin, B.; Martin, J. P.; Martin, T. A.; Martin, V. J.; dit Latour, B. Martin; Martinez, H.; Martinez, M.; Martin-Haugh, S.; Martyniuk, A. C.; Marx, M.; Marzano, F.; Marzin, A.; Masetti, L.; Mashimo, T.; Mashinistov, R.; Masik, J.; Maslennikov, A. L.; Massa, I.; Massol, N.; Mastrandrea, P.; Mastroberardino, A.; Masubuchi, T.; Matsunaga, H.; Matsushita, T.; Mättig, P.; Mättig, S.; Mattmann, J.; Mattravers, C.; Maurer, J.; Maxfield, S. J.; Maximov, D. A.; Mazini, R.; Mazzaferro, L.; Mazzanti, M.; Goldrick, G. Mc; Kee, S. P. Mc; McCarn, A.; McCarthy, R. L.; McCarthy, T. G.; McCubbin, N. A.; McFarlane, K. W.; Mcfayden, J. A.; Mchedlidze, G.; Mclaughlan, T.; McMahon, S. J.; McPherson, R. A.; Meade, A.; Mechnich, J.; Mechtel, M.; Medinnis, M.; Meehan, S.; Meera-Lebbai, R.; Mehlhase, S.; Mehta, A.; Meier, K.; Meineck, C.; Meirose, B.; Melachrinos, C.; Garcia, B. R. Mellado; Meloni, F.; Navas, L. Mendoza; Mengarelli, A.; Menke, S.; Meoni, E.; Mercurio, K. M.; Mergelmeyer, S.; Meric, N.; Mermod, P.; Merola, L.; Meroni, C.; Merritt, F. S.; Merritt, H.; Messina, A.; Metcalfe, J.; Mete, A. S.; Meyer, C.; Meyer, C.; Meyer, J.-P.; Meyer, J.; Meyer, J.; Michal, S.; Middleton, R. P.; Migas, S.; Mijović, L.; Mikenberg, G.; Mikestikova, M.; Mikuž, M.; Miller, D. W.; Mills, C.; Milov, A.; Milstead, D. A.; Milstein, D.; Minaenko, A. A.; Moya, M. Miñano; Minashvili, I. A.; Mincer, A. I.; Mindur, B.; Mineev, M.; Ming, Y.; Mir, L. M.; Mirabelli, G.; Mitani, T.; Mitrevski, J.; Mitsou, V. A.; Mitsui, S.; Miyagawa, P. S.; Mjörnmark, J. U.; Moa, T.; Moeller, V.; Mohapatra, S.; Mohr, W.; Molander, S.; Moles-Valls, R.; Molfetas, A.; Mönig, K.; Monini, C.; Monk, J.; Monnier, E.; Berlingen, J. Montejo; Monticelli, F.; Monzani, S.; Moore, R. W.; Herrera, C. Mora; Moraes, A.; Morange, N.; Morel, J.; Moreno, D.; Llácer, M. Moreno; Morettini, P.; Morgenstern, M.; Morii, M.; Moritz, S.; Morley, A. K.; Mornacchi, G.; Morris, J. D.; Morvaj, L.; Moser, H. G.; Mosidze, M.; Moss, J.; Mount, R.; Mountricha, E.; Mouraviev, S. V.; Moyse, E. J. W.; Mudd, R. D.; Mueller, F.; Mueller, J.; Mueller, K.; Mueller, T.; Mueller, T.; Muenstermann, D.; Munwes, Y.; Quijada, J. A. Murillo; Murray, W. J.; Mussche, I.; Musto, E.; Myagkov, A. G.; Myska, M.; Nackenhorst, O.; Nadal, J.; Nagai, K.; Nagai, R.; Nagai, Y.; Nagano, K.; Nagarkar, A.; Nagasaka, Y.; Nagel, M.; Nairz, A. M.; Nakahama, Y.; Nakamura, K.; Nakamura, T.; Nakano, I.; Namasivayam, H.; Nanava, G.; Napier, A.; Narayan, R.; Nash, M.; Nattermann, T.; Naumann, T.; Navarro, G.; Neal, H. A.; Nechaeva, P. Yu.; Neep, T. J.; Negri, A.; Negri, G.; Negrini, M.; Nektarijevic, S.; Nelson, A.; Nelson, T. K.; Nemecek, S.; Nemethy, P.; Nepomuceno, A. A.; Nessi, M.; Neubauer, M. S.; Neumann, M.; Neusiedl, A.; Neves, R. M.; Nevski, P.; Newcomer, F. M.; Newman, P. R.; Nguyen, D. H.; Hong, V. Nguyen Thi; Nickerson, R. B.; Nicolaidou, R.; Nicquevert, B.; Nielsen, J.; Nikiforou, N.; Nikiforov, A.; Nikolaenko, V.; Nikolic-Audit, I.; Nikolics, K.; Nikolopoulos, K.; Nilsson, P.; Ninomiya, Y.; Nisati, A.; Nisius, R.; Nobe, T.; Nodulman, L.; Nomachi, M.; Nomidis, I.; Norberg, S.; Nordberg, M.; Novakova, J.; Nozaki, M.; Nozka, L.; Ntekas, K.; Nuncio-Quiroz, A.-E.; Hanninger, G. Nunes; Nunnemann, T.; Nurse, E.; O'Brien, B. J.; O'grady, F.; O'Neil, D. C.; O'Shea, V.; Oakes, L. B.; Oakham, F. G.; Oberlack, H.; Ocariz, J.; Ochi, A.; Ochoa, M. I.; Oda, S.; Odaka, S.; Ogren, H.; Oh, A.; Oh, S. H.; Ohm, C. C.; Ohshima, T.; Okamura, W.; Okawa, H.; Okumura, Y.; Okuyama, T.; Olariu, A.; Olchevski, A. G.; Pino, S. A. Olivares; Oliveira, M.; Damazio, D. Oliveira; Garcia, E. Oliver; Olivito, D.; Olszewski, A.; Olszowska, J.; Onofre, A.; Onyisi, P. U. E.; Oram, C. J.; Oreglia, M. J.; Oren, Y.; Orestano, D.; Orlando, N.; Barrera, C. Oropeza; Orr, R. S.; Osculati, B.; Ospanov, R.; y Garzon, G. Otero; Otono, H.; Ouchrif, M.; Ouellette, E. A.; Ould-Saada, F.; Ouraou, A.; Oussoren, K. P.; Ouyang, Q.; Ovcharova, A.; Owen, M.; Owen, S.; Ozcan, V. E.; Ozturk, N.; Pachal, K.; Pages, A. Pacheco; Aranda, C. Padilla; Griso, S. Pagan; Paganis, E.; Pahl, C.; Paige, F.; Pais, P.; Pajchel, K.; Palacino, G.; Palestini, S.; Pallin, D.; Palma, A.; Palmer, J. D.; Pan, Y. B.; Panagiotopoulou, E.; Vazquez, J. G. Panduro; Pani, P.; Panikashvili, N.; Panitkin, S.; Pantea, D.; Papadopoulou, Th. D.; Papageorgiou, K.; Paramonov, A.; Hernandez, D. Paredes; Parker, M. A.; Parodi, F.; Parsons, J. A.; Parzefall, U.; Pashapour, S.; Pasqualucci, E.; Passaggio, S.; Passeri, A.; Pastore, F.; Pastore, Fr.; Pásztor, G.; Pataraia, S.; Patel, N. D.; Pater, J. R.; Patricelli, S.; Pauly, T.; Pearce, J.; Pedersen, M.; Lopez, S. Pedraza; Pedro, R.; Peleganchuk, S. V.; Pelikan, D.; Peng, H.; Penning, B.; Penwell, J.; Perepelitsa, D. V.; Cavalcanti, T. Perez; Codina, E. Perez; García-Estañ, M. T. Pérez; Reale, V. Perez; Perini, L.; Pernegger, H.; Perrino, R.; Peschke, R.; Peshekhonov, V. D.; Peters, K.; Peters, R. F. Y.; Petersen, B. A.; Petersen, J.; Petersen, T. C.; Petit, E.; Petridis, A.; Petridou, C.; Petrolo, E.; Petrucci, F.; Petteni, M.; Pezoa, R.; Phillips, P. W.; Piacquadio, G.; Pianori, E.; Picazio, A.; Piccaro, E.; Piccinini, M.; Piec, S. M.; Piegaia, R.; Pignotti, D. T.; Pilcher, J. E.; Pilkington, A. D.; Pina, J.; Pinamonti, M.; Pinder, A.; Pinfold, J. L.; Pingel, A.; Pinto, B.; Pizio, C.; Pleier, M.-A.; Pleskot, V.; Plotnikova, E.; Plucinski, P.; Poddar, S.; Podlyski, F.; Poettgen, R.; Poggioli, L.; Pohl, D.; Pohl, M.; Polesello, G.; Policicchio, A.; Polifka, R.; Polini, A.; Pollard, C. S.; Polychronakos, V.; Pomeroy, D.; Pommès, K.; Pontecorvo, L.; Pope, B. G.; Popeneciu, G. A.; Popovic, D. S.; Poppleton, A.; Bueso, X. Portell; Pospelov, G. E.; Pospisil, S.; Potamianos, K.; Potrap, I. N.; Potter, C. J.; Potter, C. T.; Poulard, G.; Poveda, J.; Pozdnyakov, V.; Prabhu, R.; Pralavorio, P.; Pranko, A.; Prasad, S.; Pravahan, R.; Prell, S.; Price, D.; Price, J.; Price, L. E.; Prieur, D.; Primavera, M.; Proissl, M.; Prokofiev, K.; Prokoshin, F.; Protopapadaki, E.; Protopopescu, S.; Proudfoot, J.; Prudent, X.; Przybycien, M.; Przysiezniak, H.; Psoroulas, S.; Ptacek, E.; Pueschel, E.; Puldon, D.; Purohit, M.; Puzo, P.; Pylypchenko, Y.; Qian, J.; Quadt, A.; Quarrie, D. R.; Quayle, W. B.; Quilty, D.; Radeka, V.; Radescu, V.; Radhakrishnan, S. K.; Radloff, P.; Ragusa, F.; Rahal, G.; Rajagopalan, S.; Rammensee, M.; Rammes, M.; Randle-Conde, A. S.; Rangel-Smith, C.; Rao, K.; Rauscher, F.; Rave, T. C.; Ravenscroft, T.; Raymond, M.; Read, A. L.; Rebuzzi, D. M.; Redelbach, A.; Redlinger, G.; Reece, R.; Reeves, K.; Reinsch, A.; Reisin, H.; Reisinger, I.; Relich, M.; Rembser, C.; Ren, Z. L.; Renaud, A.; Rescigno, M.; Resconi, S.; Resende, B.; Reznicek, P.; Rezvani, R.; Richter, R.; Ridel, M.; Rieck, P.; Rijssenbeek, M.; Rimoldi, A.; Rinaldi, L.; Ritsch, E.; Riu, I.; Rivoltella, G.; Rizatdinova, F.; Rizvi, E.; Robertson, S. H.; Robichaud-Veronneau, A.; Robinson, D.; Robinson, J. E. M.; Robson, A.; de Lima, J. G. Rocha; Roda, C.; Santos, D. Roda Dos; Rodrigues, L.; Roe, S.; Røhne, O.; Rolli, S.; Romaniouk, A.; Romano, M.; Romeo, G.; Adam, E. Romero; Rompotis, N.; Roos, L.; Ros, E.; Rosati, S.; Rosbach, K.; Rose, A.; Rose, M.; Rosendahl, P. L.; Rosenthal, O.; Rossetti, V.; Rossi, E.; Rossi, L. P.; Rosten, R.; Rotaru, M.; Roth, I.; Rothberg, J.; Rousseau, D.; Royon, C. R.; Rozanov, A.; Rozen, Y.; Ruan, X.; Rubbo, F.; Rubinskiy, I.; Rud, V. I.; Rudolph, C.; Rudolph, M. S.; Rühr, F.; Ruiz-Martinez, A.; Rumyantsev, L.; Rurikova, Z.; Rusakovich, N. A.; Ruschke, A.; Rutherfoord, J. P.; Ruthmann, N.; Ruzicka, P.; Ryabov, Y. F.; Rybar, M.; Rybkin, G.; Ryder, N. C.; Saavedra, A. F.; Sacerdoti, S.; Saddique, A.; Sadeh, I.; Sadrozinski, H. F.-W.; Sadykov, R.; Tehrani, F. Safai; Sakamoto, H.; Sakurai, Y.; Salamanna, G.; Salamon, A.; Saleem, M.; Salek, D.; De Bruin, P. H. Sales; Salihagic, D.; Salnikov, A.; Salt, J.; Ferrando, B. M. Salvachua; Salvatore, D.; Salvatore, F.; Salvucci, A.; Salzburger, A.; Sampsonidis, D.; Sanchez, A.; Sánchez, J.; Martinez, V. Sanchez; Sandaker, H.; Sander, H. G.; Sanders, M. P.; Sandhoff, M.; Sandoval, T.; Sandoval, C.; Sandstroem, R.; Sankey, D. P. C.; Sansoni, A.; Santoni, C.; Santonico, R.; Santos, H.; Castillo, I. Santoyo; Sapp, K.; Sapronov, A.; Saraiva, J. G.; Sarkisyan-Grinbaum, E.; Sarrazin, B.; Sartisohn, G.; Sasaki, O.; Sasaki, Y.; Sasao, N.; Satsounkevitch, I.; Sauvage, G.; Sauvan, E.; Sauvan, J. B.; Savard, P.; Savinov, V.; Savu, D. O.; Sawyer, C.; Sawyer, L.; Saxon, D. H.; Saxon, J.; Sbarra, C.; Sbrizzi, A.; Scanlon, T.; Scannicchio, D. A.; Scarcella, M.; Schaarschmidt, J.; Schacht, P.; Schaefer, D.; Schaelicke, A.; Schaepe, S.; Schaetzel, S.; Schäfer, U.; Schaffer, A. C.; Schaile, D.; Schamberger, R. D.; Scharf, V.; Schegelsky, V. A.; Scheirich, D.; Schernau, M.; Scherzer, M. I.; Schiavi, C.; Schieck, J.; Schillo, C.; Schioppa, M.; Schlenker, S.; Schmidt, E.; Schmieden, K.; Schmitt, C.; Schmitt, C.; Schmitt, S.; Schneider, B.; Schnellbach, Y. J.; Schnoor, U.; Schoeffel, L.; Schoening, A.; Schoenrock, B. D.; Schorlemmer, A. L. S.; Schott, M.; Schouten, D.; Schovancova, J.; Schram, M.; Schramm, S.; Schreyer, M.; Schroeder, C.; Schroer, N.; Schuh, N.; Schultens, M. J.; Schultz-Coulon, H.-C.; Schulz, H.; Schumacher, M.; Schumm, B. A.; Schune, Ph.; Schwartzman, A.; Schwegler, Ph.; Schwemling, Ph.; Schwienhorst, R.; Schwindling, J.; Schwindt, T.; Schwoerer, M.; Sciacca, F. G.; Scifo, E.; Sciolla, G.; Scott, W. G.; Scutti, F.; Searcy, J.; Sedov, G.; Sedykh, E.; Seidel, S. C.; Seiden, A.; Seifert, F.; Seixas, J. M.; Sekhniaidze, G.; Sekula, S. J.; Selbach, K. E.; Seliverstov, D. M.; Sellers, G.; Seman, M.; Semprini-Cesari, N.; Serfon, C.; Serin, L.; Serkin, L.; Serre, T.; Seuster, R.; Severini, H.; Sforza, F.; Sfyrla, A.; Shabalina, E.; Shamim, M.; Shan, L. Y.; Shank, J. T.; Shao, Q. T.; Shapiro, M.; Shatalov, P. B.; Shaw, K.; Sherwood, P.; Shimizu, S.; Shimojima, M.; Shin, T.; Shiyakova, M.; Shmeleva, A.; Shochet, M. J.; Short, D.; Shrestha, S.; Shulga, E.; Shupe, M. A.; Shushkevich, S.; Sicho, P.; Sidorov, D.; Sidoti, A.; Siegert, F.; Sijacki, Dj.; Silbert, O.; Silva, J.; Silver, Y.; Silverstein, D.; Silverstein, S. B.; Simak, V.; Simard, O.; Simic, Lj.; Simion, S.; Simioni, E.; Simmons, B.; Simoniello, R.; Simonyan, M.; Sinervo, P.; Sinev, N. B.; Sipica, V.; Siragusa, G.; Sircar, A.; Sisakyan, A. N.; Sivoklokov, S. Yu.; Sjölin, J.; Sjursen, T. B.; Skinnari, L. A.; Skottowe, H. P.; Skovpen, K. Yu.; Skubic, P.; Slater, M.; Slavicek, T.; Sliwa, K.; Smakhtin, V.; Smart, B. H.; Smestad, L.; Smirnov, S. Yu.; Smirnov, Y.; Smirnova, L. N.; Smirnova, O.; Smith, K. M.; Smizanska, M.; Smolek, K.; Snesarev, A. A.; Snidero, G.; Snow, J.; Snyder, S.; Sobie, R.; Socher, F.; Sodomka, J.; Soffer, A.; Soh, D. A.; Solans, C. A.; Solar, M.; Solc, J.; Soldatov, E. Yu.; Soldevila, U.; Camillocci, E. Solfaroli; Solodkov, A. A.; Solovyanov, O. V.; Solovyev, V.; Soni, N.; Sood, A.; Sopko, V.; Sopko, B.; Sosebee, M.; Soualah, R.; Soueid, P.; Soukharev, A. M.; South, D.; Spagnolo, S.; Spanò, F.; Spearman, W. R.; Spighi, R.; Spigo, G.; Spousta, M.; Spreitzer, T.; Spurlock, B.; Denis, R. D. St.; Stahlman, J.; Stamen, R.; Stanecka, E.; Stanek, R. W.; Stanescu, C.; Stanescu-Bellu, M.; Stanitzki, M. M.; Stapnes, S.; Starchenko, E. A.; Stark, J.; Staroba, P.; Starovoitov, P.; Staszewski, R.; Stavina, P.; Steele, G.; Steinbach, P.; Steinberg, P.; Stekl, I.; Stelzer, B.; Stelzer, H. J.; Stelzer-Chilton, O.; Stenzel, H.; Stern, S.; Stewart, G. A.; Stillings, J. A.; Stockton, M. C.; Stoebe, M.; Stoerig, K.; Stoicea, G.; Stonjek, S.; Stradling, A. R.; Straessner, A.; Strandberg, J.; Strandberg, S.; Strandlie, A.; Strauss, E.; Strauss, M.; Strizenec, P.; Ströhmer, R.; Strom, D. M.; Stroynowski, R.; Stucci, S. A.; Stugu, B.; Stumer, I.; Stupak, J.; Sturm, P.; Styles, N. A.; Su, D.; Su, J.; Subramania, HS.; Subramaniam, R.; Succurro, A.; Sugaya, Y.; Suhr, C.; Suk, M.; Sulin, V. V.; Sultansoy, S.; Sumida, T.; Sun, X.; Sundermann, J. E.; Suruliz, K.; Susinno, G.; Sutton, M. R.; Suzuki, Y.; Svatos, M.; Swedish, S.; Swiatlowski, M.; Sykora, I.; Sykora, T.; Ta, D.; Tackmann, K.; Taenzer, J.; Taffard, A.; Tafirout, R.; Taiblum, N.; Takahashi, Y.; Takai, H.; Takashima, R.; Takeda, H.; Takeshita, T.; Takubo, Y.; Talby, M.; Talyshev, A. A.; Tam, J. Y. C.; Tamsett, M. C.; Tan, K. G.; Tanaka, J.; Tanaka, R.; Tanaka, S.; Tanaka, S.; Tanasijczuk, A. J.; Tani, K.; Tannoury, N.; Tapprogge, S.; Tarem, S.; Tarrade, F.; Tartarelli, G. F.; Tas, P.; Tasevsky, M.; Tashiro, T.; Tassi, E.; Delgado, A. Tavares; Tayalati, Y.; Taylor, C.; Taylor, F. E.; Taylor, G. N.; Taylor, W.; Teischinger, F. A.; Castanheira, M. Teixeira Dias; Teixeira-Dias, P.; Temming, K. K.; Ten Kate, H.; Teng, P. K.; Terada, S.; Terashi, K.; Terron, J.; Terzo, S.; Testa, M.; Teuscher, R. J.; Therhaag, J.; Theveneaux-Pelzer, T.; Thoma, S.; Thomas, J. P.; Thompson, E. N.; Thompson, P. D.; Thompson, P. D.; Thompson, A. S.; Thomsen, L. A.; Thomson, E.; Thomson, M.; Thong, W. M.; Thun, R. P.; Tian, F.; Tibbetts, M. J.; Tic, T.; Tikhomirov, V. O.; Tikhonov, Yu. A.; Timoshenko, S.; Tiouchichine, E.; Tipton, P.; Tisserant, S.; Todorov, T.; Todorova-Nova, S.; Toggerson, B.; Tojo, J.; Tokár, S.; Tokushuku, K.; Tollefson, K.; Tomlinson, L.; Tomoto, M.; Tompkins, L.; Toms, K.; Topilin, N. D.; Torrence, E.; Torres, H.; Pastor, E. Torró; Toth, J.; Touchard, F.; Tovey, D. R.; Tran, H. L.; Trefzger, T.; Tremblet, L.; Tricoli, A.; Trigger, I. M.; Trincaz-Duvoid, S.; Tripiana, M. F.; Triplett, N.; Trischuk, W.; Trocmé, B.; Troncon, C.; Trottier-McDonald, M.; Trovatelli, M.; True, P.; Trzebinski, M.; Trzupek, A.; Tsarouchas, C.; Tseng, J. C.-L.; Tsiareshka, P. V.; Tsionou, D.; Tsipolitis, G.; Tsirintanis, N.; Tsiskaridze, S.; Tsiskaridze, V.; Tskhadadze, E. G.; Tsukerman, I. I.; Tsulaia, V.; Tsung, J.-W.; Tsuno, S.; Tsybychev, D.; Tua, A.; Tudorache, A.; Tudorache, V.; Tuna, A. N.; Tupputi, S. A.; Turchikhin, S.; Turecek, D.; Cakir, I. Turk; Turra, R.; Tuts, P. M.; Tykhonov, A.; Tylmad, M.; Tyndel, M.; Uchida, K.; Ueda, I.; Ueno, R.; Ughetto, M.; Ugland, M.; Uhlenbrock, M.; Ukegawa, F.; Unal, G.; Undrus, A.; Unel, G.; Ungaro, F. C.; Unno, Y.; Urbaniec, D.; Urquijo, P.; Usai, G.; Usanova, A.; Vacavant, L.; Vacek, V.; Vachon, B.; Valencic, N.; Valentinetti, S.; Valero, A.; Valery, L.; Valkar, S.; Gallego, E. Valladolid; Vallecorsa, S.; Ferrer, J. A. Valls; Van Berg, R.; Van Der Deijl, P. C.; van der Geer, R.; van der Graaf, H.; Van Der Leeuw, R.; van der Ster, D.; van Eldik, N.; van Gemmeren, P.; Van Nieuwkoop, J.; van Vulpen, I.; van Woerden, M. C.; Vanadia, M.; Vandelli, W.; Vaniachine, A.; Vankov, P.; Vannucci, F.; Vardanyan, G.; Vari, R.; Varnes, E. W.; Varol, T.; Varouchas, D.; Vartapetian, A.; Varvell, K. E.; Vassilakopoulos, V. I.; Vazeille, F.; Schroeder, T. Vazquez; Veatch, J.; Veloso, F.; Veneziano, S.; Ventura, A.; Ventura, D.; Venturi, M.; Venturi, N.; Venturini, A.; Vercesi, V.; Verducci, M.; Verkerke, W.; Vermeulen, J. C.; Vest, A.; Vetterli, M. C.; Viazlo, O.; Vichou, I.; Vickey, T.; Boeriu, O. E. Vickey; Viehhauser, G. H. A.; Viel, S.; Vigne, R.; Villa, M.; Perez, M. Villaplana; Vilucchi, E.; Vincter, M. G.; Vinogradov, V. B.; Virzi, J.; Vitells, O.; Viti, M.; Vivarelli, I.; Vaque, F. Vives; Vlachos, S.; Vladoiu, D.; Vlasak, M.; Vogel, A.; Vokac, P.; Volpi, G.; Volpi, M.; Volpini, G.; von der Schmitt, H.; von Radziewski, H.; von Toerne, E.; Vorobel, V.; Vos, M.; Voss, R.; Vossebeld, J. H.; Vranjes, N.; Milosavljevic, M. Vranjes; Vrba, V.; Vreeswijk, M.; Anh, T. Vu; Vuillermet, R.; Vukotic, I.; Vykydal, Z.; Wagner, W.; Wagner, P.; Wahrmund, S.; Wakabayashi, J.; Walch, S.; Walder, J.; Walker, R.; Walkowiak, W.; Wall, R.; Waller, P.; Walsh, B.; Wang, C.; Wang, H.; Wang, H.; Wang, J.; Wang, J.; Wang, K.; Wang, R.; Wang, S. M.; Wang, T.; Wang, X.; Warburton, A.; Ward, C. P.; Wardrope, D. R.; Warsinsky, M.; Washbrook, A.; Wasicki, C.; Watanabe, I.; Watkins, P. M.; Watson, A. T.; Watson, I. J.; Watson, M. F.; Watts, G.; Watts, S.; Waugh, A. T.; Waugh, B. M.; Webb, S.; Weber, M. S.; Weber, S. W.; Webster, J. S.; Weidberg, A. R.; Weigell, P.; Weingarten, J.; Weiser, C.; Weits, H.; Wells, P. S.; Wenaus, T.; Wendland, D.; Weng, Z.; Wengler, T.; Wenig, S.; Wermes, N.; Werner, M.; Werner, P.; Wessels, M.; Wetter, J.; Whalen, K.; White, A.; White, M. J.; White, R.; White, S.; Whiteson, D.; Whittington, D.; Wicke, D.; Wickens, F. J.; Wiedenmann, W.; Wielers, M.; Wienemann, P.; Wiglesworth, C.; Wiik-Fuchs, L. A. M.; Wijeratne, P. A.; Wildauer, A.; Wildt, M. A.; Wilkens, H. G.; Will, J. Z.; Williams, H. H.; Williams, S.; Willis, W.; Willocq, S.; Wilson, J. A.; Wilson, A.; Wingerter-Seez, I.; Winkelmann, S.; Winklmeier, F.; Wittgen, M.; Wittig, T.; Wittkowski, J.; Wollstadt, S. J.; Wolter, M. W.; Wolters, H.; Wong, W. C.; Wosiek, B. K.; Wotschack, J.; Woudstra, M. J.; Wozniak, K. W.; Wraight, K.; Wright, M.; Wu, S. L.; Wu, X.; Wu, Y.; Wulf, E.; Wyatt, T. R.; Wynne, B. M.; Xella, S.; Xiao, M.; Xu, C.; Xu, D.; Xu, L.; Yabsley, B.; Yacoob, S.; Yamada, M.; Yamaguchi, H.; Yamaguchi, Y.; Yamamoto, A.; Yamamoto, K.; Yamamoto, S.; Yamamura, T.; Yamanaka, T.; Yamauchi, K.; Yamazaki, Y.; Yan, Z.; Yang, H.; Yang, H.; Yang, U. K.; Yang, Y.; Yanush, S.; Yao, L.; Yasu, Y.; Yatsenko, E.; Wong, K. H. Yau; Ye, J.; Ye, S.; Yen, A. L.; Yildirim, E.; Yilmaz, M.; Yoosoofmiya, R.; Yorita, K.; Yoshida, R.; Yoshihara, K.; Young, C.; Young, C. J. S.; Youssef, S.; Yu, D. R.; Yu, J.; Yu, J.; Yuan, L.; Yurkewicz, A.; Zabinski, B.; Zaidan, R.; Zaitsev, A. M.; Zaman, A.; Zambito, S.; Zanello, L.; Zanzi, D.; Zaytsev, A.; Zeitnitz, C.; Zeman, M.; Zemla, A.; Zengel, K.; Zenin, O.; Ženiš, T.; Zerwas, D.; della Porta, G. Zevi; Zhang, D.; Zhang, H.; Zhang, J.; Zhang, L.; Zhang, X.; Zhang, Z.; Zhao, Z.; Zhemchugov, A.; Zhong, J.; Zhou, B.; Zhou, L.; Zhou, N.; Zhu, C. G.; Zhu, H.; Zhu, J.; Zhu, Y.; Zhuang, X.; Zibell, A.; Zieminska, D.; Zimine, N. I.; Zimmermann, C.; Zimmermann, R.; Zimmermann, S.; Zimmermann, S.; Zinonos, Z.; Ziolkowski, M.; Zitoun, R.; Zobernig, G.; Zoccoli, A.; zur Nedden, M.; Zurzolo, G.; Zutshi, V.; Zwalinski, L.

2014-07-01

The prompt and non-prompt production cross-sections for the χ c1 and χ c2 charmonium states are measured in pp collisions at = 7 TeV with the ATLAS detector at the LHC using 4 .5 fb-1 of integrated luminosity. The χ c states are reconstructed through the radiative decay χ c → J/ψγ (with J/ψ → μ + μ -) where photons are reconstructed from γ → e + e - conversions. The production rate of the χ c2 state relative to the χ c1 state is measured for prompt and non-prompt χ c as a function of J/ψ transverse momentum. The prompt χ c cross-sections are combined with existing measurements of prompt J/ψ production to derive the fraction of prompt J/ψ produced in feed-down from χ c decays. The fractions of χ c1 and χ c2 produced in b-hadron decays are also measured. [Figure not available: see fulltext.