Implementation of the Recommendations of the Presidential Commission on the Space Shuttle Challenger Accident

NASA Technical Reports Server (NTRS)

1987-01-01

This final status report describes the actions taken by NASA in response to the recommendations of the Presidential Commission on the Space Shuttle Challenger Accident (Mission 51-L). The Commission recommendations and NASA's responses to them are summarized in the Executive Summary, which is accompanied by a schedule showing significant program milestones. A detailed discussion of the activities undertaken by NASA to implement each of the nine Commission recommendations is included and other related NASA actions required for safe return to flight are discussed. A copy of the interim plan submitted to the President one year ago and other significant reference documents are included as appendixes.

Commercial-Aircraft Protection System

NASA Astrophysics Data System (ADS)

Case, Russell L., Jr.; Wolff, Peter H.

2004-09-01

Recent world events have identified needs for a commercial aircraft defense system against Man-Portable Air Defense Systems (MANPADS), such as SA-7 and Stinger shoulder launched surface-to-air missiles. Technical challenges include target detection, identification and countermeasures. Political and societal challenges include cost, time to deployment, ground and air safety, and reliability. These challenges, as well as many others, have been met and overcome with the development of Thor Systems' Commercial-Aircraft Protection System (C-APS). C-APS makes use of commercial technology such as radar and infrared sensors with a laser-based countermeasure. Unlike adapted military systems, C-APS detects the threat long before the military versions by employing a 360 degree hemispherical scan, identifying the threat with an infrared sensor and employing a directed laser to not only deflect the target but to permanently disable its seeker. Enhanced capabilities include multiple threat elimination and closed-loop technology for kill verification. All of this is accomplished with development costs less than half that required to convert military technology, manufacturing costs significantly less than competitive products, and a maintenance cycle coincident with standard FAA requirements, which are significantly longer than current systems.

Aging and Cognitive Performance: Challenges and Implications for Physicians Practicing in the 21st Century

ERIC Educational Resources Information Center

Durning, Steven J.; Artino, Anthony R.; Holmboe, Eric; Beckman, Thomas J.; van der Vleuten, Cees; Schuwirth, Lambert

2010-01-01

The demands of physician practice are growing. Some specialties face critical shortages and a significant percentage of physicians are aging. To improve health care it is paramount to understand and address challenges, including cognitive issues, facing aging physicians. In this article, we outline several issues related to cognitive performance…

CCTC and the Process for Reauthorization of Bilingual Teacher Preparation Standards: A Critical-Historical Perspective

ERIC Educational Resources Information Center

Cadiero-Kaplan, Karen; Berta-Avila, Margarita; Flores, Juan

2007-01-01

California and the rest of the United Sates are undergoing significant challenges in providing educational opportunities for an increasingly diverse population. These challenges include inadequate literacy and numeracy skills among large segments of the student and adult populations; an ongoing shift in the demographic profile of the population,…

The effects of danofloxacin and tilmicosin on neutrophil function and lung consolidation in beef heifer calves with induced Pasteurella (Mannheimia) haemolytica pneumonia.

PubMed

Fajt, V R; Apley, M D; Roth, J A; Frank, D E; Brogden, K A; Skogerboe, T L; Shostrom, V K; Chin, Y-L

2003-06-01

Pneumonia caused by Pasteurella (Mannheimia) haemolytica was induced in weaned beef heifer calves, approximately 6 months of age. Calves were treated at 20 h after challenge with therapeutic doses of danofloxacin or tilmicosin. Peripheral blood neutrophils were collected at 3, 24 and 48 h after treatment. The ex vivo effects on neutrophil function, neutrophil apoptosis, and hematological parameters were examined, as was the effect on percentage lung consolidation. Neutrophil function assays included random migration under agarose, cytochrome C reduction, iodination, Staphylococcus aureus ingestion, chemotaxis, and antibody-dependent and antibody-independent cell-mediated cytotoxicity. Apoptosis was determined using a cell death detection kit. Killing was performed at 72 h after treatment. Statistical comparisons were made among the three groups of challenged-treated animals: saline, danofloxacin, and tilmicosin. Comparisons were also made between nonchallenged nontreated animals (NCH) and challenged saline-treated animals. There were no significant differences for any of the neutrophil function assays or neutrophil apoptosis among the challenged-treated groups. This suggests that danofloxacin and tilmicosin have no clinically significant effects on neutrophil function or apoptosis. There were also no significant differences in percentage lung consolidation among the challenged-treated groups. Significant differences were found between the NCH calves and the challenged saline-treated calves in several neutrophil assays, which were attributed to effects of P. haemolytica infection.

Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

PubMed Central

Bakshi, Fatma A.; Jaka, Hyasinta

2018-01-01

Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention. PMID:29666656

A Ship for Scientific Drilling.

ERIC Educational Resources Information Center

Peterson, M. N. A.; MacTernan, F. C.

1982-01-01

Traces the history and development of the Deep Sea Drilling Project, focusing on the Glomar Challenger, drilling improvements, and international significance. Includes photographs, illustrations, and tables. (DC)

Trajectory design for Saturnian Ocean Worlds orbiters using multidimensional Poincaré maps

NASA Astrophysics Data System (ADS)

Davis, Diane Craig; Phillips, Sean M.; McCarthy, Brian P.

2018-02-01

Missions based on low-energy orbits in the vicinity of planetary moons, such as Titan or Enceladus, involve significant end-to-end trajectory design challenges due to the gravitational effects of the distant larger primary. To address these challenges, the current investigation focuses on the visualization and use of multidimensional Poincaré maps to perform preliminary design of orbits with significant out-of-plane components, including orbits that provide polar coverage. Poincaré maps facilitate the identification of families of solutions to a given orbit problem and provide the ability to easily respond to changing inputs and requirements. A visual-based design process highlights a variety of trajectory options near Saturn's ocean worlds, including both moon-centered orbits and libration point orbits.

Clinical predictors of challenging atrioventricular node ablation procedure for rate control in patients with atrial fibrillation.

PubMed

Polin, Baptiste; Behar, Nathalie; Galand, Vincent; Auffret, Vincent; Behaghel, Albin; Pavin, Dominique; Daubert, Jean-Claude; Mabo, Philippe; Leclercq, Christophe; Martins, Raphael P

2017-10-15

Atrioventricular node (AVN) ablation is usually a simple procedure but may sometimes be challenging. We aimed at identifying pre-procedural clinical predictors of challenging AVN ablation. Patients referred for AVN ablation from 2009 to 2015 were retrospectively included. Baseline clinical data, procedural variables and outcomes of AVN ablation were collected. A "challenging procedure" was defined 1) total radiofrequency delivery to get persistent AVN block≥400s, 2) need for left-sided arterial approach or 3) failure to obtain AVN ablation. 200 patients were included (71±10years). A total of 37 (18.5%) patients had "challenging" procedures (including 9 failures, 4.5%), while 163 (81.5%) had "non-challenging" ablations. In multivariable analysis, male sex (Odds ratio (OR)=4.66, 95% confidence interval (CI): 1.74-12.46), body mass index (BMI, OR=1.08 per 1kg/m 2 , 95%CI 1.01-1.16), operator experience (OR=0.40, 95%CI 0.17-0.94), and moderate-to-severe tricuspid regurgitation (TR, OR=3.65, 95%CI 1.63-8.15) were significant predictors of "challenging" ablations. The proportion as a function of number of predictors was analyzed (from 0 to 4, including male sex, operator inexperience, a BMI>23.5kg/m 2 and moderate-to-severe TR). There was a gradual increase in the risk of "challenging" procedure with the number of predictors by patient (No predictor: 0%; 1 predictor: 6.3%; 2 predictors: 16.5%; 3 predictors: 32.5%; 4 predictors: 77.8%). Operator experience, male sex, higher BMI and the degree of TR were independent predictors of "challenging" AVN ablation procedure. The risk increases with the number of predictors by patient. Copyright © 2017. Published by Elsevier B.V.

Challenges Facing Higher Education at the Millennium. American Council on Education/Oryx Press Series on Higher Education.

ERIC Educational Resources Information Center

Hirsch, Werner Z., Ed.; Weber, Luc E., Ed.

This collection of 17 essays focuses on the major changes that higher education needs to make so that it can effectively pursue teaching and research and significantly contribute public service in a rapidly changing world. The essays include: (1) "Survey of the Main Challenges Facing Higher Education at the Millennium" (Luc E. Weber);…

Guar meal ameliorates Eimeria tenella infection in broiler chicks.

PubMed

Hassan, Sherif M; El-Gayar, Amal K; Cadwell, David J; Bailey, Christopher A; Cartwright, Aubrey L

2008-10-20

Guar meal contains relatively high levels of saponins, which are known to have antiprotozoal activity and may be effective against coccidiosis. A 2x2 factorial experiment investigated the impact of guar meal (0 or 5%) corn-soy-based starter broiler diets on chicks unchallenged or challenged with Eimeria tenella. At 1 day of age, 120 unsexed RossxRoss broiler chicks were randomly distributed among four treatment groups. Chicks were challenged with 5x10(3) sporulated oocysts of E. tenella in 0.5 ml at 10 days of age by oral gavage. Weekly body weight, body weight gains, feed conversion ratio and mortality rate were recorded for chicks fed from 0 to 21 days of age. Oocysts shed per gram feces were recorded from 6 to 10 days post-challenge. Results showed that challenged chicks fed 0% guar meal had significantly higher oocysts per gram shed in feces than the other groups. No significant differences among treatment groups in mortality rate were observed. Body weights of unchallenged and challenged chicks fed 0% guar meal were significantly higher than those fed 5% guar meal at 2 weeks of age. Results indicated that including 5% guar meal in the diet of chicks challenged with E. tenella decreased oocysts shed per gram feces and prevented bloody diarrhea, but without affects on body weight and feed conversion ratio at 11 days post-challenge.

The practices, challenges and recommendations of South African audiologists regarding managing children with auditory processing disorders

PubMed Central

Govender, Samantha; Khan, Nasim

2016-01-01

Audiologists managing children with auditory processing disorders (APD) encounter challenges that include conflicting definitions, several classification profiles, problems with differential diagnosis and a lack of standardised guidelines. The heterogeneity of the disorder and its concomitant childhood disorders makes diagnosis difficult. Linguistic and cultural issues are additional challenges faced by South African audiologists. The study aimed to describe the practices, challenges and recommendations of South African audiologists managing children with APD. A quantitative, non-experimental descriptive survey was used to obtain data from 156 audiologists registered with the Health Professions of South Africa. Findings revealed that 67% screened for APD, 42% assessed while 43% provided intervention. A variety of screening and assessment procedures were being administered, with no standard test battery identified. A range of intervention strategies being used are discussed. When the relationship between the number of years of experience and the audiologists’ level of preparedness to practice in the field of APD was compared, a statistically significant difference (p = 0.049) was seen in that participants with more than 10 years of experience were more prepared to practice in this area. Those participants having qualified as speech-language therapists and audiologists were significantly more prepared (p = 0.03) to practice than the audiologists who comprised the sample. Challenges experienced by the participants included the lack of linguistically and culturally appropriate screening and assessment tools and limited normative data. Recommendations included reviewing the undergraduate audiology training programmes, reinstituting the South African APD Taskforce, developing linguistically and culturally appropriate normative data, creating awareness among educators and involving them in the multidisciplinary team. PMID:27380913

Advanced protein formulations

PubMed Central

Wang, Wei

2015-01-01

It is well recognized that protein product development is far more challenging than that for small-molecule drugs. The major challenges include inherent sensitivity to different types of stresses during the drug product manufacturing process, high rate of physical and chemical degradation during long-term storage, and enhanced aggregation and/or viscosity at high protein concentrations. In the past decade, many novel formulation concepts and technologies have been or are being developed to address these product development challenges for proteins. These concepts and technologies include use of uncommon/combination of formulation stabilizers, conjugation or fusion with potential stabilizers, site-specific mutagenesis, and preparation of nontraditional types of dosage forms—semiaqueous solutions, nonfreeze-dried solid formulations, suspensions, and other emerging concepts. No one technology appears to be mature, ideal, and/or adequate to address all the challenges. These gaps will likely remain in the foreseeable future and need significant efforts for ultimate resolution. PMID:25858529

2014 Runtime Systems Summit. Runtime Systems Report

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

Sarkar, Vivek; Budimlic, Zoran; Kulkani, Milind

2016-09-19

This report summarizes runtime system challenges for exascale computing, that follow from the fundamental challenges for exascale systems that have been well studied in past reports, e.g., [6, 33, 34, 32, 24]. Some of the key exascale challenges that pertain to runtime systems include parallelism, energy efficiency, memory hierarchies, data movement, heterogeneous processors and memories, resilience, performance variability, dynamic resource allocation, performance portability, and interoperability with legacy code. In addition to summarizing these challenges, the report also outlines different approaches to addressing these significant challenges that have been pursued by research projects in the DOE-sponsored X-Stack and OS/R programs. Sincemore » there is often confusion as to what exactly the term “runtime system” refers to in the software stack, we include a section on taxonomy to clarify the terminology used by participants in these research projects. In addition, we include a section on deployment opportunities for vendors and government labs to build on the research results from these projects. Finally, this report is also intended to provide a framework for discussing future research and development investments for exascale runtime systems, and for clarifying the role of runtime systems in exascale software.« less

Epigallocatechin-3-gallate protects Kuruma shrimp Marsupeneaus japonicus from white spot syndrome virus and Vibrio alginolyticus.

PubMed

Wang, Zhi; Sun, Baozhen; Zhu, Fei

2018-07-01

Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea and exhibits potential antibacterial and anticancer activities. In this study, EGCG was used in pathogen-challenge experiments in shrimp to discover its effect on the innate immune system of an invertebrate. Kuruma shrimp Marsupeneaus japonicus was used as an experimental model and challenged with white spot syndrome virus (WSSV) and the Gram-negative bacterium Vibrio alginolyticus. Pathogen-challenge experiments showed that EGCG pretreatment significantly delayed and reduced mortality upon WSSV and V. alginolyticus infection, with VP-28 copies of WSSV also reduced. Quantitative reverse transcription polymerase chain reaction revealed the positive influence of EGCG on several innate immune-related genes, including IMD, proPO, QM, myosin, Rho, Rab7, p53, TNF-alpha, MAPK, and NOS, and we observed positive influences on three immune parameters, including total hemocyte count and phenoloxidase and superoxide dismutase activities, by EGCG treatment. Additionally, results showed that EGCG treatment significantly reduced apoptosis upon V. alginolyticus challenge. These results indicated the positive role of EGCG in the shrimp innate immune system as an enhancer of immune parameters and an inhibitor of apoptosis, thereby delaying and reducing mortality upon pathogen challenge. Our findings provide insight into potential therapeutic or preventive functions associated with EGCG to enhance shrimp immunity and protect shrimp from pathogen infection. Copyright © 2018 Elsevier Ltd. All rights reserved.

U.S. Department of Education, Office of Inspector General Semiannual Report to Congress, October 1, 2000-March 31, 2001.

ERIC Educational Resources Information Center

Office of Inspector General (ED), Washington, DC.

The Office of Inspector General responded to a joint request by the House and Senate to update them on its audit, investigation, and inspection efforts on the most significant challenges facing the Department of Education for the October 1, 2000 to March 31, 2001 period. These challenges include improving financial management; improving the…

Long-term protective effects of methamphetamine preconditioning against single-day methamphetamine toxic challenges.

PubMed

Hodges, A B; Ladenheim, B; McCoy, M T; Beauvais, G; Cai, N; Krasnova, I N; Cadet, J L

2011-03-01

Methamphetamine (METH) use is associated with neurotoxic effects which include decreased levels of dopamine (DA), serotonin (5-HT) and their metabolites in the brain. We have shown that escalating METH dosing can protect against METH induced neurotoxicity in rats sacrificed within 24 hours after a toxic METH challenge. The purpose of the current study was to investigate if the protective effects of METH persisted for a long period of time. We also tested if a second challenge with a toxic dose of METH would cause further damage to monoaminergic terminals. Saline-pretreated rats showed significant METH-induced decreases in striatal DA and 5-HT levels in rats sacrificed 2 weeks after the challenge. Rats that received two METH challenges showed no further decreases in striatal DA or 5-HT levels in comparison to the single METH challenge. In contrast, METH-pretreated rats showed significant protection against METH-induced striatal DA and 5-HT depletion. In addition, the METH challenge causes substantial decreases in cortical 5-HT levels which were not further potentiated by a second drug challenge. METH preconditioning provided almost complete protection against METH -induced 5-HT depletion. These results are consistent with the idea that METH pretreatment renders the brain refractory to METH-induced degeneration of brain monoaminergic systems.

Psychosocial interventions for reducing vocal challenging behavior in persons with autistic disorder: a multilevel meta-analysis of single-case experiments.

PubMed

Vanderkerken, Lien; Heyvaert, Mieke; Maes, Bea; Onghena, Patrick

2013-12-01

Vocal challenging behavior (VCB) forms a common problem in individuals with autistic disorder. Since VCB is associated with negative outcomes for the individual and his or her environment, it is important to know how to manage this type of CB. To evaluate the effectiveness of several psychosocial interventions applied to decrease VCB in individuals with autistic disorder, we conducted a meta-analysis of single-case experiments (SCEs). Fifty-two SCEs, including 74 participants, were combined using a multilevel meta-analysis. The overall treatment effect was large and statistically significant. However, the effect varied significantly over the included studies and participants. Examining this variance, evidence was found for a moderator effect of VCB type and intervention type, with, on average, the largest effects for interventions used to reduce VCB including stereotypical VCB and for interventions containing both antecedent and consequence components. Age, gender, primary treatment setting, publication year, and study quality did not significantly moderate the intervention effect. Copyright © 2013 Elsevier Ltd. All rights reserved.

Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

PubMed

Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

2018-05-09

The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to communicate and advocate more effectively. Rehabilitation professionals can support people with scleroderma by providing them with information on connecting with scleroderma patient organizations or by facilitating local patient support networks.

Creating Effective Video to Promote Student-Centered Teaching

ERIC Educational Resources Information Center

Gainsburg, Julie

2009-01-01

Training and investing teachers at all career levels in student-centered practices is widely recognized as a significant challenge. Various studies document the failure of student-centered teaching practices to take hold in K-12 mathematics classrooms in significant ways, including collaborative work; problems that are cognitively demanding or…

Pedagogies for Inclusion of Junior Primary Students with Disabilities in PE

ERIC Educational Resources Information Center

Overton, Hannah; Wrench, Alison; Garrett, Robyne

2017-01-01

Background: Laws and legislation have prompted movement from special education towards inclusive education, whereby students with disabilities are included in mainstream physical education (PE) classes. It is widely acknowledged that including students with disabilities in PE presents significant challenges in relation to meeting the diverse needs…

Overview of NASA's Next Generation Air Transportation System (NextGen) Research

NASA Technical Reports Server (NTRS)

Swenson, Harry N.

2009-01-01

This slide presentation is an overview of the research for the Next Generation Air Transportation System (NextGen). Included is a review of the current air transportation system and the challenges of air transportation research. Also included is a review of the current research highlights and significant accomplishments.

Challenges to implementing Gavi's health system strengthening support in Chad and Cameroon: results from a mixed-methods evaluation.

PubMed

Dansereau, Emily; Miangotar, Yodé; Squires, Ellen; Mimche, Honoré; El Bcheraoui, Charbel

2017-11-16

Since 2005, Gavi has provided health system strengthening (HSS) grants to address bottlenecks affecting immunization services. This study is the first to evaluate the Gavi HSS implementation process in either Cameroon or Chad, two countries with significant health system challenges and poor achievement on the child and maternal health Millennium Development Goals. We triangulated quantitative and qualitative data including financial records, document review, field visit questionnaires, and key informant interviews (KII) with representatives from the Ministries of Health, Gavi, and other partners. We conducted a Root Cause Analysis of key implementation challenges, guided by the Consolidated Framework for Implementation Research. We conducted 124 field visits and 43 KIIs in Cameroon, and 57 field visits and 39 KIIs in Chad. Cameroon's and Chad's HSS programs were characterized by delayed disbursements, significant deviations from approved expenditures, and reprogramming of funds. Nearly a year after the programs were intended to be complete, many district and facility-level activities were only partially implemented and significant funds remained unabsorbed. Root causes of these challenges included unpredictable Gavi processes and disbursements, poor communication between the countries and Gavi, insufficient country planning without adequate technical assistance, lack of country staff and leadership, and weak country systems to manage finances and promote institutional memory. Though Chad and Cameroon both critically needed support to strengthen their weak health systems, serious challenges drastically limited implementation of their Gavi HSS programs. Implementation of future HSS programs in these and similar settings can be improved by transparent and reliable procedures and communication from Gavi, proposals that account for countries' programmatic capacity and the potential for delayed disbursements, implementation practices that foster learning and adaptation, and an early emphasis on developing managerial and other human resources.

Deep Space Control Challenges of the New Millennium

NASA Technical Reports Server (NTRS)

Bayard, David S.; Burdick, Garry M.

1999-01-01

The exploration of deep space presents a variety of significant control challenges. Long communication delays coupled with challenging new science objectives require high levels of system autonomy and increasingly demanding pointing and control capabilities. Historically, missions based on the use of a large single spacecraft have been successful and popular since the early days of NASA. However, these large spacecraft missions are currently being displaced by more frequent and more focused missions based on the use of smaller and less expensive spacecraft designs. This trend drives the need to design smart software and good algorithms which together with the miniaturization of control components will improve performance while replacing the heavier and more expensive hardware used in the past. NASA's future space exploration will also include mission types that have never been attempted before, posing significant challenges to the underlying control system. This includes controlled landing on small bodies (e.g., asteroids and comets), sample return missions (where samples are brought back from other planets), robotic exploration of planetary surfaces (e.g., intelligent rovers), high precision formation flying, and deep space optical interferometry, While the control of planetary spacecraft for traditional flyby and orbiter missions are based on well-understood methodologies, control approaches for many future missions will be fundamentally different. This paradigm shift will require completely new control system development approaches, system architectures, and much greater levels of system autonomy to meet expected performance in the presence of significant environmental disturbances, and plant uncertainties. This paper will trace the motivation for these changes and will layout the approach taken to meet the new challenges. Emerging missions will be used to explain and illustrate the need for these changes.

Electro-textile garments for power and data distribution

NASA Astrophysics Data System (ADS)

Slade, Jeremiah R.; Winterhalter, Carole

2015-05-01

U.S. troops are increasingly being equipped with various electronic assets including flexible displays, computers, and communications systems. While these systems can significantly enhance operational capabilities, forming reliable connections between them poses a number of challenges in terms of comfort, weight, ergonomics, and operational security. IST has addressed these challenges by developing the technologies needed to integrate large-scale cross-seam electrical functionality into virtually any textile product, including the various garments and vests that comprise the warfighter's ensemble. Using this technology IST is able to develop textile products that do not simply support or accommodate a network but are the network.

Quantifying VOC emissions from polymers: A case study

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

Schulze, J.K.; Qasem, J.S.; Snoddy, R.

1996-12-31

Evaluating residual volatile organic compound emissions emanating from low-density polyethylene can pose significant challenges. These challenges include quantifying emissions from: (a) multiple process lines with different operating conditions; (b) several different comonomers; (c) variations of comonomer content in each grade; and (d) over 120 grades of LDPE. This presentation is a Case Study outlining a project to develop grade-specific emission data for low-density polyethylene pellets. This study included extensive laboratory analyses and required the development of a relational database to compile analytical results, calculate the mean concentration and standard deviation, and generate emissions reports.

Planning as an Iterative Process

NASA Technical Reports Server (NTRS)

Smith, David E.

2012-01-01

Activity planning for missions such as the Mars Exploration Rover mission presents many technical challenges, including oversubscription, consideration of time, concurrency, resources, preferences, and uncertainty. These challenges have all been addressed by the research community to varying degrees, but significant technical hurdles still remain. In addition, the integration of these capabilities into a single planning engine remains largely unaddressed. However, I argue that there is a deeper set of issues that needs to be considered namely the integration of planning into an iterative process that begins before the goals, objectives, and preferences are fully defined. This introduces a number of technical challenges for planning, including the ability to more naturally specify and utilize constraints on the planning process, the ability to generate multiple qualitatively different plans, and the ability to provide deep explanation of plans.

To Grow or Not to Grow? A Post-Great Recession Synopsis of the Political, Financial, and Social Contract Challenges Facing the University of California. Research & Occasional Paper Series: CSHE.15.13

ERIC Educational Resources Information Center

Douglass, John Aubrey

2013-01-01

After more than two decades of state disinvestment, the University of California faces significant challenges and misunderstandings regarding its operating costs, its wide array of activities, and its mission. Reduced funding from the state for public higher education, including UC, has essentially severed the historic link between state…

IFE Chamber Technology - Status and Future Challenges

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

Meier, W.R.; Raffray, A.R.; Abdel-Khalik, S.I.

2003-07-15

Significant progress has been made on addressing critical issues for inertial fusion energy (IFE) chambers for heavy-ion, laser and Z-pinch drivers. A variety of chamber concepts are being investigated including drywall (currently favored for laser IFE), wetted-wall (applicable to both laser and ion drivers), and thick-liquid-wall (favored by heavy ion and z-pinch drivers). Recent progress and remaining challenges in developing IFE chambers are reviewed.

Deep Space Exploration: Will We Be Ready? Infectious Diseases, Microgravity and Other Forces Affecting Health Pose Challenges for Humans Planning to Explore Space

NASA Technical Reports Server (NTRS)

LaRocco, Mark T.; Pierson, Duane L.

1999-01-01

In contemplating space travel beyond earth orbits, we humans face significant barriers and major challenges. Although researchers involved in several scientific subdisciplines, including space medicine and space life sciences, may provide insights to help overcome those barriers, their efforts are at an early stage of development, leaving open many questions of potentially major consequence.

A qualitative exploration of the major challenges facing pharmacovigilance in Saudi Arabia.

PubMed

Aljadhey, Hisham; Mahmoud, Mansour A; Alshammari, Thamir M; Al-Dhaeefi, Mohammed; Le Louet, Herve; Perez-Gutthann, Susana; Pitts, Peter J

2015-09-01

To explore the challenges facing pharmacovigilance in Saudi Arabia and formulate recommendations to improve it from the perspective of healthcare professionals in Saudi Arabia. This was a qualitative study of 4 focus group discussions with pharmacists, physicians, and academicians held under the auspices of the King Saud University School of Pharmacy and the Center for Medicine in the Public Interest, Riyadh, Saudi Arabia. A total of 29 eligible healthcare professionals were invited to participate in the discussion. The predefined themes of the study were the current practice and major challenges facing pharmacovigilance in regulatory bodies, hospitals, the community, and academia, as well as recommendations to improve pharmacovigilance practice.  Of the 29 participants invited, 27 attended the discussion. Challenges facing regulatory bodies included complicated adverse drug reactions (ADR) reporting forms, lack of feedback on ADRs submitted to the Saudi Food and Drug Authority, lack of decisions from the local authority to withdraw medications, and lack of data on pharmacovigilance. The challenges to pharmacovigilance in hospitals included the lack of knowledge of the significance of ADR reporting, workload, blaming culture, and lack of collaboration between regulatory bodies and hospitals. However, challenges facing pharmaceutical industries included the lack of drug manufacturers in Saudi Arabia and lack of interest in pharmacovigilance. Recommendations to improve pharmacovigilance included the need for communication, stronger regulatory requirements, the need for research, the need for unified ADRs reporting, and continuous education and training.  The study has identified the challenges facing pharmacovigilance in Saudi Arabia and made certain recommendations to overcome them. These recommendations might be helpful for regulatory bodies to enhance spontaneous reporting and promote pharmacovigilance.

Immunomodulatory effects of feed-borne Fusarium mycotoxins in chickens infected with coccidia.

PubMed

Girgis, George N; Sharif, Shayan; Barta, John R; Boermans, Herman J; Smith, Trevor K

2008-11-01

The potential for Fusarium mycotoxins to modulate immunity was studied in chickens raised to 10 weeks of age using an enteric coccidial infection model. Experimental diets included: control, diets containing grains naturally contaminated with Fusarium mycotoxins, and diets containing contaminated grains + 0.2% polymeric glucomannan mycotoxin adsorbent (GMA). Contaminated diets contained up to 3.8 microg/g deoxynivalenol (DON), 0.3 microg/g 15-acetyl DON and 0.2 microg/g zearalenone. An optimized mixture (inducing lesions without mortality) of Eimeria acervulina, E. maxima and E. tenella was used to challenge birds at 8 weeks of age. Immune parameters were studied prior to challenge, at the end of the challenge period (7 days post-inoculation, PI), and at the end of the recovery period (14 days PI). Total serum immunoglobulin (Ig) A and IgG concentrations in challenged birds fed the contaminated diet were higher than controls at the end of the challenge period. Serum concentration of IgA, but not IgG, was significantly decreased at the end of the recovery period in birds fed the contaminated diet. The percentage of CD4+ and CD8+ cell populations in blood mononuclear cells decreased significantly at the end of the challenge period in birds fed the control or the contaminated diet compared to their percentages prior to challenge. The pre-challenge percentage of CD8+ population was restored at the end of the recovery period only in birds fed the control diet. Interferon-gamma (IFN-gamma) gene expression in caecal tonsils was up-regulated in challenged birds fed the contaminated diet at the end of the challenge period. No significant effect of diet was observed on oocyst counts despite the changes in the studied immune parameters. It was concluded that Fusarium mycotoxins modulate the avian immune system. This modulation involves alteration of gene expression but apparently does not enhance susceptibility or resistance to a primary coccidial challenge.

Including Adulthood in Music Education Perspectives and Policy: A Lifespan View

ERIC Educational Resources Information Center

Myers, David E.

2012-01-01

Music learning among adults is witnessing rapid escalation as an important area of research and practice among music education professionals. In contrast to the years encompassed by childhood and adolescence, a significant challenge in teaching adults is that average life expectancies in developed countries include some 55 to 65 years beyond age…

Engineering empty space between Si nanoparticles for lithium-ion battery anodes.

PubMed

Wu, Hui; Zheng, Guangyuan; Liu, Nian; Carney, Thomas J; Yang, Yuan; Cui, Yi

2012-02-08

Silicon is a promising high-capacity anode material for lithium-ion batteries yet attaining long cycle life remains a significant challenge due to pulverization of the silicon and unstable solid-electrolyte interphase (SEI) formation during the electrochemical cycles. Despite significant advances in nanostructured Si electrodes, challenges including short cycle life and scalability hinder its widespread implementation. To address these challenges, we engineered an empty space between Si nanoparticles by encapsulating them in hollow carbon tubes. The synthesis process used low-cost Si nanoparticles and electrospinning methods, both of which can be easily scaled. The empty space around the Si nanoparticles allowed the electrode to successfully overcome these problems Our anode demonstrated a high gravimetric capacity (~1000 mAh/g based on the total mass) and long cycle life (200 cycles with 90% capacity retention). © 2012 American Chemical Society

Enhanced pneumonia and disease in pigs vaccinated with an inactivated human-like (δ-cluster) H1N2 vaccine and challenged with pandemic 2009 H1N1 influenza virus.

PubMed

Gauger, Phillip C; Vincent, Amy L; Loving, Crystal L; Lager, Kelly M; Janke, Bruce H; Kehrli, Marcus E; Roth, James A

2011-03-24

Influenza is an economically important respiratory disease affecting swine world-wide with potential zoonotic implications. Genetic reassortment and drift has resulted in genetically and antigenically distinct swine influenza viruses (SIVs). Consequently, prevention of SIV infection is challenging due to the increased rate of genetic change and a potential lack of cross-protection between vaccine strains and circulating novel isolates. This report describes a vaccine-heterologous challenge model in which pigs were administered an inactivated H1N2 vaccine with a human-like (δ-cluster) H1 six and three weeks before challenge with H1 homosubtypic, heterologous 2009 pandemic H1N1. At necropsy, macroscopic and microscopic pneumonia scores were significantly higher in the vaccinated and challenged (Vx/Ch) group compared to non-vaccinated and challenged (NVx/Ch) pigs. The Vx/Ch group also demonstrated enhanced clinical disease and a significantly elevated pro-inflammatory cytokine profile in bronchoalveolar lavage fluid compared to the NVx/Ch group. In contrast, viral shedding and replication were significantly higher in NVx/Ch pigs although all challenged pigs, including Vx/Ch pigs, were shedding virus in nasal secretions. Hemagglutination inhibition (HI) and serum neutralizing (SN) antibodies were detected to the priming antigen in the Vx/Ch pigs but no measurable cross-reacting HI or SN antibodies were detected to pandemic H1N1 (pH1N1). Overall, these results suggest that inactivated SIV vaccines may potentiate clinical signs, inflammation and pneumonia following challenge with divergent homosubtypic viruses that do not share cross-reacting HI or SN antibodies. Published by Elsevier Ltd.

Pharmacologically induced alcohol craving in treatment seeking alcoholics correlates with alcoholism severity, but is insensitive to acamprosate

PubMed Central

Umhau, John C; Schwandt, Melanie L; Usala, Julie; Geyer, Christopher; Singley, Erick; George, David T; Heilig, Markus

2011-01-01

Modulation of alcohol craving induced by challenge stimuli may predict the efficacy of new pharmacotherapies for alcoholism. We evaluated two pharmacological challenges, the α2-adrenergic antagonist yohimbine, which reinstates alcohol seeking in rats, and the serotonergic compound meta-chlorophenylpiperazine (mCPP), previously reported to increase alcohol craving in alcoholics. To assess the predictive validity of this approach, the approved alcoholism medication acamprosate was evaluated for its ability to modulate challenge-induced cravings. A total of 35 treatment seeking alcohol dependent inpatients in early abstinence were randomized to placebo or acamprosate (2997 mg daily). Following two weeks of medication, subjects underwent three challenge sessions with yohimbine, mCPP or saline infusion under double blind conditions, carried out in counterbalanced order, and separated by at least 5 days. Ratings of cravings and anxiety, as well as biochemical measures were obtained. In all, 25 subjects completed all three sessions and were included in the analysis. Cravings were modestly, but significantly higher following both yohimbine and mCPP challenge compared with saline infusion. The mCPP, but not yohimbine significantly increased anxiety ratings. Both challenges produced robust ACTH, cortisol and prolactin responses. There was a significant correlation between craving and the degree of alcoholism severity. Acamprosate administration did not influence craving. Both yohimbine and mCPP challenges lead to elevated alcohol craving in a clinical population of alcoholics, and these cravings correlate with alcoholism severity. Under the experimental conditions used, alcohol cravings induced by these two stimuli are not sensitive to acamprosate at clinically used doses. PMID:21289601

Challenges in Hospital-Associated Infection Management: A Unit Perspective.

PubMed

Stacy, Kathleen M

2015-01-01

Maintaining a successful unit-based continuous quality improvement program for managing hospital-associated infections is a huge challenge and an overwhelming task. It requires strong organizational support and unit leadership, human and fiscal resources, time, and a dedicated and motivated nursing staff. A great deal of effort goes into implementing, monitoring, reporting, and evaluating quality improvement initiatives and can lead to significant frustration on the part of the leadership team and nursing staff when quality improvement efforts fail to produce the desired results. Each initiative presents its own unique set of challenges; however, common issues influence all initiatives. These common issues include organization and unit culture, current clinical practice guidelines being used to drive the initiatives, performance discrepancies on the part of nursing staff, availability of resources including equipment and supplies, monitoring of the data, and conflicting quality improvement priorities.

News of the Year. LJ News Report: Looking Back, Looking Ahead; Facing the Challenges of a New Era in School Librarianship; Publishing in 2001: Shake-Outs, Downsizing, and E-Book Disappointments.

ERIC Educational Resources Information Center

Berry, John; Bryant, Eric; Rogers, Michael; Albanese, Andrew; Oder, Norman; Selverstone, Harriet; Milliot, Jim

2002-01-01

Includes three reports: one from "Library Journal" that reviews significant issues of the year, including budget reversals; Internet filtering, digital copyright, distance education, and electronic books; one that discusses school librarianship, including staffing, collection development, and information literacy; and one that discusses…

Silent Bias: Challenges, Obstacles, and Strategies for Leadership Development in Academic Medicine-Lessons From Oral Histories of Women Professors at the University of Kansas.

PubMed

Pingleton, Susan K; Jones, Emily V M; Rosolowski, Tacey A; Zimmerman, Mary K

2016-08-01

Despite dramatic increases in female learners and junior faculty, a significant gap remains in female leadership in academic medicine. To assess challenges and obstacles encountered, strategies for academic success, and lessons learned for leadership development, the authors conducted an in-depth study of women full professors. The authors used a qualitative oral history approach, interviewing 87% of the cohort of female full professors at one Midwestern medical school in 2013 using a pretested, open-ended, semistructured interview guide. Interviews were videotaped and the audio recordings transcribed. Content was sorted into categories and key themes identified within each category. Participants described significant challenges: being treated with "silent bias," "being ignored," and being seen as an "other." Coping strategies included downplaying, keeping a distance, employing humor, and using symbols (e.g., white coat) to carefully present themselves. Explanations for success included intelligence, meritocracy, being even-tempered, and carefully constructing femininity. The participants recommended individual skills and actions to prepare for leadership development. Virtually all women could describe an individual mentor (sponsor), usually male, who provided essential assistance for their career success. At the same time, they stressed the importance of institutional support for diversity, especially with child care. Attaining "full professor" status is the pinnacle of academic success. Women who successfully navigated this academic ladder describe significant external and internal challenges that require multiple strategies to overcome. Leadership development entails a combination of individual support through mentors and sponsors, self-education and reflection, and organizational structural support to promote diversity.

Cow's milk allergic children-Can component-resolved diagnostics predict duration and severity?

PubMed

Petersen, Thomas Houmann; Mortz, Charlotte Gotthard; Bindslev-Jensen, Carsten; Eller, Esben

2018-03-01

Cow's milk allergy (CMA) affects 2% of all children. This study investigatescomponent-resolved diagnostics(CRD) to cow's milk proteins in children suspected of CMA, by correlating the level of CRD with outcome of the oral challenge. Furthermore, we evaluate the ability of serial CRD measurements to distinguish children with persistent CMA from children developing tolerance. We included data from 78 children referred to the Allergy Centre during a 13-year period. Results from oral food challenges including threshold, severity, and sensitization data (IgE antibodies to whole milk protein, IgE components toward milk and skin prick test (SPT)) were collected. The milk allergic children were re-evaluated with sensitization data and rechallenges regularly. Thirty-nine children had negative first challenges, and 39 had positive first challenges. The positive group was rechallenged and separated into 3 groups depending on time to remission. At inclusion, children with persistent CMA had significantly larger size of SPT and higher levels of s-IgE to milk and CRD compared to the other groups. SPT wheal size was significantly larger in children with persistent CMA compared to children outgrowing CMA. Furthermore, a correlation between s-IgE level to cow's milk and casein and the severity of the allergic reaction elicited by food challenges was found. Oral food challenge cannot be replaced by s-IgE to whole milk protein or milk components nor SPT in the diagnosis of CMA; however, high levels of milk components and s-IgE to milk increase the risk of a long-lasting or persisting CMA. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Nonclinical safety testing of biopharmaceuticals--Addressing current challenges of these novel and emerging therapies.

PubMed

Brennan, Frank R; Baumann, Andreas; Blaich, Guenter; de Haan, Lolke; Fagg, Rajni; Kiessling, Andrea; Kronenberg, Sven; Locher, Mathias; Milton, Mark; Tibbitts, Jay; Ulrich, Peter; Weir, Lucinda

2015-10-01

Non-clinical safety testing of biopharmaceuticals can present significant challenges to human risk assessment with these often innovative and complex drugs. Hot Topics in this field were discussed recently at the 4th Annual European Biosafe General Membership meeting. In this feature article, the presentations and subsequent discussions from the main sessions are summarized. The topics covered include: (i) wanted versus unwanted immune activation, (ii) bi-specific protein scaffolds, (iii) use of Pharmacokinetic (PK)/Pharmacodynamic (PD) data to impact/optimize toxicology study design, (iv) cytokine release and challenges to human translation (v) safety testing of cell and gene therapies including chimeric antigen receptor T (CAR-T) cells and retroviral vectors and (vi) biopharmaceutical development strategies encompassing a range of diverse topics including optimizing entry of monoclonal antibodies (mAbs) into the brain, safety testing of therapeutic vaccines, non-clinical testing of biosimilars, infection in toxicology studies with immunomodulators and challenges to human risk assessment, maternal and infant anti-drug antibody (ADA) development and impact in non-human primate (NHP) developmental toxicity studies, and a summary of an NC3Rs workshop on the future vision for non-clinical safety assessment of biopharmaceuticals. Copyright © 2015 Elsevier Inc. All rights reserved.

Traffic Flow Management Wrap-Up

NASA Technical Reports Server (NTRS)

Grabbe, Shon

2011-01-01

Traffic Flow Management involves the scheduling and routing of air traffic subject to airport and airspace capacity constraints, and the efficient use of available airspace. Significant challenges in this area include: (1) weather integration and forecasting, (2) accounting for user preferences in the Traffic Flow Management decision making process, and (3) understanding and mitigating the environmental impacts of air traffic on the environment. To address these challenges, researchers in the Traffic Flow Management area are developing modeling, simulation and optimization techniques to route and schedule air traffic flights and flows while accommodating user preferences, accounting for system uncertainties and considering the environmental impacts of aviation. This presentation will highlight some of the major challenges facing researchers in this domain, while also showcasing recent innovations designed to address these challenges.

You pray to your God: A qualitative analysis of challenges in the provision of safe, timely, and affordable surgical care in Uganda.

PubMed

Albutt, Katherine; Yorlets, Rachel R; Punchak, Maria; Kayima, Peter; Namanya, Didacus B; Anderson, Geoffrey A; Shrime, Mark G

2018-01-01

Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care. The framework approach was used for thematic and explanatory data analysis. The Ugandan public health care sector continues to face significant challenges in the provision of safe, timely, and affordable surgical care. These challenges can be broadly grouped into preparedness and policy, service delivery, and the financial burden of surgical care. Hospital staff reported challenges including: (1) significant delays in accessing surgical care, compounded by a malfunctioning referral system; (2) critical workforce shortages; (3) operative capacity that is limited by inadequate infrastructure and overwhelmed by emergency and obstetric volume; (4) supply chain difficulties pertaining to provision of essential medications, equipment, supplies, and blood; (5) significant, variable, and sometimes catastrophic expenditures for surgical patients and their families; and (6) a lack of surgery-specific policies and priorities. Despite these challenges, innovative strategies are being used in the public to provide surgical care to those most in need. Barriers to the provision of surgical care are cross-cutting and involve constraints in infrastructure, service delivery, workforce, and financing. Understanding current strengths and shortfalls of Uganda's surgical system is a critical first step in developing effective, targeted policy and programming that will build and strengthen its surgical capacity.

The development of a questionnaire to assess the perceptions of care staff towards people with intellectual disabilities who display challenging behaviour.

PubMed

Williams, Ruth J; Rose, John L

2007-06-01

The perceptions of staff about challenging behaviour may be a key factor in designing successful behavioural interventions. There is a lack of robust psychometric instruments designed to assess staff attributions towards incidents of challenging behaviour. The aim of this research was to develop a scale based upon the self-regulation theory of illness behaviour. Two staff focus groups identified and clarified relevant constructs to be included in the Challenging Behaviour Perception Questionnaire (CBPQ), which was then completed by 51 staff. Some correlations between the CBPQ and the Attributional Style Questionnaire were found. A significant amount of the variance in the perception of challenging behaviour was explained by the subscales of the new questionnaire. In particular, episodic timeline would seem to be a promising area for further investigation.

People, Pope and Planet: A Hermeneutic and Spectacle Analysis of "Laudato Si'" for Global Citizenship Educators

ERIC Educational Resources Information Center

Gaudelli, William

2017-01-01

Global citizenship education presents a number of challenges for educators, including the wide variety of texts available to be studied. I explore "Laudato Si'," Pope Francis' 2015 statement on global warming and human development. "Laudato Si'" includes contents that are broad, connective, and significant/relevant, making it a…

Context-specific and/or context-free challenges and opportunities in writing scholarly reviews in health care management: a conceptual note.

PubMed

Blair, John D

2011-01-01

Challenges and opportunities arise from the significantly different perspectives of context-specific versus context-free researchers and the literatures they contribute to. Reviews of one type or the other or both types of literatures may provide different understandings of the state of the art in a particular area of health care management. Suggestions for writing quality reviews are also included along with suggested topics for future reviews.

Cell and Gene Therapies: European View on Challenges in Translation and How to Address Them

PubMed Central

Rousseau, Cécile F.; Mačiulaitis, Romaldas; Śladowski, Dariusz; Narayanan, Gopalan

2018-01-01

Advanced therapy medicinal products (ATMPs), i.e., cell and gene therapy products, is a rapidly evolving field of therapeutic development. A significant proportion of the products are being developed by academia or small/medium-sized enterprises (SMEs). The many challenges in translation posed by this class of products include aspects covering: manufacturing, non-clinical development plan as relevant to clinical trial, marketing authorization, and reimbursement. In this context, the term translation refers to the relevance of non-clinical data in relation to how it impacts on appropriate and efficient clinical development. In order to successfully overcome these challenges, a clear understanding of the requirements and expectations of all the stakeholders is critical. This article aims to cover the potential challenges related to such translation and suggested approaches to find solutions based on experience and learnings from the perspective of European Union. While commercial challenges have a significant impact on the ATMPs in general, it is considered outside the scope of this article. However, by adopting a strong scientific basis for translation as suggested in this article, it is likely such an approach would help rather than harm successful real world clinical use of ATMPs.

Opportunities and Challenges for Practical Training in Public Health: Insights from Practicum Coordinators in Ontario.

PubMed

Wegener, Jessica; Petitclerc, Marilyne

2018-06-12

Dietetic educators and practicum coordinators (PC) play critical roles in preparing students for practice. Dietitians have made significant progress in the development of educational curricula, competencies, and other resources to support knowledge and skill attainment in public health. There are identified gaps in the literature concerning practical training in sustainable food systems and public health, creating barriers in knowledge exchange and improvements in practicum programs in Canada. This paper discusses the potential opportunities and challenges associated with the number of placements for practical training in public health based on interviews with PCs in Ontario. The findings are limited to the perspectives of 7 PCs with experience in practical training and are a starting point for ongoing evaluation. Identified opportunities within traditional and "emerging settings" for practical training in public health included: the uniqueness of the experience, the potential for students to learn outside their comfort zones, and greater possibilities for dietitians in new roles and settings. Challenges included the need for significant PC engagement with nondietetic preceptors and a narrow view of dietetic practice among some dietitians. Interprofessional teams, emerging settings, and flexible learning approaches may create and support practical training opportunities in food systems and public health going forward.

Fear of Vomiting and Low Body Weight in Two Pediatric Patients: Diagnostic Challenges.

PubMed

Maertens, Charlotte; Couturier, Jennifer; Grant, Christina; Johnson, Natasha

2017-01-01

Fear of vomiting can be a symptom associated with several disorders, including Eating Disorders (ED), Specific Phobia (Emetophobia), Avoidant Restrictive Food Intake Disorder (ARFID) and Obsessive Compulsive Disorder (OCD), making proper diagnosis challenging. At this time the literature exploring this symptom is limited, and to our knowledge very few cases have been described in the child and adolescent population. We report here the cases of one child and one adolescent presenting with significant weight loss, food restriction and fear of vomiting. The child's fear of vomiting masked a concurrent desire to achieve fitness and weight loss, which was uncovered following weight restoration. The adolescent patient, although significantly underweight and food avoidant, also expressed no concerns with body image, until weight restored. The history, course in hospital and management of these patients is discussed, along with several challenges that complicated the diagnosis.

Barrett Wendell's Theory of Discourse.

ERIC Educational Resources Information Center

Newkirk, Thomas

1991-01-01

Discusses Barrett Wendell's theory of discourse, including a critique of his definitions and an assessment of his discourse scheme. Challenges the image of Wendell as a technocrat who never rose above a consideration of style to examine more significant rhetorical issues. (MG)

Implantable radio frequency identification sensors: wireless power and communication.

PubMed

Hutchens, Chriswell; Rennaker, Robert L; Venkataraman, Srinivasan; Ahmed, Rehan; Liao, Ran; Ibrahim, Tamer

2011-01-01

There are significant technical challenges in the development of a fully implantable wirelessly powered neural interface. Challenges include wireless transmission of sufficient power to the implanted device to ensure reliable operation for decades without replacement, minimizing tissue heating, and adequate reliable communications bandwidth. Overcoming these challenges is essential for the development of implantable closed loop system for the treatment of disorders ranging from epilepsy, incontinence, stroke and spinal cord injury. We discuss the development of the wireless power, communication and control for a Radio-Frequency Identification Sensor (RFIDS) system with targeted power range for a 700 mV, 30 to 40 uA load attained at -2 dBm.

Financial sustainability of academic health centers: identifying challenges and strategic responses.

PubMed

Stimpson, Jim P; Li, Tao; Shiyanbola, Oyewale O; Jacobson, Janelle J

2014-06-01

Academic health centers (AHCs) play a vital role in the health care system. The training of health care personnel and delivery of health care services, especially to the most complex and financially challenged patients, has been a responsibility increasingly shouldered by AHCs over the years. Additionally, AHCs play a significant role in researching and developing new treatment protocols, including discovering and validating new health technologies. However, AHCs face unique financial challenges in fulfilling their social mission in the health care system. Reforms being implemented under the Affordable Care Act and shifting economic patterns are threatening the financial sustainability of AHCs.The authors review challenges facing AHCs, including training new health care professionals with fewer funding resources, disproportionate clinical care of complex and costly patients, charity care to uninsured and underinsured, and reduced research funding opportunities. Then, they provide a review of some potential solutions to these challenges, including new reimbursement methods, improvements in operational efficiency, price regulation, subsidization of education, improved decision making and communication, utilization of industrial management tools, and increasing internal and external cooperation. Devising solutions to the evolving problems of AHCs is crucial to improving health care delivery in the United States. Most likely, a combination of market, government, and system reforms will be needed to improve the viability of AHCs and assist them in fulfilling their social and organizational missions.

Innovation Inspired by Nature: Capabilities, Potentials and Challenges

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2012-01-01

Through evolution, nature came up with many effective solutions to its challenges and continually improving them. By mimicking, coping and being inspired, humans have been using Nature's solutions to address their own challenges. In recent years, the implementation of nature's capabilities has intensified with our growing understanding of the various biological and nastic mechanisms and processes. Successes include even the making of humanlike robots that perform such lifelike tasks as walking, talking, making eye-contact, interpreting speech and facial expressions, as well as many other humanlike functions. Generally, once humans are able to implement a function then, thru rapid advances in technology, capabilities are developed that can significantly exceed the original source of inspiration in Nature. Examples include flight where there is no species that can fly as high, carry so much mass, has so large dimensions and fly so fast, and operate at as such extreme conditions as our aircraft and other aerospace systems. However, using the capabilities of today's technology, there are many challenges that are not feasible to address in mimicking characteristics of species and plants. In this manuscript, state-of-the-art of biomimetic capabilities, potentials and challenges are reviewed.

An Appraisal of Social Network Theory and Analysis as Applied to Public Health: Challenges and Opportunities.

PubMed

Valente, Thomas W; Pitts, Stephanie R

2017-03-20

The use of social network theory and analysis methods as applied to public health has expanded greatly in the past decade, yielding a significant academic literature that spans almost every conceivable health issue. This review identifies several important theoretical challenges that confront the field but also provides opportunities for new research. These challenges include (a) measuring network influences, (b) identifying appropriate influence mechanisms, (c) the impact of social media and computerized communications, (d) the role of networks in evaluating public health interventions, and (e) ethics. Next steps for the field are outlined and the need for funding is emphasized. Recently developed network analysis techniques, technological innovations in communication, and changes in theoretical perspectives to include a focus on social and environmental behavioral influences have created opportunities for new theory and ever broader application of social networks to public health topics.

Inhalation delivery of protein therapeutics.

PubMed

Kane, Colleen; O'Neil, Karyn; Conk, Michelle; Picha, Kristen

2013-04-01

Inhaled therapeutics are used routinely to treat a variety of pulmonary diseases including asthma, COPD and cystic fibrosis. In addition, biological therapies represent the fastest growing segment of approved pharmaceuticals. However, despite the increased availability of biological therapies, nearly all inhaled therapeutics are small molecule drugs with only a single inhaled protein therapeutic approved. There remains a significant unmet need for therapeutics in pulmonary diseases, and biological therapies with potential to alter disease progression represent a significant opportunity to treat these challenging diseases. This review provides a background into efforts to develop inhaled biological therapies and highlights some of the associated challenges. In addition, we speculate on the ideal properties of a biologic therapy for inhaled delivery.

Gut Health of Pigs: Challenge Models and Response Criteria with a Critical Analysis of the Effectiveness of Selected Feed Additives - A Review.

PubMed

Adewole, D I; Kim, I H; Nyachoti, C M

2016-07-01

The gut is the largest organ that helps with the immune function. Gut health, especially in young pigs has a significant benefit to health and performance. In an attempt to maintain and enhance intestinal health in pigs and improve productivity in the absence of in-feed antibiotics, researchers have evaluated a wide range of feed additives. Some of these additives such as zinc oxide, copper sulphate, egg yolk antibodies, mannan-oligosaccharides and spray dried porcine plasma and their effectiveness are discussed in this review. One approach to evaluate the effectiveness of these additives in vivo is to use an appropriate disease challenge model. Over the years, researchers have used a number of challenge models which include the use of specific strains of enterotoxigenic Escherichia coli, bacteria lipopolysaccharide challenge, oral challenge with Salmonella enteric serotype Typhimurium, sanitation challenge, and Lawsonia intercellularis challenge. These challenge models together with the criteria used to evaluate the responses of the animals to them are also discussed in this review.

Gut Health of Pigs: Challenge Models and Response Criteria with a Critical Analysis of the Effectiveness of Selected Feed Additives — A Review

PubMed Central

Adewole, D. I.; Kim, I. H.; Nyachoti, C. M.

2016-01-01

The gut is the largest organ that helps with the immune function. Gut health, especially in young pigs has a significant benefit to health and performance. In an attempt to maintain and enhance intestinal health in pigs and improve productivity in the absence of in-feed antibiotics, researchers have evaluated a wide range of feed additives. Some of these additives such as zinc oxide, copper sulphate, egg yolk antibodies, mannan-oligosaccharides and spray dried porcine plasma and their effectiveness are discussed in this review. One approach to evaluate the effectiveness of these additives in vivo is to use an appropriate disease challenge model. Over the years, researchers have used a number of challenge models which include the use of specific strains of enterotoxigenic Escherichia coli, bacteria lipopolysaccharide challenge, oral challenge with Salmonella enteric serotype Typhimurium, sanitation challenge, and Lawsonia intercellularis challenge. These challenge models together with the criteria used to evaluate the responses of the animals to them are also discussed in this review. PMID:26954144

Implantable brain computer interface: challenges to neurotechnology translation.

PubMed

Konrad, Peter; Shanks, Todd

2010-06-01

This article reviews three concepts related to implantable brain computer interface (BCI) devices being designed for human use: neural signal extraction primarily for motor commands, signal insertion to restore sensation, and technological challenges that remain. A significant body of literature has occurred over the past four decades regarding motor cortex signal extraction for upper extremity movement or computer interface. However, little is discussed regarding postural or ambulation command signaling. Auditory prosthesis research continues to represent the majority of literature on BCI signal insertion. Significant hurdles continue in the technological translation of BCI implants. These include developing a stable neural interface, significantly increasing signal processing capabilities, and methods of data transfer throughout the human body. The past few years, however, have provided extraordinary human examples of BCI implant potential. Despite technological hurdles, proof-of-concept animal and human studies provide significant encouragement that BCI implants may well find their way into mainstream medical practice in the foreseeable future.

Space flight nutrition research: platforms and analogs

NASA Technical Reports Server (NTRS)

Smith, Scott M.; Uchakin, Peter N.; Tobin, Brian W.

2002-01-01

Conducting research during actual or simulated weightlessness is a challenging endeavor, where even the simplest activities may present significant challenges. This article reviews some of the potential obstacles associated with performing research during space flight and offers brief descriptions of current and previous space research platforms and ground-based analogs, including those for human, animal, and cell-based research. This review is intended to highlight the main issues of space flight research analogs and leave the specifics for each physiologic system for the other papers in this section.

Photochemical Carboxylation of Activated C(sp3 )-H Bonds with CO2.

PubMed

Gui, Yong-Yuan; Zhou, Wen-Jun; Ye, Jian-Heng; Yu, Da-Gang

2017-04-10

From ugly duckling to beautiful C1: Although CO 2 may represent an ideal C1 source, it is challenging to use it as a raw material and direct carboxylation with CO 2 has mainly been confined to highly reactive species. However, recent significant breakthroughs have been made in photochemical carboxylation of challenging, un-acidic, C(sp 3 )-H bonds, including benzylic, allylic and amine C-H bonds. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Black swans, wicked problems, and science during crises

USGS Publications Warehouse

Machlis, G.E.; McNutt, M.K.

2011-01-01

Oceanic resources face challenges that are significant and widespread, including (but not limited to) overharvesting, climate change, selected stock collapse, coral reef decline, species extinction, pollution, and more. These challenges are the focus of much ocean science, which is helping to inform policy and guide management actions. The steady growth of research results and the emergence of new research needs have been systematically reviewed through periodic assessments, such as those of the Intergovernmental Oceanographic Commission (Valdés et al., 2010).

Fostering sustained energy behavior change and increasing energy literacy in a student housing energy challenge

NASA Astrophysics Data System (ADS)

Brewer, Robert Stephen

We designed the Kukui Cup challenge to foster energy conservation and increase energy literacy. Based on a review of the literature, the challenge combined a variety of elements into an overall game experience, including: real-time energy feedback, goals, commitments, competition, and prizes. We designed a software system called Makahiki to provide the online portion of the Kukui Cup challenge. Energy use was monitored by smart meters installed on each floor of the Hale Aloha residence halls on the University of Hawai'i at Manoa campus. In October 2011, we ran the UH Kukui Cup challenge for the over 1000 residents of the Hale Aloha towers. To evaluate the Kukui Cup challenge, I conducted three experiments: challenge participation, energy literacy, and energy use. Many residents participated in the challenge, as measured by points earned and actions completed through the challenge website. I measured the energy literacy of a random sample of Hale Aloha residents using an online energy literacy questionnaire administered before and after the challenge. I found that challenge participants' energy knowledge increased significantly compared to non-challenge participants. Positive self-reported energy behaviors increased after the challenge for both challenge participants and non-participants, leading to the possibility of passive participation by the non-challenge participants. I found that energy use varied substantially between and within lounges over time. Variations in energy use over time complicated the selection of a baseline of energy use to compare the levels during and after the challenge. The best team reduced its energy use during the challenge by 16%. However, team energy conservation did not appear to correlate to participation in the challenge, and there was no evidence of sustained energy conservation after the challenge. The problems inherent in assessing energy conservation using a baseline call into question this common practice. My research has generated several contributions, including: a demonstration of increased energy literacy as a result of the challenge, the discovery of fundamental problems with the use of baselines for assessing energy competitions, the creation of two open source software systems, and the creation of an energy literacy assessment instrument.

Profiling 976 ToxCast chemicals across 331 enzymatic and receptor signaling assays

EPA Science Inventory

Understanding potential health risks is a significant challenge for large numbers of diverse chemicals with poorly characterized exposures and mechanisms of toxicities. The present study analyzes chemical-target activity profiles of 976 chemicals (including failed pharmaceuticals...

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

Cutler, Dylan; Frank, Stephen; Slovensky, Michelle

Rich, well-organized building performance and energy consumption data enable a host of analytic capabilities for building owners and operators, from basic energy benchmarking to detailed fault detection and system optimization. Unfortunately, data integration for building control systems is challenging and costly in any setting. Large portfolios of buildings--campuses, cities, and corporate portfolios--experience these integration challenges most acutely. These large portfolios often have a wide array of control systems, including multiple vendors and nonstandard communication protocols. They typically have complex information technology (IT) networks and cybersecurity requirements and may integrate distributed energy resources into their infrastructure. Although the challenges are significant,more » the integration of control system data has the potential to provide proportionally greater value for these organizations through portfolio-scale analytics, comprehensive demand management, and asset performance visibility. As a large research campus, the National Renewable Energy Laboratory (NREL) experiences significant data integration challenges. To meet them, NREL has developed an architecture for effective data collection, integration, and analysis, providing a comprehensive view of data integration based on functional layers. The architecture is being evaluated on the NREL campus through deployment of three pilot implementations.« less

Fat-Soluble Vitamins: Clinical Indications and Current Challenges for Chromatographic Measurement

PubMed Central

Albahrani, Ali A.; Greaves, Ronda F.

2016-01-01

Fat-soluble vitamins, including vitamins A, D and E, are required for a wide variety of physiological functions. Over the past two decades, deficiencies of these vitamins have been associated with increased risk of cancer, type II diabetes mellitus and a number of immune system disorders. In addition, there is increasing evidence of interactions between these vitamins, especially between vitamins A and D. As a result of this enhanced clinical association with disease, translational clinical research and laboratory requests for vitamin measurements have significantly increased. These laboratory requests include measurement of 25-OHD (vitamin D), retinol (vitamin A) and α-tocopherol (vitamin E); the most accepted blood indicators for the assessment of body fat-soluble vitamin (FSV) status. There are significant obstacles to precise FSV measurement in blood. These obstacles include their physical and chemical properties, incomplete standardisation of measurement and limitations in the techniques that are currently used for quantification. The aim of this review is to briefly outline the metabolism and interactions of FSV as a prelude to identifying the current challenges for the quantification of blood vitamins A, D and E. PMID:27057076

Fat-Soluble Vitamins: Clinical Indications and Current Challenges for Chromatographic Measurement.

PubMed

Albahrani, Ali A; Greaves, Ronda F

2016-02-01

Fat-soluble vitamins, including vitamins A, D and E, are required for a wide variety of physiological functions. Over the past two decades, deficiencies of these vitamins have been associated with increased risk of cancer, type II diabetes mellitus and a number of immune system disorders. In addition, there is increasing evidence of interactions between these vitamins, especially between vitamins A and D. As a result of this enhanced clinical association with disease, translational clinical research and laboratory requests for vitamin measurements have significantly increased. These laboratory requests include measurement of 25-OHD (vitamin D), retinol (vitamin A) and α-tocopherol (vitamin E); the most accepted blood indicators for the assessment of body fat-soluble vitamin (FSV) status. There are significant obstacles to precise FSV measurement in blood. These obstacles include their physical and chemical properties, incomplete standardisation of measurement and limitations in the techniques that are currently used for quantification. The aim of this review is to briefly outline the metabolism and interactions of FSV as a prelude to identifying the current challenges for the quantification of blood vitamins A, D and E.

Evaluation of the efficacy of an autogenous Escherichia coli vaccine in broiler breeders.

PubMed

Li, Lili; Thøfner, Ida; Christensen, Jens Peter; Ronco, Troels; Pedersen, Karl; Olsen, Rikke H

2017-06-01

In poultry production Escherichia coli autogenous vaccines are often used. However, the efficacy of autogenous E. coli vaccinations has not been evaluated experimentally in chickens after start of lay. The aim of the present study was to evaluate the protective effect of an autogenous E. coli vaccine in broiler breeders. Three groups of 28-week-old broiler breeders (unvaccinated, vaccinated once and twice, respectively) were challenged with a homologous E. coli strain (same strain as included in the vaccine) or a heterologous challenge strain in an experimental ascending model. The clinical outcome was most pronounced in the unvaccinated group; however, the vast majority of chickens in the vaccinated groups had severe pathological manifestations similar to findings in the unvaccinated group after challenge with a homologous as well as a heterologous E. coli strain. Although significant titre rises in IgY antibodies were observed in the twice vaccinated group, antibodies did not confer significant protection in terms of pathological impact. Neither could transfer of maternal-derived antibodies to offspring be demonstrated. In conclusion, with the use of the present model for ascending infection, significant protection of an autogenous E. coli vaccine against neither a homologous nor a heterologous E. coli challenge could not be documented.

The promise of e-health--a Canadian perspective.

PubMed

Alvarez, Richard C

2004-01-01

Canadians value their health care system above any other social programme. Canada's system of health care faces significant financial and population pressures, relating to cost, access, quality, accountability, and the intergration of information and communication technologies (ICTs). The health-system also faces certain unique challenges that include care delivery within a highly decentralised system of financing and accountability, and care delivery to a significant portion of the population sparsely distributed across a land mass of 10 million square kilometres, in areas of extreme climatic conditions. All of these challenges are significant catalysts in the development of technologies that aim to significantly mitigate or eliminate these selfsame challenges. The system is undergoing widespread review, nationally and within each province and territory, where the bulk of care provision is financed and managed. The challenges are being addressed by national, regional and provincial initiatives in the public, private and not-for-profit sectors. The promise of e-health lies in the manner and degree to which it can mitigate or resolve these challenges to the health system and build on advancements in ICTs supporting the development of a health infostructure. Canada is actively developing and implementing technological solutions to deliver health information and health care services across the country. These solutions, while exciting and promising, also present new challenges, particularly in regard to acceptable standards, choice of technologies, overcoming traditional jurisdictional boundaries, up-front investment, and privacy and confidentiality. Many organizations and governments are working to address these challenges. Canada Health Infoway, a not-for-profit corporation, was founded by the first ministers in 2001 to accelerate the establishment of an interoperable, pan-Canadian electronic health record. It works with partners in the federal, provincial and territorial jurisdictions to define replicable solutions for establishment of the major elements necessary to achieve this goal. The Canadian Institute for Health Information (CIHI) will also continue to play an increasingly significant role in these initiatives, as the management of health information becomes a more crucial factor in the successful delivery of health care services in the new millennium.

Valuable yet Vulnerable-A review of the challenges encountered by older nurses in the workplace.

PubMed

Ryan, C; Bergin, M; Wells, J S

2017-07-01

As the global nursing workforce ages, developing a comprehensive understanding of the experiences, needs and values specific to older nurses is increasingly significant. This paper reviews the evidence with regard to the specific challenges encountered by older nurses in the workplace. A scoping review of the published literature was conducted using the electronic databases Medline, CINAHL, PsycINFO, Science Direct and Google Scholar. A total of 20 papers were included in this review, most of which were qualitative (n=14). Three quantitative studies were identified (including one study which combined a physical exam with survey methods) as well as three mixed method studies. The challenges faced by older nurses in their practice are synthesised across three primary domains: Nursing and the ageing body; Recognition and support of the older nurse and Demands associated with middle-age. As older nurses form a substantial proportion of the healthcare workforce in many countries, the development and implementation of strategies to address these challenges is of utmost importance. Copyright © 2017 Elsevier Ltd. All rights reserved.

The 20-20-20 Airships NASA Centennial Challenge

NASA Astrophysics Data System (ADS)

Kiessling, Alina; Diaz, Ernesto; Miller, Sarah; Rhodes, Jason; Ortega, Sam; Hall, Jeffrey L.; Friedl, Randy; Booth, Jeff

2015-01-01

A NASA Centennial Challenge; (www.nasa.gov/challenges) is in development to spur innovation in stratospheric airships as a science platform. We anticipate a multi-million dollar class prize for the first organization to fly a powered airship that remains stationary at 20km (65,000 ft) altitude for over 20 hours with a 20kg payload. The design must be scalable to longer flights with more massive payloads.In NASA's constrained budget environment, there are few opportunities for space missions in astronomy and Earth science, and these have very long lead times. We believe that airships (powered, maneuverable, lighter-than-air vehicles) could offer significant gains in observing time, sky and ground coverage, data downlink capability, and continuity of observations over existing suborbital options at competitive prices. This technology would also have broad commercial applications including communications and asset tracking. We seek to spur private industry (or non-profit institutions, including Universities) to demonstrate the capability for sustained airship flights as astronomy and Earth science platforms. This poster will introduce the challenge in development and provide details of who to contact for more information.

Veterinary parasitology teaching in China in the 21st century - Challenges, opportunities and perspectives.

PubMed

Liu, Guo-Hua; Zhang, Long-Xian; Zou, Feng-Cai; Yuan, Zi-Guo; Zhao, Guang-Hui; Hu, Min; Suo, Xun; Zhu, Xing-Quan

2018-03-15

China has made significant achievements in social-economic development in the last three decades, and the numbers of livestock and companion animals are rapidly increasing. Some advances have been made in the control and prevention of animal parasitic diseases, but there are still some significant challenges, particularly in relation to foodborne parasitic zoonoses and vector-borne diseases. In addition, new molecular (e.g., genomic and transcriptomic) technologies have been developed and are gradually being introduced into the veterinary parasitology field. Therefore, teaching of veterinary parasitology in Chinese universities has undergone significant changes over the years, in terms of topics, depth and breadth, and also in the ways in which courses are delivered. In this article, we describe the current status of veterinary parasitology teaching at the undergraduate and postgraduate levels in Chinese universities, summarise changes and improvement in veterinary parasitology teaching, and discuss the challenges and opportunities for veterinary parasitology teaching in the 21st century, including the use of new teaching technologies and the integration of the "One Health" concept into veterinary parasitology courses. Copyright © 2018 Elsevier B.V. All rights reserved.

The challenges, advantages and future of phenome-wide association studies.

PubMed

Hebbring, Scott J

2014-02-01

Over the last decade, significant technological breakthroughs have revolutionized human genomic research in the form of genome-wide association studies (GWASs). GWASs have identified thousands of statistically significant genetic variants associated with hundreds of human conditions including many with immunological aetiologies (e.g. multiple sclerosis, ankylosing spondylitis and rheumatoid arthritis). Unfortunately, most GWASs fail to identify clinically significant associations. Identifying biologically significant variants by GWAS also presents a challenge. The GWAS is a phenotype-to-genotype approach. As a complementary/alternative approach to the GWAS, investigators have begun to exploit extensive electronic medical record systems to conduct a genotype-to-phenotype approach when studying human disease - specifically, the phenome-wide association study (PheWAS). Although the PheWAS approach is in its infancy, this method has already demonstrated its capacity to rediscover important genetic associations related to immunological diseases/conditions. Furthermore, PheWAS has the advantage of identifying genetic variants with pleiotropic properties. This is particularly relevant for HLA variants. For example, PheWAS results have demonstrated that the HLA-DRB1 variant associated with multiple sclerosis may also be associated with erythematous conditions including rosacea. Likewise, PheWAS has demonstrated that the HLA-B genotype is not only associated with spondylopathies, uveitis, and variability in platelet count, but may also play an important role in other conditions, such as mastoiditis. This review will discuss and compare general PheWAS methodologies, describe both the challenges and advantages of the PheWAS, and provide insight into the potential directions in which PheWAS may lead. © 2013 The Authors. Immunology Published by John Wiley & Sons Ltd.

Profiling 976 ToxCast chemicals across 331 enzymatic and receptor signaling assays (Communities of Practice)

EPA Science Inventory

Understanding potential health risks is a significant challenge for large numbers of diverse chemicals with poorly characterized exposures and mechanisms of toxicities. The present study analyzes chemical-target activity profiles of 976 chemicals (including failed pharmaceuticals...

The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms.

PubMed

Barrett, Frederick S; Bradstreet, Matthew P; Leoutsakos, Jeannie-Marie S; Johnson, Matthew W; Griffiths, Roland R

2016-12-01

Acute adverse psychological reactions to classic hallucinogens ("bad trips" or "challenging experiences"), while usually benign with proper screening, preparation, and support in controlled settings, remain a safety concern in uncontrolled settings (such as illicit use contexts). Anecdotal and case reports suggest potential adverse acute symptoms including affective (panic, depressed mood), cognitive (confusion, feelings of losing sanity), and somatic (nausea, heart palpitation) symptoms. Responses to items from several hallucinogen-sensitive questionnaires (Hallucinogen Rating Scale, the States of Consciousness Questionnaire, and the Five-Dimensional Altered States of Consciousness questionnaire) in an Internet survey of challenging experiences with the classic hallucinogen psilocybin were used to construct and validate a Challenging Experience Questionnaire. The stand-alone Challenging Experience Questionnaire was then validated in a separate sample. Seven Challenging Experience Questionnaire factors (grief, fear, death, insanity, isolation, physical distress, and paranoia) provide a phenomenological profile of challenging aspects of experiences with psilocybin. Factor scores were associated with difficulty, meaningfulness, spiritual significance, and change in well-being attributed to the challenging experiences. The factor structure did not differ based on gender or prior struggle with anxiety or depression. The Challenging Experience Questionnaire provides a basis for future investigation of predictors and outcomes of challenging experiences with classic hallucinogens. © The Author(s) 2016.

Photonic integrated circuits: new challenges for lithography

NASA Astrophysics Data System (ADS)

Bolten, Jens; Wahlbrink, Thorsten; Prinzen, Andreas; Porschatis, Caroline; Lerch, Holger; Giesecke, Anna Lena

2016-10-01

In this work routes towards the fabrication of photonic integrated circuits (PICs) and the challenges their fabrication poses on lithography, such as large differences in feature dimension of adjacent device features, non-Manhattan-type features, high aspect ratios and significant topographic steps as well as tight lithographic requirements with respect to critical dimension control, line edge roughness and other key figures of merit not only for very small but also for relatively large features, are highlighted. Several ways those challenges are faced in today's low-volume fabrication of PICs, including the concept multi project wafer runs and mix and match approaches, are presented and possible paths towards a real market uptake of PICs are discussed.

Sensory-Challenge Balance Exercises Improve Multisensory Reweighting in Fall-Prone Older Adults.

PubMed

Allison, Leslie K; Kiemel, Tim; Jeka, John J

2018-04-01

Multisensory reweighting (MSR) deficits in older adults contribute to fall risk. Sensory-challenge balance exercises may have value for addressing the MSR deficits in fall-prone older adults. The purpose of this study was to examine the effect of sensory-challenge balance exercises on MSR and clinical balance measures in fall-prone older adults. We used a quasi-experimental, repeated-measures, within-subjects design. Older adults with a history of falls underwent an 8-week baseline (control) period. This was followed by an 8-week intervention period that included 16 sensory-challenge balance exercise sessions performed with computerized balance training equipment. Measurements, taken twice before and once after intervention, included laboratory measures of MSR (center of mass gain and phase, position, and velocity variability) and clinical tests (Activities-specific Balance Confidence Scale, Berg Balance Scale, Sensory Organization Test, Limits of Stability test, and lower extremity strength and range of motion). Twenty adults 70 years of age and older with a history of falls completed all 16 sessions. Significant improvements were observed in laboratory-based MSR measures of touch gain (P = 0.006) and phase (P = 0.05), Berg Balance Scale (P = 0.002), Sensory Organization Test (P = 0.002), Limits of Stability Test (P = 0.001), and lower extremity strength scores (P = 0.005). Mean values of vision gain increased more than those for touch gain, but did not reach significance. A balance exercise program specifically targeting multisensory integration mechanisms improved MSR, balance, and lower extremity strength in this mechanistic study. These valuable findings provide the scientific rationale for sensory-challenge balance exercise to improve perception of body position and motion in space and potential reduction in fall risk.

Cultural and Family Challenges to Managing Type 2 Diabetes in Immigrant Chinese Americans

PubMed Central

Chesla, Catherine A.; Chun, Kevin M.; Kwan, Christine M.L.

2009-01-01

OBJECTIVE Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. RESEARCH DESIGN AND METHODS This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. RESULTS Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. CONCLUSIONS Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted. PMID:19628812

Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans.

PubMed

Chesla, Catherine A; Chun, Kevin M; Kwan, Christine M L

2009-10-01

Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted.

Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease

PubMed Central

2011-01-01

Background Due to the restrictive nature of a gluten-free diet, celiac patients are looking for alternative therapies. While drug-development programs include gluten challenges, knowledge regarding the duration of gluten challenge and gluten dosage is insufficient. We challenged adult celiac patients with gluten with a view to assessing the amount needed to cause some small-bowel mucosal deterioration. Methods Twenty-five celiac disease adults were challenged with low (1-3 g) or moderate (3-5g) doses of gluten daily for 12 weeks. Symptoms, small-bowel morphology, densities of CD3+ intraepithelial lymphocytes (IELs) and celiac serology were determined. Results Both moderate and low amounts of gluten induced small-bowel morphological damage in 67% of celiac patients. Moderate gluten doses also triggered mucosal inflammation and more gastrointestinal symptoms leading to premature withdrawals in seven cases. In 22% of those who developed significant small- intestinal damage, symptoms remained absent. Celiac antibodies seroconverted in 43% of the patients. Conclusions Low amounts of gluten can also cause significant mucosal deterioration in the majority of the patients. As there are always some celiac disease patients who will not respond within these conditions, sample sizes must be sufficiently large to attain to statistical power in analysis. PMID:22115041

Best Practices in Working with Students with Emotion Dysregulation

ERIC Educational Resources Information Center

Cunningham, Jennifer; Mendez, Linda M. Raffaele; Sundman-Wheat, Ashley N.

2011-01-01

Students with emotion dysregulation have significant difficulty modulating emotional reactions, particularly in response to frustration or challenge. These children can present with a variety of DSM diagnoses in schools, including attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), major depressive disorder (MDD),…

The American Science Pipeline: Sustaining Innovation in a Time of Economic Crisis

ERIC Educational Resources Information Center

Hue, Gillian; Sales, Jessica; Comeau, Dawn; Lynn, David G.; Eisen, Arri

2010-01-01

Significant limitations have emerged in America's science training pipeline, including inaccessibility, inflexibility, financial limitations, and lack of diversity. We present three effective programs that collectively address these challenges. The programs are grounded in rigorous science and integrate through diverse disciplines across…

Conjunctival provocation tests: a predictive factor for patients' seasonal allergic rhinoconjunctivitis symptoms.

PubMed

Kruse, Kristian; Gerwin, Eva; Eichel, Andrea; Shah-Hosseini, Kija; Mösges, Ralph

2015-01-01

No parameters currently exist that can reliably predict the impact of preseasonal immunotherapy on the symptoms occurring during the season. The purpose of our studies was to prove a correlation between preseasonal conjunctival allergen challenge and coseasonal primary clinical endpoints using the total combined score, ie, a combination of symptoms and medication score, as the primary outcome parameter. Twelve weeks before both the birch and the grass pollen seasons, 2 separate prospective, double-blind, randomized, controlled studies were conducted followed by posttrial observations for each study during the active season. In the studies, patients who reacted to conjunctival allergen challenge were treated with sublingual immunotherapy tablets that contain either birch and/or alder or grass pollen allergoids. In all, 158 patients were included in the grass and 160 in the tree pollen study; of these, 100 and 109 patients, respectively, took part in the posttrial observations. When comparing patients with and without a positive reaction in the final conjunctival allergen challenge, the results revealed a significant difference in the total combined score (grass: P < .001; birch: P = .025). The same applied to the rescue medication score (P = .005; P = .025). A significant difference regarding the rhinoconjunctivitis symptom score was shown in the grass pollen study (P = .002), and the difference of well days was significant in the tree pollen study (P = .049). When comparing patients based on their reaction to allergen challenge after immunotherapy, each study leads to similarly significant results. Therefore, conjunctival allergen challenge can be used effectively as a parameter to predict allergic rhinoconjunctivitis symptoms during the season in patients treated with preseasonal sublingual immunotherapy tablets. Whether this can be transferred to untreated patients needs to be determined. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Child's Challenging Behaviour Scale, Version 2 (CCBS-2): Psychometric Evaluation With Young Children.

PubMed

Bourke-Taylor, Helen; Pallant, Julie; Cordier, Reinie

In this article, we evaluate psychometric properties of the Child's Challenging Behaviour Scale, Version 2 (CCBS-2) with mothers of young, typically developing children. A cross-sectional mail survey with Australian mothers (N = 337) included the CCBS-2, the Depression Anxiety Stress Scales, and the Parents' Evaluation of Developmental Status scale. Internal consistency was good, and no gender differences in CCBS-2 scores were significant. Significant results included differences between CCBS-2 scores: among children grouped according to age, among children grouped according to pre- and post-school entry, among mothers grouped according to extent of any symptom type, and between this sample and a previously collected age-matched sample of children with disabilities. Of the properties tested, results support sound psychometrics. The CCBS-2 can be used to differentiate children according to age, school entry, and disability as well as to identify families for potential services in behavior management and mental health. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Challenging authority during a life-threatening crisis: the effect of operating theatre hierarchy.

PubMed

Sydor, D T; Bould, M D; Naik, V N; Burjorjee, J; Arzola, C; Hayter, M; Friedman, Z

2013-03-01

Effective operating theatre (OT) communication is important for team function and patient safety. Status asymmetry between team members may contribute to communication breakdown and threaten patient safety. We investigated how hierarchy in the OT team influences an anaesthesia trainee's ability to challenge an unethical decision by a consultant anaesthetist in a simulated crisis scenario. We prospectively randomized 49 postgraduate year (PGY) 2-5 anaesthesia trainees at two academic hospitals to participate in a videotaped simulated crisis scenario with a simulated OT team practicing either a hierarchical team structure (Group H) or a non-hierarchical team structure (Group NH). The scenario allowed trainees several opportunities to challenge their consultant anaesthetist when administering blood to a Jehovah's Witness. Three independent, blinded raters scored the performances using a modified advocacy-inquiry score (AIS). The primary outcome was the comparison of the best-response AIS between Groups H vs NH. Secondary outcomes included the comparison of best AIS by PGY and the percentage in each group that checked and administered blood. The AIS did not differ between the groups (P=0.832) but significantly improved from PGY2 to PGY5 (P=0.026). The rates of checking blood (92% vs 76%, P=0.082) and administering blood (62% vs 57%, P=0.721) were high in both groups but not significantly different between the groups. This study did not show a significant effect of OT team hierarchical structure on trainee's ability to challenge authority; however, the results are concerning. The challenges were suboptimal in quality and there was an alarming high rate of blood checking and administration in both groups. This may reflect lack of training in appropriately and effectively challenging authority within the formal curriculum with implications for patient safety.

The potential for gamma-emitting radionuclides to contribute to an understanding of erosion processes in South Africa

NASA Astrophysics Data System (ADS)

Foster, Ian D. L.; Boardman, John; Collins, Adrian L.; Copeland-Phillips, Ruth; Kuhn, Nikolaus J.; Mighall, Tim M.; Pulley, Simon; Rowntree, Kate M.

2017-03-01

Several research projects undertaken by the authors and others over the last 14 years have used fallout and geogenic radionuclides for understanding erosion processes and sediment yield dynamics in South Africa over the last 100-200 years as European settlers colonised the interior plains and plateaux of the country and imported new livestock and farming techniques to the region. These projects have used two fallout radionuclides (210Pb and 137Cs) to date sediments accumulating in reservoirs, farm dams, wetlands, alluvial fans and floodouts and have used other fallout nuclides (7Be) and long-lived geogenic radionuclides (e.g. 40K, 235U) as part of a composite fingerprint exploring contemporary sediment sources and changes to sources through time. While successful in many parts of the world, applying these techniques in Southern Africa has posed a number of challenges often not encountered elsewhere. Here we explore some of the benefits and challenges in using gamma-emitting radionuclides, especially 137Cs, in these landscapes. Benefits include the potential for discriminating gully sidewall from topsoil sources, which has helped to identify contemporary gully systems as sediment conduits, rather than sources, and for providing a time-synchronous marker horizon in a range of sedimentary environments that has helped to develop robust chronologies. Challenges include the spatial variability in soil cover on steep rocky hillslopes, which is likely to challenge assumptions about the uniformity of initial fallout nuclide distribution, the paucity of stable (non-eroding) sites in order to estimate atmospheric fallout inventories, and the limited success of 210Pb dating in some rapidly accumulating high altitude catchments where sediments often comprise significant amounts of sand and gravel. Despite these challenges we present evidence suggesting that the use of gamma-emitting radionuclides can make a significant contribution to our understanding of erosion processes and sediment yield dynamics. Future research highlighted in the conclusion will try to address current challenges and outline new projects established to address them more fully.

Differential Responses of Cecal Microbiota to Fishmeal, Eimeria and Clostridium perfringens in a Necrotic Enteritis Challenge Model in Chickens

PubMed Central

Rodgers, Nicholas; Swick, Robert A.; Moore, Robert J.

2014-01-01

Clostridium perfringens causes enteric diseases in animals and humans. In poultry, avian-specific C. perfringens strains cause necrotic enteritis, an economically significant poultry disease that costs the global industry over $2 billion annually in losses and control measures. With removal of antibiotic growth promoters in some countries this disease appears to be on the rise. In experimental conditions used to study disease pathogenesis and potential control measures, reproduction of the disease relies on the use of predisposing factors such as Eimeria infection and the use of high protein diets, indicating complex mechanisms involved in the onset of necrotic enteritis. The mechanisms by which the predisposing factors contribute to disease progression are not well understood but it has been suggested that they may cause perturbations in the microbiota within the gastrointestinal tract. We inspected changes in cecal microbiota and short chain fatty acids (SCFA) induced by Eimeria and fishmeal, in birds challenged or not challenged with C. perfringens. C. perfringens challenge in the absence of predisposing factors did not cause significant changes in either the alpha or beta diversity of the microbiota nor in concentrations of SCFA. Moreover, there was no C. perfringens detected in the cecal microbiota 2 days post-challenge without the presence of predisposing factors. In contrast, both fishmeal and Eimeria caused significant changes in microbiota, seen in both alpha and beta diversity and also enabled C. perfringens to establish itself post challenge. Eimeria had its strongest influence on intestinal microbiota and SCFA when combined with fishmeal. Out of 6 SCFAs measured, including butyric acid, none were significantly influenced by C. perfringens, but their levels were strongly modified following the use of both predisposing factors. There was little overlap in the changes caused following Eimeria and fishmeal treatments, possibly indicating multiple routes for progressing towards clinical symptoms of necrotic enteritis. PMID:25167074

Spintronic logic: from switching devices to computing systems

NASA Astrophysics Data System (ADS)

Friedman, Joseph S.

2017-09-01

Though numerous spintronic switching devices have been proposed or demonstrated, there has been significant difficulty in translating these advances into practical computing systems. The challenge of cascading has impeded the integration of multiple devices into a logic family, and several proposed solutions potentially overcome these challenges. Here, the cascading techniques by which the output of each spintronic device can drive the input of another device are described for several logic families, including spin-diode logic (in particular, all-carbon spin logic), complementary magnetic tunnel junction logic (CMAT), and emitter-coupled spin-transistor logic (ECSTL).

Materials and structures technology insertion into spacecraft systems: Successes and challenges

NASA Astrophysics Data System (ADS)

Rawal, Suraj

2018-05-01

Over the last 30 years, significant advancements have led to the use of multifunctional materials and structures technologies in spacecraft systems. This includes the integration of adaptive structures, advanced composites, nanotechnology, and additive manufacturing technologies. Development of multifunctional structures has been directly influenced by the implementation of processes and tools for adaptive structures pioneered by Prof. Paolo Santini. Multifunctional materials and structures incorporating non-structural engineering functions such as thermal, electrical, radiation shielding, power, and sensors have been investigated. The result has been an integrated structure that offers reduced mass, packaging volume, and ease of integration for spacecraft systems. Current technology development efforts are being conducted to develop innovative multifunctional materials and structures designs incorporating advanced composites, nanotechnology, and additive manufacturing. However, these efforts offer significant challenges in the qualification and acceptance into spacecraft systems. This paper presents a brief overview of the technology development and successful insertion of advanced material technologies into spacecraft structures. Finally, opportunities and challenges to develop and mature next generation advanced materials and structures are presented.

Graduate Teaching Assistants: Responding to the Challenges of Internationalisation

ERIC Educational Resources Information Center

Winter, Jennie; Turner, Rebecca; Gedye, Sharon; Nash, Patricia; Grant, Vivien

2015-01-01

The last decade has seen intensification in moves to professionalise the practice of university teaching, including graduate teaching assistants (GTAs). It has also seen significant growth in terms of the internationalisation of the postgraduate student body and changing expectations around doctoral training. These transformations have…

Integrated Outdoor Education and Adventure Programs.

ERIC Educational Resources Information Center

Schleien, Stuart J.; And Others

This guide presents a comprehensive framework for the development and provision of outdoor education and adventure programs for people of all abilities, including those who significantly challenge the service delivery system. Chapter 1 provides a rationale for the integration of disabled persons into outdoor education and adventure programs, and…

The Future Role of the United States in Global Health: Emphasis on Cardiovascular Disease.

PubMed

Fuster, Valentin; Frazer, Jendayi; Snair, Megan; Vedanthan, Rajesh; Dzau, Victor

2017-12-26

U.S. global health investment has focused on detection, treatment, and eradication of infectious diseases such as tuberculosis, malaria, and human immunodeficiency virus/acquired immunodeficiency syndrome, with significant results. Although efforts should be maintained and expanded to provide ongoing therapy for chronic infectious disease, there is a pressing need to meet the challenge of noncommunicable diseases, which constitute the highest burden of diseases globally. A Committee of the National Academies of Sciences, Engineering, and Medicine has made 14 recommendations that require ongoing commitments to eradication of infectious disease and increase the emphasis on chronic diseases such as cardiovascular disease. These include improving early detection and treatment, mitigating disease risk factors, shifting global health infrastructure to include management of cardiovascular disease, developing global partners and private-public ventures to meet infrastructure and funding challenges, streamlining medical product development and supply, increasing research and development capacity, and addressing gaps in global political and institutional leadership to meet the shifting challenge. Copyright © 2017. Published by Elsevier Inc.

Dietary Aloe vera supplementation on growth performance, some haemato-biochemical parameters and disease resistance against Streptococcus iniae in tilapia (GIFT).

PubMed

Gabriel, Ndakalimwe Naftal; Qiang, Jun; He, Jie; Ma, Xin Yu; Kpundeh, Mathew D; Xu, Pao

2015-06-01

This study investigated effects of dietary Aloe vera on growth performance, some haemato-biochemical parameters and disease resistance against Streptococcus iniae in tilapia (GIFT). Five groups were designed including a basal diet (control) and 100% A. vera powder incorporated in fish feed at 0.5% 1%, 2%, and 4%/kg feed, which were administered for 8 weeks. Fish fed 0.5%, 1%, and 2% A. vera supplemented diet significantly improved (p < 0.05) weight gain, absolute growth rate and specific growth rate. Feed intake significantly increased in fish fed with A. vera diet at 1% and 2%/kg feed. Feed efficiency ratio, feed conversion ratio, and hepatosomatic index were significantly enhanced in 4% A. vera supplemented fish over unsupplemented ones (p < 0.05). Several haemato-biochemical indices were examined before and after fish were challenged with S. iniae pathogen containing 7.7 × 10(6) CFU cells mL(-1). A. vera supplemented fish showed a significant increase (p < 0.05) in red blood cells, hematocrits (Hb), hemoglobin (Hb), white blood cells (WBC), neutrophils, monocytes, eosinophils, serum total protein, glucose and cortisol after challenge when compared to unsupplemented ones. Meanwhile, 4% A. vera supplemented fish showed a decrease (p < 0.05) in RBC, Hb, Ht, WBC, and mean corpuscular hemoglobin (MCH) after challenge compared to unsupplemented ones and other supplemented ones. In addition, lower mean corpuscular volume values (MCV) (p < 0.05) were observed in fish fed with A. vera diet at 2% and 4% A. vera/kg feed than those fed unsupplemented diet. Unchallenged fish fed 0.5%, 1%, and 2% A. vera showed significantly higher values (p < 0.05) of mean corpuscular hemoglobin concentration (MCHC) than those fed unsupplemented diet and 4% A. vera supplemented diet. There was a significant increase (p < 0.05) in the neutrophil to lymphocyte ratio (N/L) within experimental groups after challenge; N/L ratio in A. vera unsupplemented fish and those supplemented with A. vera diet at 1%/kg feed increased significantly (p < 0.05) throughout challenge period; while those fed 4% A. vera supplemented diet maintained higher values at all experimental stages among groups. There was a significant correlation (p < 0.05, r = 0.53) between N/L ratio and glucose concentration, 96 h after challenge. Aloe had no significant effect (p > 0.05) on the survival of the fish when compared to the control; no mortality was recorded in challenge trial. Overall, our results indicated that dietary aloe supplementation could improve growth, feed utilization, and haemato-biochemical parameters of cultured tilapia. Copyright © 2015 Elsevier Ltd. All rights reserved.

The development of immune responses in Balb/c mice following inoculation with attenuated or virulent Neospora caninum tachyzoites.

PubMed

Bartley, P M; Wright, S E; Maley, S W; Buxton, D; Nath, M; Innes, E A

2009-07-01

Balb/c mice were inoculated intraperitoneally (i.p.) with either 5 x 10(6) live virulent (group 1) or 5 x 10(6) live attenuated (group 2) tachyzoites, or Vero cells (group 3). Animals were killed at 0, 14, 28 and 42 days post-inoculation (p.i.), with the remaining mice receiving a lethal challenge on day 48 p.i. Serum, spleen and brain samples were collected post-mortem to examine humoral and cell-mediated immune responses as well as pathological lesions and to quantify parasite loads. On day 14 p.i. group 2 (attenuated) demonstrated statistically significant (P < 0.001) lower levels of mean morbidity and weight loss, while also showing significantly (P = 0.01) higher levels of splenocyte proliferation and IFN-gamma production (P = 0.003), compared to group 1 (virulent). Histology of brain samples showed milder lesions and a lower incidence of positive immunohistochemistry, demonstrating tachyzoites and tissue cysts, and statistically significant (P = 0.03) lower mean burdens of parasite DNA in group 2 (attenuated) compared to group 1 (virulent). All mice in group 2 were protected following challenge on day 48 p.i. whereas naïve control mice succumbed to the challenge. No mice from group 1 (virulent) survived beyond day 24 p.i. so they were not included in the challenge.

Low-shrink composite resins: a review of their history, strategies for managing shrinkage, and clinical significance.

PubMed

Pitel, Mark L

2013-09-01

Despite numerous advances in composite resin technology over the course of many decades, shrinkage behavior and the resultant stresses inherent to direct placed composite restorations continue to challenge clinicians. This overview of composite resins includes a review of their history and development along with a discussion of strategies for reducing polymerization shrinkage. An assessment of the clinical significance of these materials is also provided, including a discussion of the differences between polymerization shrinkage and stress, incremental layering versus bulk placement, and the emergence of lower shrinkage stress monomer chemistry.

Single-stage-to-orbit: Meeting the challenge

NASA Astrophysics Data System (ADS)

Freeman, Delma C., Jr.; Talay, Theodore A.; Austin, Robert Eugene

1995-10-01

There has been and continues to be significant discussion about the viability of fully reusable, single-stage-to-orbit (SSTO) concepts for delivery of payloads to orbit. Often, these discussions have focused in detail on performance and technology requirements relating to the technical feasibility of the concept, with only broad generalizations on how the SSTO will achieve its economic goals of greatly reduced vehicle ground and flight operations costs. With the current industry and NASA Reusable Launch Vehicle Technology Program efforts underway to mature and demonstrate technologies leading to a viable commercial launch system that also satisfies national needs, achieving acceptable recurring costs becomes a significant challenge. This paper reviews the current status of the Reusable Launch Vehicle Technology Program including the DC-XA, X-33, and X-34 flight systems and associated technology programs. The paper also examines lessons learned from the recently completed DC-X reusable rocket demonstrator program. It examines how these technologies and flight systems address the technical and operability challenges of SSTO whose solutions are necessary to reduce costs. The paper also discusses the management and operational approaches that address the challenge of a new cost-effective, reusable launch vehicle system.

Single-stage-to-orbit — Meeting the challenge

NASA Astrophysics Data System (ADS)

Freeman, Delma C.; Talay, Theodore A.; Austin, Robert Eugene

1996-02-01

There has been and continues to be significant discussion about the viability of fully reusable, single-stage-to-orbit (SSTO) concepts for delivery of payloads to orbit. Often, these discussions have focused in detail on performance and technology requirements relating to the technical feasibility of the concept, with only broad generalizations on how the SSTO will achieve its economic goals of greatly reduced vehicle ground and flight operations costs. With the current industry and NASA Reusable Launch Vehicle Technology Program efforts underway to mature and demonstrate technologies leading to a viable commercial launch system that also satisfies national needs, achieving acceptable recurring costs becomes a significant challenge. This paper reviews the current status of the Reusable Launch Vehicle Technology Program including the DC-XA, X-33, X-34 flight systems and associated technology programs. The paper also examines lessons learned from the recently completed DC-X reusable rocket demonstrator program. It examines how these technologies and flight systems address the technical and operability challenges of SSTO whose solutions are necessary to reduce costs. The paper also discusses the management and operational approaches that address the challenge of a new cost-effective, reusable launch vehicle system.

DoD And VA Health Care: Federal Recovery Coordination Program Continues to Expand But Faces Significant Challenges

DTIC Science & Technology

2011-03-01

FRCP) Enrollees, September 2010 Diagnoses Percentage of enrollees Traumatic brain injury 54 Psychological diagnosis 43 Orthopedic injury 25...analysis of FRCP data. Note: These diagnoses may not represent each enrollee’s primary medical diagnosis . Additionally, approximately 70 percent of...FRCP enrollees have more than one diagnosis . a“Medical diagnosis ” includes diagnoses such as stroke, heart attack, and cancer. b“Other” includes

Health-related quality of life among long-term rectal cancer survivors with an ostomy: manifestations by sex.

PubMed

Krouse, Robert S; Herrinton, Lisa J; Grant, Marcia; Wendel, Christopher S; Green, Sylvan B; Mohler, M Jane; Baldwin, Carol M; McMullen, Carmit K; Rawl, Susan M; Matayoshi, Eric; Coons, Stephen Joel; Hornbrook, Mark C

2009-10-01

Intestinal stomas can pose significant challenges for long-term (> or = 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75.

Health-Related Quality of Life Among Long-Term Rectal Cancer Survivors With an Ostomy: Manifestations by Sex

PubMed Central

Krouse, Robert S.; Herrinton, Lisa J.; Grant, Marcia; Wendel, Christopher S.; Green, Sylvan B.; Mohler, M. Jane; Baldwin, Carol M.; McMullen, Carmit K.; Rawl, Susan M.; Matayoshi, Eric; Coons, Stephen Joel; Hornbrook, Mark C.

2009-01-01

Purpose Intestinal stomas can pose significant challenges for long-term (≥ 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). Patients and Methods This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Results Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Conclusion Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75. PMID:19720920

The effect of dietary fructooligosaccharide supplementation on growth performance, intestinal morphology, and immune responses in broiler chickens challenged with Salmonella Enteritidis lipopolysaccharides.

PubMed

Shang, Yue; Regassa, Alemu; Kim, Ji Hyuk; Kim, Woo Kyun

2015-12-01

This study was conducted to examine the effects of fructooligosaccharide (FOS) supplementation on growth performance, lymphoid organ weight, intestinal morphology, and immunological status in broilers (n=180) challenged with Salmonella Enteritidis lipopolysaccharides (LPS). Birds were randomly assigned into a 3×2 factorial arrangement that included 1) 3 dietary treatments from d one to 21: positive control (PC), wheat-corn-soybean meal based diet contained antibiotics (virginiamycin and monensin); negative control (NC), as PC without antibiotics; and NC+FOS, as NC supplemented with 0.5% FOS, and 2) 2 intraperitoneal injections: 2 mg/kg Salmonella Enteritidis LPS or sterile phosphate buffered saline (PBS) on d 21. Growth performance and relative lymphoid organ weight were not significantly different among the treatments. Villus height, crypt depth, and total mucosa thickness were significantly increased (P<0.05) in the ileum of broiler chickens fed NC+FOS when compared to PC and NC. Birds in NC+FOS treatment had reduced heterophil but increased monocyte count when compared to NC (P<0.05). Significant diet×challenge interaction was observed on natural IgY levels (P<0.0001), and a significant dietary effect was observed on specific IgY levels in chickens fed NC+FOS (P=0.003). Supplementation of FOS also increased the expression of interleukin (IL)-1ß, -10, and interferon (IFN)-γ mRNA in the ileum of the birds. In summary, Salmonella Enteritidis LPS challenge established significant differences in the immune responses in broiler chickens. FOS supplementation increased ileal mucosa thickness and elevated the expressions of certain cytokine genes. It also led to the alteration of leukocyte compositions and serum IgY levels in response to LPS challenge, suggesting FOS supplementation may be effective to induce protective outcomes in gut health and immunity of broiler chickens. © 2015 Poultry Science Association Inc.

Library outreach: overcoming health literacy challenges*

PubMed Central

Parker, Ruth; Kreps, Gary L.

2005-01-01

Objective: This paper examines the powerful influences of consumer health literacy on access to and use of relevant health information. Method: The paper describes how widespread problems with health literacy significantly limit effective dissemination of relevant health information in society, especially to many vulnerable populations where health literacy challenges are especially pervasive. Results: The paper examines strengths and weaknesses of different programs for addressing health literacy problems, including educational programs, message design programs, and strategic communication training and intervention programs. Implications: The paper evaluates strategies that can be implemented throughout the modern health care system to address problems of health literacy by improving health information access, processing, and understanding. It concludes by examining several strategies that libraries can adopt to overcome many health literacy challenges. PMID:16239962

Kinetics of Leptospira interrogans Infection in Hamsters after Intradermal and Subcutaneous Challenge

PubMed Central

Coutinho, Mariana L.; Matsunaga, James; Wang, Long-Chieh; de la Peña Moctezuma, Alejandro; Lewis, Michael S.; Babbitt, Jane T.; Aleixo, Jose Antonio G.; Haake, David A.

2014-01-01

Background Leptospirosis is a zoonosis caused by highly motile, helically shaped bacteria that penetrate the skin and mucous membranes through lesions or abrasions, and rapidly disseminate throughout the body. Although the intraperitoneal route of infection is widely used to experimentally inoculate hamsters, this challenge route does not represent a natural route of infection. Methodology/Principal Findings Here we describe the kinetics of disease and infection in hamster model of leptospirosis after subcutaneous and intradermal inoculation of Leptospira interrogans serovar Copenhageni, strain Fiocruz L1-130. Histopathologic changes in and around the kidney, including glomerular and tubular damage and interstitial inflammatory changes, began on day 5, and preceded deterioration in renal function as measured by serum creatinine. Weight loss, hemoconcentration, increased absolute neutrophil counts (ANC) in the blood and hepatic dysfunction were first noted on day 6. Vascular endothelial growth factor, a serum marker of sepsis severity, became elevated during the later stages of infection. The burden of infection, as measured by quantitative PCR, was highest in the kidney and peaked on day 5 after intradermal challenge and on day 6 after subcutaneous challenge. Compared to subcutaneous challenge, intradermal challenge resulted in a lower burden of infection in both the kidney and liver on day 6, lower ANC and less weight loss on day 7. Conclusions/Significance The intradermal and subcutaneous challenge routes result in significant differences in the kinetics of dissemination and disease after challenge with L. interrogans serovar Copenhageni strain Fiocruz L1-130 at an experimental dose of 2×106 leptospires. These results provide new information regarding infection kinetics in the hamster model of leptospirosis. PMID:25411782

Efficient Exploration of Membrane-Associated Phenomena at Atomic Resolution.

PubMed

Vermaas, Josh V; Baylon, Javier L; Arcario, Mark J; Muller, Melanie P; Wu, Zhe; Pogorelov, Taras V; Tajkhorshid, Emad

2015-06-01

Biological membranes constitute a critical component in all living cells. In addition to providing a conducive environment to a wide range of cellular processes, including transport and signaling, mounting evidence has established active participation of specific lipids in modulating membrane protein function through various mechanisms. Understanding lipid-protein interactions underlying these mechanisms at a sufficiently high resolution has proven extremely challenging, partly due to the semi-fluid nature of the membrane. In order to address this challenge computationally, multiple methods have been developed, including an alternative membrane representation termed highly mobile membrane mimetic (HMMM) in which lateral lipid diffusion has been significantly enhanced without compromising atomic details. The model allows for efficient sampling of lipid-protein interactions at atomic resolution, thereby significantly enhancing the effectiveness of molecular dynamics simulations in capturing membrane-associated phenomena. In this review, after providing an overview of HMMM model development, we will describe briefly successful application of the model to study a variety of membrane processes, including lipid-dependent binding and insertion of peripheral proteins, the mechanism of phospholipid insertion into lipid bilayers, and characterization of optimal tilt angle of transmembrane helices. We conclude with practical recommendations for proper usage of the model in simulation studies of membrane processes.

Practical challenges related to point of care testing.

PubMed

Shaw, Julie L V

2016-04-01

Point of care testing (POCT) refers to laboratory testing that occurs near to the patient, often at the patient bedside. POCT can be advantageous in situations requiring rapid turnaround time of test results for clinical decision making. There are many challenges associated with POCT, mainly related to quality assurance. POCT is performed by clinical staff rather than laboratory trained individuals which can lead to errors resulting from a lack of understanding of the importance of quality control and quality assurance practices. POCT is usually more expensive than testing performed in the central laboratory and requires a significant amount of support from the laboratory to ensure the quality testing and meet accreditation requirements. Here, specific challenges related to POCT compliance with accreditation standards are discussed along with strategies that can be used to overcome these challenges. These areas include: documentation of POCT orders, charting of POCT results as well as training and certification of individuals performing POCT. Factors to consider when implementing connectivity between POCT instruments and the electronic medical record are also discussed in detail and include: uni-directional versus bidirectional communication, linking patient demographic information with POCT software, the importance of positive patient identification and considering where to chart POCT results in the electronic medical record.

The European flood risk directive: challenges for research

NASA Astrophysics Data System (ADS)

Mostert, E.; Junier, S. J.

2009-07-01

In recent years, flood management has shifted from protection against floods to managing the risks of floods. In Europe, this shift is reflected in the Flood risk directive of October 2007 (2007/60/EC; FRD). The FRD requires EU Member States to undertake a preliminary assessment of flood risks and, for areas with a significant flood risk, to prepare flood hazard and flood risk maps and flood risk management plans. The purpose of this paper is to introduce the FRD and discuss the challenges that the FRD poses to research. These challenges include the issue how to define and measure ''flood risk'', the selection of alternatives to be assessed, coping with uncertainty, risk communication, nurturing trust and promoting collaboration. These research challenges cannot be addressed properly within any single discipline and without involving the flood risk managers and other stakeholders. The paper therefore concludes that there is a large need for interdisciplinary and participatory research. This constitutes in fact the biggest research challenge.

Introduction: the realities of antiretroviral therapy rollout: overcoming challenges to successful programmatic implementation.

PubMed

Ojikutu, Bisola

2007-12-01

In 2006, 2 million human immunodeficiency virus (HIV)-infected people living in low- to middle-income countries were receiving antiretroviral therapy (ART). Although this is an improvement over previous years, significant operational challenges have inhibited progress toward universal access to HIV care and treatment. Despite these challenges, the intense efforts focused on addressing the HIV epidemic present an opportunity for overall health systems improvement in developing nations. In October 2006, Harvard University's Centers for AIDS Research, the Nelson Mandela School of Medicine, the Department of Health of KwaZulu-Natal, and the Medical Research Council of South Africa held a conference entitled "The Realities of Antiretroviral Therapy Rollout: Challenges to Successful Programmatic Implementation" in Durban, South Africa. The goal of the meeting was to bring together international and local leadership, including policy makers, health care workers, and funders, to propose an agenda that would address the challenges to more expeditious provision of HIV care and treatment in resource-limited settings.

Sources, factors, mechanisms and possible solutions to pollutants in marine ecosystems.

PubMed

Mostofa, Khan M G; Liu, Cong-Qiang; Vione, Davide; Gao, Kunshan; Ogawa, Hiroshi

2013-11-01

Algal toxins or red-tide toxins produced during algal blooms are naturally-derived toxic emerging contaminants (ECs) that may kill organisms, including humans, through contaminated fish or seafood. Other ECs produced either naturally or anthropogenically ultimately flow into marine waters. Pharmaceuticals are also an important pollution source, mostly due to overproduction and incorrect disposal. Ship breaking and recycle industries (SBRIs) can also release various pollutants and substantially deteriorate habitats and marine biodiversity. Overfishing is significantly increasing due to the global food crisis, caused by an increasing world population. Organic matter (OM) pollution and global warming (GW) are key factors that exacerbate these challenges (e.g. algal blooms), to which acidification in marine waters should be added as well. Sources, factors, mechanisms and possible remedial measures of these challenges to marine ecosystems are discussed, including their eventual impact on all forms of life including humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

Culture as a variable in neuroscience and clinical neuropsychology: A comprehensive review

PubMed Central

Wajman, José Roberto; Bertolucci, Paulo Henrique Ferreira; Mansur, Letícia Lessa; Gauthier, Serge

2015-01-01

Culture is a dynamic system of bidirectional influences among individuals and their environment, including psychological and biological processes, which facilitate adaptation and social interaction. One of the main challenges in clinical neuropsychology involves cognitive, behavioral and functional assessment of people with different sociocultural backgrounds. In this review essay, examining culture from a historical perspective to ethical issues in cross-cultural research, including the latest significant and publications, the authors sought to explore the main features related to cultural variables in neuropsychological practice and to debate the challenges found regarding the operational methods currently in use. Literature findings suggest a more comprehensive approach in cognitive and behavioral neuroscience, including an interface between elementary disciplines and applied neuropsychology. Thus, as a basis for discussion on this issue, the authors analyzed key-topics related to the study of new trends in sociocultural neuroscience and the application of their concepts from a clinical perspective. PMID:29213964

The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms

PubMed Central

Barrett, Frederick S.; Bradstreet, Matthew P.; Leoutsakos, Jeannie-Marie S.; Johnson, Matthew W.; Griffiths, Roland R.

2017-01-01

Acute adverse psychological reactions to classic hallucinogens (“bad trips”, or “challenging experiences”), while usually benign with proper screening, preparation, and support in controlled settings, remain a safety concern in uncontrolled settings (such as illicit use contexts). Anecdotal and case reports suggest potential adverse acute symptoms including affective (panic, depressed mood), cognitive (confusion, feelings of losing sanity), and somatic (nausea, heart palpitation) symptoms. Responses to items from several hallucinogen-sensitive questionnaires (Hallucinogen Rating Scale, the States of Consciousness Questionnaire, and the 5-Dimensional Altered States of Consciousness questionnaire) in an internet survey of challenging experiences with the classic hallucinogen psilocybin were used to construct and validate a Challenging Experience Questionnaire (CEQ). The stand-alone CEQ was then validated in a separate sample. Seven CEQ factors (grief, fear, death, insanity, isolation, physical distress, and paranoia) provide a phenomenological profile of challenging aspects of experiences with psilocybin. Factor scores were associated with the difficulty, meaningfulness, spiritual significance, and change in well-being attributed to the challenging experiences. The factor structure did not differ based on gender or prior struggle with anxiety or depression. The CEQ provides a basis for future investigation of predictors and outcomes of challenging experiences with psilocybin, and should be explored as a measure of challenging experiences with the broad class of classic hallucinogens. PMID:27856683

Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations.

PubMed

Zada, Gabriel; Cavallo, Luigi M; Esposito, Felice; Fernandez-Jimenez, Julio Cesar; Tasiou, Anastasia; De Angelis, Michelangelo; Cafiero, Tullio; Cappabianca, Paolo; Laws, Edward R

2010-10-01

In addition to difficulties with anesthetic and medical management, transsphenoidal operations in patients with longstanding acromegaly are associated with inherent intraoperative challenges because of anatomical variations that occur frequently in these patients. The object of this study was to review the overall safety profile and anatomical/technical challenges associated with transsphenoidal surgery in patients with acromegaly. The authors performed a retrospective analysis of 169 patients who underwent endoscopic transsphenoidal operations for growth hormone-secreting adenomas to assess the incidence of surgical complications. A review of frequently occurring anatomical challenges and operative strategies employed during each phase of the operation to address these particular issues was performed. Of 169 cases reviewed, there was no perioperative mortality. Internal carotid artery injury occurred in 1 patient (0.6%) with complex sinus anatomy, who remained neurologically intact following endovascular unilateral carotid artery occlusion. Other complications included: significant postoperative epistaxis (5 patients [3%]), transient diabetes insipidus (5 patients [3%]), delayed symptomatic hyponatremia (4 patients [2%]), CSF leak (2 patients [1%]), and pancreatitis (1 patient [0.6%]). Preoperative considerations in patients with acromegaly should include a cardiopulmonary evaluation and planning regarding intubation and other aspects of the anesthetic technique. During the nasal phase of the transsphenoidal operation, primary challenges include maintaining adequate visualization and hemostasis, which is frequently compromised by redundant, edematous nasal mucosa and bony hypertrophy of the septum and the nasal turbinates. During the sphenoid phase, adequate bony removal, optimization of working space, and correlation of imaging studies to intraoperative anatomy are major priorities. The sellar phase is frequently challenged by increased sellar floor thickness, distinct patterns of tumor extension and bony invasion, and anatomical variations in the caliber and course of the internal carotid artery. Specific operative techniques for addressing each of these intraoperative challenges are discussed. Transsphenoidal surgery in patients with longstanding acromegaly frequently poses greater challenges than operations for other types of sellar lesions, yet these challenges may be safely and effectively overcome with the anticipation of specific issues and implementation of various intraoperative techniques.

Cyberbullying

ERIC Educational Resources Information Center

Feinberg, Ted; Robey, Nicole

2008-01-01

Cyberspace presents a serious challenge for adults who are concerned about the safety and well-being of adolescents. Approximately 93% of U.S. youths ages 12-17 use the Internet, a significant increase from 2004. The number of teens with online profiles, including those on social networking sites, also has increased. Importantly, 38% of high…

Developing Approaches to Outdoor Education that Promote Sustainability Education

ERIC Educational Resources Information Center

Hill, Allen

2012-01-01

Social, economic, and environmental issues facing 21st century societies compel a transformative shift towards sustainability in all spheres of life, including education. The challenges this holds for outdoor education programs and practices is significant. If outdoor education theory and practice is to make a greater contribution to…

Midlife Eriksonian Psychosocial Development: Setting the Stage for Late-Life Cognitive and Emotional Health

ERIC Educational Resources Information Center

Malone, Johanna C.; Liu, Sabrina R.; Vaillant, George E.; Rentz, Dorene M.; Waldinger, Robert J.

2016-01-01

Erikson's (1950) model of adult psychosocial development outlines the significance of successful involvement within one's relationships, work, and community for healthy aging. He theorized that the consequences of not meeting developmental challenges included stagnation and emotional despair. Drawing on this model, the present study uses…

Children with Speech Sound Disorders at School: Challenges for Children, Parents and Teachers

ERIC Educational Resources Information Center

Daniel, Graham R.; McLeod, Sharynne

2017-01-01

Teachers play a major role in supporting children's educational, social, and emotional development although may be unprepared for supporting children with speech sound disorders. Interviews with 34 participants including six focus children, their parents, siblings, friends, teachers and other significant adults in their lives highlighted…

Incest: A College Student Nightmare Which Challenges Our Boundaries.

ERIC Educational Resources Information Center

Witchel, Robert I.

Statistics indicate that 100,000 to 500,000 children are sexually abused yearly. Changing child abuse laws, significant attention by the media, and sexual abuse prevention programs have contributed to the explosion of incest disclosures from children and adults, including college students. Studies support the prevalence of incest victims within…

Cable Technology: A Challenge for Adult Educators.

ERIC Educational Resources Information Center

Palchinsky, Jo

The penetration of cable television throughout American communities makes it a potentially significant tool for improving the quality and accessibility of adult education. As cities begin to include in the cable franchise allotment monies for access by community members, adult educators need to become actively involved during the development of a…

Charter Management Organizations: Innovations, Opportunities, and Challenges. Research Brief

ERIC Educational Resources Information Center

Center on Reinventing Public Education, 2010

2010-01-01

Over the past two decades, charter management organizations (CMOs) have become a significant force in the public K-12 charter school landscape. CMOs, nonprofit entities that directly manage public charter schools, are meant to meld the benefits of school districts--including economies of scale, collaboration among similar schools, and support…

Leadership Values, Trust and Negative Capability: Managing the Uncertainties of Future English Higher Education

ERIC Educational Resources Information Center

Jameson, Jill

2012-01-01

The complex leadership attribute of "negative capability" in managing uncertainty and engendering trust may be amongst the qualities enabling institutions to cope with multiple recent government policy challenges affecting English higher education, including significant increases in student fees. Research findings are reported on changes…

Day-by-Day: Higher Education in Afghanistan

ERIC Educational Resources Information Center

Roof, David J.

2015-01-01

This paper examines higher education in Afghanistan. Based on qualitative research, including interviews with key policymakers and stakeholders, the paper examines the primary issues, challenges, progress, and future vision for higher education in the country. The research reveals that one of the most significant issues in the country in the…

IDRA Newsletter. Volume 35, No. 7

ERIC Educational Resources Information Center

Goodman, Christie L., Ed.

2008-01-01

Each edition of the IDRA Newsletter strives to provide many different perspectives on the issues in education topics discussed and to define its significance in the state and national dialogue. This issue focuses on Teaching Quality and includes: (1) The "Fourth-Grade Slump" and Math Achievement: Addressing the Challenge with Student Engagement…

Psychological stress during exercise: immunoendocrine and oxidative responses.

PubMed

Huang, Chun-Jung; Webb, Heather E; Evans, Ronald K; McCleod, Kelly A; Tangsilsat, Supatchara E; Kamimori, Gary H; Acevedo, Edmund O

2010-12-01

The purpose of this study was to examine the changes in catecholamines (epinephrine [EPI] and norepinephrine [NE]), interleukin-2 (IL-2) and a biomarker of oxidative stress (8-isoprostane) in healthy individuals who were exposed to a dual challenge (physical and psychological stress). Furthermore, this study also examined the possible relationships between catecholamines (NE and EPI) and 8-isoprostane and between IL-2 and 8-isoprostane following a combined physical and psychological challenge. Seven healthy male subjects completed two experimental conditions. The exercise-alone condition (EAC) consisted of cycling at 60% VO(2max) for 37 min, while the dual-stress condition (DSC) included 20 min of a mental challenge while cycling. DSC showed greater EPI and 8-isoprostane levels (significant condition by time interaction). NE and IL-2 revealed significant change across time in both conditions. In addition, following dual stress, EPI area-under-the-curve (AUC) demonstrated a positive correlation with NE AUC and IL-2 AUC. NE AUC was positively correlated with IL-2 AUC and peak 8-isoprostane, and peak IL-2 was positively correlated with peak 8-isoprostane in response to a dual stress. The potential explanation for elevated oxidative stress during dual stress may be through the effects of the release of catecholamines and IL-2. These findings may further provide the potential explanation that dual stress alters physiological homeostasis in many occupations including firefighting, military operations and law enforcement. A greater understanding of these responses to stress can assist in finding strategies (e.g. exercise training) to overcome the inherent psychobiological challenges associated with physically and mentally demanding professions.

The safety of the H1N1 influenza A vaccine in egg allergic individuals.

PubMed

Greenhawt, Matthew J; Chernin, Anna S; Howe, Laura; Li, James T; Sanders, Georgiana

2010-11-01

The safety of H1N1 vaccine is unknown in egg allergic (EA) recipients. To establish the safety of administering H1N1 vaccine and to evaluate the predictability of H1N1 skin testing in EA patients. In a controlled, prospective trial, H1N1 skin testing and vaccination was compared between EA patients (n = 105) and non-EA controls (n = 19). Those with negative H1N1 skin test results received a full H1N1 dose; those with a positive skin test result received a graded challenge (10%, 90%). Booster vaccine, if required, was given as a single dose from a different lot without prior testing. Prick and intradermal test results were positive in 3 (2.4%) of 124 and 41 (33.1%) of 124 study participants, respectively. Forty-one individuals received a 2-step graded vaccine challenge, including 13 of 25 with a history of egg anaphylaxis. No significant allergic reactions resulted from either method of vaccination or from subsequent booster doses. All study participants received the H1N1 vaccine without significant allergic reactions. Skin testing is unnecessary and does not predict vaccine tolerance. All study participants who received a graded challenge tolerated a single dose booster from a different, untested lot, including 7 individuals with a history of egg-induced anaphylaxis. We recommend administration of H1N1 vaccine to EA children without prior skin testing or graded challenge dosing. Copyright © 2010 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

The challenges of sequencing by synthesis.

PubMed

Fuller, Carl W; Middendorf, Lyle R; Benner, Steven A; Church, George M; Harris, Timothy; Huang, Xiaohua; Jovanovich, Stevan B; Nelson, John R; Schloss, Jeffery A; Schwartz, David C; Vezenov, Dmitri V

2009-11-01

DNA sequencing-by-synthesis (SBS) technology, using a polymerase or ligase enzyme as its core biochemistry, has already been incorporated in several second-generation DNA sequencing systems with significant performance. Notwithstanding the substantial success of these SBS platforms, challenges continue to limit the ability to reduce the cost of sequencing a human genome to $100,000 or less. Achieving dramatically reduced cost with enhanced throughput and quality will require the seamless integration of scientific and technological effort across disciplines within biochemistry, chemistry, physics and engineering. The challenges include sample preparation, surface chemistry, fluorescent labels, optimizing the enzyme-substrate system, optics, instrumentation, understanding tradeoffs of throughput versus accuracy, and read-length/phasing limitations. By framing these challenges in a manner accessible to a broad community of scientists and engineers, we hope to solicit input from the broader research community on means of accelerating the advancement of genome sequencing technology.

Redefining Quality Measurement in Cancer Care.

PubMed

Nardi, Elizabeth A; McCanney, James; Winckworth-Prejsnar, Katy; Schatz, Alyssa A; Adelson, Kerin; Neubauer, Marcus; Smith, Mary Lou; Walters, Ronald; Carlson, Robert W

2018-05-01

Quality measurement in oncology is increasing in significance as payment schemes shift from volume to value. As demand for quality measures increases, challenges in the development of quality measures, standardization across measures, and the limitations of health information technology have become apparent. Moreover, the time and financial burden associated with developing, tracking, and reporting quality measures are substantial. Despite these challenges, best practices and leaders in the field of quality measurement in oncology have emerged. To understand the current challenges and promising practices in quality measurement and to explore future considerations for measure development and measure reporting in oncology, NCCN convened the NCCN Policy Summit: Redefining Quality Measurement in Oncology. The summit included discussion of the current quality landscape and efforts to develop quality measures, use of quality measures in various programs, patient perspective of quality, and challenges and best practices for quality reporting. Copyright © 2018 by the National Comprehensive Cancer Network.

Bridging the communication gap: successes and challenges of mobile phone technology in a health and demographic surveillance system in northern Nigeria.

PubMed

Doctor, Henry V; Olatunji, Alabi; Jumare, Abdul'azeez

2012-01-01

Maternal and child health indicators are generally poor in Nigeria with the northern part of the country having the worst indicators than the southern part. Efforts to address maternal and health challenges in Nigeria include, among others, improvement in health and management information systems. We report on the experience of mobile phone technology in supporting the activities of a health and demographic surveillance system in northern Nigeria. Our experience calls for the need for the Nigerian Government, the mobile network companies, and the international community at large to consolidate their efforts in addressing the mobile network coverage and power supply challenges in order to create an enabling environment for socio-economic development particularly in rural and disadvantaged areas. Unless power and mobile network challenges are addressed, health interventions that rely on mobile phone technology will not have a significant impact in improving maternal and child health.

Exploring challenges to telehealth communication by specialists in poison information.

PubMed

Rothwell, Erin; Ellington, Lee; Planalp, Sally; Crouch, Barbara

2012-01-01

The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty managing caller misunderstandings, maintaining distinctive assessments for routine calls, and managing the multifaceted aspects of job stress. The desire for training to enhance telehealth and cultural competency skills was also mentioned, and these findings might provide guidance for the development of training opportunities for telehealth professionals.

Clinical decision-making and secondary findings in systems medicine.

PubMed

Fischer, T; Brothers, K B; Erdmann, P; Langanke, M

2016-05-21

Systems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology (especially systems biology); "big data" statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate systems medicine knowledge and clinicians working to apply it. This article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through "big data" approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the "death computer," to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their "quantified self." This paper examines possible ethical challenges that are likely to be raised as systems medicine to be translated into clinical medicine. These include the epistemological challenges for clinical decision-making, the use of scoring systems optimized by big data techniques and the risk that incidental and secondary findings will significantly increase. While some ethical implications remain still hypothetical we should use the opportunity to prospectively identify challenges to avoid making foreseeable mistakes when systems medicine inevitably arrives in routine care.

Penetration of Combustion Aerosol Particles Through Filters of NIOSH-Certified Filtering Facepiece Respirators (FFRs).

PubMed

Gao, Shuang; Kim, Jinyong; Yermakov, Michael; Elmashae, Yousef; He, Xinjian; Reponen, Tiina; Grinshpun, Sergey A

2015-01-01

Filtering facepiece respirators (FFRs) are commonly worn by first responders, first receivers, and other exposed groups to protect against exposure to airborne particles, including those originated by combustion. Most of these FFRs are NIOSH-certified (e.g., N95-type) based on the performance testing of their filters against charge-equilibrated aerosol challenges, e.g., NaCl. However, it has not been examined if the filtration data obtained with the NaCl-challenged FFR filters adequately represent the protection against real aerosol hazards such as combustion particles. A filter sample of N95 FFR mounted on a specially designed holder was challenged with NaCl particles and three combustion aerosols generated in a test chamber by burning wood, paper, and plastic. The concentrations upstream (Cup) and downstream (Cdown) of the filter were measured with a TSI P-Trak condensation particle counter and a Grimm Nanocheck particle spectrometer. Penetration was determined as (Cdown/Cup) ×100%. Four test conditions were chosen to represent inhalation flows of 15, 30, 55, and 85 L/min. Results showed that the penetration values of combustion particles were significantly higher than those of the "model" NaCl particles (p < 0.05), raising a concern about applicability of the N95 filters performance obtained with the NaCl aerosol challenge to protection against combustion particles. Aerosol type, inhalation flow rate and particle size were significant (p < 0.05) factors affecting the performance of the N95 FFR filter. In contrast to N95 filters, the penetration of combustion particles through R95 and P95 FFR filters (were tested in addition to N95) were not significantly higher than that obtained with NaCl particles. The findings were attributed to several effects, including the degradation of an N95 filter due to hydrophobic organic components generated into the air by combustion. Their interaction with fibers is anticipated to be similar to those involving "oily" particles. The findings of this study suggest that the efficiency of N95 respirator filters obtained with the NaCl aerosol challenge may not accurately predict (and rather overestimate) the filter efficiency against combustion particles.

Distribution System Pricing with Distributed Energy Resources

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

Hledik, Ryan; Lazar, Jim; Schwartz, Lisa

Technological changes in the electric utility industry bring tremendous opportunities and significant challenges. Customers are installing clean sources of on-site generation such as rooftop solar photovoltaic (PV) systems. At the same time, smart appliances and control systems that can communicate with the grid are entering the retail market. Among the opportunities these changes create are a cleaner and more diverse power system, the ability to improve system reliability and system resilience, and the potential for lower total costs. Challenges include integrating these new resources in a way that maintains system reliability, provides an equitable sharing of system costs, and avoidsmore » unbalanced impacts on different groups of customers, including those who install distributed energy resources (DERs) and low-income households who may be the least able to afford the transition.« less

Sterilization techniques for biodegradable scaffolds in tissue engineering applications

PubMed Central

Dai, Zheng; Ronholm, Jennifer; Tian, Yiping; Sethi, Benu; Cao, Xudong

2016-01-01

Biodegradable scaffolds have been extensively studied due to their wide applications in biomaterials and tissue engineering. However, infections associated with in vivo use of these scaffolds by different microbiological contaminants remain to be a significant challenge. This review focuses on different sterilization techniques including heat, chemical, irradiation, and other novel sterilization techniques for various biodegradable scaffolds. Comparisons of these techniques, including their sterilization mechanisms, post-sterilization effects, and sterilization efficiencies, are discussed. PMID:27247758

Current challenges in optimizing systemic therapy for patients with pancreatic cancer: expert perspectives from the Australasian Gastrointestinal Trials Group (AGITG) with invited international faculty.

PubMed

Segelov, Eva; Lordick, Florian; Goldstein, David; Chantrill, Lorraine A; Croagh, Daniel; Lawrence, Ben; Arnold, Dirk; Chau, Ian; Obermannova, Radka; Price, Timothy Jay

2017-10-01

Despite recent progress, the outlook for most patients with pancreatic cancer remains poor. There is variation in how patients are managed globally due to differing interpretations of the evidence, partly because studies in this disease are challenging to undertake. This article collates the evidence upon which current best practice is based and offers an expert opinion from an international faculty on how latest developments should influence current treatment paradigms. Areas covered: Optimal chemotherapy for first and subsequent lines of therapy; optimal management of locally advanced, non-metastatic cancer including the role of neoadjuvant chemo(radio)therapy, current evidence for adjuvant chemotherapy, major advances in pancreatic cancer genomics and challenges in supportive care particularly relevant to patients with pancreatic cancer. For each section, literature was reviewed by comprehensive search techniques, including clinical trial websites and abstracts from international cancer meetings. Expert commentary: For each section, a commentary is provided. Overall the challenges identified were: difficulties in diagnosing pancreatic cancer early, challenges for performing randomised clinical trials in all stages of the disease, some progress in systemic therapy with new agents and in identifying molecular subtypes that may be clinically relevant and move towards personalized therapy, but still, pancreatic cancer remains a very poor prognosis cancer with significant palliative care needs.

Rewards and unique challenges faced by African-American custodial grandmothers: the importance of future planning.

PubMed

Crowther, Martha R; Huang, Chao-Hui Sylvia; Allen, Rebecca S

2015-01-01

This exploratory study examined the context and consequences of custodial grandparenting, along with attitudes and preferences regarding future planning among 22 African-American custodial grandmothers. A mixed-method research design was employed. Based on our integration of two theories regarding future planning and health behavior change, caregiving, emotional distress, religiosity and spirituality, and future planning were assessed using questionnaires along with semi-structured interviews. African-American custodial grandmothers (mean age M = 53.64, SD = 9.58) perceived their caregiving role as rewarding (72%) yet challenging (86%). More than 40% reported significant emotional distress (CES-D ≥ 16) that warrants clinical attention. Findings showed that while 64% of study participants had future plans regarding who will substitute in their caregiving role if they become incapacitated, only 9% had completed a living will. Three major themes emerged regarding custodial grandmothers' caregiving role which includes: (1) rewards; (2) challenges including feeling overwhelmed and health concerns; and (3) caregiving decisions including conflicts between 'My plan was…/put self on-hold' for grandchildren and difficulty with future planning. These themes highlighted the dynamics of caregiving across time, including current context and the ongoing process of decision-making. Findings suggest that while African-American custodial grandmothers find caregiving rewarding, they face unique challenges in contemplating and developing future plans. Custodial grandmothers think about substitute caregivers for their grandchildren but need assistance communicating a plan focused on their own needs for future care. Culturally sensitive interventions designed to facilitate effective utilization of future plans within this caregiver population are needed.

Human recognition in a video network

NASA Astrophysics Data System (ADS)

Bhanu, Bir

2009-10-01

Video networks is an emerging interdisciplinary field with significant and exciting scientific and technological challenges. It has great promise in solving many real-world problems and enabling a broad range of applications, including smart homes, video surveillance, environment and traffic monitoring, elderly care, intelligent environments, and entertainment in public and private spaces. This paper provides an overview of the design of a wireless video network as an experimental environment, camera selection, hand-off and control, anomaly detection. It addresses challenging questions for individual identification using gait and face at a distance and present new techniques and their comparison for robust identification.

Early viral replication and induced or constitutive immunity in rainbow trout families with differential resistance to Infectious hematopoietic necrosis virus (IHNV)

USGS Publications Warehouse

Purcell, M.K.; LaPatra, S.E.; Woodson, J.C.; Kurath, G.; Winton, J.R.

2010-01-01

The main objective of this study was to assess correlates of innate resistance in rainbow trout full-sibling families that differ in susceptibility to Infectious hematopoietic necrosis virus (IHNV). As part of a commercial breeding program, full-sibling families were challenged with IHNV by waterborne exposure at the 1 g size to determine susceptibility to IHNV. Progeny from select families (N = 7 families) that varied in susceptibility (ranging from 32 to 90% cumulative percent mortality (CPM)) were challenged again at the 10 g size by intra-peritoneal injection and overall mortality, early viral replication and immune responses were evaluated. Mortality challenges included 20–40 fish per family while viral replication and immune response studies included 6 fish per family at each time point (24, 48 and 72 h post-infection (hpi)). CPM at the 1 g size was significantly correlated with CPM at the 10 g size, indicating that inherent resistance was a stable trait irrespective of size. In the larger fish, viral load was measured by quantitative reverse-transcriptase PCR in the anterior kidney and was a significant predictor of family disease outcome at 48 hpi. Type I interferon (IFN) transcript levels were significantly correlated with an individual's viral load at 48 and 72 hpi, while type II IFN gene expression was significantly correlated with an individual's viral load at 24 and 48 hpi. Mean family type I but not type II IFN gene expression was weakly associated with susceptibility at 72 hpi. There was no association between mean family susceptibility and the constitutive expression of a range of innate immune genes (e.g. type I and II IFN pathway genes, cytokine and viral recognition receptor genes). The majority of survivors from the challenge had detectable serum neutralizing antibody titers but no trend was observed among families. This result suggests that even the most resistant families experienced sufficient levels of viral replication to trigger specific immunity. In summary, disease outcome for each family was determined very early in the infection process and resistance was associated with lower early viral replication.

Adolescents with Depressive Symptoms and Their Challenges with Learning in School

ERIC Educational Resources Information Center

Humensky, Jennifer; Kuwabara, Sachiko A.; Fogel, Joshua; Wells, Corrie; Goodwin, Brady; Van Voorhees, Benjamin W.

2010-01-01

We examine school performance among 83 adolescents at risk for major depression. Negative mood interfered with subjective measures of school performance, including ability to do well in school, homework completion, concentrate in class, interact with peers, and going to class. No significant relationships were found for mood and objective measures…

Student Data Protection in a South African ODL University Context: Risks, Challenges and Lessons from Comparative Jurisdictions

ERIC Educational Resources Information Center

Singh, Divya; Ramutsheli, Mashamaite Peterlia

2016-01-01

Personal information is among the most significant assets for businesses today, and clear transactional rules are becoming increasingly important. Organizations, including universities, are charged with more responsibility than ever to protect the personal information used during the course of their business, specifically student data. The paper…

Challenges for Human Rights Education in Swiss Secondary Schools from a Teacher Perspective

ERIC Educational Resources Information Center

Rinaldi, Stefanie

2017-01-01

In Swiss high schools, teachers have significant leeway in determining the learning objectives and contents of curricula, including the recommended transversal theme of human rights. Teachers' views on human rights and human rights education (HRE) are, therefore, a determining factor for HRE's successful implementation. This article presents the…

Mistaking Identities: Challenging Representations of Language, Gender, and Race in High Tech Television Programs.

ERIC Educational Resources Information Center

Voithofer, R. J.

Television programs are increasingly featuring information technologies like computers as significant narrative devices, including the use of computer-based technologies as virtual worlds or environments in which characters interact, the use of computers as tools in problem solving and confronting conflict, and characters that are part human, part…

Technology Utilisation in Elementary Schools in Turkey's Capital: A Case Study

ERIC Educational Resources Information Center

Karaca, Feride; Can, Gulfidan; Yildirim, Soner

2013-01-01

A case study was conducted to explore teachers' current technology use in elementary schools in Ankara, the capital of Turkey. The data were collected through a survey, and participants included 1030 classroom teachers across eight districts. The present study results revealed that significant challenges remain with regard to technology use in the…

Life Skills at a Tribal College: A Culturally Relevant Educational Intervention

ERIC Educational Resources Information Center

Keith, Jill F.; Stastny, Sherri N.; Agnew, Wanda; Brunt, Ardith; Aune, Pat

2017-01-01

American Indians, Alaska Natives, and Native Hawaiians (AI/AN/NH) experience the lowest rates of college retention and significant barriers to graduation. In addition, AI/AN/NH individuals face health challenges that include higher rates of obesity, overweight, and type 2 diabetes. We designed a culturally relevant life skills curriculum based on…

Social Influence on Information Technology Adoption and Sustained Use in Healthcare: A Hierarchical Bayesian Learning Method Analysis

ERIC Educational Resources Information Center

Hao, Haijing

2013-01-01

Information technology adoption and diffusion is currently a significant challenge in the healthcare delivery setting. This thesis includes three papers that explore social influence on information technology adoption and sustained use in the healthcare delivery environment using conventional regression models and novel hierarchical Bayesian…

Ethical Principles in Practice: Evidence from Participatory Action Research

ERIC Educational Resources Information Center

Smith, Liz

2008-01-01

A significant challenge for all participants in the autism spectrum disorder participatory action research (ASD PAR) project, including the Ministry of Education, the local project teams (LPT) and mentors, was the lack of availability of a single ethics approval process for the project in its entirety and, in particular, one that could accommodate…

The Dawn of a New Professionalism in the French Academy? Academics Facing the Challenges of Change

ERIC Educational Resources Information Center

Evans, Linda; Cosnefroy, Laurent

2013-01-01

Using as an analytical framework Evans's conceptualisation of professionalism, this article examines the implications for academic professionalism in the French higher education sector of reforms and significant changes that have evolved over the last few decades, including: the "Investissements d'Avenir" programme, the "Loi de…

Rachel's Challenge: A Moral Compass for Character Education

ERIC Educational Resources Information Center

Hollingshead, Barbara; Crump, Christi; Eddy, Rochelle; Rowe, Dina

2009-01-01

Though American life in 1923 was significantly different than the present day, authors John Dewey and Diana Brannon share similar concerns about character. Historically, educators as far back as the 1800s have felt an obligation to the community to transcend the primary purpose for schooling by including character education in their curricula.…

Where Do Young People Work?

ERIC Educational Resources Information Center

Maguire, Sue; Huddleston, Prue

2009-01-01

The current policy intention, that all young people remain in some form of accredited education or training to the age of 18 by 2015, poses significant challenges. The jobs without training (JWT) group includes young people who are in full-time work and not in receipt of training leading to National Vocational Qualification level 2 (or above);…

Maintaining saproxylic insects in Canada's extensively managed boreal forests: a review

Treesearch

David W. Langor; John R. Spence; H.E. James Hammond; Joshua Jacobs; Tyler P. Cobb

2006-01-01

Recent work on saproxylic insect assemblages in western Canadian boreal forests has demonstrated high faunal diversity and variability, and that adequate assessment of these insects involves significant sampling and taxonomic challenges. Some major determinants of assemblage structure include tree species, degree of decay, stand age and cause of tree death. Experiments...

Modeling Reading Growth in Grades 3 to 5 with an Alternate Assessment

ERIC Educational Resources Information Center

Farley, Dan; Anderson, Daniel; Irvin, P. Shawn; Tindal, Gerald

2017-01-01

Modeling growth for students with significant cognitive disabilities (SWSCD) is difficult due to a variety of factors, including, but not limited to, missing data, test scaling, group heterogeneity, and small sample sizes. These challenges may account for the paucity of previous research exploring the academic growth of SWSCD. Our study represents…

Ammonia losses from a southern high plains dairy during summer

USDA-ARS?s Scientific Manuscript database

Animal agriculture is a significant source of ammonia (NH3). Cattle excrete a large amount of nitrogen (N); most urinary N is converted to NH3, volatilized and lost to the atmosphere. Open lot dairies on the southern High Plains are a growing industry and face environmental challenges including repo...

In Their Own Voices: Study Habits of Distance Education Students

ERIC Educational Resources Information Center

Buck, Stefanie

2016-01-01

Distance learners must balance many challenges when studying away from their home institution, including balancing work, family and study times. How, where, and when a student organizes and interacts with his or her study environment is a significant factor in student persistence and retention. Support services provided by the home institution,…

Race and Resources: Black Parents' Perspectives on Post-Apartheid South African Schools

ERIC Educational Resources Information Center

Ndimande, Bekisizwe S.

2012-01-01

The dismantling of apartheid in 1994 brought an array of democratic changes in South Africa, including changes in curriculum and educational policies. One of the most momentous changes was the desegregation of public schools. While this was significant in South African education politics, it presented some educational challenges, especially to…

Designing a Multi-Objective Multi-Support Accuracy Assessment of the 2001 National Land Cover Data (NLCD 2001) of the Conterminous United States

EPA Science Inventory

The database design and diverse application of NLCD 2001 pose significant challenges for accuracy assessment because numerous objectives are of interest, including accuracy of land cover, percent urban imperviousness, percent tree canopy, land-cover composition, and net change. ...

Influence of Risk Factors for Child Disruptive Behavior on Parent Attendance at a Preventive Intervention

ERIC Educational Resources Information Center

Ryan, Sarah M.; Boxmeyer, Caroline L.; Lochman, John E.

2009-01-01

Although preventive interventions that include both parent and child components produce stronger effects on disruptive behavior than child-only interventions, engaging parents in behavioral parent training is a significant challenge. This study examined the effects of specific risk factors for child disruptive behavior on parent attendance in…

3-Year-Olds' Comprehension, Production, and Generalization of Sesotho Passives

ERIC Educational Resources Information Center

Demuth, Katherine; Moloi, Francina; Machobane, Malillo

2010-01-01

Researchers have long been puzzled by the challenge English passive constructions present for language learners, with adult-like comprehension and production emerging only around the age of 5. It has therefore been of significant interest that researchers of other languages, including the Bantu language Sesotho, have reported acquisition of the…

Challenging the Post-Fordist/Flexible Organisation Thesis: The Case of Reformed Educational Organisations

ERIC Educational Resources Information Center

Brehony, Kevin J.; Deem, Rosemary

2005-01-01

This paper examines claims that recent reforms to UK education have led to significant organisational changes in primary school and higher education. It also examines two main theoretical explanations for these, namely post-Fordism and New Managerialism. Examples of changes in both schools and universities, including flexibility and teamwork, are…

Growing Older With HIV/AIDS: New Public Health Challenges

PubMed Central

Cahill, Sean; Valadéz, Robert

2013-01-01

At present, the health care infrastructure is ill-equipped to handle the unique treatment and care needs of HIV-positive older adults. The long-term effects of antiretroviral use are still being discovered and have been associated with a number of comorbidities. Stigma presents challenges for those in need of services and health care, and can significantly affect mental health and treatment adherence. The training of elder service providers and health care providers in meeting the needs of HIV-positive older adults, including gay and transgender people, is needed as the population ages. HIV-related and antigay stigma should be challenged by social marketing campaigns. Continued research and key policy changes could greatly improve health outcomes for HIV-positive elderly persons by increasing access to treatment and support. PMID:23327276

Near Real-Time Call Detail Record ETL Flows

NASA Astrophysics Data System (ADS)

Cochinwala, Munir; Panagos, Euthimios

Telecommunication companies face significant business challenges as they strive to reduce subscriber churn and increase average revenue per user (ARPU) by offering new services and incorporating new functionality into existing services. The increased number of service offerings and available functionality result in an ever growing volume of call detail records (CDRs). For many services (e.g., pre-paid), CDRs need to be processed and analyzed in near real-time for several reasons, including charging, on-line subscriber access to their accounts, and analytics for predicting subscriber usage and preventing fraudulent activity. In this paper, we describe the challenges associated with near real-time extract, transform, and load (ETL) of CDR data warehouse flows for supporting both the operational and business intelligence needs of telecommunication services, and we present our approach to addressing these challenges.

Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments.

PubMed

Dougherty, Scott; Beaton, Andrea; Nascimento, Bruno R; Zühlke, Liesl J; Khorsandi, Maziar; Wilson, Nigel

2018-01-01

Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs.

Core Competencies for Doctoral Education in Public Health

PubMed Central

Calhoun, Judith G.; Weist, Elizabeth M.; Raczynski, James M.

2012-01-01

The Association of Schools of Public Health (ASPH) released the Doctor of Public Health (DrPH) Core Competency Model in 2009. Between 2007 and 2009, a national expert panel with members of the academic and practice communities guided by the ASPH Education Committee developed its 7 performance domains, including 54 competencies. We provide an overview and analysis of the challenges and issues associated with the variability in DrPH degree offerings, reflect on the model development process and related outcomes, and discuss the significance of the model, future applications, and challenges for integration across educational settings. With the model, ASPH aims to stimulate national discussion on the competencies needed by DrPH graduates with the new challenges of 21st-century public health practice and to better define the DrPH degree. PMID:22095342

Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments

PubMed Central

Dougherty, Scott; Beaton, Andrea; Nascimento, Bruno R; Zühlke, Liesl J; Khorsandi, Maziar; Wilson, Nigel

2018-01-01

Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs. PMID:29440834

Policy development and the estuary environment: a Severn Estuary case study.

PubMed

Ballinger, R; Stojanovic, T

2010-01-01

The paper reviews the development of key policy relating to estuary management, highlighting the trends and drivers in policy development which have shaped the management and protection of the estuary environment. Focusing on policy developments over the last three decades, the paper draws attention to the significant influence of European policy and new approaches to environmental governance in stimulating wider and more integrated approaches to the environmental management of the estuary, as well as highlighting considerable environmental improvements associated with increased environmental regulation. The paper discusses how 'fit for purpose' the policy framework is to address current challenges, including those identified by recent stakeholder consultations. Significant issues include limited understanding and information related to the cause-effect relationships between policy and environmental quality as well as ongoing institutional and policy fragmentation associated with devolutionary processes. Such fragmentation, alongside under-investment in integrated estuary planning, is likely to prove a particular challenge to balanced and informed decision-making. Whilst the paper focuses on the Severn experience, the approach adopted will be of interest to all assessing policy-environment linkages. (c) 2009 Elsevier Ltd. All rights reserved.

Nanoparticle Approaches against Bacterial Infections

PubMed Central

Gao, Weiwei; Thamphiwatana, Soracha; Angsantikul, Pavimol; Zhang, Liangfang

2014-01-01

Despite the wide success of antibiotics, the treatment of bacterial infection still faces significant challenges, particularly the emergence of antibiotic resistance. As a result, nanoparticle drug delivery platforms including liposomes, polymeric nanoparticles, dendrimers, and various inorganic nanoparticles have been increasingly exploited to enhance the therapeutic effectiveness of existing antibiotics. This review focuses on areas where nanoparticle approaches hold significant potential to advance the treatment of bacterial infection. These areas include targeted antibiotic delivery, environmentally responsive antibiotic delivery, combinatorial antibiotic delivery, nanoparticle-enabled antibacterial vaccination, and nanoparticle-based bacterial detection. In each area we highlight the innovative antimicrobial nanoparticle platforms and review their progress made against bacterial infections. PMID:25044325

Communication analysis for feedback control of civil infrastructure using cochlea-inspired sensing nodes

NASA Astrophysics Data System (ADS)

Peckens, Courtney A.; Cook, Ireana; Lynch, Jerome P.

2016-04-01

Wireless sensor networks (WSNs) have emerged as a reliable, low-cost alternative to the traditional wired sensing paradigm. While such networks have made significant progress in the field of structural monitoring, significantly less development has occurred for feedback control applications. Previous work in WSNs for feedback control has highlighted many of the challenges of using this technology including latency in the wireless communication channel and computational inundation at the individual sensing nodes. This work seeks to overcome some of those challenges by drawing inspiration from the real-time sensing and control techniques employed by the biological central nervous system and in particular the mammalian cochlea. A novel bio-inspired wireless sensor node was developed that employs analog filtering techniques to perform time-frequency decomposition of a sensor signal, thus encompassing the functionality of the cochlea. The node then utilizes asynchronous sampling of the filtered signal to compress the signal prior to communication. This bio-inspired sensing architecture is extended to a feedback control application in order to overcome the traditional challenges currently faced by wireless control. In doing this, however, the network experiences high bandwidths of low-significance information exchange between nodes, resulting in some lost data. This study considers the impact of this lost data on the control capabilities of the bio-inspired control architecture and finds that it does not significantly impact the effectiveness of control.

Challenges in Cost-Effectiveness Analysis Modelling of HPV Vaccines in Low- and Middle-Income Countries: A Systematic Review and Practice Recommendations.

PubMed

Ekwunife, Obinna I; O'Mahony, James F; Gerber Grote, Andreas; Mosch, Christoph; Paeck, Tatjana; Lhachimi, Stefan K

2017-01-01

Low- and middle-income countries (LMICs) face a number of challenges in implementing cervical cancer prevention programmes that do not apply in high-income countries. This review assessed how context-specific challenges of implementing cervical cancer prevention strategies in LMICs were accounted for in existing cost-effectiveness analysis (CEA) models of human papillomavirus (HPV) vaccination. The databases of MEDLINE, EMBASE, NHS Economic Evaluation Database, EconLit, Web of Science, and the Center for the Evaluation of Value and Risk in Health (CEA) Registry were searched for studies published from 2006 to 2015. A descriptive, narrative, and interpretative synthesis of data was undertaken. Of the 33 studies included in the review, the majority acknowledged cost per vaccinated girl (CVG) (26 studies) and vaccine coverage rate (21 studies) as particular challenges for LMICs, while nine studies identified screening coverage rate as a challenge. Most of the studies estimated CVG as a composite of different cost items. However, the basis for the items within this composite cost was unclear. The majority used an assumption rather than an observed rate to represent screening and vaccination coverage rates. CVG, vaccine coverage and screening coverage were shown by some studies through sensitivity analyses to reverse the conclusions regarding cost-effectiveness, thereby significantly affecting policy recommendations. While many studies recognized aspects of the particular challenges of HPV vaccination in LMICs, greater efforts need to be made in adapting models to account for these challenges. These include adapting costings of HPV vaccine delivery from other countries, learning from the outcomes of cervical cancer screening programmes in the same geographical region, and taking into account the country's previous experience with other vaccination programmes.

De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges.

PubMed

Daniel Markley, J; Bernard, Shaina; Bearman, Gonzalo; Stevens, Michael P

2017-04-01

Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. A consensus definition of ADE remains elusive at this time. Preliminary studies utilizing rapid diagnostic tests including matrix-assisted laser desorption/ionization time of flight (MALDI-TOF), procalcitonin, and other molecular techniques have demonstrated the potential to support ADE strategies. In the absence of evidence-based, highly specific ADE protocols, the likelihood that individual providers will make consistent, often challenging, decisions to de-escalate antibiotic therapy is low. Antimicrobial stewardship programs should support local physicians with ADE and develop innovative ways to integrate ADE into the broader construct of antimicrobial stewardship programs. The evolving field of rapid diagnostics has significant potential to improve ADE strategies, but more research is needed to fully realize this goal.

How common are challenging behaviours amongst individuals with Fragile X Syndrome? A systematic review.

PubMed

Hardiman, Rebecca Lyndsey; McGill, Peter

2018-05-01

Fragile X Syndrome (FXS) appears to be associated with an increased risk for engaging in challenging behaviour, particularly self-injury, relative to those with mixed aetiology learning disabilities. Such behavioural issues are reported to be of high concern for those providing support. As such, this systematic review aimed to gain further epidemiological data regarding challenging behaviours in individuals with FXS, including: self-injurious behaviour (SIB), hand-biting as a specific topography of SIB, aggression and property destruction. Twenty eight manuscripts were identified which reported the prevalence of a relevant topography of behaviour, with widely varying prevalence estimates. Weighted averages of the prevalence of behaviours were calculated across studies. Comparison of proportions revealed significant gender differences and differences in the prevalence of types of behaviour. It is hoped that this comprehensive overview of data on this clinically significant topic will help to inform and drive future investigation to understand and provide effective intervention for the benefit of those with FXS. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Family Commitment and Work Characteristics among Pharmacists

PubMed Central

Gubbins, Paul O.; Ragland, Denise; Castleberry, Ashley N.; Payakachat, Nalin

2015-01-01

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse’s family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants’ mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males (p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment (p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated. PMID:28975924

Family Commitment and Work Characteristics among Pharmacists.

PubMed

Gubbins, Paul O; Ragland, Denise; Castleberry, Ashley N; Payakachat, Nalin

2015-12-17

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse's family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants' mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males ( p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment ( p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated.

Assessment of a respiratory face mask for capturing air pollutants and pathogens including human influenza and rhinoviruses.

PubMed

Zhou, S Steve; Lukula, Salimatu; Chiossone, Cory; Nims, Raymond W; Suchmann, Donna B; Ijaz, M Khalid

2018-03-01

Prevention of infection with airborne pathogens and exposure to airborne particulates and aerosols (environmental pollutants and allergens) can be facilitated through use of disposable face masks. The effectiveness of such masks for excluding pathogens and pollutants is dependent on the intrinsic ability of the masks to resist penetration by airborne contaminants. This study evaluated the relative contributions of a mask, valve, and Micro Ventilator on aerosol filtration efficiency of a new N95 respiratory face mask. The test mask was challenged, using standardized methods, with influenza A and rhinovirus type 14, bacteriophage ΦΧ174, Staphylococcus aureus ( S . aureus ), and model pollutants. The statistical significance of results obtained for different challenge microbial agents and for different mask configurations (masks with operational or nonoperational ventilation fans and masks with sealed Smart Valves) was assessed. The results demonstrate >99.7% efficiency of each test mask configuration for exclusion of influenza A virus, rhinovirus 14, and S . aureus and >99.3% efficiency for paraffin oil and sodium chloride (surrogates for PM 2.5 ). Statistically significant differences in effectiveness of the different mask configurations were not identified. The efficiencies of the masks for excluding smaller-size (i.e., rhinovirus and bacteriophage ΦΧ174) vs. larger-size microbial agents (influenza virus, S . aureus ) were not significantly different. The masks, with or without features intended for enhancing comfort, provide protection against both small- and large-size pathogens. Importantly, the mask appears to be highly efficient for filtration of pathogens, including influenza and rhinoviruses, as well as the fine particulates (PM 2.5 ) present in aerosols that represent a greater challenge for many types of dental and surgical masks. This renders this individual-use N95 respiratory mask an improvement over the former types of masks for protection against a variety of environmental contaminants including PM 2.5 and pathogens such as influenza and rhinoviruses.

Assessment of a respiratory face mask for capturing air pollutants and pathogens including human influenza and rhinoviruses

PubMed Central

Zhou, S. Steve; Lukula, Salimatu; Chiossone, Cory; Nims, Raymond W.; Suchmann, Donna B.

2018-01-01

Background Prevention of infection with airborne pathogens and exposure to airborne particulates and aerosols (environmental pollutants and allergens) can be facilitated through use of disposable face masks. The effectiveness of such masks for excluding pathogens and pollutants is dependent on the intrinsic ability of the masks to resist penetration by airborne contaminants. This study evaluated the relative contributions of a mask, valve, and Micro Ventilator on aerosol filtration efficiency of a new N95 respiratory face mask. Methods The test mask was challenged, using standardized methods, with influenza A and rhinovirus type 14, bacteriophage ΦΧ174, Staphylococcus aureus (S. aureus), and model pollutants. The statistical significance of results obtained for different challenge microbial agents and for different mask configurations (masks with operational or nonoperational ventilation fans and masks with sealed Smart Valves) was assessed. Results The results demonstrate >99.7% efficiency of each test mask configuration for exclusion of influenza A virus, rhinovirus 14, and S. aureus and >99.3% efficiency for paraffin oil and sodium chloride (surrogates for PM2.5). Statistically significant differences in effectiveness of the different mask configurations were not identified. The efficiencies of the masks for excluding smaller-size (i.e., rhinovirus and bacteriophage ΦΧ174) vs. larger-size microbial agents (influenza virus, S. aureus) were not significantly different. Conclusions The masks, with or without features intended for enhancing comfort, provide protection against both small- and large-size pathogens. Importantly, the mask appears to be highly efficient for filtration of pathogens, including influenza and rhinoviruses, as well as the fine particulates (PM2.5) present in aerosols that represent a greater challenge for many types of dental and surgical masks. This renders this individual-use N95 respiratory mask an improvement over the former types of masks for protection against a variety of environmental contaminants including PM2.5 and pathogens such as influenza and rhinoviruses. PMID:29707364

Experimental infection of Muscovy ducks with highly pathogenic avian influenza virus (H5N1) belonging to clade 2.2.

PubMed

Guionie, Olivier; Guillou-Cloarec, Cécile; Courtois, David; Bougeard, B Stéphanie; Amelot, Michel; Jestin, Véronique

2010-03-01

Highly pathogenic (HP) H5N1 avian influenza (AI) is enzootic in several countries of Asia and Africa and constitutes a major threat, at the world level, for both animal and public health. Ducks play an important role in the epidemiology of AI, including HP H5N1 AI. Although vaccination can be a useful tool to control AI, duck vaccination has not proved very efficient in the field, indicating a need to develop new vaccines and a challenge model to evaluate the protection for duck species. Although Muscovy duck is the duck species most often reared in France, the primary duck-producing country in Europe, and is also produced in Asia, it is rarely studied. Our team recently demonstrated a good cross-reactivity with hemagglutinin from clade 2.2 and inferred that this could be a good vaccine candidate for ducks. Two challenges using two French H5N1 HP strains, 1) A/mute swan/France/06299/06 (Swan/06299), clade 2.2.1, and 2) A/mute swan/France/070203/07 (Swan/070203), clade 2.2 (but different from subclade 2.2.1), were performed (each) on 20 Muscovy ducks (including five contacts) inoculated by oculo-nasal route (6 log10 median egg infectious doses per duck). Clinical signs were recorded daily, and cloacal and oropharyngeal swabs were collected throughout the assay. Autopsies were done on all dead ducks, and organs were taken for analyses. Virus was measured by quantitative reverse transcriptase-PCR based on the M gene AI virus. Ducks presented severe nervous signs in both challenges. Swan/070203 strain led to 80% morbidity (12/15 sick ducks) and 73% mortality (11/15 ducks) at 13.5 days postinfection (dpi), whereas Swan/06299 strain produced 100% mortality at 6.5 dpi. Viral RNA load was significantly lower via the cloacal route than via the oropharyngeal route in both trials, presenting a peak in the first challenge at 3.5 dpi and being more stable in the second challenge. The brain was the organ containing the highest viral RNA load in both challenges. Viral RNA load in a given organ was similar or statistically significantly higher in ducks challenged with Swan/06299 strain. Thus, the Swan/06299 strain was more virulent and could be used as a putative challenge model. Moreover, challenged ducks and contacts contained the same amounts of viral RNA load, demonstrating the rapid and efficient transmission of H5N1 HP in Muscovy ducks in our experimental conditions.

Monophosphoryl Lipid A Enhances Efficacy of a Francisella tularensis LVS-Catanionic Nanoparticle Subunit Vaccine against F. tularensis Schu S4 Challenge by Augmenting both Humoral and Cellular Immunity

PubMed Central

Richard, Katharina; Mann, Barbara J.; Qin, Aiping; Barry, Eileen M.; Ernst, Robert K.

2017-01-01

ABSTRACT Francisella tularensis, a bacterial biothreat agent, has no approved vaccine in the United States. Previously, we showed that incorporating lysates from partially attenuated F. tularensis LVS or fully virulent F. tularensis Schu S4 strains into catanionic surfactant vesicle (V) nanoparticles (LVS-V and Schu S4-V, respectively) protected fully against F. tularensis LVS intraperitoneal (i.p.) challenge in mice. However, we achieved only partial protection against F. tularensis Schu S4 intranasal (i.n.) challenge, even when employing heterologous prime-boost immunization strategies. We now extend these findings to show that both LVS-V and Schu S4-V immunization (i.p./i.p.) elicited similarly high titers of anti-F. tularensis IgG and that the titers could be further increased by adding monophosphoryl lipid A (MPL), a nontoxic Toll-like receptor 4 (TLR4) adjuvant that is included in several U.S. FDA-approved vaccines. LVS-V+MPL immune sera also detected more F. tularensis antigens than LVS-V immune sera and, after passive transfer to naive mice, significantly delayed the time to death against F. tularensis Schu S4 subcutaneous (s.c.) but not i.n. challenge. Active immunization with LVS-V+MPL (i.p./i.p.) also increased the frequency of gamma interferon (IFN-γ)-secreting activated helper T cells, IFN-γ production, and the ability of splenocytes to control intramacrophage F. tularensis LVS replication ex vivo. Active LVS-V+MPL immunization via heterologous routes (i.p./i.n.) significantly elevated IgA and IgG levels in bronchoalveolar lavage fluid and significantly enhanced protection against i.n. F. tularensis Schu S4 challenge (to ∼60%). These data represent a significant step in the development of a subunit vaccine against the highly virulent type A strains. PMID:28077440

Application of Life Cycle Assessment on Electronic Waste Management: A Review.

PubMed

Xue, Mianqiang; Xu, Zhenming

2017-04-01

Electronic waste is a rich source of both valuable materials and toxic substances. Management of electronic waste is one of the biggest challenges of current worldwide concern. As an effective and prevailing environmental management tool, life cycle assessment can evaluate the environmental performance of electronic waste management activities. Quite a few scientific literatures reporting life cycle assessment of electronic waste management with significant outcomes have been recently published. This paper reviewed the trends, characteristics, research gaps, and challenges of these studies providing detailed information for practitioners involved in electronic waste management. The results showed that life cycle assessment studies were most carried out in Europe, followed by Asia and North America. The research subject of the studies mainly includes monitors, waste printed circuit boards, mobile phones, computers, printers, batteries, toys, dishwashers, and light-emitting diodes. CML was the most widely used life cycle impact assessment method in life cycle assessment studies on electronic waste management, followed by EI99. Furthermore, 40% of the reviewed studies combined with other environmental tools, including life cycle cost, material flow analysis, multi-criteria decision analysis, emergy analysis, and hazard assessment which came to more comprehensive conclusions from different aspects. The research gaps and challenges including uneven distribution of life cycle assessment studies, life cycle impact assessment methods selection, comparison of the results, and uncertainty of the life cycle assessment studies were examined. Although life cycle assessment of electronic waste management facing challenges, their results will play more and more important role in electronic waste management practices.

Application of Life Cycle Assessment on Electronic Waste Management: A Review

NASA Astrophysics Data System (ADS)

Xue, Mianqiang; Xu, Zhenming

2017-04-01

Electronic waste is a rich source of both valuable materials and toxic substances. Management of electronic waste is one of the biggest challenges of current worldwide concern. As an effective and prevailing environmental management tool, life cycle assessment can evaluate the environmental performance of electronic waste management activities. Quite a few scientific literatures reporting life cycle assessment of electronic waste management with significant outcomes have been recently published. This paper reviewed the trends, characteristics, research gaps, and challenges of these studies providing detailed information for practitioners involved in electronic waste management. The results showed that life cycle assessment studies were most carried out in Europe, followed by Asia and North America. The research subject of the studies mainly includes monitors, waste printed circuit boards, mobile phones, computers, printers, batteries, toys, dishwashers, and light-emitting diodes. CML was the most widely used life cycle impact assessment method in life cycle assessment studies on electronic waste management, followed by EI99. Furthermore, 40% of the reviewed studies combined with other environmental tools, including life cycle cost, material flow analysis, multi-criteria decision analysis, emergy analysis, and hazard assessment which came to more comprehensive conclusions from different aspects. The research gaps and challenges including uneven distribution of life cycle assessment studies, life cycle impact assessment methods selection, comparison of the results, and uncertainty of the life cycle assessment studies were examined. Although life cycle assessment of electronic waste management facing challenges, their results will play more and more important role in electronic waste management practices.

Positioning challenges in reconfigurable semi-autonomous robotic NDE inspection

NASA Astrophysics Data System (ADS)

Pierce, S. Gareth; Dobie, Gordon; Summan, Rahul; Mackenzie, Liam; Hensman, James; Worden, Keith; Hayward, Gordon

2010-03-01

This paper describes work conducted into mobile, wireless, semi-autonomous NDE inspection robots developed at The University of Strathclyde as part of the UK Research Centre for Non Destructive Evaluation (RCNDE). The inspection vehicles can incorporate a number of different NDE payloads including ultrasonic, eddy current, visual and magnetic based payloads, and have been developed to try and improve NDE inspection techniques in challenging inspection areas (for example oil, gas, and nuclear structures). A significant research challenge remains in the accurate positioning and guidance of such vehicles for real inspection tasks. Employing both relative and absolute position measurements, we discuss a number of approaches to position estimation including Kalman and particle filtering. Using probabilistic approaches enables a common mathematical framework to be employed for both positioning and data fusion from different NDE sensors. In this fashion the uncertainties in both position and defect identification and classification can be dealt with using a consistent approach. A number of practical constraints and considerations to different precision positioning techniques are discussed, along with NDE applications and the potential for improved inspection capabilities by utilising the inherent reconfigurable capabilities of the inspection vehicles.

Model-based nonlinear control of hydraulic servo systems: Challenges, developments and perspectives

NASA Astrophysics Data System (ADS)

Yao, Jianyong

2018-06-01

Hydraulic servo system plays a significant role in industries, and usually acts as a core point in control and power transmission. Although linear theory-based control methods have been well established, advanced controller design methods for hydraulic servo system to achieve high performance is still an unending pursuit along with the development of modern industry. Essential nonlinearity is a unique feature and makes model-based nonlinear control more attractive, due to benefit from prior knowledge of the servo valve controlled hydraulic system. In this paper, a discussion for challenges in model-based nonlinear control, latest developments and brief perspectives of hydraulic servo systems are presented: Modelling uncertainty in hydraulic system is a major challenge, which includes parametric uncertainty and time-varying disturbance; some specific requirements also arise ad hoc difficulties such as nonlinear friction during low velocity tracking, severe disturbance, periodic disturbance, etc.; to handle various challenges, nonlinear solutions including parameter adaptation, nonlinear robust control, state and disturbance observation, backstepping design and so on, are proposed and integrated, theoretical analysis and lots of applications reveal their powerful capability to solve pertinent problems; and at the end, some perspectives and associated research topics (measurement noise, constraints, inner valve dynamics, input nonlinearity, etc.) in nonlinear hydraulic servo control are briefly explored and discussed.

Challenges to recruitment and retention of African Americans in the gene-environment trial of response to dietary interventions (GET READI) for heart health

PubMed Central

Kennedy, Betty M.; Harsha, David W.; Bookman, Ebony B.; Hill, Yolanda R.; Rankinen, Tuomo; Rodarte, Ruben Q.; Murla, Connie D.

2011-01-01

In this paper, challenges to recruiting African Americans specifically for a dietary feeding trial are examined, learning experiences gained and suggestions to overcome these challenges in future trials are discussed. A total of 333 individuals were randomized in the trial and 234 (167 sibling pairs and 67 parents/siblings) completed the dietary intervention and required DNA blood sampling for genetic analysis. The trial used multiple strategies for recruitment. Hand distributed letters and flyers through mass distribution at various churches resulted in the largest number (n = 153, 46%) of African Americans in the trial. Word of mouth accounted for the second largest number (n = 120, 36%) and included prior study participants. These two recruitment sources represented 82% (n = 273) of the total number of individuals randomized in GET READI. The remaining 18% (n = 60) consisted of a combination of sources including printed message on check stubs, newspaper articles, radio and TV appearances, screening events and presentations. Though challenging, the recruitment efforts for GET READI produced a significant number of African American participants despite the inability to complete the trial as planned because of low recruitment yields. Nevertheless, the recruitment process produced substantial numbers that successfully completed all study requirements. PMID:21865154

Paving the Path for Human Space Exploration: The Challenges and Opportunities

NASA Technical Reports Server (NTRS)

Hansen, Lauri

2016-01-01

Lauri Hansen, Director of Engineering at NASA Johnson Space Center will discuss the challenges of human space exploration. The future of human exploration begins with our current earth reliant missions in low earth orbit. These missions utilize the International Space Station to learn how to safely execute deep space missions. In addition to serving as an exploration test bed and enabling world class research, the International Space Station enables NASA to build international and commercial partnerships. NASA's next steps will be to enable the commercialization of low earth orbit while concentrating on developing the spacecraft and infrastructure necessary for deep space exploration and long duration missions. The Orion multi-purpose crew vehicle and the Space Launch System rocket are critical building blocks in this next phase of exploration. There are many challenges in designing spacecraft to perform these missions including safety, complex vehicle design, and mass challenges. Orion development is proceeding well, and includes a significant partnership with the European Space Agency (ESA) to develop and build the Service Module portion of the spacecraft. Together, NASA and ESA will provide the capability to take humans further than we have ever been before - 70,000 km past the moon. This will be the next big step in expanding the frontiers of human exploration, eventually leading to human footprints on Mars.

Optimising the use of observational electronic health record data: Current issues, evolving opportunities, strategies and scope for collaboration.

PubMed

Liaw, Siaw-Teng; Powell-Davies, Gawaine; Pearce, Christopher; Britt, Helena; McGlynn, Lisa; Harris, Mark F

2016-03-01

With increasing computerisation in general practice, national primary care networks are mooted as sources of data for health services and population health research and planning. Existing data collection programs - MedicinesInsight, Improvement Foundation, Bettering the Evaluation and Care of Health (BEACH) - vary in purpose, governance, methodologies and tools. General practitioners (GPs) have significant roles as collectors, managers and users of electronic health record (EHR) data. They need to understand the challenges to their clinical and managerial roles and responsibilities. The aim of this article is to examine the primary and secondary use of EHR data, identify challenges, discuss solutions and explore directions. Representatives from existing programs, Medicare Locals, Local Health Districts and research networks held workshops on the scope, challenges and approaches to the quality and use of EHR data. Challenges included data quality, interoperability, fragmented governance, proprietary software, transparency, sustainability, competing ethical and privacy perspectives, and cognitive load on patients and clinicians. Proposed solutions included effective change management; transparent governance and management of intellectual property, data quality, security, ethical access, and privacy; common data models, metadata and tools; and patient/community engagement. Collaboration and common approaches to tools, platforms and governance are needed. Processes and structures must be transparent and acceptable to GPs.

How diet modification challenges are magnified in vulnerable or marginalized people with diabetes and heart disease: a systematic review and qualitative meta-synthesis.

PubMed

Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

2013-01-01

Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here--and of this synthesis--do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes.

How Diet Modification Challenges Are Magnified in Vulnerable or Marginalized People With Diabetes and Heart Disease

PubMed Central

Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

2013-01-01

Background Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. Objectives To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. Data Sources This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Review Methods Qualitative meta-synthesis was used to integrate findings across primary research studies. Results Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. Limitations While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here—and of this synthesis—do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Conclusions Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Plain Language Summary Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes. PMID:24228077

Meta-analysis of variables affecting mouse protection efficacy of whole organism Brucella vaccines and vaccine candidates

PubMed Central

2013-01-01

Background Vaccine protection investigation includes three processes: vaccination, pathogen challenge, and vaccine protection efficacy assessment. Many variables can affect the results of vaccine protection. Brucella, a genus of facultative intracellular bacteria, is the etiologic agent of brucellosis in humans and multiple animal species. Extensive research has been conducted in developing effective live attenuated Brucella vaccines. We hypothesized that some variables play a more important role than others in determining vaccine protective efficacy. Using Brucella vaccines and vaccine candidates as study models, this hypothesis was tested by meta-analysis of Brucella vaccine studies reported in the literature. Results Nineteen variables related to vaccine-induced protection of mice against infection with virulent brucellae were selected based on modeling investigation of the vaccine protection processes. The variable "vaccine protection efficacy" was set as a dependent variable while the other eighteen were set as independent variables. Discrete or continuous values were collected from papers for each variable of each data set. In total, 401 experimental groups were manually annotated from 74 peer-reviewed publications containing mouse protection data for live attenuated Brucella vaccines or vaccine candidates. Our ANOVA analysis indicated that nine variables contributed significantly (P-value < 0.05) to Brucella vaccine protection efficacy: vaccine strain, vaccination host (mouse) strain, vaccination dose, vaccination route, challenge pathogen strain, challenge route, challenge-killing interval, colony forming units (CFUs) in mouse spleen, and CFU reduction compared to control group. The other 10 variables (e.g., mouse age, vaccination-challenge interval, and challenge dose) were not found to be statistically significant (P-value > 0.05). The protection level of RB51 was sacrificed when the values of several variables (e.g., vaccination route, vaccine viability, and challenge pathogen strain) change. It is suggestive that it is difficult to protect against aerosol challenge. Somewhat counter-intuitively, our results indicate that intraperitoneal and subcutaneous vaccinations are much more effective to protect against aerosol Brucella challenge than intranasal vaccination. Conclusions Literature meta-analysis identified variables that significantly contribute to Brucella vaccine protection efficacy. The results obtained provide critical information for rational vaccine study design. Literature meta-analysis is generic and can be applied to analyze variables critical for vaccine protection against other infectious diseases. PMID:23735014

Management of diabetes in Indigenous communities: lessons from the Australian Aboriginal population.

PubMed

Nguyen, H D; Chitturi, S; Maple-Brown, L J

2016-11-01

Type 2 diabetes mellitus and other chronic cardio-metabolic conditions are significant contributors to the large disparities in life expectancy between Indigenous and non-Indigenous Australians. Type 2 diabetes is more prevalent from a young age among Indigenous Australians and is often preceded by a cluster of risk factors, including central obesity, dyslipidaemia, albuminuria and socio-economic disadvantage. Management of type 2 diabetes in Australian Indigenous peoples can be challenging in the setting of limited resources and socio-economic disadvantage. Key strategies to address these challenges include working in partnership with patients, communities and primary healthcare services (PHC, Aboriginal community controlled and government services) and working in a multidisciplinary team. Population prevention measures are required within and beyond the health system, commencing as early as possible in the life course. © 2016 Royal Australasian College of Physicians.

Maternal mortality in developing countries: challenges in scaling-up priority interventions.

PubMed

Prata, Ndola; Passano, Paige; Sreenivas, Amita; Gerdts, Caitlin Elisabeth

2010-03-01

Although maternal mortality is a significant global health issue, achievements in mortality decline to date have been inadequate. A review of the interventions targeted at maternal mortality reduction demonstrates that most developing countries face tremendous challenges in the implementation of these interventions, including the availability of unreliable data and the shortage in human and financial resources, as well as limited political commitment. Examples from developing countries, such as Sri Lanka, Malaysia and Honduras, demonstrate that maternal mortality will decline when appropriate strategies are in place. Such achievable strategies need to include redoubled commitments on the part of local, national and global political bodies, concrete investments in high-yield and cost-effective interventions and the delegation of some clinical tasks from higher-level healthcare providers to mid- or lower-level healthcare providers, as well as improved health-management information systems.

Physical education issues for students with autism: school nurse challenges.

PubMed

Rutkowski, Elaine M; Brimer, Debbie

2014-08-01

Extant studies indicate persons with autism have difficulties in social interaction, verbal and nonverbal communication, repetitive behaviors, and poor ability to generalize learned skills. Obesity has also been identified as significantly affecting children with autism spectrum disorders (ASD). Negative experience in physical education (PE) may be the antecedent behavior to lack of activities that are mediators to sedentary lifestyles and contributors to the chronic illnesses associated with overweight and obesity. Students with ASD often cannot perform required activities to meet required PE standards. It is imperative school nurses be aware of the many challenges students with ASD bring into a PE class. School nurses provide education for the members of the school community, including the Individualized Education Plan team, regarding the need for attention to limitations, including physical activity, of students with ASD. © The Author(s) 2013.

Natural resource assessment: an approach to science based planning in national parks

USGS Publications Warehouse

Mahan, C.G.; Vanderhorst, J.P.; Young, J.A.

2009-01-01

We conducted a natural resource assessment at two national parks, New River Gorge National River and Shenandoah National Park, to help meet the goals of the Natural Resource Challenge-a program to help strengthen natural resource management at national parks. We met this challenge by synthesizing and interpreting natural resource information for planning purposes and we identified information gaps and natural significance of resources. We identified a variety of natural resources at both parks as being globally and/or nationally significant, including large expanses of unfragmented, mixed-mesophytic forests that qualify for wilderness protection, rare plant communities, diverse assemblages of neotropical migratory birds and salamanders, and outstanding aquatic recreational resources. In addition, these parks function, in part, as ecological reserves for plants in and wildlife. With these significant natural resources in mind, we also developed a suite of natural resource management recommendations in light of increasing threats from within and outside park boundaries. We hope that our approach can provide a blueprint for natural resource conservation at publically owned lands.

Natural resource assessment: an approach to science based planning in national parks.

PubMed

Mahan, Carolyn G; Vanderhorst, James P; Young, John A

2009-06-01

We conducted a natural resource assessment at two national parks, New River Gorge National River and Shenandoah National Park, to help meet the goals of the Natural Resource Challenge--a program to help strengthen natural resource management at national parks. We met this challenge by synthesizing and interpreting natural resource information for planning purposes and we identified information gaps and natural significance of resources. We identified a variety of natural resources at both parks as being globally and/or nationally significant, including large expanses of unfragmented, mixed-mesophytic forests that qualify for wilderness protection, rare plant communities, diverse assemblages of neotropical migratory birds and salamanders, and outstanding aquatic recreational resources. In addition, these parks function, in part, as ecological reserves for plants in and wildlife. With these significant natural resources in mind, we also developed a suite of natural resource management recommendations in light of increasing threats from within and outside park boundaries. We hope that our approach can provide a blueprint for natural resource conservation at publically owned lands.

Advanced Engineering Environments: Implications for Aerospace Manufacturing

NASA Technical Reports Server (NTRS)

Thomas, D.

2001-01-01

There are significant challenges facing today's aerospace industry. Global competition, more complex products, geographically-distributed design teams, demands for lower cost, higher reliability and safer vehicles, and the need to incorporate the latest technologies quicker all face the developer of aerospace systems. New information technologies offer promising opportunities to develop advanced engineering environments (AEEs) to meet these challenges. Significant advances in the state-of-the-art of aerospace engineering practice are envisioned in the areas of engineering design and analytical tools, cost and risk tools, collaborative engineering, and high-fidelity simulations early in the development cycle. These advances will enable modeling and simulation of manufacturing methods, which will in turn allow manufacturing considerations to be included much earlier in the system development cycle. Significant cost savings, increased quality, and decreased manufacturing cycle time are expected to result. This paper will give an overview of the NASA's Intelligent Synthesis Environment, the agency initiative to develop an AEE, with a focus on the anticipated benefits in aerospace manufacturing.

Durable protection of rhesus macaques immunized with a replicating adenovirus-SIV multigene prime/protein boost vaccine regimen against a second SIVmac251 rectal challenge: role of SIV-specific CD8+ T cell responses.

PubMed

Malkevitch, Nina V; Patterson, L Jean; Aldrich, M Kristine; Wu, Yichen; Venzon, David; Florese, Ruth H; Kalyanaraman, V S; Pal, Ranajit; Lee, Eun Mi; Zhao, Jun; Cristillo, Anthony; Robert-Guroff, Marjorie

2006-09-15

Previously, priming with replication-competent adenovirus-SIV multigenic vaccines and boosting with envelope subunits strongly protected 39% of rhesus macaques against rectal SIV(mac251) challenge. To evaluate protection durability, eleven of the protected and two SIV-infected unimmunized macaques that controlled viremia were re-challenged rectally with SIV(mac251). Strong protection was observed in 8/11 vaccinees, including two exhibiting <50 SIV RNA copies. Decreased viremia compared to naïve controls was observed in the other three. The SIV-infected unimmunized macaques modestly controlled viremia but exhibited CD4 counts < or =200, unlike the protected macaques. Durable protection was associated with significantly increased SIV-specific ELISPOT responses and lymphoproliferative responses to p27 at re-challenge. After CD8 depletion, 2 of 8 re-challenged, protected vaccinees maintained <50 SIV RNA copies; SIV RNA emerged in 6. Re-appearance of CD8 cells and restoration of SIV-specific cellular immunity coincided with viremia suppression. Overall, cellular immunity induced by vaccination and/or low-level, inapparent viremia post-first SIV(mac251) challenge, was associated with durable protection against re-challenge.

Challenges and Opportunities of Airborne Metagenomics

PubMed Central

Behzad, Hayedeh; Gojobori, Takashi; Mineta, Katsuhiko

2015-01-01

Recent metagenomic studies of environments, such as marine and soil, have significantly enhanced our understanding of the diverse microbial communities living in these habitats and their essential roles in sustaining vast ecosystems. The increase in the number of publications related to soil and marine metagenomics is in sharp contrast to those of air, yet airborne microbes are thought to have significant impacts on many aspects of our lives from their potential roles in atmospheric events such as cloud formation, precipitation, and atmospheric chemistry to their major impact on human health. In this review, we will discuss the current progress in airborne metagenomics, with a special focus on exploring the challenges and opportunities of undertaking such studies. The main challenges of conducting metagenomic studies of airborne microbes are as follows: 1) Low density of microorganisms in the air, 2) efficient retrieval of microorganisms from the air, 3) variability in airborne microbial community composition, 4) the lack of standardized protocols and methodologies, and 5) DNA sequencing and bioinformatics-related challenges. Overcoming these challenges could provide the groundwork for comprehensive analysis of airborne microbes and their potential impact on the atmosphere, global climate, and our health. Metagenomic studies offer a unique opportunity to examine viral and bacterial diversity in the air and monitor their spread locally or across the globe, including threats from pathogenic microorganisms. Airborne metagenomic studies could also lead to discoveries of novel genes and metabolic pathways relevant to meteorological and industrial applications, environmental bioremediation, and biogeochemical cycles. PMID:25953766

Cognitive culture: theoretical and empirical insights into social learning strategies.

PubMed

Rendell, Luke; Fogarty, Laurel; Hoppitt, William J E; Morgan, Thomas J H; Webster, Mike M; Laland, Kevin N

2011-02-01

Research into social learning (learning from others) has expanded significantly in recent years, not least because of productive interactions between theoretical and empirical approaches. This has been coupled with a new emphasis on learning strategies, which places social learning within a cognitive decision-making framework. Understanding when, how and why individuals learn from others is a significant challenge, but one that is critical to numerous fields in multiple academic disciplines, including the study of social cognition. Copyright © 2010 Elsevier Ltd. All rights reserved.

Designing and Conducting a Purification Scheme as an Organic Chemistry Laboratory Practical

ERIC Educational Resources Information Center

Graham, Kate J.; Johnson, Brian J.; Jones, T. Nicholas; McIntee, Edward J.; Schaller, Chris P.

2008-01-01

An open-ended laboratory practical has been developed that challenges students to evaluate when different purification techniques are appropriate. In contrast to most lab practicals, the overall grade includes an evaluation of spectral analysis as well as writing skills. However, a significant portion of the grade lies in successful execution of a…

"I Don't Come out with Big Words like Other People": Interviewing Adolescents as Part of Communication Profiling

ERIC Educational Resources Information Center

Spencer, Sarah; Clegg, Judy; Stackhouse, Joy

2010-01-01

Assessing adolescent language skills poses significant challenges due to the subtle nature of language proficiency at this age, along with the high linguistic demands both academically and socially. As with young children, the current range of language assessments designed specifically for adolescents mostly includes standardized tests. This…

Now More than Ever: Building and Sustaining Capacity for School-Located Vaccination Initiatives

ERIC Educational Resources Information Center

Kuehnert, Paul

2010-01-01

The fall 2009 campaign to vaccinate high-risk U.S. residents against the 2009 H1N1 influenza virus presented three key challenges that had significant impact on the effectiveness of campaigns conducted by local health departments (LHDs), schools, and other community partners. These issues included those of communication and trust, both between…

Realigning Resources for District Success: Duval County Public Schools Final Report

ERIC Educational Resources Information Center

Travers, Jonathan; Ferris, Kristen

2011-01-01

Duval County Public Schools (DCPS) is poised to take action today that will lead to serving all students more effectively. Although the challenges are significant, including deep budget cuts, the district made the strategic choice to look thoroughly at how resources are currently allocated and now has a foundation for making decisions that will…

Challenges of Serving Students with Emotional and Behavioral Disorders: Legal and Policy Considerations

ERIC Educational Resources Information Center

Smith, Carl R.; Katsiyannis, Antonis; Ryan, Joseph B.

2011-01-01

Significant issues still confront the field of emotional or behavioral disorders (E/BD) in providing a free, appropriate, public educational (FAPE) program for these students. This paper reviews recent case law for several critical areas of concern to the field today, including: (a) response to intervention (RTI) and child find procedures, (b)…

Nitrogen-induced terrestrial eutrophication: cascading effects and impacts on ecosystem services

Treesearch

Christopher M. Clark; Michael D. Bell; James W. Boyd; Jana E. Compton; Eric A. Davidson; Christine Davis; Mark E. Fenn; Linda Geiser; Laurence Jones; Tamara F. Blett

2017-01-01

Human activity has significantly increased the deposition of nitrogen (N) on terrestrial ecosystems over pre-industrial levels leading to a multitude of effects including losses of biodiversity, changes in ecosystem functioning, and impacts on human well-being. It is challenging to explicitly link the level of deposition on an ecosystem to the cascade of...

Interactive-GIS-Tutor (IGIST) Integration: Creating a Digital Space Gateway within a Textbook-Bound South African Geography Class

ERIC Educational Resources Information Center

Fleischmann, E. M-L.; van der Westhuizen, C. P.; Cilliers, D.

2015-01-01

Currently there is a global drive among political and educational institutions to implement geographic information system (GIS) practice in secondary schools. However, Geography teachers worldwide, including in South Africa, face significant practical challenges in this regard. Lack of curriculum aligned GIS resources, funds and teacher GIS…

Consequence Maps: A Novel Behavior Management Tool for Educators

ERIC Educational Resources Information Center

Tobin, Catherine E.; Simpson, Richard

2012-01-01

Behavior management remains one of the most significant challenges faced by classroom personnel. One relatively novel and promising management approach involves the use of "Consequence Maps". In this article we discuss the use of this method, including its application and evaluation. A case study of a six-year-old boy in a self-contained special…

The Effectiveness of Mentoring Youth with Externalizing and Internalizing Behavioral Problems on Youth Outcomes and Parenting Stress: A Meta-Analysis

ERIC Educational Resources Information Center

La Valle, Chelsea

2015-01-01

Parents of children with significant externalizing and internalizing behavioral problems habitually report greater parenting stress compared to parents of children without these challenges. One avenue to alleviate parenting stress and ameliorate youth outcomes is youth mentoring, which includes a supportive adult paired with a child with the…

Evaluating Processes and Platforms for Potential ePortfolio Use: The Role of the Middle Agent

ERIC Educational Resources Information Center

Slade, Christine; Murfin, Keith; Readman, Kylie

2013-01-01

With the changing face of higher education comes a demand to include new technological tools. Universities need to build their capacity to respond to new technology-related challenges. The introduction of ePortfolios is a significant strategy in this response. A number of organizational change management models are used to analyze the…

Deinstitutionalization: Its Impact on Community Mental Health Centers and the Seriously Mentally Ill

ERIC Educational Resources Information Center

Kliewer, Stephen P.; McNally Melissa; Trippany, Robyn L.

2009-01-01

Deinstitutionalization has had a significant impact on the mental health system, including the client, the agency, and the counselor. For clients with serious mental illness, learning to live in a community setting poses challenges that are often difficult to overcome. Community mental health agencies must respond to these specific needs, thus…

Simulation Training in Health Care

DTIC Science & Technology

2015-06-01

Harvey simulates cardiac and lung disease , including blood pressure, breathing, pulses, heart sounds, and murmurs. A significant step toward the...fluoroscopy, cardiovascu- lar and pulmonary disease diagnosis and treatment, anesthesia, patient -centered programs, basic vital signs emergency care, infant...effectiveness. However, in health care, ethical considerations and the quantification of the expenses of clinician “learning” on patients is a challenge to

Single Student Parents Face Financial Difficulties, Debt, without Adequate Aid. Fact Sheet #C394

ERIC Educational Resources Information Center

Miller, Kevin

2012-01-01

Parents with dependent children were nearly one quarter of students enrolled for credit at American postsecondary institutions in 2008. These students face significant challenges to remaining enrolled and graduating, including limited access to affordable child care, difficulty balancing the demands of school with the demands of work and family,…

Realigning Resources for District Success: Duval County Public Schools Final Report. Executive Summary

ERIC Educational Resources Information Center

Travers, Jonathan; Ferris, Kristen

2011-01-01

Duval County Public Schools (DCPS) is poised to take action today that will lead to serving all students more effectively. Although the challenges are significant, including deep budget cuts, the district made the strategic choice to look thoroughly at how resources are currently allocated and now has a foundation for making decisions that will…

Barriers to Employment for Transition-age Youth with Developmental and Psychiatric Disabilities.

PubMed

Noel, Valerie A; Oulvey, Eugene; Drake, Robert E; Bond, Gary R

2017-05-01

Youth with developmental and psychiatric disabilities encounter significant vocational challenges, even when they receive supported employment services. We examined the barriers to employment for 280 transition-age youth with disabilities enrolled in supported employment in eight community rehabilitation centers. Employment team members identified each youth's top three barriers to employment using a 21-item checklist. Lack of work experience, transportation problems, and program engagement issues represented common barriers for both youth with developmental disabilities (53, 36, and 25%) and youth with psychiatric disabilities (20, 33, and 26%). Additional common barriers among youth with developmental disabilities included cognitive problems (32%) and lack of social skills (23%) and among youth with psychiatric disabilities included poor control of psychiatric symptoms (23%). Despite receiving evidence-based employment services, youth with disabilities encounter many barriers to employment. Awareness of typical barriers for transition-age youth, including those specific to different disability groups, may help employment programs anticipate challenges and develop strategies that avoid these barriers and their effects on employment opportunities.

Family psychology: Past and future reflections on the field.

PubMed

Parke, Ross D

2017-04-01

Prominent issues in the field of family psychology during my term as editor (1998-2003) of this journal were briefly noted, including a focus on marital issues, divorce, remarriage and family conflict. Parenting, attachment and parent-child relationships were also significant topics in this period. Special sections of the journal focused on cultural variations, families and the law, families and religion, and family routines and rituals. Several neglected issues that need more attention in the future were noted. These include the need to recognize the embeddedness of families in socioecological contexts, the importance of monitoring the impact of secular changes on families, and the value and limitations of viewing family psychology as a separate field. Other topics for a future agenda include the challenge of defining "family" in the midst of changing family forms, the effects of technological change on families, and the challenges of integrating biological research into the family psychology agenda. A multilevel bio-social approach to family research was recommended. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Cancer in the Solomon Islands.

PubMed

Martiniuk, Alexandra; Jagilli, Rooney; Natuzzi, Eileen; Ilopitu, John Wesley; Oipata, Meltus; Christie, Annie-Marie; Korini, Jefferey; Vujovich-Dunn, Cassandra; Yu, William

2017-10-01

The Solomon Islands, with a population of 550,000, has significant challenges in addressing non-communicable diseases, including cancer, in the face of significant economic, cultural, general awareness and health system challenges. To summarise the existing knowledge regarding cancer in the Solomon Islands, to gather new data and make recommendations. A literature review was undertaken and cancer data from the National Referral Hospital, Honiara were analysed and are presented. Key stakeholders were interviewed for their perspectives including areas to target for ongoing, incremental improvements. Last, a health services audit for cancer using the WHO SARA tool was undertaken. Breast and cervical cancer remain the first and second most commonly identified cancers in the Solomon Islands. The Solomons cancer registry is hospital based and suffers from incomplete data collection due to its passive nature, lack of resources for data entry and processing resulting in weak data which is rarely used for decision-making. The health system audit revealed system and individual reasons for delayed diagnosis or lack of cancer treatment or palliation in the Solomon Islands. Reasons included lack of patient knowledge regarding symptoms, late referrals to the National Referral Hospital and inability of health care workers to detect cancers either due to lack of skills to do so, or lack of diagnostic capabilities, and an overall lack of access to any health care, due to geographical barriers and overall national economic fragility. The Solomon Islands is challenged in preventing, diagnosing, treating and palliating cancer. Stakeholders recommend establishing specialty expertise (in the form of a cancer unit), improved registry processes and increased collaboration between the sole tertiary hospital nationwide and other Solomon health services as important targets for incremental improvement. Copyright © 2017. Published by Elsevier Ltd.

Bridging the Communication Gap: Successes and Challenges of Mobile Phone Technology in a Health and Demographic Surveillance System in Northern Nigeria

PubMed Central

Doctor, Henry V.; Olatunji, Alabi; Jumare, Abdul’Azeez

2012-01-01

Maternal and child health indicators are generally poor in Nigeria with the northern part of the country having the worst indicators than the southern part. Efforts to address maternal and health challenges in Nigeria include, among others, improvement in health and management information systems. We report on the experience of mobile phone technology in supporting the activities of a health and demographic surveillance system in northern Nigeria. Our experience calls for the need for the Nigerian Government, the mobile network companies, and the international community at large to consolidate their efforts in addressing the mobile network coverage and power supply challenges in order to create an enabling environment for socio-economic development particularly in rural and disadvantaged areas. Unless power and mobile network challenges are addressed, health interventions that rely on mobile phone technology will not have a significant impact in improving maternal and child health. PMID:23569650

Summary of the 2014 Sandia V&V Challenge Workshop

DOE PAGES

Schroeder, Benjamin B.; Hu, Kenneth T.; Mullins, Joshua Grady; ...

2016-02-19

A discussion of the five responses to the 2014 Sandia Verification and Validation (V&V) Challenge Problem, presented within this special issue, is provided hereafter. Overviews of the challenge problem workshop, workshop participants, and the problem statement are also included. Brief summations of teams' responses to the challenge problem are provided. Issues that arose throughout the responses that are deemed applicable to the general verification, validation, and uncertainty quantification (VVUQ) community are the main focal point of this paper. The discussion is oriented and organized into big picture comparison of data and model usage, VVUQ activities, and differentiating conceptual themes behindmore » the teams' VVUQ strategies. Significant differences are noted in the teams' approaches toward all VVUQ activities, and those deemed most relevant are discussed. Beyond the specific details of VVUQ implementations, thematic concepts are found to create differences among the approaches; some of the major themes are discussed. Lastly, an encapsulation of the key contributions, the lessons learned, and advice for the future are presented.« less

Implementing the World Report on Disability in West Africa: challenges and opportunities for Ghana.

PubMed

Tuakli-Wosornu, Yetsa A; Haig, Andrew J

2014-01-01

Disability issues have taken a prominent role on international stages in recent years. Beginning with the May 2005 World Health Assembly Resolution 58.23 and culminating in the June 2011 World Bank and World Health Organization World Report on Disability, comprehensive disability analyses from nations at various stages of development can now be accessed and used by relevant stakeholders in health, policy, and aide arenas. The implementation of this landmark report is critical for the advancement of social inclusion in diverse countries, including those with limited resources. However, activating the World Report on Disability in resource-limited countries remains a significant challenge because of threadbare data and cultural, institutional, and physical barriers to social inclusion. This review summarizes current national disability data and describes challenges and opportunities for the implementation of the World Report on Disability in Ghana. As a structural point of departure, the article uses the three broad categories of challenges outlined by the World Health Organization: attitudinal, physical, and institutional.

Online Learning: Addressing Challenges and Seizing Opportunities. Oregon

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Minnesota

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Idaho

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. New Mexico

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. New Hampshire

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Hawaii

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Wisconsin

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Improving and Accelerating Drug Development for Nervous System Disorders

PubMed Central

Pankevich, Diana E.; Altevogt, Bruce M.; Dunlop, John; Gage, Fred H.; Hyman, Steve E.

2014-01-01

Advances in the neurosciences have placed the field in the position where it is poised to significantly reduce the burden of nervous system disorders. However, drug discovery, development and translation for nervous system disorders still pose many unique challenges. The key scientific challenges can be summarized as follows: mechanisms of disease, target identification and validation, predictive models, biomarkers for patient stratification and as endpoints for clinical trials, clear regulatory pathways, reliability and reproducibility of published data, and data sharing and collaboration. To accelerate nervous system drug development the Institute of Medicine’s Forum on Neuroscience and Nervous System Disorders has hosted a series of public workshops that brought together representatives of industry, government (including both research funding and regulatory agencies), academia, and patient groups to discuss these challenges and offer potential strategies to improve the translational neuroscience. PMID:25442933

OSG-GEM: Gene Expression Matrix Construction Using the Open Science Grid.

PubMed

Poehlman, William L; Rynge, Mats; Branton, Chris; Balamurugan, D; Feltus, Frank A

2016-01-01

High-throughput DNA sequencing technology has revolutionized the study of gene expression while introducing significant computational challenges for biologists. These computational challenges include access to sufficient computer hardware and functional data processing workflows. Both these challenges are addressed with our scalable, open-source Pegasus workflow for processing high-throughput DNA sequence datasets into a gene expression matrix (GEM) using computational resources available to U.S.-based researchers on the Open Science Grid (OSG). We describe the usage of the workflow (OSG-GEM), discuss workflow design, inspect performance data, and assess accuracy in mapping paired-end sequencing reads to a reference genome. A target OSG-GEM user is proficient with the Linux command line and possesses basic bioinformatics experience. The user may run this workflow directly on the OSG or adapt it to novel computing environments.

OSG-GEM: Gene Expression Matrix Construction Using the Open Science Grid

PubMed Central

Poehlman, William L.; Rynge, Mats; Branton, Chris; Balamurugan, D.; Feltus, Frank A.

2016-01-01

High-throughput DNA sequencing technology has revolutionized the study of gene expression while introducing significant computational challenges for biologists. These computational challenges include access to sufficient computer hardware and functional data processing workflows. Both these challenges are addressed with our scalable, open-source Pegasus workflow for processing high-throughput DNA sequence datasets into a gene expression matrix (GEM) using computational resources available to U.S.-based researchers on the Open Science Grid (OSG). We describe the usage of the workflow (OSG-GEM), discuss workflow design, inspect performance data, and assess accuracy in mapping paired-end sequencing reads to a reference genome. A target OSG-GEM user is proficient with the Linux command line and possesses basic bioinformatics experience. The user may run this workflow directly on the OSG or adapt it to novel computing environments. PMID:27499617

Dendrimer advances for the central nervous system delivery of therapeutics.

PubMed

Xu, Leyuan; Zhang, Hao; Wu, Yue

2014-01-15

The effectiveness of noninvasive treatment for central nervous system (CNS) diseases is generally limited by the poor access of therapeutic agents into the CNS. Most CNS drugs cannot permeate into the brain parenchyma because of the blood-brain barrier (BBB), and overcoming this has become one of the most significant challenges in the development of CNS therapeutics. Rapid advances in nanotechnology have provided promising solutions to this challenge. This review discusses the latest applications of dendrimers in the treatment of CNS diseases with an emphasis on brain tumors. Dendrimer-mediated drug delivery, imaging, and diagnosis are also reviewed. The toxicity, biodistribution, and transport mechanisms in dendrimer-mediated delivery of CNS therapeutic agents bypassing or crossing the BBB are also discussed. Future directions and major challenges of dendrimer-mediated delivery of CNS therapeutic agents are included.

Detecting drug-target binding in cells using fluorescence-activated cell sorting coupled with mass spectrometry analysis.

PubMed

Wilson, Kris; Webster, Scott P; Iredale, John P; Zheng, Xiaozhong; Homer, Natalie Z; Pham, Nhan T; Auer, Manfred; Mole, Damian J

2017-12-15

The assessment of drug-target engagement for determining the efficacy of a compound inside cells remains challenging, particularly for difficult target proteins. Existing techniques are more suited to soluble protein targets. Difficult target proteins include those with challenging in vitro solubility, stability or purification properties that preclude target isolation. Here, we report a novel technique that measures intracellular compound-target complex formation, as well as cellular permeability, specificity and cytotoxicity-the toxicity-affinity-permeability-selectivity (TAPS) technique. The TAPS assay is exemplified here using human kynurenine 3-monooxygenase (KMO), a challenging intracellular membrane protein target of significant current interest. TAPS confirmed target binding of known KMO inhibitors inside cells. We conclude that the TAPS assay can be used to facilitate intracellular hit validation on most, if not all intracellular drug targets.

Detecting drug-target binding in cells using fluorescence-activated cell sorting coupled with mass spectrometry analysis

NASA Astrophysics Data System (ADS)

Wilson, Kris; Webster, Scott P.; Iredale, John P.; Zheng, Xiaozhong; Homer, Natalie Z.; Pham, Nhan T.; Auer, Manfred; Mole, Damian J.

2018-01-01

The assessment of drug-target engagement for determining the efficacy of a compound inside cells remains challenging, particularly for difficult target proteins. Existing techniques are more suited to soluble protein targets. Difficult target proteins include those with challenging in vitro solubility, stability or purification properties that preclude target isolation. Here, we report a novel technique that measures intracellular compound-target complex formation, as well as cellular permeability, specificity and cytotoxicity-the toxicity-affinity-permeability-selectivity (TAPS) technique. The TAPS assay is exemplified here using human kynurenine 3-monooxygenase (KMO), a challenging intracellular membrane protein target of significant current interest. TAPS confirmed target binding of known KMO inhibitors inside cells. We conclude that the TAPS assay can be used to facilitate intracellular hit validation on most, if not all intracellular drug targets.

Triggering Events for the First Space Settlement

NASA Astrophysics Data System (ADS)

Gale, Anita E.; Edwards, Richard P.

2003-01-01

We know where humankind is now in its limited ability to venture into space, and we can envision technologies that include routine space flight and large human populations in space; the challenge is to figure out how to get from where we are now to what we can envision. Although the technical challenges of space infrastructure development will be significant, the factors most responsible for preventing us from surmounting those challenges are politics and economics. Various rationales have been proposed by other authors and are summarized, with assessments of the hurdles involved in each. In an effort to make Space Settlement Design Competitions for high school students as realistic as possible, the co-authors developed a compelling rationale for building the first community in space and the infrastructure required to support it, which passes the tests of economic necessity and political appeal.

Dendrimer Advances for the Central Nervous System Delivery of Therapeutics

PubMed Central

2013-01-01

The effectiveness of noninvasive treatment for central nervous system (CNS) diseases is generally limited by the poor access of therapeutic agents into the CNS. Most CNS drugs cannot permeate into the brain parenchyma because of the blood-brain barrier (BBB), and overcoming this has become one of the most significant challenges in the development of CNS therapeutics. Rapid advances in nanotechnology have provided promising solutions to this challenge. This review discusses the latest applications of dendrimers in the treatment of CNS diseases with an emphasis on brain tumors. Dendrimer-mediated drug delivery, imaging, and diagnosis are also reviewed. The toxicity, biodistribution, and transport mechanisms in dendrimer-mediated delivery of CNS therapeutic agents bypassing or crossing the BBB are also discussed. Future directions and major challenges of dendrimer-mediated delivery of CNS therapeutic agents are included. PMID:24274162

Programming and Tuning a Quantum Annealing Device to Solve Real World Problems

NASA Astrophysics Data System (ADS)

Perdomo-Ortiz, Alejandro; O'Gorman, Bryan; Fluegemann, Joseph; Smelyanskiy, Vadim

2015-03-01

Solving real-world applications with quantum algorithms requires overcoming several challenges, ranging from translating the computational problem at hand to the quantum-machine language to tuning parameters of the quantum algorithm that have a significant impact on the performance of the device. In this talk, we discuss these challenges, strategies developed to enhance performance, and also a more efficient implementation of several applications. Although we will focus on applications of interest to NASA's Quantum Artificial Intelligence Laboratory, the methods and concepts presented here apply to a broader family of hard discrete optimization problems, including those that occur in many machine-learning algorithms.

Anorectal injury in pelvic blast.

PubMed

Brogden, Tom G; Garner, J P

2013-03-01

The signature injury of the Afghanistan campaign has, amongst other things, included an increased incidence of destructive anorectal injury. There is no significant body of evidence about this type of injury on which to base management strategies. This review examines the historical military data, later civilian reports, many of which have challenged the military dogmas of Vietnam, and the spartan contemporaneous military data which does not particularly address pelviperineal blast injury. There is no evidence to support a move away from the doctrine of the four D's (diversion, distal washout, drainage and direct repair), but sound surgical judgement remains the mainstay of managing these challenging and highly morbid injuries.

Overcoming Challenges to Childhood Immunizations Status.

PubMed

Sabnis, Svapna S; Conway, James H

2015-10-01

Vaccines are one of the greatest public health achievements, preventing both mortality and morbidity. However, overall immunization rates are still below the 90% target for Healthy People 2020. There remain significant disparities in immunization rates between children of different racial/ethnic groups, as well as among economically disadvantaged populations. There are systemic issues and challenges in providing access to immunization opportunities. In addition, vaccine hesitancy contributes to underimmunization. Multiple strategies are needed to improve immunization rates, including improving access to vaccines and minimizing financial barriers to families. Vaccine status should be assessed and vaccines given at all possible opportunities. Copyright © 2015 Elsevier Inc. All rights reserved.

Lipid-polymer hybrid nanoparticle-mediated therapeutics delivery: advances and challenges.

PubMed

Bose, Rajendran J C; Ravikumar, Rramaswamy; Karuppagounder, Vengadeshprabu; Bennet, Devasier; Rangasamy, Sabarinathan; Thandavarayan, Rajarajan A

2017-08-01

With rapid advances in nanomedicine, lipid-polymer hybrid nanoparticles (LPHNPs) have emerged as promising nanocarriers for several biomedical applications, including therapeutics delivery and biomedical imaging. Significant research has been dedicated to biomimetic or targeting functionalization, as well as controlled and image-guided drug-release capabilities. Despite this research, the clinical translation of LPHNP-mediated therapeutics delivery has progressed incrementally. In this review, we discuss the recent advances in and challenges to the development and application of LPHNPs, present examples to demonstrate the advantages of LPHNPs in therapeutics delivery and imaging applications, and discuss the translational obstacles to LPHNP technology. Copyright © 2017. Published by Elsevier Ltd.

Tackling the x-ray cargo inspection challenge using machine learning

NASA Astrophysics Data System (ADS)

Jaccard, Nicolas; Rogers, Thomas W.; Morton, Edward J.; Griffin, Lewis D.

2016-05-01

The current infrastructure for non-intrusive inspection of cargo containers cannot accommodate exploding com-merce volumes and increasingly stringent regulations. There is a pressing need to develop methods to automate parts of the inspection workflow, enabling expert operators to focus on a manageable number of high-risk images. To tackle this challenge, we developed a modular framework for automated X-ray cargo image inspection. Employing state-of-the-art machine learning approaches, including deep learning, we demonstrate high performance for empty container verification and specific threat detection. This work constitutes a significant step towards the partial automation of X-ray cargo image inspection.

Tree physiology research in a changing world.

PubMed

Kaufmann, Merrill R.; Linder, Sune

1996-01-01

Changes in issues and advances in methodology have contributed to substantial progress in tree physiology research during the last several decades. Current research focuses on process interactions in complex systems and the integration of processes across multiple spatial and temporal scales. An increasingly important challenge for future research is assuring sustainability of production systems and forested ecosystems in the face of increased demands for natural resources and human disturbance of forests. Meeting this challenge requires significant shifts in research approach, including the study of limitations of productivity that may accompany achievement of system sustainability, and a focus on the biological capabilities of complex land bases altered by human activity.

Addendum to the article: Misuse of null hypothesis significance testing: Would estimation of positive and negative predictive values improve certainty of chemical risk assessment?

PubMed

Bundschuh, Mirco; Newman, Michael C; Zubrod, Jochen P; Seitz, Frank; Rosenfeldt, Ricki R; Schulz, Ralf

2015-03-01

We argued recently that the positive predictive value (PPV) and the negative predictive value (NPV) are valuable metrics to include during null hypothesis significance testing: They inform the researcher about the probability of statistically significant and non-significant test outcomes actually being true. Although commonly misunderstood, a reported p value estimates only the probability of obtaining the results or more extreme results if the null hypothesis of no effect was true. Calculations of the more informative PPV and NPV require a priori estimate of the probability (R). The present document discusses challenges of estimating R.

Consumer perspectives on involving family and significant others in a healthy lifestyle intervention.

PubMed

Aschbrenner, Kelly; Bartels, Stephen; Mueser, Kim; Carpenter-Song, Elizabeth; Kinney, Allison

2012-11-01

This focus group study explored the potential benefits and challenges of involving family members and significant others in a healthy lifestyle program for people with serious mental illness (SMI). Six focus group interviews were conducted with a total of 30 people with SMI, who were participants in a healthy lifestyle intervention. Separate focus groups were conducted for high and low achievers in the program based on clinically significant weight loss or significant increase in fitness. Thematic analysis revealed that social support for diet and exercise was a perceived benefit to involving others in a healthy lifestyle program. Other perceived benefits were the potential to increase others' understanding of the challenges of living with mental illness and to enhance the quality of relationships. Participants identified practical and logistical concerns that could interfere with participation, including partner reliability and desirability, scheduling, and lack of financial resources. Participants in the high achiever group expressed a greater desire to involve others in exercise than did participants in the low achiever group. Programs aimed at helping people with SMI make lifestyle changes may increase their effectiveness by involving significant others. Mobilizing social support networks for health behavior change is an ideal role for social workers.

Recombinant Immunotoxin Therapy of Solid Tumors: Challenges and Strategies.

PubMed

Shan, Liang; Liu, Yuanyi; Wang, Paul

2013-01-01

Immunotoxins are a group of protein-based therapeutics, basically comprising two functional moieties: one is the antibody or antibody Fv fragment that allows the immunotoxin to bind specifically to target cells; another is the plant or bacterial toxin that kills the cells upon internalization. Immunotoxins have several unique features which are superior to conventional chemotherapeutics, including high specificity, extraordinary potency, and no known drug resistance. Development of immunotoxins evolves with time and technology, but significant progress has been achieved in the past 20 years after introduction of recombinant DNA technique and generation of the first single-chain variable fragment of monoclonal antibodies. Since then, more than 1,000 recombinant immunotoxins have been generated against cancer. However, most success in immunotoxin therapy has been achieved against hematological malignancies, several issues persist to be significant barriers for effective therapy of human solid tumors. Further development of immunotoxins will largely focus on the improvement of penetration capability to solid tumor mass and elimination of immunogenicity occurred when given repeatedly to patients. Promising strategies may include construction of recombinant antibody fragments with higher binding affinity and stability, elimination of immunodominant T- and B-cell epitopes of toxins, modification of immunotoxins with macromolecules like poly(ethylene glycol) and liposomes, and generation of immunotoxins with humanized antibody fragments and human endogenous cytotoxic enzymes. In this paper, we briefly reviewed the evolution of immunotoxin development and then discussed the challenges of immunotoxin therapy for human solid tumors and the potential strategies we may seek to overcome the challenges.

Central Role of the Trehalose Biosynthesis Pathway in the Pathogenesis of Human Fungal Infections: Opportunities and Challenges for Therapeutic Development

PubMed Central

Thammahong, Arsa; Puttikamonkul, Srisombat; Perfect, John R.; Brennan, Richard G.

2017-01-01

SUMMARY Invasive fungal infections cause significant morbidity and mortality in part due to a limited antifungal drug arsenal. One therapeutic challenge faced by clinicians is the significant host toxicity associated with antifungal drugs. Another challenge is the fungistatic mechanism of action of some drugs. Consequently, the identification of fungus-specific drug targets essential for fitness in vivo remains a significant goal of medical mycology research. The trehalose biosynthetic pathway is found in a wide variety of organisms, including human-pathogenic fungi, but not in humans. Genes encoding proteins involved in trehalose biosynthesis are mechanistically linked to the metabolism, cell wall homeostasis, stress responses, and virulence of Candida albicans, Cryptococcus neoformans, and Aspergillus fumigatus. While there are a number of pathways for trehalose production across the tree of life, the TPS/TPP (trehalose-6-phosphate synthase/trehalose-6-phosphate phosphatase) pathway is the canonical pathway found in human-pathogenic fungi. Importantly, data suggest that proteins involved in trehalose biosynthesis play other critical roles in fungal metabolism and in vivo fitness that remain to be fully elucidated. By further defining the biology and functions of trehalose and its biosynthetic pathway components in pathogenic fungi, an opportunity exists to leverage this pathway as a potent antifungal drug target. The goal of this review is to cover the known roles of this important molecule and its associated biosynthesis-encoding genes in the human-pathogenic fungi studied to date and to employ these data to critically assess the opportunities and challenges facing development of this pathway as a therapeutic target. PMID:28298477

A cross-cultural survey of residents' perceived barriers in questioning/challenging authority.

PubMed

Kobayashi, H; Pian-Smith, M; Sato, M; Sawa, R; Takeshita, T; Raemer, D

2006-08-01

To identify perceived barriers to residents' questioning or challenging their seniors, to determine how these barriers affect decisions, and to assess how these barriers differ across cultures. A written questionnaire was administered to residents in teaching hospitals in the US and Japan to assess factors affecting residents' willingness to question or challenge their superiors. The responses were analyzed for statistical significance of differences between the two cultures and to determine the importance of issues affecting decisions. Questionnaires were completed by 175 US and 65 Japanese residents, with an overall response rate of 71%. Trainees from both countries believe that questioning and challenging contribute to safety. The perceived importance of specific beliefs about the workplace differed across cultures in seven out of 22 questions. Residents' decisions to make a challenge were related to the relationships and perceived response of the superiors. There was no statistical difference between the US and Japanese residents in terms of the threshold for challenging their seniors. We have identified attributes of residents' beliefs of communication, including several cross-cultural differences in the importance of values and issues affecting one's decision to question or challenge. In contrast, there was no difference in the threshold for challenging seniors by the Japanese and US residents studied. Changes in organizational and professional culture may be as important, if not more so, than national culture to encourage "speaking up". Residents should be encouraged to overcome barriers to challenging, and training programs should foster improved relationships and communication between trainers and trainees.

International Space Station Passive Thermal Control System Analysis, Top Ten Lessons-Learned

NASA Technical Reports Server (NTRS)

Iovine, John

2011-01-01

The International Space Station (ISS) has been on-orbit for over 10 years, and there have been numerous technical challenges along the way from design to assembly to on-orbit anomalies and repairs. The Passive Thermal Control System (PTCS) management team has been a key player in successfully dealing with these challenges. The PTCS team performs thermal analysis in support of design and verification, launch and assembly constraints, integration, sustaining engineering, failure response, and model validation. This analysis is a significant body of work and provides a unique opportunity to compile a wealth of real world engineering and analysis knowledge and the corresponding lessons-learned. The analysis lessons encompass the full life cycle of flight hardware from design to on-orbit performance and sustaining engineering. These lessons can provide significant insight for new projects and programs. Key areas to be presented include thermal model fidelity, verification methods, analysis uncertainty, and operations support.

Web-based technical assistance and training to promote community tobacco control policy change.

PubMed

Young, Walter F; Montgomery, Debbie; Nycum, Colleen; Burns-Martin, Lavon; Buller, David B

2006-01-01

In 1998 the tobacco industry was released of claims that provided monetary relief for states. A significant expansion of tobacco control activity in many states created a need to develop local capacity. Technical assistance and training for new and experienced staff became a significant challenge for tobacco control leadership. In Colorado, this challenge was addressed in part through the development of a technical assistance and training Web site designed for local tobacco control staff and coalition members. Researchers, technical Web site development specialists, state health agency, and state tobacco control coalition staff collaborated to develop, promote, and test the efficacy of this Web site. The work group embodied a range of skills including tobacco control, Web site technical development, marketing, training, and project management. Persistent marketing, updating of Web site content, and institutionalizing it as a principal source of information and training were key to use by community coalition members.

Twelve Years of Fogarty-Funded Bioethics Training in Latin America and the Caribbean: Achievements and Challenges

PubMed Central

Saenz, Carla; Heitman, Elizabeth; Luna, Florencia; Litewka, Sergio; Goodman, Kenneth W.; Macklin, Ruth

2017-01-01

The landscape in research ethics has changed significantly in Latin America and the Caribbean over the past two decades. Research ethics has gone from being a largely foreign concept and unfamiliar practice to an integral and growing feature of regional health research systems. Four bioethics training programs have been funded by the Fogarty International Center (FIC) in this region in the past 12 years. Overall, they have contributed significantly to changing the face of research ethics through the creation of locally relevant training materials and courses (including distance learning), academic publications, workshops, and conferences in Spanish, and strengthening ethics review committees and national systems of governance. This paper outlines their achievements and challenges, and reflects on current regional needs and what the future may hold for research ethics and bioethics training in Latin America and the Caribbean. PMID:24782074

Evaluation of interventions to reduce multiply controlled vocal stereotypy.

PubMed

Scalzo, Rachel; Henry, Kelsey; Davis, Tonya N; Amos, Kally; Zoch, Tamara; Turchan, Sarah; Wagner, Tara

2015-07-01

This study examined four interventions targeted at decreasing multiply controlled vocal stereotypy for a 12-year-old boy diagnosed with autism spectrum disorder and a severe intellectual disability. These interventions included Noncontingent Music, Differential Reinforcement of Other Behaviors, Self-Recording, and Functional Communication Training (FCT). In addition to measuring vocal stereotypy during each condition, task engagement and challenging behavior were also monitored. Across conditions, vocal stereotypy did not vary significantly from baseline except in FCT, when it decreased significantly. Task engagement was higher in this condition as well. It is hypothesized that FCT provided an enriched environment by increasing social interaction and access to desired items as well as removal of less preferred activities. For these reasons, there was a decrease in the need for the participant to engage in vocal stereotypy and challenging behavior and increase in his ability to engage in a task. © The Author(s) 2015.

Emerging Public Health Challenges of Shiga Toxin-Producing Escherichia coli Related to Changes in the Pathogen, the Population, and the Environment.

PubMed

Karmali, Mohamed A

2017-02-01

Emerging public health challenges of Shiga toxin (stx)-producing Escherichia coli (STEC) include the occurrence of more frequent or severe disease and risk factors shifts associated with changes, often interconnected, in the pathogen, the population, and the environment. In 3 outbreaks with heightened severity attributed to enhanced pathogen virulence, including the acquisition of an stx2 phage in 1 outbreak, population and environmental factors likely contributed significantly to disease outcomes. Evolving population risk factors that are associated with more severe disease include consumption of fresh produce, contact with STEC-contaminated environments, demographics, socioeconomic status, and immunity. Risks of increasing STEC environmental pollution are related to continued intensification of agriculture and super-shedder cattle. Mitigation strategies include surveillance and research on emerging STEC, development of effective communications and public education strategies, and improved policies and interventions to mitigate risks, including those related to the contamination of produce and the environment, using a "One Health" approach. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Understanding sickle cell carrier status identified through newborn screening: a qualitative study

PubMed Central

Miller, Fiona A; Paynter, Martha; Hayeems, Robin Z; Little, Julian; Carroll, June C; Wilson, Brenda J; Allanson, Judith; Bytautas, Jessica P; Chakraborty, Pranesh

2010-01-01

The expansion of newborn screening (NBS) is increasing the generation of incidental results, notably carrier results. Although carrier status is generally understood to be clinically benign, concerns persist that parents may misunderstand its meaning, with deleterious effects on children and their families. Expansion of the NBS panel in Ontario, Canada in 2006 to include sickle cell disorders drew attention to the policy challenge of incidental carrier results. We conducted a study of consumer and provider attitudes to inform policy on disclosure. In this paper, we report the results of (i) qualitative interviews with health-care providers, advocates and parents of carrier infants and (ii) focus groups with new parents and individuals active with the sickle cell community. Lay and provider participants generally believed that carrier results were clinically insignificant. However, some uncertainty persisted among lay consumers in the form of conjecture or doubt. In addition, consumers and advocates who were most informed about the disease articulated insistent yet dissonant claims of clinical significance. Meanwhile, providers referenced research knowledge to offer an equivocal assessment of the possibility and significance of clinically symptomatic carrier status. We conclude that many interpretations of carrier status are in circulation, failing to fit neatly into the categories of ‘clinically significant' or ‘benign.' This creates challenges for communicating clearly with parents – challenges exacerbated by inconsistent messages from screening programs regarding the significance of sickle cell carrier status. Disclosure policy related to incidentally generated infant carrier results needs to account for these complex realities. PMID:19809482

-Omic and Electronic Health Records Big Data Analytics for Precision Medicine

PubMed Central

Wu, Po-Yen; Cheng, Chih-Wen; Kaddi, Chanchala D.; Venugopalan, Janani; Hoffman, Ryan; Wang, May D.

2017-01-01

Objective Rapid advances of high-throughput technologies and wide adoption of electronic health records (EHRs) have led to fast accumulation of -omic and EHR data. These voluminous complex data contain abundant information for precision medicine, and big data analytics can extract such knowledge to improve the quality of health care. Methods In this article, we present -omic and EHR data characteristics, associated challenges, and data analytics including data pre-processing, mining, and modeling. Results To demonstrate how big data analytics enables precision medicine, we provide two case studies, including identifying disease biomarkers from multi-omic data and incorporating -omic information into EHR. Conclusion Big data analytics is able to address –omic and EHR data challenges for paradigm shift towards precision medicine. Significance Big data analytics makes sense of –omic and EHR data to improve healthcare outcome. It has long lasting societal impact. PMID:27740470

Durability Challenges for Next Generation of Gas Turbine Engine Materials

NASA Technical Reports Server (NTRS)

Misra, Ajay K.

2012-01-01

Aggressive fuel burn and carbon dioxide emission reduction goals for future gas turbine engines will require higher overall pressure ratio, and a significant increase in turbine inlet temperature. These goals can be achieved by increasing temperature capability of turbine engine hot section materials and decreasing weight of fan section of the engine. NASA is currently developing several advanced hot section materials for increasing temperature capability of future gas turbine engines. The materials of interest include ceramic matrix composites with 1482 - 1648 C temperature capability, advanced disk alloys with 815 C capability, and low conductivity thermal barrier coatings with erosion resistance. The presentation will provide an overview of durability challenges with emphasis on the environmental factors affecting durability for the next generation of gas turbine engine materials. The environmental factors include gaseous atmosphere in gas turbine engines, molten salt and glass deposits from airborne contaminants, impact from foreign object damage, and erosion from ingestion of small particles.

Terra Mission Operations: Launch to the Present (and Beyond)

NASA Technical Reports Server (NTRS)

Kelly, Angelita; Moyer, Eric; Mantziaras, Dimitrios; Case, Warren

2014-01-01

The Terra satellite, flagship of NASA's long-term Earth Observing System (EOS) Program, continues to provide useful earth science observations well past its 5-year design lifetime. This paper describes the evolution of Terra operations, including challenges and successes and the steps taken to preserve science requirements and prolong spacecraft life. Working cooperatively with the Terra science and instrument teams, including NASA's international partners, the mission operations team has successfully kept the Terra operating continuously, resolving challenges and adjusting operations as needed. Terra retains all of its observing capabilities (except Short Wave Infrared) despite its age. The paper also describes concepts for future operations. This paper will review the Terra spacecraft mission successes and unique spacecraft component designs that provided significant benefits extending mission life and science. In addition, it discusses special activities as well as anomalies and corresponding recovery efforts. Lastly, it discusses future plans for continued operations.

Challenges and Opportunities in the Discovery of New Therapeutics Targeting the Kynurenine Pathway.

PubMed

Dounay, Amy B; Tuttle, Jamison B; Verhoest, Patrick R

2015-11-25

The kynurenine pathway is responsible for the metabolism of more than 95% of dietary tryptophan (TRP) and produces numerous bioactive metabolites. Recent studies have focused on three enzymes in this pathway: indoleamine dioxygenase (IDO1), kynurenine monooxygenase (KMO), and kynurenine aminotransferase II (KAT II). IDO1 inhibitors are currently in clinical trials for the treatment of cancer, and these agents may also have therapeutic utility in neurological disorders, including multiple sclerosis. KMO inhibitors are being investigated as potential treatments for neurodegenerative diseases, such as Huntington's and Alzheimer's diseases. KAT II inhibitors have been proposed in new therapeutic approaches toward psychiatric and cognitive disorders, including cognitive impairment associated with schizophrenia. Numerous medicinal chemistry studies are currently aimed at the design of novel, potent, and selective inhibitors for each of these enzymes. The emerging opportunities and significant challenges associated with pharmacological modulation of these enzymes will be explored in this review.

Response to Electroconvulsive Therapy in Patients With Autism Spectrum Disorder and Intractable Challenging Behaviors Associated With Symptoms of Catatonia.

PubMed

Sajith, Sreedharan Geetha; Liew, Siew Fai; Tor, Phern Chern

2017-03-01

There are several reports of electroconvulsive therapy (ECT) used in autism spectrum disorder (ASD) in the context of catatonic symptoms. We describe response to ECT in two adults with ASD and intellectual disability with intractable aggression and self-injurious behaviors associated with catatonic symptoms who had not responded to standard interventions. Unilateral ECT at a frequency of 3 times a week was given followed by weekly maintenance ECT. Patients' catatonic symptoms included episodes of agitation and echophenomena. Electroconvulsive therapy resulted in significant improvement in their behavior problems but 1 patient relapsed when the ECT was discontinued or frequency of treatment reduced. The second patient required 2 courses of ECT before improvement which was maintained on weekly ECT. Electroconvulsive therapy could be a potentially beneficial intervention in patients with ASD and severe challenging behaviors associated with catatonic symptoms including agitated or excited forms of catatonia.

Institutional Alliances to Reduce Cancer Disparities in Chicago

PubMed Central

Simon, Melissa A.; Malin, Emily L.; Hitsman, Brian L.; Ciecierski, Christina C.; Victorson, David E.; Banas, Jennifer R.; Stuart, Moira; Luedke, Tracy; Cella, David

2017-01-01

A partnership formed between Northeastern Illinois University (NEIU) and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University sought to address well-documented cancer health disparities in Chicago by developing a collaborative research, training, and educational infrastructure between a minority-serving institution and a National Cancer Institute designated comprehensive cancer center. With a critical examination of partnership documentation and outputs, we describe the partnership’s community-engaged approaches, challenges, and lessons learned. Northeastern Illinois University and the Lurie Cancer Center engaged in a yearlong partnership-building phase, identified interdisciplinary research teams, formed a governance structure, and identified collective aims. Partnership outcomes included funded inter-institutional research projects, new curriculum, and an annual research trainee program. Significant challenges faced included uncertain fiscal climate, widespread turnover, and dissimilar institutional demands. Lessons learned from this minority serving institution and comprehensive cancer center partnership may be useful for bridging distinct academic communities in the pursuit of ameliorating health disparities. PMID:27763461

Challenges faced by multidisplinary new investigators on addressing grand challenges in global health.

PubMed

Logie, Carmen; Dimaras, Helen; Fortin, Anny; Ramón-García, Santiago

2014-04-15

The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an 'Integrated Innovation™' approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the 'Rising Stars in Global Health' award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors' visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators. We propose a more balanced way forward that can harness technology to foster mentorship across time and space to support the development of such skills and ideas among new investigators.

International Students in Western Developed Countries: History, Challenges, and Prospects

ERIC Educational Resources Information Center

Akanwa, Emmanuel E.

2015-01-01

Many scholars have described the various challenges international students face in Western developed countries including the United States, the United Kingdom, and Australia. Some of the challenges include differences in culture, language barriers, adjustment problems, medical concerns, pedagogical challenges, housing issues, lack of support…

Current state of pediatric cardiac transplantation

PubMed Central

2018-01-01

Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing. The biggest gap impacting both waitlist and overall survival remains mechanical support options for infants and patients with single ventricle physiology. Though acute rejection has decreased progressively, both diagnosis and management of antibody-mediated rejection has become increasingly challenging and complex, as has the ability to understand the implication of anti-HLA antibodies detected both pre- and post-transplantation—including when and how to intervene. Trends in immunosuppression protocols include more use of induction therapy and steroid avoidance or withdrawal protocols. Common long-term morbidities include renal insufficiency, which can be mitigated with surveillance and renal-sparing strategies, and infections. Functional outcomes are excellent, but significant psychosocial challenges exist in relation to neurodevelopment, non-adherence, and transition from child-centered to adult-centered care. Cardiac allograft vasculopathy (CAV) remains a barrier to long-term survival, though it is more apparent that objective evidence of an impact on the allograft is important with regards to impact on outcomes. Retransplantation is rare in pediatric heart transplant recipients. Pediatric heart transplantation continues to evolve in order to address the challenges of the diverse group of patients that reach end-stage heart failure during childhood. PMID:29492382

Large-scale online semantic indexing of biomedical articles via an ensemble of multi-label classification models.

PubMed

Papanikolaou, Yannis; Tsoumakas, Grigorios; Laliotis, Manos; Markantonatos, Nikos; Vlahavas, Ioannis

2017-09-22

In this paper we present the approach that we employed to deal with large scale multi-label semantic indexing of biomedical papers. This work was mainly implemented within the context of the BioASQ challenge (2013-2017), a challenge concerned with biomedical semantic indexing and question answering. Our main contribution is a MUlti-Label Ensemble method (MULE) that incorporates a McNemar statistical significance test in order to validate the combination of the constituent machine learning algorithms. Some secondary contributions include a study on the temporal aspects of the BioASQ corpus (observations apply also to the BioASQ's super-set, the PubMed articles collection) and the proper parametrization of the algorithms used to deal with this challenging classification task. The ensemble method that we developed is compared to other approaches in experimental scenarios with subsets of the BioASQ corpus giving positive results. In our participation in the BioASQ challenge we obtained the first place in 2013 and the second place in the four following years, steadily outperforming MTI, the indexing system of the National Library of Medicine (NLM). The results of our experimental comparisons, suggest that employing a statistical significance test to validate the ensemble method's choices, is the optimal approach for ensembling multi-label classifiers, especially in contexts with many rare labels.

Flood Forecasting in Wales: Challenges and Solutions

NASA Astrophysics Data System (ADS)

How, Andrew; Williams, Christopher

2015-04-01

With steep, fast-responding river catchments, exposed coastal reaches with large tidal ranges and large population densities in some of the most at-risk areas; flood forecasting in Wales presents many varied challenges. Utilising advances in computing power and learning from best practice within the United Kingdom and abroad have seen significant improvements in recent years - however, many challenges still remain. Developments in computing and increased processing power comes with a significant price tag; greater numbers of data sources and ensemble feeds brings a better understanding of uncertainty but the wealth of data needs careful management to ensure a clear message of risk is disseminated; new modelling techniques utilise better and faster computation, but lack the history of record and experience gained from the continued use of more established forecasting models. As a flood forecasting team we work to develop coastal and fluvial forecasting models, set them up for operational use and manage the duty role that runs the models in real time. An overview of our current operational flood forecasting system will be presented, along with a discussion on some of the solutions we have in place to address the challenges we face. These include: • real-time updating of fluvial models • rainfall forecasting verification • ensemble forecast data • longer range forecast data • contingency models • offshore to nearshore wave transformation • calculation of wave overtopping

Conducting Biobehavioral Research in Patients With Advanced Cancer: Recruitment Challenges and Solutions.

PubMed

Gilbertson-White, Stephanie; Bohr, Nicole; Wickersham, Karen E

2017-10-01

Despite significant advances in cancer treatment and symptom management interventions over the last decade, patients continue to struggle with cancer-related symptoms. Adequate baseline and longitudinal data are crucial for designing interventions to improve patient quality of life and reduce symptom burden; however, recruitment of patients with advanced cancer in longitudinal research is difficult. Our purpose is to describe challenges and solutions to recruitment of patients with advanced cancer in two biobehavioral research studies examining cancer-related symptoms. Study 1: Symptom data and peripheral blood for markers of inflammation were collected from newly diagnosed patients receiving chemotherapy on the first day of therapy and every 3-4 weeks for up to 6 months. Study 2: Symptom data, blood, and skin biopsies were collected from cancer patients taking epidermal growth factor receptor inhibitors at specific time points over 4 months. Screening and recruitment results for both studies are summarized. Timing informed consent with baseline data collection prior to treatment initiation was a significant recruitment challenge for both the studies. Possible solutions include tailoring recruitment to fit clinic needs, increasing research staff availability during clinic hours, and adding recruitment sites. Identifying solutions to these challenges will permit the conduct of studies that may lead to identification of factors contributing to variability in symptoms and development of tailored patient interventions for patients with advanced cancer.

Including Migrant Worker Children in the Learning and Social Context of the Rural Primary School

ERIC Educational Resources Information Center

Hamilton, Paula

2013-01-01

Many of the larger towns and cities within the UK have long experienced a cosmopolitan mix of cultures, resulting in ethnically and linguistically diverse schools. However, the wider expansion of the European Union in 2004 has brought about significant changes and challenges for many schools, particularly for those in more rural areas. This…

Improving Cultural Competency and Disease Awareness among Oncology Nurses Caring for Adult T-Cell Leukemia and Lymphoma Patients

ERIC Educational Resources Information Center

Cortese-Peske, Marisa A.

2013-01-01

Foreign-born residents face significant challenges accessing and receiving quality healthcare in the U.S. These obstacles include a lack of information on how to access care, fear, as well as communication and cultural barriers (Portes, Fernandez-Kelly & Light, 2012). Increasing healthcare providers' knowledge regarding a patient's…

The States and School Finance--After Rodriguez. A Background Paper for the National Governors' Conference and the National Legislative Conference.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO. Dept. of Research and Information Services.

This publication examines a number of key issues and recent trends related to the general topic of school finance. Chapter 1 reviews several significant court cases challenging state school finance systems, including San Antonio Independent School District v. Rodriguez, Robinson v. Cahill, and Serrano v. Priest. Chapter 2 describes major new…

Can Online Peer Review Assignments Replace Essays in Third Year University Courses? And If So, What Are the Challenges?

ERIC Educational Resources Information Center

Smith, Martin

2012-01-01

Essays are a traditional component of the course requirements in many post-secondary courses. However, the practical and pedagogical disadvantages of essays are significant. These include the increasing ease with which essays can be plagiarized, the lack of peer involvement in the traditional essay submission and feedback process, the usual lack…

Supporting Individuals with Autism Spectrum Disorders: Quality Employment Practices. The Institute Brief. Issue Number 25. ICI Professional Development Series

ERIC Educational Resources Information Center

Kurtz, Alan; Jordan, Melanie

2008-01-01

It has been known for decades that individuals with autism spectrum disorders (ASD), including those with significant impairment or who have behaviors that others find challenging, can work when they are given appropriate supports (Smith, Belcher, & Juhrs, 1995). It is also clear that individuals with ASD can benefit from employment. Benefits…

Exploring the Role of Future Perspective in Predicting Turkish University Students' Beliefs about Global Climate Change

ERIC Educational Resources Information Center

Ates, Deniz; Teksöz, Gaye; Ertepinar, Hamide

2017-01-01

Recent studies indicate that limited understanding about causes and its potential impacts of climate change and fault beliefs by people across different countries of the world including Turkey is a real challenge. Acceptance of climate change as a real threat, believing its existence, and knowing causes and consequences are very significant for…

Governor and Course Leaders' Reflections on HE in FE: Strategic Ambition and Curriculum Practice in Two Large Colleges in England

ERIC Educational Resources Information Center

Dhillon, Jaswinder K.; Bentley, Jon

2016-01-01

In the turbulent "dog eat dog" environment of the learning and skills sector in England the provision and expansion of higher education taught in further education colleges (HE in FE) offers potential opportunities for greater diversification of higher education. However, it also presents significant challenges, which include developing…

LLNL Mercury Project Trinity Open Science Final Report

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

Dawson, Shawn A.

The Mercury Monte Carlo particle transport code is used to simulate the transport of radiation through urban environments. These challenging calculations include complicated geometries and require significant computational resources to complete. In the proposed Trinity Open Science calculations, I will investigate computer science aspects of the code which are relevant to convergence of the simulation quantities with increasing Monte Carlo particle counts.

The Sexual and Reproductive Health of Young People in Low and Middle Income Countries

ERIC Educational Resources Information Center

Edwards, Orain; Peterson, Nicholas

2013-01-01

Young people ages 10-24 account for 25 percent of the world's population: a total of 1.8 billion, most of whom are living in low- and middle-income countries. They face significant challenges, including HIV, sexually transmitted infections (STIs), adolescent pregnancy, unsafe abortion, and gender-based violence. Youth have the right to lead…

This Ad is for You: Targeting and the Effect of Alcohol Advertising on Youth Drinking.

PubMed

Molloy, Eamon

2016-02-01

Endogenous targeting of alcohol advertisements presents a challenge for empirically identifying a causal effect of advertising on drinking. Drinkers prefer a particular media; firms recognize this and target alcohol advertising at these media. This paper overcomes this challenge by utilizing novel data with detailed individual measures of media viewing and alcohol consumption and three separate empirical techniques, which represent significant improvements over previous methods. First, controls for the average audience characteristics of the media an individual views account for attributes of magazines and television programs alcohol firms may consider when deciding where to target advertising. A second specification directly controls for each television program and magazine a person views. The third method exploits variation in advertising exposure due to a 2003 change in an industry-wide rule that governs where firms may advertise. Although the unconditional correlation between advertising and drinking by youth (ages 18-24) is strong, models that include simple controls for targeting imply, at most, a modest advertising effect. Although the coefficients are estimated less precisely, estimates with models including more rigorous controls for targeting indicate no significant effect of advertising on youth drinking. Copyright © 2015 John Wiley & Sons, Ltd.

The Open Microscopy Environment: open image informatics for the biological sciences

NASA Astrophysics Data System (ADS)

Blackburn, Colin; Allan, Chris; Besson, Sébastien; Burel, Jean-Marie; Carroll, Mark; Ferguson, Richard K.; Flynn, Helen; Gault, David; Gillen, Kenneth; Leigh, Roger; Leo, Simone; Li, Simon; Lindner, Dominik; Linkert, Melissa; Moore, Josh; Moore, William J.; Ramalingam, Balaji; Rozbicki, Emil; Rustici, Gabriella; Tarkowska, Aleksandra; Walczysko, Petr; Williams, Eleanor; Swedlow, Jason R.

2016-07-01

Despite significant advances in biological imaging and analysis, major informatics challenges remain unsolved: file formats are proprietary, storage and analysis facilities are lacking, as are standards for sharing image data and results. While the open FITS file format is ubiquitous in astronomy, astronomical imaging shares many challenges with biological imaging, including the need to share large image sets using secure, cross-platform APIs, and the need for scalable applications for processing and visualization. The Open Microscopy Environment (OME) is an open-source software framework developed to address these challenges. OME tools include: an open data model for multidimensional imaging (OME Data Model); an open file format (OME-TIFF) and library (Bio-Formats) enabling free access to images (5D+) written in more than 145 formats from many imaging domains, including FITS; and a data management server (OMERO). The Java-based OMERO client-server platform comprises an image metadata store, an image repository, visualization and analysis by remote access, allowing sharing and publishing of image data. OMERO provides a means to manage the data through a multi-platform API. OMERO's model-based architecture has enabled its extension into a range of imaging domains, including light and electron microscopy, high content screening, digital pathology and recently into applications using non-image data from clinical and genomic studies. This is made possible using the Bio-Formats library. The current release includes a single mechanism for accessing image data of all types, regardless of original file format, via Java, C/C++ and Python and a variety of applications and environments (e.g. ImageJ, Matlab and R).

Real-Time Operation of the International Space Station

NASA Astrophysics Data System (ADS)

Suffredini, M. T.

2002-01-01

The International Space Station is on orbit and real-time operations are well underway. Along with the assembly challenges of building and operating the International Space Station , scientific activities are also underway. Flight control teams in three countries are working together as a team to plan, coordinate and command the systems on the International Space Station.Preparations are being made to add the additional International Partner elements including their operations teams and facilities. By October 2002, six Expedition crews will have lived on the International Space Station. Management of real-time operations has been key to these achievements. This includes the activities of ground teams in control centers around the world as well as the crew on orbit. Real-time planning is constantly challenged with balancing the requirements and setting the priorities for the assembly, maintenance, science and crew health functions on the International Space Station. It requires integrating the Shuttle, Soyuz and Progress requirements with the Station. It is also necessary to be able to respond in case of on-orbit anomalies and to set plans and commands in place to ensure the continues safe operation of the Station. Bringing together the International Partner operations teams has been challenging and intensely rewarding. Utilization of the assets of each partner has resulted in efficient solutions to problems. This paper will describe the management of the major real-time operations processes, significant achievements, and future challenges.

The 20-20-20 Airships NASA Centennial Challenge

NASA Astrophysics Data System (ADS)

Kiessling, Alina; Diaz, Ernesto; Rhodes, Jason; Ortega, Sam; Eberly, Eric

2015-08-01

A 2013 Keck Institute for Space Studies (KISS) study examined airships as a possible platform for Earth and space science. Airships, lighter than air, powered, maneuverable vehicles, could offer significant gains in observing time, sky and ground coverage, data downlink capability, and continuity of observations over existing suborbital options at competitive prices. The KISS study recommended three courses of action to spur the development and use of airships as a science platform. One of those recommendations was that a prize competition be developed to demonstrate a stratospheric airship. Consequently, we have been developing a NASA Centennial Challenge; (www.nasa.gov/challenges) to spur innovation in stratospheric airships as a science platform. We anticipate a multi-million dollar class prize for the first organization to fly a powered airship that remains stationary at 20km (65,000 ft) altitude for over 20 hours with a 20kg payload. The design must be scalable to longer flights with more massive payloads. A second prize tier, for a 20km flight lasting 200 hours with a 200kg payload would incentivize a further step toward a scientifically compelling and viable new platform. This technology would also have broad commercial applications including communications, asset tracking, and surveillance. Via the 20-20-20 Centennial Challenge, we are seeking to spur private industry (or non-profit institutions, including Universities) to demonstrate the capability for sustained airship flights as astronomy and Earth science platforms.

Structuring agency: examining healthcare management in the USA and Australia using organizational theory.

PubMed

Payne, Julianne; Leiter, Jeffrey

2013-01-01

Since the 1970s, the healthcare industry has undergone significant changes. Using neo-institutional and resource dependency theories, the purpose of this paper is to explore how managers perceive constraint and enact agency amidst these historic challenges--perhaps most significantly, declining funding and increasing regulation. The data come from ten interviews with healthcare managers, spanning for-profit, non-profit, and government legal forms and hospital and nursing home sub-industries in both Queensland, Australia and North Carolina, USA. The authors look for patterns across the interviews. The paper shows that governments and umbrella "parent" organizations force managers to adhere to institutional expectations in exchange for resource investment. Managers navigate these environmental obstacles using a shared business-minded approach and competitive differentiation. Yet various interest groups--including front-line workers, physicians, and patients--challenge this paradigm, as they demand a focus on quality of care. Managers' efforts are likewise curbed by the very resource and institutional pressures they resist. The authors understand changes in the healthcare industry as resulting from an increasingly powerful managerial logic, at odds with traditional professional and societal values. Interest groups are best positioned to challenge this logic.

The role of farming and rural development as central to our diets.

PubMed

Fanzo, Jessica

2018-05-21

Farming and rural development are central to the diversity of global food systems and diets, both significant factors in determining the nutrition and health outcomes of the world's population. Diets are not static and indeed are changing due to globalization, urbanization and demographic shifts. In addition, multiple burdens of malnutrition (both undernutrition and overweight and obesity) are not improving fast enough and in some cases, reversing for the worse. Unhealthy diets are major contributors to these burdens. Rural people and particularly smallholder farmers, are critical in delivering the key nutrients in the global food supply that make up our diets for human health. However, rural populations in some parts of the world are often poor, and suffer burdens of malnutrition on both ends of the spectrum - undernourished or overweight. They are also faced with significant challenges, often due to poor investment towards rural development. Challenges include natural resource declines, climate change risk, women disempowerment, conflict, and urbanization; which wreak havoc on these populations. If actions are not taken and their livelihoods are not prioritized, it will be a challenge to achieve sustainable development in these rural places that are so essential for future food systems. Copyright © 2018 Elsevier Inc. All rights reserved.

Operation Protective Edge - A Unique Challenge for a Civilian EMS Agency.

PubMed

Jaffe, Eli; Strugo, Refael; Wacht, Oren

2015-10-01

During July through August 2014, Operation Protective Edge, a military conflict between Israel and the Hamas regime in Gaza, dramatically affected both populations. Magen David Adom (MDA), the Israeli national Emergency Medical Service (EMS) and a member of the Red Cross, faced a unique challenge during the conflict: to continue providing crucial service to the entire civilian population of Israel, which was under constant missile threat. This challenge included not only providing immediate care for routine EMS calls under missile threat, but also preparing and delivering immediate care to civilians injured in attacks on major cities, as well as small communities, in Israel. This task is a challenge for a civilian EMS agency that normally operates in a non-military environment, yet, in an instant, must enhance its capability to respond to a considerable threat to its population. During Operation Protective Edge, MDA provided care for 842 wounded civilians and utilized a significant amount of its resources. Providing EMS services for a civilian population in a mixed civilian/military scenario is a challenging task on a national level for an EMS system, especially when the threat lasts for weeks. This report describes MDA's preparedness and operations during Operation Protective Edge, and the unique EMS challenges and dilemmas the agency faced.

Asthma control in patients on fixed dose combination evaluated with mannitol challenge test.

PubMed

Romberg, Kerstin A M; Berggren, Anna-Carin; Bjermer, Leif

2014-02-01

Asthma is often difficult to control and it is likely that not all patients are optimally treated. This study aimed to explore asthma control in adults receiving fixed dose combination (FDC) therapy. Control of asthma was assessed using the mannitol challenge test as a monitoring tool to see if this would give additional information compared to the asthma control test (ACT). The study was an open-label, prospective study on 98 adults prescribed with FDC therapies for at least three months. 74 patients considered that their asthma was well controlled. However, 60 patients had a positive mannitol challenge test (PD15 < 635 mg), and when those with a positive response to the short-acting β2-agonist (≥15%) after the mannitol challenge test were included, this increased to 64 patients (65%). Exploratory analysis determined that the spirometry parameters; FEV1/FVC and FEV1% of predicted, were statistically significant predictors of a positive mannitol challenge test. Co-morbid conditions such as concomitant upper airway involvement or eczema did not predict mannitol reactivity. Although most patients rated their asthma as well controlled, many provided a positive mannitol challenge test, suggesting the presence of underlying inflammation, despite treatment with fixed dose combination therapy. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon.

PubMed

Schmitt, Margaret L; Clatworthy, David; Ratnayake, Ruwan; Klaesener-Metzner, Nicole; Roesch, Elizabeth; Wheeler, Erin; Sommer, Marni

2017-01-01

There is a significant gap in empirical evidence on the menstrual hygiene management (MHM) challenges faced by adolescent girls and women in emergency contexts, and on appropriate humanitarian response approaches to meet their needs in diverse emergency contexts. To begin filling the gap in the evidence, we conducted a study in two diverse contexts (Myanmar and Lebanon), exploring the MHM barriers facing girls and women, and the various relevant sectoral responses being conducted (e.g. water, sanitation and hygiene (WASH), Protection, Health, Education and Camp Management). Two qualitative assessments were conducted: one in camps for internally displaced populations in Myanmar, and one with refugees living in informal settlements and host communities in Lebanon. Key informant interviews were conducted with emergency response staff in both sites, and focus group discussion and participatory mapping activities conducted with adolescent girls and women. Key findings included that there was insufficient access to safe and private facilities for MHM coupled with displacement induced shifts in menstrual practices by girls and women. Among staff, there was a narrow interpretation of what an MHM response includes, with a focus on supplies; significant interest in understanding what an improved MHM response would include and acknowledgement of limited existing MHM guidance across various sectors; and insufficient consultation with beneficiaries, related to discomfort asking about menstruation, and limited coordination between sectors. There is a significant need for improved guidance across all relevant sectors for improving MHM response in emergency context, along with increased evidence on effective approaches for integrating MHM into existing responses.

Proteomics, lipidomics, metabolomics: a mass spectrometry tutorial from a computer scientist's point of view.

PubMed

Smith, Rob; Mathis, Andrew D; Ventura, Dan; Prince, John T

2014-01-01

For decades, mass spectrometry data has been analyzed to investigate a wide array of research interests, including disease diagnostics, biological and chemical theory, genomics, and drug development. Progress towards solving any of these disparate problems depends upon overcoming the common challenge of interpreting the large data sets generated. Despite interim successes, many data interpretation problems in mass spectrometry are still challenging. Further, though these challenges are inherently interdisciplinary in nature, the significant domain-specific knowledge gap between disciplines makes interdisciplinary contributions difficult. This paper provides an introduction to the burgeoning field of computational mass spectrometry. We illustrate key concepts, vocabulary, and open problems in MS-omics, as well as provide invaluable resources such as open data sets and key search terms and references. This paper will facilitate contributions from mathematicians, computer scientists, and statisticians to MS-omics that will fundamentally improve results over existing approaches and inform novel algorithmic solutions to open problems.

The laboratory workforce shortage: a managerial perspective.

PubMed

Cortelyou-Ward, Kendall; Ramirez, Bernardo; Rotarius, Timothy

2011-01-01

Most clinical laboratories in the nation report severe difficulties in recruitment and retention of most types of personnel. Other important factors impacting this problem include work complexities, increased automation, and a graying workforce. As a further challenge, institutional needs for clinical laboratory personnel are expected to grow significantly in the next decade. This article examines the current situation of the clinical laboratory workforce. It analyzes the different types of personnel; the managerial, supervision, and line positions that are key for different types of laboratories; the job outlook and recent projections for different types of staff; and the current issues, trends, and challenges of the laboratory workforce. Laboratory managers need to take action with strategies suggested for overcoming these challenges. Most importantly, they need to become transformational leaders by developing effective staffing models, fostering healthy and productive work environments, and creating value with a strategic management culture and implementation of knowledge management.

Nanotechnology: Development and challenges in Indonesia

NASA Astrophysics Data System (ADS)

Joni, I. Made; Muthukannan, Vanitha; Hermawan, Wawan; Panatarani, Camellia

2018-02-01

Nanotechnology today is regarded as a revolutionary technology that can help to address the key needs related to energy, environment, health and agriculture in developing countries. This paper is a short review on the development and challenges of nanotechnology in Indonesia. Nanotechnology offers great potential benefits, there is emerging concerns arising from its novel physicochemical properties. The main applications of nanotechnology in the different sectors which is vital and its economic impact in Indonesia is also discussed. The achievment and development of nanotechnology including synthesis and dispersion of nanoparticles (NPs) and its applications in various fields is briefly addressed in Nanotehcnology and Graphene Research Center, Universitas Padjadjaran (Unpad). Despite significant progress in developmental goals, many challenges in the development of nanotechnology proccesing need to be resolved such as support infrastructure and evolution of new form of collaborative arrangements between various sectors and policies which is emerged as an important factor enabling development.

Clostridium difficile Drug Pipeline: Challenges in Discovery and Development of New Agents

PubMed Central

2015-01-01

In the past decade Clostridium difficile has become a bacterial pathogen of global significance. Epidemic strains have spread throughout hospitals, while community acquired infections and other sources ensure a constant inoculation of spores into hospitals. In response to the increasing medical burden, a new C. difficile antibiotic, fidaxomicin, was approved in 2011 for the treatment of C. difficile-associated diarrhea. Rudimentary fecal transplants are also being trialed as effective treatments. Despite these advances, therapies that are more effective against C. difficile spores and less damaging to the resident gastrointestinal microbiome and that reduce recurrent disease are still desperately needed. However, bringing a new treatment for C. difficile infection to market involves particular challenges. This review covers the current drug discovery pipeline, including both small molecule and biologic therapies, and highlights the challenges associated with in vitro and in vivo models of C. difficile infection for drug screening and lead optimization. PMID:25760275

Biomimetics and the Development of Humanlike Robots as the Ultimate Challenge

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2011-01-01

Evolution led to effective solutions to nature's challenges and they were improved over millions of years. Humans have always made efforts to use nature as a model for innovation and problems solving. These efforts became more intensive in recent years where systematic studies of nature are being made towards better understanding and applying more sophisticated capabilities. Making humanlike robots, including the appearance, functions and intelligence, poses the ultimate challenges to biomimetics. For many years, making such robots was considered science fiction, but as a result of significant advances in biologically inspired technologies, such robots are increasingly becoming an engineering reality. There are already humanlike robots that walk, talk, interpret speech, make eye-contact and facial expressions, as well as perform many other humanlike functions. In this paper, the state-of-the-art of humanlike robots, potential applications and issues of concern will be reviewed.

The sibling experience: growing up with a child who has pervasive developmental disorder or mental retardation.

PubMed

Schuntermann, Peter

2007-01-01

Parents raising a child with significant developmental challenges are profoundly aware of the often sustained impact of that child's special needs upon their other children. Supported by recent research on siblings of developmentally challenged children, clinicians are advocating family-based interventions that take into account the needs of siblings. This article reviews the experience of siblings who live with brothers or sisters diagnosed with pervasive developmental disorder or mental retardation. Contributions from research on typical siblings are drawn upon when appropriate. Six domains of the sibling experience are identified. These domains explore relational shifts within sibling relationships and through the expectable differential parental treatment of each child. Shifts considered in this review include the interrelationships with the extended family, peers, and friendships, all of which contribute to shaping the meaning that siblings give to living with developmentally challenged brothers or sisters across time.

Innovative Trajectory Designs to meet Exploration Challenges

NASA Technical Reports Server (NTRS)

Folta, David C.

2006-01-01

This document is a viewgraph presentation of the conference paper. Missions incorporated into NASA's Vision for Space Exploration include many different destinations and regions; are challenging to plan; and need new and innovative trajectory design methods to enable them. By combining proven methods with chaos dynamics, exploration goals that require maximum payload mass or minimum duration can be achieved. The implementation of these innovative methods, such as weak stability boundaries, has altered NASA's approach to meet exploration challenges and is described to show how exploration goals may be met in the next decade. With knowledge that various perturbations play a significant role, the mission designer must rely on both traditional design strategies as well as these innovative methods. Over the past decades, improvements have been made that would at first glance seem dramatic. This paper provides a brief narrative on how a fundamental shift has occurred and how chaos dynamics improve the design of exploration missions with complex constraints.

Conservation biology in Asia: the major policy challenges.

PubMed

McNeely, Jeffrey A; Kapoor-Vijay, Promila; Zhi, Lu; Olsvig-Whittaker, Linda; Sheikh, Kashif M; Smith, Andrew T

2009-08-01

With about half the world's human population and booming economies, Asia faces numerous challenges to its biodiversity. The Asia Section of the Society for Conservation Biology has identified some key policy issues in which significant progress can be made. These include developing new sources of funding for forest conservation; identifying potential impacts of energy alternatives on the conservation of biodiversity; curbing the trade in endangered species of plants and animals; a special focus on the conservation of mountain biodiversity; enhancing relevant research; ensuring that conservation biology contributes to major international conventions and funding mechanisms; using conservation biology to build a better understanding of zoonotic diseases; more effectively addressing human-animal conflicts; enhancing community-based conservation; and using conservation biology to help address the pervasive water-deficit problems in much of Asia. These challenges can be met through improved regional cooperation among the relevant stakeholders.

The Critical Care Obesity Paradox and Implications for Nutrition Support.

PubMed

Patel, Jayshil J; Rosenthal, Martin D; Miller, Keith R; Codner, Panna; Kiraly, Laszlo; Martindale, Robert G

2016-09-01

Obesity is a leading cause of preventable death worldwide. The prevalence of obesity has been increasing and is associated with an increased risk for other co-morbidities. In the critical care setting, nearly one third of patients are obese. Obese critically ill patients pose significant physical and on-physical challenges to providers, including optimization of nutrition therapy. Intuitively, obese patients would have worse critical care-related outcome. On the contrary, emerging data suggests that critically ill obese patients have improved outcomes, and this phenomenon has been coined "the obesity paradox." The purposes of this review will be to outline the historical views and pathophysiology of obesity and epidemiology of obesity, describe the challenges associated with obesity in the intensive care unit setting, review critical care outcomes in the obese, define the obesity-critical care paradox, and identify the challenges and role of nutrition support in the critically ill obese patient.

Post-traumatic Stress Symptoms in Post-ICU Family Members: Review and Methodological Challenges

PubMed Central

Petrinec, Amy B.; Daly, Barbara J.

2018-01-01

Family members of intensive care unit (ICU) patients are at risk for symptoms of post-traumatic stress disorder (PTSD) following ICU discharge. The aim of this systematic review is to examine the current literature regarding post-ICU family PTSD symptoms with an emphasis on methodological issues in conducting research on this challenging phenomenon. An extensive review of the literature was performed confining the search to English language studies reporting PTSD symptoms in adult family members of adult ICU patients. Ten studies were identified for review published from 2004–2012. Findings demonstrate a significant prevalence of family PTSD symptoms in the months following ICU hospitalization. However, there are several methodological challenges to the interpretation of existing studies and to the conduct of future research including differences in sampling, identification of risk factors and covariates of PTSD, and lack of consensus regarding the most appropriate PTSD symptom measurement tools and timing. PMID:25061017

Herbal medicine research and global health: an ethical analysis.

PubMed

Tilburt, Jon C; Kaptchuk, Ted J

2008-08-01

Governments, international agencies and corporations are increasingly investing in traditional herbal medicine research. Yet little literature addresses ethical challenges in this research. In this paper, we apply concepts in a comprehensive ethical framework for clinical research to international traditional herbal medicine research. We examine in detail three key, underappreciated dimensions of the ethical framework in which particularly difficult questions arise for international herbal medicine research: social value, scientific validity and favourable risk-benefit ratio. Significant challenges exist in determining shared concepts of social value, scientific validity and favourable risk-benefit ratio across international research collaborations. However, we argue that collaborative partnership, including democratic deliberation, offers the context and process by which many of the ethical challenges in international herbal medicine research can, and should be, resolved. By "cross-training" investigators, and investing in safety-monitoring infrastructure, the issues identified by this comprehensive framework can promote ethically sound international herbal medicine research that contributes to global health.

The chronic kidney disease epidemic: a challenge for nephrology training programs.

PubMed

Kohan, Donald E; Rosenberg, Mark E

2009-09-01

A major challenge facing the nephrology community in the United States is the training of adequate numbers of nephrologists to meet patient care and research needs. There is particular cause for concern because of the increasing incidence and prevalence of patients with chronic kidney disease. Data on the clinical and research nephrology workforce are incomplete or absent. However, the number of such individuals likely is inadequate to meet current and projected needs. To solve these workforce shortages, significant issues with regard to clinical and research training need to be addressed. These include funding of fellowship training, increasing the pipeline of medical students and internal medicine residents, and enhancing interest in nephrology among international and particularly US medical graduates. This review discusses these challenges facing the renal community, with emphasis on the care, prevention, and treatment of chronic kidney disease, and identifies potential pathways to developing solutions.

Challenges and opportunities of airborne metagenomics.

PubMed

Behzad, Hayedeh; Gojobori, Takashi; Mineta, Katsuhiko

2015-05-06

Recent metagenomic studies of environments, such as marine and soil, have significantly enhanced our understanding of the diverse microbial communities living in these habitats and their essential roles in sustaining vast ecosystems. The increase in the number of publications related to soil and marine metagenomics is in sharp contrast to those of air, yet airborne microbes are thought to have significant impacts on many aspects of our lives from their potential roles in atmospheric events such as cloud formation, precipitation, and atmospheric chemistry to their major impact on human health. In this review, we will discuss the current progress in airborne metagenomics, with a special focus on exploring the challenges and opportunities of undertaking such studies. The main challenges of conducting metagenomic studies of airborne microbes are as follows: 1) Low density of microorganisms in the air, 2) efficient retrieval of microorganisms from the air, 3) variability in airborne microbial community composition, 4) the lack of standardized protocols and methodologies, and 5) DNA sequencing and bioinformatics-related challenges. Overcoming these challenges could provide the groundwork for comprehensive analysis of airborne microbes and their potential impact on the atmosphere, global climate, and our health. Metagenomic studies offer a unique opportunity to examine viral and bacterial diversity in the air and monitor their spread locally or across the globe, including threats from pathogenic microorganisms. Airborne metagenomic studies could also lead to discoveries of novel genes and metabolic pathways relevant to meteorological and industrial applications, environmental bioremediation, and biogeochemical cycles. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Paving the road to personalized medicine: recommendations on regulatory, intellectual property and reimbursement challenges

PubMed Central

Knowles, Lori; Luth, Westerly; Bubela, Tania

2017-01-01

Abstract Personalized medicine (PM) aims to harness a wave of ‘omics’ discoveries to facilitate research and discovery of targeted diagnostics and therapies and increase the efficiency of healthcare systems by predicting and treating individual predispositions to diseases or conditions. Despite significant investment, limited progress has been made bringing PM to market. We describe the major perceived regulatory, intellectual property, and reimbursement challenges to the development, translation, adoption, and implementation of PM products into clinical care. We conducted a scoping review to identify (i) primary challenges for the development and implementation of PM identified in the academic literature; (ii) solutions proposed in the academic literature to address these challenges; and (iii) gaps that exist in that literature. We identified regulatory barriers to PM development and recommendations in 344 academic papers. Regulatory uncertainty was a cross-cutting theme that appeared in conjunction with other themes including: reimbursement; clinical trial regulation; regulation of co-development; unclear evidentiary requirements; insufficient incentives for research and development; incompatible information systems; and different regulation of different diagnostics. To fully realize the benefits of PM for healthcare systems and patients, regulatory, intellectual property, and reimbursement challenges need to be addressed in lock step with scientific advances. PMID:29868182

Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities.

PubMed

Wenger, Lisa M; Rosenthal, Meagen; Sharpe, Jane Pearson; Waite, Nancy

2016-01-01

An expanding body of literature is exploring the presence and impact of health and health care disparities among marginalized populations. This research challenges policy makers, health professionals, and scholars to examine how unjust and avoidable inequities are created at the societal, institutional, and individual level, and explore strategies for mitigating challenges. Recognizing the significance of this broader conversation, this scoping review provides an overview of pharmacy-specific research attentive to health-related disparities. Following Arksey and O'Malley's framework, a rigorous screening process yielded 93 peer-reviewed and 23 grey literature articles, each analyzed for core themes. Lending critical insight to how pharmacy practice researchers are conceptualizing and measuring health inequities, this review highlights three paths of inquiry evident across this literature, including research focused on what pharmacists know about marginalized groups, how pharmacists perceive these groups, and how they provide services. Striving to drive research and practice forward, this review details research gaps and opportunities, including a need to expand the scope of research and integrate knowledge. As pharmacists endeavor to provide equitable and impactful patient care, it is essential to understand challenges, and build strong evidence for meaningful action. Copyright © 2016 Elsevier Inc. All rights reserved.

Pandemic policy and planning considerations for universities: findings from a tabletop exercise.

PubMed

Beaton, Randal; Stergachis, Andy; Thompson, Jack; Osaki, Carl; Johnson, Clark; Charvat, Steven J; Marsden-Haug, Nicola

2007-12-01

The potential for a novel influenza virus to cause a pandemic represents a significant threat to global health. Planning for pandemic flu, as compared to planning for other types of hazards, presents some unique challenges to businesses, communities, and education institutions. To identify and address the challenges that may be faced by major metropolitan universities during a flu pandemic, a tabletop exercise was developed, offered, and evaluated. Its purpose was to assess existing University of Washington (UW) plans and policies for responding to an influenza pandemic. On May 31, 2006, more than 50 participants, including UW administrators and unit leaders and a number of key external partners, participated in a tabletop exercise designed to simulate all phases of an influenza pandemic. This exercise revealed existing gaps in university pandemic influenza plans and policies, including issues related to isolation and quarantine, continuity of operations, disaster mental health services, integration of volunteers into a disaster response, tracking travel of university students and personnel, communication problems, and ways to meet the needs of resident and foreign students and faculty during an outbreak. Policy and planning recommendations are offered that address each of these challenges faced by UW as well as other major research universities and colleges.

Verification Challenges at Low Numbers

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

Benz, Jacob M.; Booker, Paul M.; McDonald, Benjamin S.

2013-07-16

This paper will explore the difficulties of deep reductions by examining the technical verification challenges. At each step on the road to low numbers, the verification required to ensure compliance of all parties will increase significantly. Looking post New START, the next step will likely include warhead limits in the neighborhood of 1000 (Pifer 2010). Further reductions will include stepping stones at 100’s of warheads, and then 10’s of warheads before final elimination could be considered of the last few remaining warheads and weapons. This paper will focus on these three threshold reduction levels, 1000, 100’s, 10’s. For each, themore » issues and challenges will be discussed, potential solutions will be identified, and the verification technologies and chain of custody measures that address these solutions will be surveyed. It is important to note that many of the issues that need to be addressed have no current solution. In these cases, the paper will explore new or novel technologies that could be applied. These technologies will draw from the research and development that is ongoing throughout the national lab complex, and will look at technologies utilized in other areas of industry for their application to arms control verification.« less

Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital, Dar es Salaam - Tanzania.

PubMed

Ambikile, Joel Semel; Outwater, Anne

2012-07-05

It is estimated that world-wide up to 20 % of children suffer from debilitating mental illness. Mental disorders that pose a significant concern include learning disorders, hyperkinetic disorders (ADHD), depression, psychosis, pervasive development disorders, attachment disorders, anxiety disorders, conduct disorder, substance abuse and eating disorders. Living with such children can be very stressful for caregivers in the family. Therefore, determination of challenges of living with these children is important in the process of finding ways to help or support caregivers to provide proper care for their children. The purpose of this study was to explore the psychological and emotional, social, and economic challenges that parents or guardians experience when caring for mentally ill children and what they do to address or deal with them. A qualitative study design using in-depth interviews and focus group discussions was applied. The study was conducted at the psychiatric unit of Muhimbili National Hospital in Tanzania. Two focus groups discussions (FGDs) and 8 in-depth interviews were conducted with caregivers who attended the psychiatric clinic with their children. Data analysis was done using content analysis. The study revealed psychological and emotional, social, and economic challenges caregivers endure while living with mentally ill children. Psychological and emotional challenges included being stressed by caring tasks and having worries about the present and future life of their children. They had feelings of sadness, and inner pain or bitterness due to the disturbing behaviour of the children. They also experienced some communication problems with their children due to their inability to talk. Social challenges were inadequate social services for their children, stigma, burden of caring task, lack of public awareness of mental illness, lack of social support, and problems with social life. The economic challenges were poverty, child care interfering with various income generating activities in the family, and extra expenses associated with the child's illness. Caregivers of mentally ill children experience various psychological and emotional, social, and economic challenges. Professional assistance, public awareness of mental illnesses in children, social support by the government, private sector, and non-governmental organizations (NGOs) are important in addressing these challenges.

Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions.

PubMed

Muir, Ryan T; Wang, Shelly; Warf, Benjamin C

2016-11-01

OBJECTIVE Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Significant health disparities exist for the treatment of hydrocephalus in developing nations due to a combination of medical, environmental, and socioeconomic factors. This review aims to provide the international neurosurgery community with an overview of the current challenges and future directions of neurosurgical care for children with hydrocephalus in low-income countries. METHODS The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. RESULTS Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. CONCLUSIONS Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges

PubMed Central

Salem, Haitham; Nagpal, Caesa; Pigott, Teresa; Teixeira, Antonio Lucio

2017-01-01

Background: Akathisia continues to be a significant challenge in current neurological and psychiatric practice. Prompt and accurate detection is often difficult and there is a lack of consensus concerning the neurobiological basis of akathisia. No definitive treatment has been established for akathisia despite numerous preclinical and clinical studies. Method: We reviewed antipsychotic-induced akathisia including its clinical presentation, proposed underlying pathophysiology, current and under investigation therapeutic strategies. Conclusion: Despite the initial promise that second generation antipsychotics would be devoid of akathisia effects, this has not been confirmed. Currently, there are limited therapeutic options for the clinical practice and the evidence supporting the most widely used treatments (beta blockers, anticholinergic drugs) is still absent or inconsistent. PMID:27928948

Pervasive Sensing: Addressing the Heterogeneity Problem

NASA Astrophysics Data System (ADS)

O'Grady, Michael J.; Murdoch, Olga; Kroon, Barnard; Lillis, David; Carr, Dominic; Collier, Rem W.; O'Hare, Gregory M. P.

2013-06-01

Pervasive sensing is characterized by heterogeneity across a number of dimensions. This raises significant problems for those designing, implementing and deploying sensor networks, irrespective of application domain. Such problems include for example, issues of data provenance and integrity, security, and privacy amongst others. Thus engineering a network that is fit-for-purpose represents a significant challenge. In this paper, the issue of heterogeneity is explored from the perspective of those who seek to harness a pervasive sensing element in their applications. A initial solution is proposed based on the middleware construct.

Solid Rocket Booster (SRB) Flight System Integration at Its Best

NASA Technical Reports Server (NTRS)

Wood, T. David; Kanner, Howard S.; Freeland, Donna M.; Olson, Derek T.

2011-01-01

The Solid Rocket Booster (SRB) element integrates all the subsystems needed for ascent flight, entry, and recovery of the combined Booster and Motor system. These include the structures, avionics, thrust vector control, pyrotechnic, range safety, deceleration, thermal protection, and retrieval systems. This represents the only human-rated, recoverable and refurbishable solid rocket ever developed and flown. Challenges included subsystem integration, thermal environments and severe loads (including water impact), sometimes resulting in hardware attrition. Several of the subsystems evolved during the program through design changes. These included the thermal protection system, range safety system, parachute/recovery system, and others. Because the system was recovered, the SRB was ideal for data and imagery acquisition, which proved essential for understanding loads, environments and system response. The three main parachutes that lower the SRBs to the ocean are the largest parachutes ever designed, and the SRBs are the largest structures ever to be lowered by parachutes. SRB recovery from the ocean was a unique process and represented a significant operational challenge; requiring personnel, facilities, transportation, and ground support equipment. The SRB element achieved reliability via extensive system testing and checkout, redundancy management, and a thorough postflight assessment process. However, the in-flight data and postflight assessment process revealed the hardware was affected much more strongly than originally anticipated. Assembly and integration of the booster subsystems required acceptance testing of reused hardware components for each build. Extensive testing was done to assure hardware functionality at each level of stage integration. Because the booster element is recoverable, subsystems were available for inspection and testing postflight, unique to the Shuttle launch vehicle. Problems were noted and corrective actions were implemented as needed. The postflight assessment process was quite detailed and a significant portion of flight operations. The SRBs provided fully redundant critical systems including thrust vector control, mission critical pyrotechnics, avionics, and parachute recovery system. The design intent was to lift off with full redundancy. On occasion, the redundancy management scheme was needed during flight operations. This paper describes some of the design challenges and technical issues, how the design evolved with time, and key areas where hardware reusability contributed to improved system level understanding.

Solid Rocket Booster (SRB) - Evolution and Lessons Learned During the Shuttle Program

NASA Technical Reports Server (NTRS)

Kanner, Howard S.; Freeland, Donna M.; Olson, Derek T.; Wood, T. David; Vaccaro, Mark V.

2011-01-01

The Solid Rocket Booster (SRB) element integrates all the subsystems needed for ascent flight, entry, and recovery of the combined Booster and Motor system. These include the structures, avionics, thrust vector control, pyrotechnic, range safety, deceleration, thermal protection, and retrieval systems. This represents the only human-rated, recoverable and refurbishable solid rocket ever developed and flown. Challenges included subsystem integration, thermal environments and severe loads (including water impact), sometimes resulting in hardware attrition. Several of the subsystems evolved during the program through design changes. These included the thermal protection system, range safety system, parachute/recovery system, and others. Obsolescence issues occasionally required component recertification. Because the system was recovered, the SRB was ideal for data and imagery acquisition, which proved essential for understanding loads and system response. The three main parachutes that lower the SRBs to the ocean are the largest parachutes ever designed, and the SRBs are the largest structures ever to be lowered by parachutes. SRB recovery from the ocean was a unique process and represented a significant operational challenge; requiring personnel, facilities, transportation, and ground support equipment. The SRB element achieved reliability via extensive system testing and checkout, redundancy management, and a thorough postflight assessment process. Assembly and integration of the booster subsystems was a unique process and acceptance testing of reused hardware components was required for each build. Extensive testing was done to assure hardware functionality at each level of stage integration. Because the booster element is recoverable, subsystems were available for inspection and testing postflight, unique to the Shuttle launch vehicle. Problems were noted and corrective actions were implemented as needed. The postflight assessment process was quite detailed and a significant portion of flight operations. The SRBs provided fully redundant critical systems including thrust vector control, mission critical pyrotechnics, avionics, and parachute recovery system. The design intent was to lift off with full redundancy. On occasion, the redundancy management scheme was needed during flight operations. This paper describes some of the design challenges, how the design evolved with time, and key areas where hardware reusability contributed to improved system level understanding.

Sex differences in the resistance of turkeys to Escherichia coli challenge after immunosuppression with dexamethasone.

PubMed

Huff, G R; Huff, W E; Balog, J M; Rath, N C

1999-01-01

Five-week-old male and female commercial turkeys were immunosuppressed with two levels of dexamethasone (DEX) and challenged by airsac inoculation with 100 cfu of Escherichia coli. Mortality and airsacculitis (AS) scores were significantly higher in challenged birds treated with DEX and marginally higher in males than in females. Male mortalities had significantly higher AS scores than females. Recovery of E. coli from blood and tissues was significantly higher in challenged birds treated with DEX, marginally higher in males (P = 0.09), and significantly higher in male mortalities than in female mortalities. The low level of DEX seemed to have a protective effect against bacterial challenge in males, whereas the high level of DEX had a more adverse effect in males than in females. Body weights 2 wk postchallenge were significantly decreased by both DEX and E. coli, challenge. Relative liver and heart weights were increased by both DEX and E. coli, challenge, whereas bursal:spleen ratios were decreased by both treatments. Total leukocyte counts and relative heterophil counts from blood samples taken 24 h postinfection were significantly higher in DEX-treated birds and in unchallenged DEX-treated females than in males. The DEX treatment resulted in significantly higher heterophil:lymphocyte ratios, but there was no difference between sexes. Males had significantly lower serum levels of uric acid, total protein, albumin, aspartate aminotransferase, and lactate dehydrogenase than did females. Dexamethasone treatment also resulted in lower levels of total protein, albumin, and aspartate aminotransferase. These data suggest that male turkeys may be more susceptible to colisepticemia than female turkeys, especially when under severe stress.

State-civil society partnerships for HIV/AIDS treatment and prevention in Ghana: exploring factors associated with successes and challenges.

PubMed

Hushie, Martin; Omenyo, Cephas N; van den Berg, Jacob J; Lally, Michelle A

2016-08-02

The past decade has seen an increased number of state-civil society partnerships in the global Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) response of many countries. However, there has been limited research carried out concerning the successes and challenges of these partnerships. In-depth qualitative interviews were conducted with 23 participants from 21 different state-civil society partnerships throughout Ghana including all three major geographical zones (Northern, Middle, and Southern zones) to examine the nature of these partnerships and their positive and negative effects in responding to the national HIV/AIDS epidemic. Major themes included: 1) commitment by the government and civil society organizations to work cooperatively in order to support the development and implementation of HIV/AIDS interventions in Ghana; 2) the role of civil society organizations in facilitating community mobilization; capacity building; and information, resources and skills exchange to increase the efficiency and effectiveness of these partnerships for HIV prevention and treatment; and 3) significant challenges including funding issues and other structural barriers for these partnerships that need to be addressed moving forward. Future research should focus on examining the impact of recommended changes on state-civil partnerships and studying the extent and nature of these partnerships in other countries in order to establish the generalizability of the findings from this study.

Integrating regeneration, genetic resistance, and timing of intervention for the long-term sustainability of ecosystems challenged by non-native pests - a novel proactive approach

Treesearch

A. W Schoettle; J. G. Klutsch; R. A. Sniezko

2012-01-01

Global trade increases the likelihood of introduction of non-native, invasive species which can threaten native species and their associated ecosystems. This has led to significant impacts to forested landscapes, including extensive tree mortality, shifts in ecosystem composition, and vulnerabilities to other stresses. With the increased appreciation of the importance...

Peaceful Twilight: Grand Strategy for a Power in Relative Decline

DTIC Science & Technology

2015-06-01

virtually every issue. The Republican Party has become progressively more conservative favoring a strong military, smaller government, laissez - faire ...international order, still wields a significant amount of influence on the world stage. Yet as other powers rise, new challenges to US leadership and...corrupting effects of affluence. External factors include the rise of new rivals, the growing costs of protection, loss of economic leadership , and

"Lorenzo's Oil" as a Vehicle for Teaching Chemistry Content, Processes of Science, and Sociology of Science in a General Education Chemistry Classroom

ERIC Educational Resources Information Center

Wink, Donald

2011-01-01

The film "Lorenzo's Oil" depicts the challenges faced by the parents of a child with adrenoleukodystrophy, a neurological disorder that, they were told, was certainly fatal. The film contains a significant amount of chemistry, including concepts of fatty acid metabolism, enzyme inhibition, and the purification of substances. The film also raises…

Improving Transfer of Learning: An Innovative Comentoring Program to Enhance Workplace Implementation After an Occupational Therapy Course on Autism Spectrum Disorders.

PubMed

Ashburner, Jill; Ziviani, Jenny; Rodger, Sylvia; Hinder, Elizabeth A; Cartmill, Linda; White, Jessica; Vickerstaff, Sandy

2015-01-01

Research suggests that learning gained through training is infrequently implemented in the workplace. A short-term postcourse comentoring program was developed with the aim of facilitating workplace implementation of learning after a 3-day course for occupational therapists. The program was evaluated for usefulness, successes, challenges, recommended improvements, and associations with changes in self-rated knowledge and confidence. Two months after the course, 42 participants completed an evaluation of the comentoring program with closed- and open-ended questions addressing usefulness, successes, challenges, pairing preferences, and recommendations. They also completed a record on whether or not they had worked on goals nominated in their comentoring contract. Before and 2 months after the course, they completed a self-rated questionnaire on knowledge and confidence. The comentoring program was recommended by 80% of participants. Benefits included opportunities for information and resource sharing, debriefing, problem solving, reassurance, and implementation of ideas. Ninety-five percent of participants worked on some or all their comentoring goals. Although there were significant improvements in knowledge (P < 0.001) and confidence (P < 0.001), the total comentoring evaluation score was not significantly associated with these changes. It is therefore possible that these improvements related to the course itself rather than the comentoring program. Challenges related to time, scheduling, distance, and pairing of comentors. Reported benefits of the program included enhanced psychosocial support and prompting to trial newly learned strategies. Effectiveness may be improved by setting aside time for comentoring in the workplace and better matching of comentors.

The Complexity of HIV Persistence and Pathogenesis in the Lung Under Antiretroviral Therapy: Challenges Beyond AIDS

PubMed Central

2014-01-01

Abstract Antiretroviral therapy (ART) represents a significant milestone in the battle against AIDS. However, we continue learning about HIV and confronting challenges 30 years after its discovery. HIV has cleverly tricked both the host immune system and ART. First, the many HIV subtypes and recombinant forms have different susceptibilities to antiretroviral drugs, which may represent an issue in countries where ART is just being introduced. Second, even under the suppressive pressures of ART, HIV still increases inflammatory mediators, deregulates apoptosis and proliferation, and induces oxidative stress in the host. Third, the preference of HIV for CXCR4 as a co-receptor may also have noxious outcomes, including potential malignancies. Furthermore, HIV still replicates cryptically in anatomical reservoirs, including the lung. HIV impairs bronchoalveolar T-lymphocyte and macrophage immune responses, rendering the lung susceptible to comorbidities. In addition, HIV-infected individuals are significantly more susceptible to long-term HIV-associated complications. This review focuses on chronic obstructive pulmonary disease (COPD), pulmonary arterial hypertension, and lung cancer. Almost two decades after the advent of highly active ART, we now know that HIV-infected individuals on ART live as long as the uninfected population. Fortunately, its availability is rapidly increasing in low- and middle-income countries. Nevertheless, ART is not risk-free: the developed world is facing issues with antiretroviral drug toxicity, resistance, and drug–drug interactions, while developing countries are confronting issues with immune reconstitution inflammatory syndrome. Several aspects of the complexity of HIV persistence and challenges with ART are discussed, as well as suggestions for new avenues of research. PMID:24797368

Electrical Resistivity Imaging and the Saline Water Interface in High-Quality Coastal Aquifers

NASA Astrophysics Data System (ADS)

Costall, A.; Harris, B.; Pigois, J. P.

2018-05-01

Population growth and changing climate continue to impact on the availability of natural resources. Urbanization of vulnerable coastal margins can place serious demands on shallow groundwater. Here, groundwater management requires definition of coastal hydrogeology, particularly the seawater interface. Electrical resistivity imaging (ERI) appears to be ideally suited for this purpose. We investigate challenges and drivers for successful electrical resistivity imaging with field and synthetic experiments. Two decades of seawater intrusion monitoring provide a basis for creating a geo-electrical model suitable for demonstrating the significance of acquisition and inversion parameters on resistivity imaging outcomes. A key observation is that resistivity imaging with combinations of electrode arrays that include dipole-dipole quadrupoles can be configured to illuminate consequential elements of coastal hydrogeology. We extend our analysis of ERI to include a diverse set of hydrogeological settings along more than 100 km of the coastal margin passing the city of Perth, Western Australia. Of particular importance are settings with: (1) a classic seawater wedge in an unconfined aquifer, (2) a shallow unconfined aquifer over an impermeable substrate, and (3) a shallow multi-tiered aquifer system over a conductive impermeable substrate. We also demonstrate a systematic increase in the landward extent of the seawater wedge at sites located progressively closer to the highly urbanized center of Perth. Based on field and synthetic ERI experiments from a broad range of hydrogeological settings, we tabulate current challenges and future directions for this technology. Our research contributes to resolving the globally significant challenge of managing seawater intrusion at vulnerable coastal margins.

Electrical Resistivity Imaging and the Saline Water Interface in High-Quality Coastal Aquifers

NASA Astrophysics Data System (ADS)

Costall, A.; Harris, B.; Pigois, J. P.

2018-07-01

Population growth and changing climate continue to impact on the availability of natural resources. Urbanization of vulnerable coastal margins can place serious demands on shallow groundwater. Here, groundwater management requires definition of coastal hydrogeology, particularly the seawater interface. Electrical resistivity imaging (ERI) appears to be ideally suited for this purpose. We investigate challenges and drivers for successful electrical resistivity imaging with field and synthetic experiments. Two decades of seawater intrusion monitoring provide a basis for creating a geo-electrical model suitable for demonstrating the significance of acquisition and inversion parameters on resistivity imaging outcomes. A key observation is that resistivity imaging with combinations of electrode arrays that include dipole-dipole quadrupoles can be configured to illuminate consequential elements of coastal hydrogeology. We extend our analysis of ERI to include a diverse set of hydrogeological settings along more than 100 km of the coastal margin passing the city of Perth, Western Australia. Of particular importance are settings with: (1) a classic seawater wedge in an unconfined aquifer, (2) a shallow unconfined aquifer over an impermeable substrate, and (3) a shallow multi-tiered aquifer system over a conductive impermeable substrate. We also demonstrate a systematic increase in the landward extent of the seawater wedge at sites located progressively closer to the highly urbanized center of Perth. Based on field and synthetic ERI experiments from a broad range of hydrogeological settings, we tabulate current challenges and future directions for this technology. Our research contributes to resolving the globally significant challenge of managing seawater intrusion at vulnerable coastal margins.

Central Role of the Trehalose Biosynthesis Pathway in the Pathogenesis of Human Fungal Infections: Opportunities and Challenges for Therapeutic Development.

PubMed

Thammahong, Arsa; Puttikamonkul, Srisombat; Perfect, John R; Brennan, Richard G; Cramer, Robert A

2017-06-01

Invasive fungal infections cause significant morbidity and mortality in part due to a limited antifungal drug arsenal. One therapeutic challenge faced by clinicians is the significant host toxicity associated with antifungal drugs. Another challenge is the fungistatic mechanism of action of some drugs. Consequently, the identification of fungus-specific drug targets essential for fitness in vivo remains a significant goal of medical mycology research. The trehalose biosynthetic pathway is found in a wide variety of organisms, including human-pathogenic fungi, but not in humans. Genes encoding proteins involved in trehalose biosynthesis are mechanistically linked to the metabolism, cell wall homeostasis, stress responses, and virulence of Candida albicans , Cryptococcus neoformans , and Aspergillus fumigatus . While there are a number of pathways for trehalose production across the tree of life, the TPS/TPP (trehalose-6-phosphate synthase/trehalose-6-phosphate phosphatase) pathway is the canonical pathway found in human-pathogenic fungi. Importantly, data suggest that proteins involved in trehalose biosynthesis play other critical roles in fungal metabolism and in vivo fitness that remain to be fully elucidated. By further defining the biology and functions of trehalose and its biosynthetic pathway components in pathogenic fungi, an opportunity exists to leverage this pathway as a potent antifungal drug target. The goal of this review is to cover the known roles of this important molecule and its associated biosynthesis-encoding genes in the human-pathogenic fungi studied to date and to employ these data to critically assess the opportunities and challenges facing development of this pathway as a therapeutic target. Copyright © 2017 American Society for Microbiology.

Developing an Inpatient Group Psychotherapy Program: Challenges and Lessons Learnt

PubMed Central

Razaghi, Emran Mohammad; Tabatabaee, Maryam; Pourramzani, Ali; Shirali Mohammadpour, Reza; Mousazade Moghaddam, Arezou; Yahyavi, Seyyed Taha

2015-01-01

In Iran, inpatient group psychotherapy has been limited to transient practices for research purposes or fulfilling personal interest of therapists. The goal of this paper is to share and explain the experience of developing an inpatient group psychotherapy program in Roozbeh Psychiatric Hospital, Tehran, Iran. After theoretical delineation and preparation of a draft of the program guideline, two pilot sessions were held. Based on this initial experience a final treatment guideline was prepared. Afterwards, the program was continued for more than 1 year in a female ward at Roozbeh Psychiatric Hospital. The output of this exercise was a guideline that covers important topics in development of inpatient group psychotherapy. It is concluded that inpatient group psychotherapy has its unique challenges. Of the most important challenges that can be mentioned in this regard are the participation of patients with significant differences in levels of psychopathology and psychiatric signs and symptoms, and high comorbidity with specific personality traits or disorders. Other challenges relevant to the structure of the group include items such as very limited time for working through and inevitable out-of-group contacts. PMID:26576176

Understanding partnership practice in primary health as pedagogic work: what can Vygotsky's theory of learning offer?

PubMed

Hopwood, Nick

2015-01-01

Primary health policy in Australia has followed international trends in promoting models of care based on partnership between professionals and health service users. This reform agenda has significant practice implications, and has been widely adopted in areas of primary health that involve supporting families with children. Existing research shows that achieving partnership in practice is associated with three specific challenges: uncertainty regarding the role of professional expertise, tension between immediate needs and longer-term capacity development in families, and the need for challenge while maintaining relationships based on trust. Recently, pedagogic or learning-focussed elements of partnership practice have been identified, but there have been no systematic attempts to link theories of learning with the practices and challenges of primary health-care professionals working with families in a pedagogic role. This paper explores key concepts of Vygotsky's theory of learning (including mediation, the zone of proximal development, internalisation, and double stimulation), showing how pedagogic concepts can provide a bridge between the policy rhetoric of partnership and primary health practice. The use of this theory to address the three key challenges is explicitly discussed.

The Intergenerational Legacy of Genocidal Rape: The Realities and Perspectives of Children Born of the Rwandan Genocide.

PubMed

Denov, Myriam; Woolner, Leah; Bahati, Jules Pacifique; Nsuki, Paulin; Shyaka, Obed

2017-05-01

Brutal acts of sexual violence were documented on a mass scale during the 1994 Rwandan genocide. While existing scholarship on sexual violence has significantly increased our understanding of the challenges confronting survivors, gaps in knowledge remain regarding the lived experiences of children born of genocidal rape. This study sought to explore the realities and perspectives of children born of genocidal rape, and the existing opportunities and challenges they experienced in postgenocide Rwanda. Interviews and focus groups were conducted with 60 participants born of genocidal rape in Rwanda. Findings highlight the key challenges that these youth face in the postgenocide context, including struggles with identity and belonging, ambivalence in the mother-child relationship, and a desire to learn of their biological origins and heritage. The findings suggest that children born of conflict-related sexual violence face a distinct set of challenges and needs that have yet to be formally addressed. Our findings highlight the need for the development of programs, policies, and services specific for this important, yet overlooked group of young people affected by armed conflict.

The 20-20-20 Airship Challenge

NASA Astrophysics Data System (ADS)

Kiessling, Alina; Diaz, Ernesto; Miller, Sarah; Rhodes, Jason

2014-06-01

A NASA Centennial Challenge; (http://www.nasa.gov/directorates/spacetech/centennial_challenges/index.html) is in development to spur innovation in stratospheric airships as a science platform. We anticipate a million dollar class prize for the first organization to fly a powered airship that remains stationary at 20km (65,000 ft) altitude for over 20 hours with a 20kg payload. The design must be scalable to longer flights with more massive payloads.In NASA’s constrained budget environment, there are few opportunities for space missions in astronomy and Earth science, and these have very long lead times. We believe that airships (powered, maneuverable, lighter-than-air vehicles) could offer significant gains in observing time, sky and ground coverage, data downlink capability, and continuity of observations over existing suborbital options at competitive prices. We seek to spur private industry (or non-profit institutions, including FFRDCs and Universities) to demonstrate the capability for sustained airship flights as astronomy and Earth science platforms. This poster will introduce the challenge in development and provide details of who to contact for more information.

Universal penetration test apparatus with fluid penetration sensor

DOEpatents

Johnson, Phillip W.; Stampfer, Joseph F.; Bradley, Orvil D.

1999-01-01

A universal penetration test apparatus for measuring resistance of a material to a challenge fluid. The apparatus includes a pad saturated with the challenge fluid. The apparatus includes a compression assembly for compressing the material between the pad and a compression member. The apparatus also includes a sensor mechanism for automatically detecting when the challenge fluid penetrates the material.

Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges

PubMed Central

Amarasingham, Ruben; Audet, Anne-Marie J.; Bates, David W.; Glenn Cohen, I.; Entwistle, Martin; Escobar, G. J.; Liu, Vincent; Etheredge, Lynn; Lo, Bernard; Ohno-Machado, Lucila; Ram, Sudha; Saria, Suchi; Schilling, Lisa M.; Shahi, Anand; Stewart, Walter F.; Steyerberg, Ewout W.; Xie, Bin

2016-01-01

Context: The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Objectives: Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. Methods: To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. Findings: The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and Ethics) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility.Ethics: Develop both individual-centered and society-centered risk-benefit approaches to evaluate e-HPA.Regulation and Certification: Construct a self-regulation and certification framework within e-HPA.Education and Training: Make significant changes to medical, nursing, and paraprofessional curricula by including training for understanding, evaluating, and utilizing predictive models. PMID:27141516

Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges.

PubMed

Amarasingham, Ruben; Audet, Anne-Marie J; Bates, David W; Glenn Cohen, I; Entwistle, Martin; Escobar, G J; Liu, Vincent; Etheredge, Lynn; Lo, Bernard; Ohno-Machado, Lucila; Ram, Sudha; Saria, Suchi; Schilling, Lisa M; Shahi, Anand; Stewart, Walter F; Steyerberg, Ewout W; Xie, Bin

2016-01-01

The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and ETHICS) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility. Develop both individual-centered and society-centered risk-benefit approaches to evaluate e-HPA.Regulation and Certification: Construct a self-regulation and certification framework within e-HPA.Education and Training: Make significant changes to medical, nursing, and paraprofessional curricula by including training for understanding, evaluating, and utilizing predictive models.

Identifying the challenges and facilitators of implementing a COPD care bundle.

PubMed

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges.

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg.

PubMed

Cortot, Catherine F; Sheehan, William J; Permaul, Perdita; Friedlander, James L; Baxi, Sachin N; Gaffin, Jonathan M; Dioun, Anahita F; Hoffman, Elaine B; Schneider, Lynda C; Phipatanakul, Wanda

2012-01-01

Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. We examined egg white-specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes. We conducted a retrospective chart review of children, aged 2-18 years, receiving an egg white-specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0-35 mm) for passed challenges and 17 mm (range, 10-30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white-specific IgE was 2.02 kU/L (range, <0.35-13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51-6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white-specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white-specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size.

Collaboration challenges in systematic reviews: a survey of health sciences librarians

PubMed Central

Nicholson, Joey; McCrillis, Aileen; Williams, Jeff D.

2017-01-01

Objective: While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. Methods: To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. Results: Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. Conclusions: These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges. PMID:28983202

Collaboration challenges in systematic reviews: a survey of health sciences librarians.

PubMed

Nicholson, Joey; McCrillis, Aileen; Williams, Jeff D

2017-10-01

While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges.

[Predictive value of central venous-to-arterial carbon dioxide partial pressure difference for fluid responsiveness in septic shock patients: a prospective clinical study].

PubMed

Liu, Guangyun; Huang, Huibin; Qin, Hanyu; Du, Bin

2018-05-01

To evaluate the accuracy of central venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO 2 ) before and after rapid rehydration test (fluid challenge) in predicting the fluid responsiveness in patients with septic shock. A prospective observation was conducted. Forty septic shock patients admitted to medical intensive care unit (ICU) of Peking Union Medical College Hospital from October 2015 to June 2017 were enrolled. All of the patients received fluid challenge in the presence of invasive hemodynamic monitoring. Heart rate (HR), blood pressure, cardiac index (CI), Pcv-aCO 2 and other physiological variables were recorded at 10 minutes before and immediately after fluid challenge. Fluid responsiveness was defined as an increase in CI greater than 10% after fluid challenge, whereas fluid non-responsiveness was defined as no increase or increase in CI less than 10%. The correlation between Pcv-aCO 2 and CI was explored by Pearson correlation analysis. Receiver operating characteristic (ROC) curves were established to evaluate the discriminatory abilities of baseline and the changes after fluid challenge in Pcv-aCO 2 and other physiological variables to define the fluid responsiveness. The patients were separated into two groups according to the initial value of Pcv-aCO 2 . The cut-off value of 6 mmHg (1 mmHg = 0.133 kPa) was chosen according to previous studies. The discriminatory abilities of baseline and the change in Pcv-aCO 2 (ΔPcv-aCO 2 ) were assessed in each group. A total of 40 patients were finally included in this study. Twenty-two patients responded to the fluid challenge (responders). Eighteen patients were fluid non-responders. There was no significant difference in baseline physiological variable between the two groups. Fluid challenge could increase CI and blood pressure significantly, decrease HR notably and had no effect on Pcv-aCO 2 in fluid responders. In non-responders, blood pressure was increased significantly and CI, HR, Pcv-aCO 2 showed no change after fluid challenge. Pcv-aCO 2 was comparable in responders and non-responders. In 40 patients, CI and Pcv-aCO 2 was inversely correlated before fluid challenge (r = -0.391, P = 0.012) and the correlation between them weakened after fluid challenge (r = -0.301, P = 0.059). There was no significant correlation between the changes in CI and Pcv-aCO 2 after fluid challenge (r = -0.164, P = 0.312). The baseline Pcv-aCO 2 and ΔPcv-aCO 2 could not discriminate between responders and non-responders, with the area under ROC curve (AUC) of 0.50 [95% confidence interval (95%CI) = 0.32-0.69] and 0.51 (95%CI = 0.33-0.70), respectively. HR and blood pressure before fluid challenge and their changes after fluid challenge showed very poor discriminative performances. Before fluid challenge, 16 patients had a Pcv-aCO 2 > 6 mmHg. Their mean CI was significantly lower and Pcv-aCO 2 was significantly higher than that in 24 patients whose Pcv-aCO 2 ≤ 6 mmHg [n = 24; CI (mL×s -1 ×m -2 ): 48.3±11.7 vs. 65.0±18.3, P < 0.01; Pcv-aCO 2 (mmHg): 8.4±1.9 vs. 2.9±2.8, P < 0.01]. Pcv-aCO 2 was decreased significantly after fluid challenge in patients with an initial Pcv-aCO 2 > 6 mmHg and their ΔPcv-aCO 2 was notably different as compared with the patients whose baseline Pcv-aCO 2 ≤ 6 mmHg (mmHg: -3.8±3.4 vs. 0.9±2.9, P < 0.01). 68.8% (11/16) patients responded to the fluid challenge in patients with an initial Pcv-aCO 2 > 6 mmHg. The AUC of the baseline Pcv-aCO 2 and ΔPcv-aCO 2 to define fluid responsiveness was 0.85 (95%CI = 0.66-1.00) and 0.84 (95%CI = 0.63-1.00), respectively, and the positive predictive value was 1 when the cut-off value was 8.0 mmHg and -4.2 mmHg, respectively. 45.8% (11/24) patients responded to the fluid challenge in patients whose baseline Pcv-aCO 2 ≤ 6 mmHg. There was no predictive value of baseline Pcv-aCO 2 and ΔPcv-aCO 2 on fluid responsiveness. Pcv-aCO 2 and its change cannot serve as a surrogate of the change in cardiac output to define the response to fluid challenge in septic shock patients whose baseline Pcv-aCO 2 ≤ 6 mmHg, while the predictive values of baseline Pcv-aCO 2 and the change in Pcv-aCO 2 are presented in patients with the initial value of Pcv-aCO 2 > 6 mmHg. Clinical Trials, NCT01941472.

The synergy of the whole: building a global system for clinical trials to accelerate medicines development.

PubMed

Koski, Greg; Tobin, Mary F; Whalen, Matthew

2014-10-01

The pharmaceutical industry, once highly respected, productive, and profitable, is in the throes of major change driven by many forces, including economics, science, regulation, and ethics. A variety of initiatives and partnerships have been launched to improve efficiency and productivity but without significant effect because they have failed to consider the process as a system. Addressing the challenges facing this complex endeavor requires more than modifications of individual processes; it requires a fully integrated application of systems thinking and an understanding of the desired goals and complex interactions among essential components and stakeholders of the whole. A multistakeholder collaborative effort, led by the Alliance for Clinical Research Excellence and Safety (ACRES), a global nonprofit organization operating in the public interest, is now under way to build a shared global system for clinical research. Its systems approach focuses on the interconnection of stakeholders at critical points of interaction within 4 operational domains: site development and support, quality management, information technology, and safety. The ACRES initiatives, Site Accreditation and Standards, Product Safety Culture, Global Ethical Review and Regulatory Innovation, and Quality Assurance and Safety, focus on building and implementing systems solutions. Underpinning these initiatives is an open, shared, integrated technology (site and optics and quality informatics initiative). We describe the rationale, challenges, progress, and successes of this effort to date and lessons learned. The complexity and fragmentation of the intensely proprietary ecosystem of drug development, challenging regulatory climate, and magnitude of the endeavor itself pose significant challenges, but the economic, social, and scientific rewards will more than justify the effort. An effective alliance model requires a willingness of multiple stakeholders to work together to build a shared system within a noncompetitive space that will have major benefits for all, including better access to medicines, better health, and more productive lives. Copyright © 2014 Elsevier HS Journals, Inc. All rights reserved.

Perception of care and barriers to treatment in individuals with diabetic retinopathy in India: 11-city 9-state study.

PubMed

Shukla, Rajan; Gudlavalleti, Murthy V S; Bandyopadhyay, Souvik; Anchala, Raghupathy; Gudlavalleti, Aashrai Sai Venkat; Jotheeswaran, A T; Ramachandra, Srikrishna S; Singh, Vivek; Vashist, Praveen; Allagh, Komal; Ballabh, Hira Pant; Gilbert, Clare E

2016-04-01

Diabetic retinopathy is a leading cause of visual impairment. Low awareness about the disease and inequitable distribution of care are major challenges in India. Assess perception of care and challenges faced in availing care among diabetics. The cross-sectional, hospital based survey was conducted in eleven cities. In each city, public and private providers of eye-care were identified. Both multispecialty and standalone facilities were included. Specially designed semi-open ended questionnaires were administered to the clients. 376 diabetics were interviewed in the eye clinics, of whom 62.8% (236) were selected from facilities in cities with a population of 7 million or more. The mean duration of known diabetes was 11.1 (±7.7) years. Half the respondents understood the meaning of adequate glycemic control and 45% reported that they had visual loss when they first presented to an eye facility. Facilities in smaller cities and those with higher educational status were found to be statistically significant predictors of self-reported good/adequate control of diabetes. The correct awareness of glycemic control was significantly high among attending privately-funded facilities and higher educational status. Self-monitoring of glycemic status at home was significantly associated with respondents from larger cities, privately-funded facilities, those who were better educated and reported longer duration of diabetes. Duration of diabetes (41%), poor glycemic control (39.4%) and age (20.7%) were identified as the leading causes of DR. The commonest challenges faced were lifestyle/behavior related. The findings have significant implications for the organization of diabetes services in India.

Dietary Aloe vera improves plasma lipid profile, antioxidant, and hepatoprotective enzyme activities in GIFT-tilapia (Oreochromis niloticus) after Streptococcus iniae challenge.

PubMed

Gabriel, Ndakalimwe Naftal; Qiang, Jun; Ma, Xin Yu; He, Jie; Xu, Pao; Liu, Kai

2015-10-01

The current study investigated the effects of dietary Aloe vera on plasma lipid profile status, antioxidant, and hepatoprotective enzyme activities of GIFT-tilapia juveniles under Streptococcus iniae challenge. Five dietary groups were designed including a control and 100 % Aloe powder incorporated into a tilapia feed at 0.5, 1, 2, and 4 %/kg feed, which were administered for 8 weeks. Fish fed dietary Aloe at 4 %/kg feed significantly reduced in total cholesterol, while triacylglycerol reduced (P < 0.05) in those fed 0.5, 2, and 4 % Aloe/kg feed compared to unsupplemented ones. High-density lipoprotein was significantly elevated in fish fed 0.5 and 1 % Aloe/kg feed compared to unsupplemented ones, and no significant changes (P > 0.05) were noted in low-density lipoprotein among test groups. Furthermore, high activities of superoxide dismutase, catalase, and glutathione peroxide in liver tissues were observed in Aloe-supplemented fish compared to unsupplemented ones, before and after S. iniae challenge (7.7 × 10(6) CFU cells/mL). Variations were also noted in malondialdehyde activity throughout the trial, but no significant difference (P > 0.05) was observed between groups. Meanwhile, Aloe-supplemented fish reduced serum aspartate and alanine aminotransferase (AST and ALT) activities before and after challenge. Based on the second-order polynomial regression analysis, dietary Aloe inclusion levels less than or equal to 1.88, 1.86, and 2.79 %/kg feed were determined to be suitable in improving plasma lipid profile status, antioxidant, and hepatoprotective enzyme activities in GIFT-tilapia in this study, respectively. Thus, A. vera extracts may be recommended as a tilapia feed supplement to enhance fish antioxidant and hepatoprotective capacities, especially during disease outbreaks.

Universal penetration test apparatus with fluid penetration sensor

DOEpatents

Johnson, P.W.; Stampfer, J.F.; Bradley, O.D.

1999-02-02

A universal penetration test apparatus is described for measuring resistance of a material to a challenge fluid. The apparatus includes a pad saturated with the challenge fluid. The apparatus includes a compression assembly for compressing the material between the pad and a compression member. The apparatus also includes a sensor mechanism for automatically detecting when the challenge fluid penetrates the material. 23 figs.

In Vitro Cerebrovascular Modeling in the 21st Century: Current and Prospective Technologies

PubMed Central

Palmiotti, Christopher A.; Prasad, Shikha; Naik, Pooja; Abul, Kaisar MD; Sajja, Ravi K.; Achyuta, Anilkumar H.; Cucullo, Luca

2014-01-01

The blood-brain barrier (BBB) maintains the brain homeostasis and dynamically responds to events associated with systemic and/or rheological impairments (e.g., inflammation, ischemia) including the exposure to harmful xenobiotics. Thus, understanding the BBB physiology is crucial for the resolution of major central nervous system CNS) disorders challenging both health care providers and the pharmaceutical industry. These challenges include drug delivery to the brain, neurological disorders, toxicological studies, and biodefense. Studies aimed at advancing our understanding of CNS diseases and promoting the development of more effective therapeutics are primarily performed in laboratory animals. However, there are major hindering factors inherent to in vivo studies such as cost, limited throughput and translational significance to humans. These factors promoted the development of alternative in vitro strategies for studying the physiology and pathophysiology of the BBB in relation to brain disorders as well as screening tools to aid in the development of novel CNS drugs. Herein, we provide a detailed review including pros and cons of current and prospective technologies for modelling the BBB in vitro including ex situ, cell based and computational (in silico) models. A special section is dedicated to microfluidic systems including micro-BBB, BBB-on-a-chip, Neurovascular Unit-on-a-Chip and Synthetic Microvasculature Blood-Brain Barrier. PMID:25098812

In vitro cerebrovascular modeling in the 21st century: current and prospective technologies.

PubMed

Palmiotti, Christopher A; Prasad, Shikha; Naik, Pooja; Abul, Kaisar M D; Sajja, Ravi K; Achyuta, Anilkumar H; Cucullo, Luca

2014-12-01

The blood-brain barrier (BBB) maintains the brain homeostasis and dynamically responds to events associated with systemic and/or rheological impairments (e.g., inflammation, ischemia) including the exposure to harmful xenobiotics. Thus, understanding the BBB physiology is crucial for the resolution of major central nervous system CNS) disorders challenging both health care providers and the pharmaceutical industry. These challenges include drug delivery to the brain, neurological disorders, toxicological studies, and biodefense. Studies aimed at advancing our understanding of CNS diseases and promoting the development of more effective therapeutics are primarily performed in laboratory animals. However, there are major hindering factors inherent to in vivo studies such as cost, limited throughput and translational significance to humans. These factors promoted the development of alternative in vitro strategies for studying the physiology and pathophysiology of the BBB in relation to brain disorders as well as screening tools to aid in the development of novel CNS drugs. Herein, we provide a detailed review including pros and cons of current and prospective technologies for modelling the BBB in vitro including ex situ, cell based and computational (in silico) models. A special section is dedicated to microfluidic systems including micro-BBB, BBB-on-a-chip, Neurovascular Unit-on-a-Chip and Synthetic Microvasculature Blood-brain Barrier.

Physiological and transcriptional responses and cross protection of Lactobacillus plantarum ZDY2013 under acid stress.

PubMed

Huang, Renhui; Pan, Mingfang; Wan, Cuixiang; Shah, Nagendra P; Tao, Xueying; Wei, Hua

2016-02-01

Acid tolerance responses (ATR) in Lactobacillus plantarum ZDY2013 were investigated at physiological and molecular levels. A comparison of composition of cell membrane fatty acids (CMFA) between acid-challenged and unchallenged cells showed that acid adaptation evoked a significantly higher percentage of saturated fatty acids and cyclopropane fatty acids in acid-challenged than in unchallenged cells. In addition, reverse transcription-quantitative PCR analysis in acid-adapted cells at different pH values (ranging from 3.0 to 4.0) indicated that several genes were differently regulated, including those related to proton pumps, amino acid metabolism, sugar metabolism, and class I and class III stress response pathways. Expression of genes involved in fatty acid synthesis and production of alkali was significantly upregulated. Upon exposure to pH 4.5 for 2 h, a higher survival rate (higher viable cell count) of Lactobacillus plantarum ZDY2013 was achieved following an additional challenge to 40 mM hydrogen peroxide for 60 min, but no difference in survival rate of cells was found with further challenge to heat, ethanol, or salt. Therefore, we concluded that the physiological and metabolic changes of acid-treated cells of Lactobacillus plantarum ZDY2013 help the cells resist damage caused by acid, and further initiated global response signals to bring the whole cell into a state of defense to other stress factors, especially hydrogen peroxide. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Identification of molecular and physiological responses to chronic environmental challenge in an invasive species: the Pacific oyster, Crassostrea gigas

PubMed Central

Clark, Melody S; Thorne, Michael A S; Amaral, Ana; Vieira, Florbela; Batista, Frederico M; Reis, João; Power, Deborah M

2013-01-01

Understanding the environmental responses of an invasive species is critical in predicting how ecosystem composition may be transformed in the future, especially under climate change. In this study, Crassostrea gigas, a species well adapted to the highly variable intertidal environment, was exposed to the chronic environmental challenges of temperature (19 and 24°C) and pH (ambient seawater and a reduction of 0.4 pH units) in an extended 3-month laboratory-based study. Physiological parameters were measured (condition index, shell growth, respiration, excretion rates, O:N ratios, and ability to repair shell damage) alongside molecular analyses. Temperature was by far the most important stressor, as demonstrated by reduced condition indexes and shell growth at 24°C, with relatively little effect detected for pH. Transcriptional profiling using candidate genes and SOLiD sequencing of mantle tissue revealed that classical “stress” genes, previously reported to be upregulated under acute temperature challenges, were not significantly expressed in any of the treatments, emphasizing the different response between acute and longer term chronic stress. The transcriptional profiling also elaborated on the cellular responses underpinning the physiological results, including the identification of the PI3K/AKT/mTOR pathway as a potentially novel marker for chronic environmental challenge. This study represents a first attempt to understand the energetic consequences of cumulative thermal stress on the intertidal C. gigas which could significantly impact on coastal ecosystem biodiversity and function in the future. PMID:24223268

Heart Rate Responses to Autonomic Challenges in Obstructive Sleep Apnea

PubMed Central

Macey, Paul M.; Kumar, Rajesh; Woo, Mary A.; Yan-Go, Frisca L.; Harper, Ronald M.

2013-01-01

Obstructive sleep apnea (OSA) is accompanied by structural alterations and dysfunction in central autonomic regulatory regions, which may impair dynamic and static cardiovascular regulation, and contribute to other syndrome pathologies. Characterizing cardiovascular responses to autonomic challenges may provide insights into central nervous system impairments, including contributions by sex, since structural alterations are enhanced in OSA females over males. The objective was to assess heart rate responses in OSA versus healthy control subjects to autonomic challenges, and, separately, characterize female and male patterns. We studied 94 subjects, including 37 newly-diagnosed, untreated OSA patients (6 female, age mean±std: 52.1±8.1 years; 31 male aged 54.3±8.4 years), and 57 healthy control subjects (20 female, 50.5±8.1 years; 37 male, 45.6±9.2 years). We measured instantaneous heart rate with pulse oximetry during cold pressor, hand grip, and Valsalva maneuver challenges. All challenges elicited significant heart rate differences between OSA and control groups during and after challenges (repeated measures ANOVA, p<0.05). In post-hoc analyses, OSA females showed greater impairments than OSA males, which included: for cold pressor, lower initial increase (OSA vs. control: 9.5 vs. 7.3 bpm in females, 7.6 vs. 3.7 bpm in males), OSA delay to initial peak (2.5 s females/0.9 s males), slower mid-challenge rate-of-increase (OSA vs. control: −0.11 vs. 0.09 bpm/s in females, 0.03 vs. 0.06 bpm/s in males); for hand grip, lower initial peak (OSA vs. control: 2.6 vs. 4.6 bpm in females, 5.3 vs. 6.0 bpm in males); for Valsalva maneuver, lower Valsalva ratio (OSA vs. control: 1.14 vs. 1.30 in females, 1.29 vs. 1.34 in males), and OSA delay during phase II (0.68 s females/1.31 s males). Heart rate responses showed lower amplitude, delayed onset, and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in females. The dysfunctions may reflect central injury in the syndrome, and suggest autonomic deficiencies that may contribute to further tissue and functional pathologies. PMID:24194842

Vagal afferents contribute to exacerbated airway responses following ozone and allergen challenge

PubMed Central

Schelegle, Edward S.; Walby, William F.

2012-01-01

Brown-Norway rats (n = 113) sensitized and challenged with nDer f 1 allergen were used to examine the contribution of lung sensory nerves to ozone (O3) exacerbation of asthma. Prior to their third challenge rats inhaled 1.0 ppm O3 for 8 hours. There were three groups: 1) control; 2) vagus perineural capsaicin treatment (PCT) with or without hexamethonium; and 3) vagotomy. O3 inhalation resulted in a significant increase in lung resistance (RL) and an exaggerated response to subsequent allergen challenge. PCT abolished the O3-induced increase in RL and significantly reduced the increase in RL induced by a subsequent allergen challenge, while hexamethonium treatment reestablished bronchoconstriction induced by allergen challenge. Vagotomy resulted in a significant increase in the bronchoconstriction induced by O3 inhalation and subsequent challenge with allergen. In this model of O3 exacerbation of asthma, vagal C-fibers initiate reflex bronchoconstriction, vagal myelinated fibers initiate reflex bronchodilation, and mediators released within the airway initiate bronchoconstriction. PMID:22525484

Relationship challenges and relationship maintenance activities following disclosure of transsexualism.

PubMed

Alegría, C Aramburu

2010-12-01

• Transsexual persons are increasing their visibility in society, and health care providers and others (such as social workers) will be called upon to help with issues that transsexual persons face. Challenges that face transsexual persons often include issues involving relationships. Psychiatric and mental health nurses and other caregivers can increase their therapeutic skills in working with couples that include transsexual persons by becoming aware of these challenges and subsequent activities that can help with them. • This research study looks at couple relationships in which one partner reveals male-to-female transsexual identity. These are relationships that were established as man-woman and now will transition into relationships that include a male-to-female person and a female partner. • Common challenges for these couples include issues related to: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) presenting in public. • Relationship maintenance activities that helped the couples in the study maintain and strengthen their relationships through these challenges include: (1) communication; (2) self-talk (for example, putting the situation in perspective); (3) social networks; (4) positive interactions; (5) impression management (for example, managing displays of affection in public); and (6) social activism. This qualitative study describes the relational dynamics that help sustain relationships of couples that include male-to-female transsexual persons (MTF) and their natal female partners (NF) following disclosure of transsexualism. Relationship challenges and relationship maintenance activities are identified. Each partner in 17 MTF-NF couples participated in individual surveys and interviews. The data were coded for themes related to relationship challenges and activities. MTF-NF couples experience challenges within the contexts of their relationships and of society. These challenges include: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) public presentation. Relationship maintenance activities enabled the study couples to maintain and strengthen their relationships through these challenges. These activities include: (1) communication; (2) self-talk; (3) social networks; (4) positivity; (5) impression management; and (6) social activism. Via this report, psychiatric and mental health nurses can increase their therapeutic skills in working with MTF-NF couples. © 2010 Blackwell Publishing.

Challenges and opportunities in supporting sustainable agriculture and food security

USDA-ARS?s Scientific Manuscript database

The 2014 IUPAC International Congress of Pesticide Chemistry (San Francisco, August, 2014) included a symposium on “Challenges Associated with Global Adoption of Agricultural Biotechnology” to review current obstacles in promoting GM crops. Challenges identified by symposium presenters included i) ...

Successes and Challenges in the SAGE (Summer of Applied Geophysical Experience) REU Program

NASA Astrophysics Data System (ADS)

Braile, L. W.; Baldridge, W. S.; Pellerin, L.; Ferguson, J. F.; Bedrosian, P.; Biehler, S.; Jiracek, G. R.; Snelson, C. M.; Kelley, S.; McPhee, D.

2014-12-01

The SAGE program was initiated in 1983 to provide an applied geophysics research and education experience for students. Since 1983, 820 students have completed the SAGE summer program. Beginning in 1992, with funding from the NSF, SAGE has included an REU (Research Experience for Undergraduates) experience for selected undergraduate students from U.S. colleges and universities. Since 1992, 380 undergraduate REU students have completed the SAGE program. The four week, intensive, summer program is based in Santa Fe, New Mexico, and involves students in learning geophysical theory and applications; collection of geophysical field data in the northern Rio Grande Rift area; data processing, modeling and interpretation; and presentation (oral and written) of results of each student's research results. Students (undergraduates, graduates and professionals) and faculty are together on a school campus for the summer program. Successful strategies (developed over the years) of the program include teamwork experience, mentoring of REUs (by faculty and more senior students), cultural interchange due to students from many campuses across the U.S. and international graduate students, including industry visitors who work with the students and provide networking, a capstone experience of the summer program that includes all students making a "professional-meeting" style presentation of their research and submitting a written report, a follow-up workshop for the REU students to enhance and broaden their experience, and providing professional development for the REUs through oral or poster presentations and attendance at a professional meeting. Program challenges include obtaining funding from multiple sources; significant time investment in program management, reporting, and maintaining contact with our many funding sources and industry affiliates; and, despite significant efforts, limited success in recruiting racial and ethnic minority students to the program.

Grey literature: An important resource in systematic reviews.

PubMed

Paez, Arsenio

2017-12-21

Systematic reviews aid the analysis and dissemination of evidence, using rigorous and transparent methods to generate empirically attained answers to focused research questions. Identifying all evidence relevant to the research questions is an essential component, and challenge, of systematic reviews. Grey literature, or evidence not published in commercial publications, can make important contributions to a systematic review. Grey literature can include academic papers, including theses and dissertations, research and committee reports, government reports, conference papers, and ongoing research, among others. It may provide data not found within commercially published literature, providing an important forum for disseminating studies with null or negative results that might not otherwise be disseminated. Grey literature may thusly reduce publication bias, increase reviews' comprehensiveness and timeliness and foster a balanced picture of available evidence. Grey literature's diverse formats and audiences can present a significant challenge in a systematic search for evidence. However, the benefits of including grey literature may far outweigh the cost in time and resource needed to search for it, and it is important for it to be included in a systematic review or review of evidence. A carefully thought out grey literature search strategy may be an invaluable component of a systematic review. This narrative review provides guidance about the benefits of including grey literature in a systematic review, and sources for searching through grey literature. An illustrative example of a search for evidence within grey literature sources is presented to highlight the potential contributions of such a search to a systematic review. Benefits and challenges of grey literature search methods are discussed, and recommendations made. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Reliability and validity of Short Form 36 Version 2 to measure health perceptions in a sub-group of individuals with fatigue.

PubMed

Davenport, Todd E; Stevens, Staci R; Baroni, Katie; Van Ness, J Mark; Snell, Christopher R

2011-01-01

To determine the validity and reliability of Short Form 36 Version 2 (SF36v2) in sub-groups of individuals with fatigue. Thirty subjects participated in this study, including n = 16 subjects who met case definition criteria for chronic fatigue syndrome (CFS) and n = 14 non-disabled sedentary matched control subjects. SF36v2 and Multidimensional Fatigue Inventory (MFI-20) were administered before two maximal cardiopulmonary exercise tests (CPETs) administered 24 h apart and an open-ended recovery questionnaire was administered 7 days after CPET challenge. The main outcome measures were self-reported time to recover to pre-challenge functional and symptom status, frequency of post-exertional symptoms and SF36v2 sub-scale scores. Individuals with CFS demonstrated significantly lower SF36v2 and MFI-20 sub-scale scores prior to CPET. Between-group differences remained significant post-CPET, however, there were no significant group by test interaction effects. Subjects with CFS reported significantly more total symptoms (p < 0.001), as well as reports of fatigue (p < 0.001), neuroendocrine (p < 0.001), immune (p < 0.01), pain (p < 0.01) and sleep disturbance (p < 0.01) symptoms than control subjects as a result of CPET. Many symptom counts demonstrated significant relationships with SF36v2 sub-scale scores (p < 0.05). SF36v2 and MFI-20 sub-scale scores demonstrated significant correlations (p < 0.05). Various SF36v2 sub-scale scores demonstrated significant predictive validity to identify subjects who recovered from CPET challenge within 1 day and 7 days (p < 0.05). Potential floor effects were observed for both questionnaires for individuals with CFS. Various sub-scales of SF36v2 demonstrated adequate reliability and validity for clinical and research applications. Adequacy of sensitivity to change of SF36v2 as a result of a fatiguing stressor should be the subject of additional study.

Examining the Challenging Hindrances facing in the Construction Projects: South India’s Perspective

NASA Astrophysics Data System (ADS)

Subramanyam, K.; Haridharan, M. K.

2017-07-01

Developing countries like India require a huge infrastructure to facilitate needs of the people. Construction industry provides several opportunities to the individuals. Construction manager work is to supervise and organize the construction activities in construction projects. Now a day construction manager facing challenges. This paper aimed to study the challenges facing by the construction manager in the perception of construction professionals. 39 variables were taken from the literature review which found to be severe impact on construction managers’ performance. Construction manager, project manager and site engineers are the respondents for this survey. Using SPSS, regression analysis was done and recognized significant challenges. These challenges were classified into 5 domains. In management challenges, resource availability and allocation, risks and uncertainties existing in the project onsite, top management support and cost constraints are the most significant variables. In skills requirement of a construction manager challenges, technical skills required to learn and adapt new technology in the project, decision making and planning according to the situation in site are the most significant variables. In performance challenges, implementation of tasks according to the plan is the important variable whereas in onsite challenges, manage project risks, develop project policies and procedures are the most important.

Challenging Behavior in Smith-Lemli-Opitz Syndrome: Initial Test of Biobehavioral Influences

PubMed Central

Freeman, Kurt A.; Eagle, Rose; Merkens, Louise S.; Sikora, Darryn; Pettit-Kekel, Kersti; Nguyen-Driver, Mina; Steiner, Robert D.

2013-01-01

Objective To study challenging behavior (destruction, aggression, self-injury, stereotypy) in children with Smith-Lemli-Opitz syndrome (SLOS) using a biobehavioral model that helps distinguish biological from socially mediated variables influencing the behavior. Background SLOS is an autosomal-recessive syndrome of multiple malformations and intellectual disability resulting from a genetic error in cholesterol synthesis in all cells and tissues, including brain. The exact cause of the challenging behavior in SLOS is unclear, but defective brain cholesterol synthesis may contribute. Because the precise genetic and biochemical etiology of SLOS is known, this disorder is a good model for studying biological causes of challenging behavior. Method In a preliminary application of a biobehavioral model, we studied the association between cholesterol levels (as a biochemical indicator of disease severity) and behavior subtype (“biological” vs “learned”) in 13 children with SLOS. Parents completed a questionnaire that categorized challenging behavior as influenced primarily by social or nonsocial (thus, presumably biological) factors. Results The severity of the cholesterol synthesis defect correlated significantly with behavior subtype classification for 1 of 2 challenging behaviors. Greater severity of the cholesterol synthesis defect was associated with behavior being classified as primarily influenced by biological factors. Conclusion The interplay between challenging behavior and defective cholesterol synthesis in SLOS may help explain biological influences on the behavior. Our findings have implications for research on the effectiveness of behavioral and medical treatments for behavioral difficulties in SLOS and other neurodevelopmental disorders. PMID:23538569

Neutrophilic respiratory tract inflammation and peripheral blood neutrophilia after grain sorghum dust extract challenge.

PubMed

Von Essen, S G; O'Neill, D P; McGranaghan, S; Olenchock, S A; Rennard, S I

1995-11-01

To determine if inhalation of grain sorghum dust in the laboratory would cause neutrophilic upper and lower respiratory tract inflammation in human volunteers, as well as systemic signs of illness. Prospective. University of Nebraska Medical Center. Thirty normal volunteers. Inhalation challenge with 20 mL of a nebulized solution of filter-sterilized grain sorghum dust extract (GSDE). One group received prednisone, 20 mg for 2 days, prior to the challenge. Bronchoscopy with bronchoalveolar lavage (BAL) was performed 24 h after challenge, with samples collected as bronchial and alveolar fractions. Findings included visible signs of airways inflammation, quantified as the bronchitis index. The percentage of bronchial neutrophils was significantly increased in those challenged with GSDE vs the control solution, Hanks' balanced salt solution (40.3 +/- 4.5% vs 14.3 +/- 5.1%, p < or = .01). Similar findings were seen in the alveolar fraction. Pretreatment with corticosteroids did not prevent the rise in neutrophils recovered by BAL. Peripheral blood neutrophils were also increased in volunteers challenged with the grain dust extract. To explain the increase in peripheral blood neutrophil counts, the capacity of the peripheral blood neutrophils to migrate in chemotaxis experiments was examined. The results demonstrate an increase in peripheral blood neutrophils and an increase in chemotactic responsiveness. Inhalation challenge with a grain dust extract causes respiratory tract inflammation and a peripheral blood neutrophilia. One reason for this may be an increase in activated peripheral blood neutrophils.

New diagnostic methods for pneumonia in the ICU.

PubMed

Douglas, Ivor S

2016-04-01

Pneumonia leading to severe sepsis and critical illness including respiratory failure remains a common and therapeutically challenging diagnosis. Current clinical approaches to surveillance, early detection, and conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of community-acquired and health care-acquired pneumonia, including ventilator-associated pneumonia (VAP), are the focus of recent studies reviewed here. Newer surveillance definitions are sensitive for pneumonia in the ICU including VAP but consistently underdetect patients that are clinically shown to have bacterial VAP based on clinical diagnostic criteria and response to antibiotic treatment. Routinely measured plasma biomarkers, including procalcitonin and C-reactive protein, lack sufficient precision and predictive accuracy to inform diagnosis. Novel rapid microbiological diagnostics, including nucleic-acid amplification, mass spectrometry, and fluorescence microscopy-based technologies are promising approaches for the future. Exhaled breath biomarkers, including measurement of volatile organic compounds, represent a future approach. The integration of novel diagnostics for rapid microbial identification, resistance phenotyping, and antibiotic sensitivity testing into usual care practice could significantly transform the care of patients and potentially inform significantly improved targeted antimicrobial selection, de-escalation, and stewardship.

Behavioural fever in zebrafish larvae.

PubMed

Rey, Sonia; Moiche, Visila; Boltaña, Sebastian; Teles, Mariana; MacKenzie, Simon

2017-02-01

Behavioural fever has been reported in different species of mobile ectotherms including the zebrafish, Danio rerio, in response to exogenous pyrogens. In this study we report, to our knowledge for the first time, upon the ontogenic onset of behavioural fever in zebrafish (Danio rerio) larvae. For this, zebrafish larvae (from first feeding to juveniles) were placed in a continuous thermal gradient providing the opportunity to select their preferred temperature. The novel thermal preference aquarium was based upon a continuous vertical column system and allows for non-invasive observation of larvae vertical distribution under isothermal (T R at 28 °C) and thermal gradient conditions (T CH : 28-32 °C). Larval thermal preference was assessed under both conditions with or without an immersion challenge, in order to detect the onset of the behavioural fever response. Our results defined the onset of the dsRNA induced behavioural fever at 18-20 days post fertilization (dpf). Significant differences were observed in dsRNA challenged larvae, which prefer higher temperatures (1-4 °C increase) throughout the experimental period as compared to non-challenged larvae. In parallel we measured the abundance of antiviral transcripts; viperin, gig2, irf7, trim25 and Mxb mRNAs in dsRNA challenged larvae under both thermal regimes: T R and T Ch . Significant increases in the abundance of all measured transcripts were recorded under thermal choice conditions signifying that thermo-coupling and the resultant enhancement of the immune response to dsRNA challenge occurs from 18 dpf onwards in the zebrafish. The results are of importance as they identify a key developmental stage where the neuro-immune interface matures in the zebrafish likely providing increased resistance to viral infection. Copyright © 2016 Elsevier Ltd. All rights reserved.

Outer membrane vesicles of Gallibacterium anatis induce protective immunity in egg-laying hens.

PubMed

Pors, Susanne E; Pedersen, Ida J; Skjerning, Ragnhild Bager; Thøfner, Ida C N; Persson, Gry; Bojesen, Anders M

2016-11-15

Gallibacterium anatis causes infections in the reproductive tract of egg-laying hens and induce increased mortality and decreased egg production. New prophylactic measures are needed in order to improve animal welfare and production efficiency. Bacterial outer membrane vesicles (OMVs) have previously shown promising results in protection against infections and we hypothesized that OMVs could serve as an immunogen to protect egg-laying hens against G. anatis. To investigate the immunogenic potential of G. anatis OMVs, two in vivo studies in egg-laying hens were made. The trials assessedthe degree of protection provided by immunization with G. anatis OMV against challenge and the IgY responses in serum after immunization and challenge, respectively. A total of 64 egg-laying hens were included in the trials. OMVs for immunization were produced and purified from a high-producing G. anatis ΔtolR mutant. Challenge was done with G. anatis 12656-12 and evaluated by scoring lesions and bacterial re-isolation rates from peritoneum. Finally, levels of OMV-specific IgY in sera were assayed by ELISA. Immunization with OMVs decreased the lesions scores significantly, while the bacterial re-isolation remained unchanged. Furthermore, a high OMV-specific IgY response was induced by immunization and subsequent challenge of the hens. The results strongly indicate that immunization with G. anatis OMVs provides significant protection against G. anatis challenge and induces specific antibody responses with high titers of OMV-specific IgY in serum. The results therefore show great promise for OMV based vaccines aiming at providing protecting against G. anatis in egg-laying hens. Copyright © 2016 Elsevier B.V. All rights reserved.

Knowledge management and informatics considerations for comparative effectiveness research: a case-driven exploration.

PubMed

Embi, Peter J; Hebert, Courtney; Gordillo, Gayle; Kelleher, Kelly; Payne, Philip R O

2013-08-01

As clinical data are increasingly collected and stored electronically, their potential use for comparative effectiveness research (CER) grows. Despite this promise, challenges face those wishing to leverage such data. In this paper we aim to enumerate some of the knowledge management and informatics issues common to such data reuse. After reviewing the current state of knowledge regarding biomedical informatics challenges and best practices related to CER, we then present 2 research projects at our institution. We analyze these and highlight several common themes and challenges related to the conduct of CER studies. Finally, we represent these emergent themes. The informatics challenges commonly encountered by those conducting CER studies include issues related to data information and knowledge management (eg, data reuse, data preparation) as well as those related to people and organizational issues (eg, sociotechnical factors and organizational factors). Examples of these are described in further detail and a formal framework for describing these findings is presented. Significant challenges face researchers attempting to use often diverse and heterogeneous datasets for CER. These challenges must be understood in order to be dealt with successfully and can often be overcome with the appropriate use of informatics best practices. Many research and policy questions remain to be answered in order to realize the full potential of the increasingly electronic clinical data available for such research.

Science-policy challenges for biodiversity, public health and urbanization: examples from Belgium

NASA Astrophysics Data System (ADS)

Keune, H.; Kretsch, C.; De Blust, G.; Gilbert, M.; Flandroy, L.; Van den Berge, K.; Versteirt, V.; Hartig, T.; De Keersmaecker, L.; Eggermont, H.; Brosens, D.; Dessein, J.; Vanwambeke, S.; Prieur-Richard, A. H.; Wittmer, H.; Van Herzele, A.; Linard, C.; Martens, P.; Mathijs, E.; Simoens, I.; Van Damme, P.; Volckaert, F.; Heyman, P.; Bauler, T.

2013-06-01

Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human-nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem-human/public health-urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed.

Cultivating Engagement and Enjoyment in Exergames Using Feedback, Challenge, and Rewards.

PubMed

Lyons, Elizabeth J

2015-02-01

This article reviews theoretical and empirical evidence related to three mechanisms for encouraging enjoyment during exergame play: Feedback, challenge, and rewards. A literature search and narrative review were conducted. Feedback is found in nearly all exergames, and richer, more in-depth feedback is associated with increased activity. Challenge is a vital component of any videogame, and exergames include physical as well as cognitive challenges. Flow states have traditionally been conceptualized as occurring when an optimal match between player skills and game challenge occurs. However, failure and retrial are necessary for feelings of overall satisfaction and fun, despite not necessarily being ideally fun or satisfying themselves. Rewards are a more complicated issue, with significant theoretical and empirical evidence suggesting positive and negative effects of reward systems. How rewards are integrated into the mechanics and storyline of the game likely impacts how they are perceived and, thus, their effectiveness. Finally, integration of these mechanisms into exergames requires specific attention to both cognitive and physical implementations. Movements that are not themselves enjoyable or engaging may lead to cheating and lower energy expenditure. Feedback, challenge, and rewards are promising mechanisms by which exergames could become more enjoyable. How these concepts are operationalized can affect physical and psychological reactions to exergames. Attention to these concepts in future exergame development and implementation would benefit theory, research, and practice.

Cultivating Engagement and Enjoyment in Exergames Using Feedback, Challenge, and Rewards

PubMed Central

2015-01-01

Abstract Objective: This article reviews theoretical and empirical evidence related to three mechanisms for encouraging enjoyment during exergame play: Feedback, challenge, and rewards. Materials and Methods: A literature search and narrative review were conducted. Results: Feedback is found in nearly all exergames, and richer, more in-depth feedback is associated with increased activity. Challenge is a vital component of any videogame, and exergames include physical as well as cognitive challenges. Flow states have traditionally been conceptualized as occurring when an optimal match between player skills and game challenge occurs. However, failure and retrial are necessary for feelings of overall satisfaction and fun, despite not necessarily being ideally fun or satisfying themselves. Rewards are a more complicated issue, with significant theoretical and empirical evidence suggesting positive and negative effects of reward systems. How rewards are integrated into the mechanics and storyline of the game likely impacts how they are perceived and, thus, their effectiveness. Finally, integration of these mechanisms into exergames requires specific attention to both cognitive and physical implementations. Movements that are not themselves enjoyable or engaging may lead to cheating and lower energy expenditure. Conclusions: Feedback, challenge, and rewards are promising mechanisms by which exergames could become more enjoyable. How these concepts are operationalized can affect physical and psychological reactions to exergames. Attention to these concepts in future exergame development and implementation would benefit theory, research, and practice. PMID:26181675

Assessing climate risks across different business sectors and industries: an investigation of methodological challenges at national scale for the UK

NASA Astrophysics Data System (ADS)

Surminski, Swenja; Di Mauro, Manuela; Baglee, J. Alastair R.; Connell, Richenda K.; Hankinson, Joel; Haworth, Anna R.; Ingirige, Bingunath; Proverbs, David

2018-06-01

Climate change poses severe risks for businesses, which companies as well as governments need to understand in order to take appropriate steps to manage those. This, however, represents a significant challenge as climate change risk assessment is itself a complex, dynamic and geographically diverse process. A wide range of factors including the nature of production processes and value chains, the location of business sites as well as relationships and interdependencies with customers and suppliers play a role in determining if and how companies are impacted by climate risks. This research explores the methodological challenges for a national-scale assessment of climate risks through the lens of the UK Climate Change Risk Assessment (UKCCRA) process and compares the approaches adopted in the first and second UKCCRA (2011, 2016), while also reflecting on international experiences elsewhere. A review of these issues is presented, drawing on a wide body of contemporary evidence from a range of sources including the research disciplines, grey literature and government policy. The study reveals the methodological challenges and highlights six broad themes, namely scale, evidence base, adaptation responses, scope, interdependencies and public policy. The paper concludes by identifying suitable lessons for future national climate risk assessments, which should guide the next phase of research in preparation for UKCCRA3 and those of national-level risk assessments elsewhere. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

Evaluation of anti-allergic properties of caffeic acid phenethyl ester in a murine model of systemic anaphylaxis

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

Park, Sae-Gwang; Lee, Da-Young; Seo, Su-Kil

Caffeic acid phenethyl ester (CAPE) is an active component of honeybee propolis extracts. It has several positive effects, including anti-inflammatory, anti-oxidation, anti-cancer, anti-bacterial, anti-viral, anti-fungal, and immunomodulatory effects. In particular, the suppressive effect of NF-{kappa}B may disrupt a component of allergic induction. The principal objective of this experimental study was to evaluate the effects of CAPE on the active systemic anaphylaxis induced by ovalbumin (OVA) challenge in mice. Mice were intraperitoneally sensitized and intravenously challenged with OVA. Histopathological analysis, nuclear factor (NF)-{kappa}B activation, and the plasma levels of histamine and total IgE after allergen challenge were evaluated. After challenges, allmore » of the sham-treated mice developed anaphylactic symptoms, increased plasma levels of histamine and OVA-specific IgE, marked vascular leakage, NF-{kappa}B activation, platelet-activating factor (PAF) production, and histological changes including pulmonary edema and hemorrhage in the renal medullae within 20 min. By way of contrast, a reduction in the plasma levels of histamine and OVA-specific IgE and an inhibition of NF-{kappa}B activation and PAF release were observed in the CAPE-treated mice. In addition, a significant prevention of hemoconcentration and OVA-induced pathological changes were noted. These results indicate that CAPE demonstrates an anti-allergic effect, which may be the result of its protective effects against IgE-mediated allergy.« less

Assessing climate risks across different business sectors and industries: an investigation of methodological challenges at national scale for the UK.

PubMed

Surminski, Swenja; Di Mauro, Manuela; Baglee, J Alastair R; Connell, Richenda K; Hankinson, Joel; Haworth, Anna R; Ingirige, Bingunath; Proverbs, David

2018-06-13

Climate change poses severe risks for businesses, which companies as well as governments need to understand in order to take appropriate steps to manage those. This, however, represents a significant challenge as climate change risk assessment is itself a complex, dynamic and geographically diverse process. A wide range of factors including the nature of production processes and value chains, the location of business sites as well as relationships and interdependencies with customers and suppliers play a role in determining if and how companies are impacted by climate risks. This research explores the methodological challenges for a national-scale assessment of climate risks through the lens of the UK Climate Change Risk Assessment (UKCCRA) process and compares the approaches adopted in the first and second UKCCRA (2011, 2016), while also reflecting on international experiences elsewhere. A review of these issues is presented, drawing on a wide body of contemporary evidence from a range of sources including the research disciplines, grey literature and government policy. The study reveals the methodological challenges and highlights six broad themes, namely scale, evidence base, adaptation responses, scope, interdependencies and public policy. The paper concludes by identifying suitable lessons for future national climate risk assessments, which should guide the next phase of research in preparation for UKCCRA3 and those of national-level risk assessments elsewhere.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

Preventing and managing challenging behaviour.

PubMed

Hallett, Nutmeg

2018-02-21

Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques - maintaining safety, self-regulation, effective communication, and assessment and actions - to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Ongoing ostomy self-care challenges of long-term rectal cancer survivors.

PubMed

Bulkley, Joanna E; McMullen, Carmit K; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C; Krouse, Robert S

2018-05-29

Surgical treatment for rectal cancer (RC) can result in an intestinal ostomy that requires lifelong adaptation and investment of physical, cognitive, and financial resources. However, little is known about the extent of ongoing challenges related to ostomy self-care among long-term RC survivors. We analyzed the prevalence of self-reported ostomy self-care challenges and the physical and environmental factors that can support or undermine ostomy self-care. We mailed surveys to long-term (≥ 5 years post-diagnosis) RC survivors, including 177 adults with ostomies who were members of integrated health systems in northern California, Oregon, and Washington State. Potential participants were identified through tumor registries. Data were also extracted from electronic health records. The response rate was 65%. The majority of respondents were male (67%), and the mean age was 75 years. Sixty-three percent of respondents reported at least one ostomy self-care challenge. The most common challenges were leakage or skin problems around the ostomy and needing to change the pouching system too frequently. Twenty-two percent reported difficulty caring for their ostomy. Younger age and higher BMI were consistently related to ostomy self-care challenges. The majority of RC survivors reported ostomy-related self-care challenges, and 31% experienced problems across multiple domains of ostomy self-care. In addition, most survivors reported significant physical challenges that could lead to ostomy-related disability. Although the participants surveyed had access to ostomy care nurses, the care gaps we found suggest that additional work is needed to understand barriers to ostomy care, reduce unmet needs, and improve well-being among this group.

Prenatal Adversities and Latino Children’s Autonomic Nervous System Reactivity Trajectories from 6 Months to 5 Years of Age

PubMed Central

Alkon, Abbey; Boyce, W. Thomas; Tran, Linh; Harley, Kim G.; Neuhaus, John; Eskenazi, Brenda

2014-01-01

The purpose of the study was to determine whether mothers’ adversities experienced during early pregnancy are associated with offspring’s autonomic nervous system (ANS) reactivity trajectories from 6 months to 5 years of age. This cohort study of primarily Latino families included maternal interviews at 13–14 weeks gestation about their experience of a range of adversities: father’s absence, general social support, poverty level, and household density. ANS measures of heart rate, respiratory sinus arrhythmia (parasympathetic nervous system) and preejection period (sympathetic nervous system) were collected during resting and challenging conditions on children at 6 months and 1, 3.5 and 5 years of age. Reactivity measures were calculated as the mean of the responses to challenging conditions minus a resting condition. Fixed effects models were conducted for the 212 children with two or more timepoints of ANS measures. Interactions between maternal prenatal adversity levels and child age at time of ANS protocol were included in the models, allowing the calculation of separate trajectories or slopes for each level of adversity. Results showed no significant relations between mothers’ prenatal socioeconomic or social support adversity and offspring’s parasympathetic nervous system trajectories, but there was a statistically significant relationship between social support adversity and offspring’s heart rate trajectories (p<.05) and a borderline significant relationship between socioeconomic adversity and offspring’s sympathetic nervous system trajectories (p = .05). Children whose mothers experienced one, not two, social support adversity had the smallest increases in heart rate reactivity compared to children whose mothers experienced no adversity. The children whose mothers experienced no social support and no socioeconomic adversity had the largest increases in heart rate and preejection period respectively from 6 months to 5 years showing the most plasticity. Mothers’ prenatal adverse experiences may program their children’s physiologic trajectory to dampen their heart rate or sympathetic responsivity to challenging conditions. PMID:24466003

Early experience of a safety net provider reorganizing into an accountable care organization.

PubMed

Hacker, Karen; Santos, Palmira; Thompson, Douglas; Stout, Somava S; Bearse, Adriana; Mechanic, Robert E

2014-08-01

Although safety net providers will benefit from health insurance expansions under the Affordable Care Act, they also face significant challenges in the postreform environment. Some have embraced the concept of the accountable care organization to help improve quality and efficiency while addressing financial shortfalls. The experience of Cambridge Health Alliance (CHA) in Massachusetts, where health care reform began six years ago, provides insight into the opportunities and challenges of this approach in the safety net. CHA's strategies include care redesign, financial realignment, workforce transformation, and development of external partnerships. Early results show some improvement in access, patient experience, quality, and utilization; however, the potential efficiencies will not eliminate CHA's current operating deficit. The patient population, payer mix, service mix, cost structure, and political requirements reduce the likelihood of financial sustainability without significant changes in these factors, increased public funding, or both. Thus the future of safety net institutions, regardless of payment and care redesign success, remains at risk. Copyright © 2014 by Duke University Press.

Systematic review of restraint interventions for challenging behaviour among persons with intellectual disabilities: focus on effectiveness in single-case experiments.

PubMed

Heyvaert, Mieke; Saenen, Lore; Maes, Bea; Onghena, Patrick

2014-11-01

This article is the first in a two-part series: we focus on the effectiveness of restraint interventions (RIs) for reducing challenging behaviour (CB) among persons with intellectual disabilities in this first article. In the second article, we focus on experiences with RIs for CB among people with intellectual disabilities. A mixed-methods research synthesis involving statistical meta-analysis and qualitative meta-synthesis techniques was applied to synthesize 76 retrieved articles. This first article reports on the meta-analysis of 59 single-case experiments (SCEs) on effectiveness of RIs for CB among people with intellectual disabilities. The RIs reported on in the SCEs were on average highly effective in reducing CB for people with intellectual disabilities, and this reduction in CB was statistically significant. However, the effects vary significantly over the included participants, and the published data and reported outcomes are rather unrepresentative of the everyday use of RIs among persons with intellectual disabilities. © 2014 John Wiley & Sons Ltd.

Effective literacy instruction for adults with specific learning disabilities: implications for adult educators.

PubMed

Hock, Michael F

2012-01-01

Adults with learning disabilities (LD) attending adult basic education, GED programs, or community colleges are among the lowest performers on measures of literacy. For example, on multiple measures of reading comprehension, adults with LD had a mean reading score at the third grade level, whereas adults without LD read at the fifth grade level. In addition, large numbers of adults perform at the lowest skill levels on quantitative tasks. Clearly, significant instructional challenges exist for adults who struggle with literacy issues, and those challenges can be greater for adults with LD. In this article, the literature on adults with LD is reviewed, and evidenced-based instructional practices that significantly narrow the literacy achievement gap for this population are identified. Primary attention is given to instructional factors that have been shown to affect literacy outcomes for adults with LD. These factors include the use of explicit instruction, instructional technology, and intensive tutoring in skills and strategies embedded in authentic contexts.

Discovery of functional monoclonal antibodies targeting G-protein-coupled receptors and ion channels.

PubMed

Wilkinson, Trevor C I

2016-06-15

The development of recombinant antibody therapeutics is a significant area of growth in the pharmaceutical industry with almost 50 approved monoclonal antibodies on the market in the US and Europe. Despite this growth, however, certain classes of important molecular targets have remained intractable to therapeutic antibodies due to complexity of the target molecules. These complex target molecules include G-protein-coupled receptors and ion channels which represent a large potential target class for therapeutic intervention with monoclonal antibodies. Although these targets have typically been addressed by small molecule approaches, the exquisite specificity of antibodies provides a significant opportunity to provide selective modulation of these target proteins. Given this opportunity, substantial effort has been applied to address the technical challenges of targeting these complex membrane proteins with monoclonal antibodies. In this review recent progress made in the strategies for discovery of functional monoclonal antibodies for these challenging membrane protein targets is addressed. © 2016 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society.

Challenging behaviors in young children: the father's role.

PubMed

Burbach, Ann D; Fox, Robert A; Nicholson, Bonnie C

2004-06-01

In this study, the authors examined the parenting practices, developmental expectations, and stress levels of 136 fathers and the challenging and prosocial behaviors of their 1- to 5-year-old children. In addition, the authors systematically addressed fathers' qualitative concerns about their parenting. The authors divided the participants into 4 groups and controlled for family socioeconomic status (SES) and the focus child's gender. Results showed a significantly higher use of corporal and verbal punishment and parenting stress among lower income fathers. Secondary analyses demonstrated a significant effect of paternal disciplinary practices that emphasized the frequent use of corporal and verbal punishment on child behavior problems, regardless of SES level. On a positive note, fathers from both lower and higher SES groups had reasonable developmental expectations for their boys and girls, and they reported similar frequencies of their children's prosocial behavior. The authors discuss the need for early parent education programs that include fathers and that teach specific strategies to address child behavior problems.

Crystal growth and materials research in photovoltaics: progress and challenges

NASA Astrophysics Data System (ADS)

Surek, Thomas

2005-02-01

Photovoltaics (PV) is solar electric power—a semiconductor-based technology that converts sunlight to electricity. Three decades of research has led to the discovery of new materials and devices and new processing techniques for low-cost manufacturing. This has resulted in improved sunlight-to-electricity conversion efficiencies, improved outdoor reliability, and lower module and system costs. The manufacture and sale of PV has grown into a $5 billion industry worldwide, with more than 740 megawatts of PV modules shipped in 2003. This paper reviews the significant progress that has occurred in PV materials and devices research over the past 30 years, focusing on the advances in crystal growth and materials research, and examines the challenges to reaching the ultimate potential of current-generation (crystalline silicon), next-generation (thin films and concentrators), and future-generation PV technologies. The latter includes innovative materials and device concepts that hold the promise of significantly higher conversion efficiencies and/or much lower costs.

Subsurface Thermal Energy Storage for Improved Air Conditioning Efficiency

DTIC Science & Technology

2016-11-01

current cost liability is the potential for several significant structural changes at DoD facilities around the world. These challenges include... climate , with an average high temperature of 90 degrees in July, and an average low temperature of 39 in January. The annual average temperature is 65.6...in new systems. The first three steps are recommended for every geothermal system installed in cooling dominated areas ( climatically hot areas such

The Rewards of Perseverance, Aldine Texas: The Power of a Systemwide Focus on Students, Teachers, and Leaders. School System 20/20 Case Study

ERIC Educational Resources Information Center

Baroody, Karen; Rho, Lois

2016-01-01

"The Rewards of Perseverance" tells the story of a district with a clear vision, stable leadership, and deliberate evolution in response to change. Located just north of Houston, AISD has faced daunting challenges since the 1990s--including a significant increase in high-need students, and more rigorous state tests. At the same time, the…

Peyronie's Disease: Still a Surgical Disease.

PubMed

Martinez, Daniel; Ercole, Cesar E; Hakky, Tariq S; Kramer, Andrew; Carrion, Rafael

2012-01-01

Peyronie's Disease (PD) remains a challenging and clinically significant morbid condition. Since its first description by François Gigot de la Peyronie, much of the treatment for PD remains nonstandardized. PD is characterized by the formation of fibrous plaques at the level of the tunica albuginea. Clinical manifestations include morphologic changes, such as curvatures and hourglass deformities. Here, we review the common surgical techniques for the management of patients with PD.

Meeting the challenge of interacting threats in freshwater ecosystems: A call to scientists and managers

USGS Publications Warehouse

Craig, Laura S.; Olden, Julian D.; Arthington, Angela; Entrekin, Sally; Hawkins, Charles P.; Kelly, John J.; Kennedy, Theodore A.; Maitland, Bryan M.; Rosi, Emma J.; Roy, Allison; Strayer, David L.; Tank, Jennifer L.; West, Amie O.; Wooten, Matthew S.

2017-01-01

Human activities create threats that have consequences for freshwater ecosystems and, in most watersheds, observed ecological responses are the result of complex interactions among multiple threats and their associated ecological alterations. Here we discuss the value of considering multiple threats in research and management, offer suggestions for filling knowledge gaps, and provide guidance for addressing the urgent management challenges posed by multiple threats in freshwater ecosystems. There is a growing literature assessing responses to multiple alterations, and we build off this background to identify three areas that require greater attention: linking observed alterations to threats, understanding when and where threats overlap, and choosing metrics that best quantify the effects of multiple threats. Advancing science in these areas will help us understand existing ecosystem conditions and predict future risk from multiple threats. Because addressing the complex issues and novel ecosystems that arise from the interaction of multiple threats in freshwater ecosystems represents a significant management challenge, and the risks of management failure include loss of biodiversity, ecological goods, and ecosystem services, we also identify actions that could improve decision-making and management outcomes. These actions include drawing insights from management of individual threats, using threat attributes (e.g., causes and spatio-temporal dynamics) to identify suitable management approaches, testing management strategies that are likely to be successful despite uncertainties about the nature of interactions among threats, avoiding unintended consequences, and maximizing conservation benefits. We also acknowledge the broadly applicable challenges of decision-making within a socio-political and economic framework, and suggest that multidisciplinary teams will be needed to innovate solutions to meet the current and future challenge of interacting threats in freshwater ecosystems. 

Evaluation of carbon nanotube probes in critical dimension atomic force microscopes.

PubMed

Choi, Jinho; Park, Byong Chon; Ahn, Sang Jung; Kim, Dal-Hyun; Lyou, Joon; Dixson, Ronald G; Orji, Ndubuisi G; Fu, Joseph; Vorburger, Theodore V

2016-07-01

The decreasing size of semiconductor features and the increasing structural complexity of advanced devices have placed continuously greater demands on manufacturing metrology, arising both from the measurement challenges of smaller feature sizes and the growing requirement to characterize structures in more than just a single critical dimension. For scanning electron microscopy, this has resulted in increasing sophistication of imaging models. For critical dimension atomic force microscopes (CD-AFMs), this has resulted in the need for smaller and more complex tips. Carbon nanotube (CNT) tips have thus been the focus of much interest and effort by a number of researchers. However, there have been significant issues surrounding both the manufacture and use of CNT tips. Specifically, the growth or attachment of CNTs to AFM cantilevers has been a challenge to the fabrication of CNT tips, and the flexibility and resultant bending artifacts have presented challenges to using CNT tips. The Korea Research Institute for Standards and Science (KRISS) has invested considerable effort in the controlled fabrication of CNT tips and is collaborating with the National Institute of Standards and Technology on the application of CNT tips for CD-AFM. Progress by KRISS on the precise control of CNT orientation, length, and end modification, using manipulation and focused ion beam processes, has allowed us to implement ball-capped CNT tips and bent CNT tips for CD-AFM. Using two different generations of CD-AFM instruments, we have evaluated these tip types by imaging a line/space grating and a programmed line edge roughness specimen. We concluded that these CNTs are capable of scanning the profiles of these structures, including re-entrant sidewalls, but there remain important challenges to address. These challenges include tighter control of tip geometry and careful optimization of scan parameters and algorithms for using CNT tips.

Collaboration and communication in colorectal cancer care: a qualitative study of the challenges experienced by patients and health care professionals

PubMed Central

Kamradt, Martina; Baudendistel, Ines; Längst, Gerda; Kiel, Marion; Eckrich, Felicitas; Winkler, Eva; Szecsenyi, Joachim; Ose, Dominik

2015-01-01

Background. Colorectal cancer is becoming a chronic condition. This has significant implications for the delivery of health care and implies the involvement of a range of health care professionals (HCPs) from different settings to ensure the needed quality and continuity of care. Objectives. To explore the challenges that patients and HCPs experience in the course of colorectal cancer care and the perceived consequences caused by these challenges. Methods. Ten semi-structured focus groups were conducted including patients receiving treatment for colorectal cancer, representatives of patient support groups, physicians and other non-physician HCPs from different health care settings. Participants were asked to share their experiences regarding colorectal cancer care. All data were audio- and videotaped, transcribed verbatim and thematically analysed using qualitative content analysis. Results. Patients and HCPs (total N = 47) experienced collaboration and communication as well as exchange of information between HCPs as challenging. Particularly communication and information exchange with GPs appeared to be lacking. The difficulties identified restricted a well-working coordination of care and seemed to cause inappropriate health care. Conclusion. Colorectal cancer care seems to require an effective, well-working collaboration and communication between the different HCPs involved ensuring the best possible care to suit patients’ individual needs. However, the perceived challenges and consequences of our participants seem to restrict the delivery of the needed quality of care. Therefore, it seems crucial (i) to include all HCPs involved, especially the GP, (ii) to support an efficient and standardized exchange of health-related information and (iii) to focus on the patients’ entire pathway of care. PMID:26311705

Genome Editing of the Blood: Opportunities and Challenges

PubMed Central

Porteus, Matthew H.

2015-01-01

The ability to remove blood cells, including hematopoietic stem cells (HSCs), from a person and then re-transplant them (hematopoietic stem cell transplantation (HSCT) is a well-established treatment paradigm that can be used in both the autologous setting or in the allogeneic setting. Using allogeneic HSCT can cure different genetic diseases of the blood but has significant limitations. An alternative to allogeneic HSCT is to transplant genetically modified HSCs instead. A powerful approach to the precision modification of HSCs is to use genome editing whereby the genome is modified with spatial precision (at an exact location) in the genome and sometimes with nucleotide precision (the exact nucleotide changes are introduced). The progress and challenges of genome editing of blood are discussed. PMID:26029496

Challenges, health implications, and advocacy opportunities for lesbian, gay, bisexual, and transgender global health providers.

PubMed

Nagata, Jason M

2017-01-01

In this commentary, I reflect on challenges with conducting global health research internationally as a lesbian, gay, bisexual, and transgender (LGBT) person, grapple with decisions related to coming out in regions with anti-LGBT laws, and outline the risks and benefits of different advocacy options related to the promotion of LGBT health globally. Despite significant advances in LGBT rights in many countries, homosexuality remains illegal in many others. Using a critical medical anthropology framework, I argue that anti-LGBT laws constitute structural violence and have many detrimental consequences including discrimination and violence; poorer mental and physical health outcomes; and risky sexual behaviors. As a global health provider, there are many options for the promotion of LGBT health worldwide.

Genetics of Nicotine Dependence and Pharmacotherapy

PubMed Central

Lessov-Schlaggar, Christina N.; Pergadia, Michele L.; Khroyan, Taline V.; Swan, Gary E.

2008-01-01

Nicotine dependence is substantially heritable. Several regions across the genome have been implicated in containing genes that confer liability to nicotine dependence and variation in individual genes has been associated with nicotine dependence. Smoking cessation measures are also heritable, and measured genetic variation is associated with nicotine dependence treatment efficacy. Despite significant strides in the understanding of the relative contribution of genetic and environmental factors to nicotine dependence and treatment, emergent challenges necessitate interdisciplinary coordinated effort for effective problem solving. These challenges include refinement of the nicotine dependence phenotype, better understanding of the dynamic interplay between genes and environment in nicotine dependence etiology, application and development of molecular and statistical methodology that can adequately address vast amounts of data, and continuous translational cross-talk. PMID:17888884

Molecular neuroanatomy: a generation of progress.

PubMed

Pollock, Jonathan D; Wu, Da-Yu; Satterlee, John S

2014-02-01

The neuroscience research landscape has changed dramatically over the past decade. Specifically, an impressive array of new tools and technologies have been generated, including but not limited to: brain gene expression atlases, genetically encoded proteins to monitor and manipulate neuronal activity, and new methods for imaging and mapping circuits. However, despite these technological advances, several significant challenges must be overcome to enable a better understanding of brain function and to develop cell type-targeted therapeutics to treat brain disorders. This review provides an overview of some of the tools and technologies currently being used to advance the field of molecular neuroanatomy, and also discusses emerging technologies that may enable neuroscientists to address these crucial scientific challenges over the coming decade. Published by Elsevier Ltd.

Remote Magnetic Navigation for Catheter Ablation in Patients With Congenital Heart Disease: A Review.

PubMed

Roy, Karine; Gomez-Pulido, Federico; Ernst, Sabine

2016-03-01

In patients with congenital heart disease, challenges to catheter-based arrhythmia interventions are unique and numerous given the complexity of the underlying defects, anatomic and surgical intervention variants including baffles, conduits, patches, and/or shunts. Remote magnetic navigation offers significant advantages in these cases that may present with limited vascular access or difficult access to the target cardiac chambers implicated by the previous surgical interventions. We reviewed the data available on the safety, feasibility, and effectiveness of magnetic navigation for the treatment of arrhythmia in congenital heart disease and discussed the specific challenges related to various congenital defects and repair with the potential advantages offered by magnetic navigation in these circumstances. © 2016 Wiley Periodicals, Inc.

The new dropout challenge: bridging gaps among students, parents, and teachers.

PubMed

Bridgeland, John M

2010-01-01

Interview and survey data reveal significant disconnects among the insights and perspectives of dropouts, parents, teachers, and administrators on the causes and solutions to the dropout challenge. Many educators, for example, do not see boredom as a factor for most dropouts, while young people who drop out see it as the central cause. The author argues that if these disconnects are not more fully understood and bridged, they will continue to set back efforts to keep more students in school and on track to graduate ready for postsecondary education. Models for how communities can engage these constituencies in productive dialogue and transformative action are included in reports and in Grad Nation, a guidebook that helps communities tackle their dropout crises.

Kidney transplantation in the elderly.

PubMed

Singh, Neeraj; Nori, Uday; Pesavento, Todd

2009-08-01

Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients. A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate. Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.

Diagnostic and surgical challenge: middle ear dermoid cyst in 12 month old with branchio-oto-renal syndrome and multiple middle-ear congenital anomalies.

PubMed

Johnston, D R; Whittemore, K; Poe, D; Robson, C D; Perez-Atayde, A R

2011-10-01

Described is the first case report, to our knowledge, of a middle-ear dermoid in a child with branchio-oto-renal (BOR) syndrome. Radiographic, pathologic, and intraoperative figures are shown. This was a diagnostic and surgical challenge as the presentation was similar to a congenital cholesteatoma and the child had numerous significant temporal bone abnormalities. After the intraoperative findings suggested a non-destructive process, the treatment strategy was altered. This case reiterates the need for a cautious, flexible operative approach in a syndromic child. Included is a relevant review of the literature and a detailed clinical analysis. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

DREAM: Distributed Resources for the Earth System Grid Federation (ESGF) Advanced Management

NASA Astrophysics Data System (ADS)

Williams, D. N.

2015-12-01

The data associated with climate research is often generated, accessed, stored, and analyzed on a mix of unique platforms. The volume, variety, velocity, and veracity of this data creates unique challenges as climate research attempts to move beyond stand-alone platforms to a system that truly integrates dispersed resources. Today, sharing data across multiple facilities is often a challenge due to the large variance in supporting infrastructures. This results in data being accessed and downloaded many times, which requires significant amounts of resources, places a heavy analytic development burden on the end users, and mismanaged resources. Working across U.S. federal agencies, international agencies, and multiple worldwide data centers, and spanning seven international network organizations, the Earth System Grid Federation (ESGF) has begun to solve this problem. Its architecture employs a system of geographically distributed peer nodes that are independently administered yet united by common federation protocols and application programming interfaces. However, significant challenges remain, including workflow provenance, modular and flexible deployment, scalability of a diverse set of computational resources, and more. Expanding on the existing ESGF, the Distributed Resources for the Earth System Grid Federation Advanced Management (DREAM) will ensure that the access, storage, movement, and analysis of the large quantities of data that are processed and produced by diverse science projects can be dynamically distributed with proper resource management. This system will enable data from an infinite number of diverse sources to be organized and accessed from anywhere on any device (including mobile platforms). The approach offers a powerful roadmap for the creation and integration of a unified knowledge base of an entire ecosystem, including its many geophysical, geographical, social, political, agricultural, energy, transportation, and cyber aspects. The resulting aggregation of data combined with analytics services has the potential to generate an informational universe and knowledge system of unprecedented size and value to the scientific community, downstream applications, decision makers, and the public.

Mainstreaming Climate Change: Recent and Ongoing Efforts to Understand, Improve, and Expand Consideration of Climate Change in Federal Water Resources Planning

NASA Astrophysics Data System (ADS)

Ferguson, I. M.; McGuire, M.; Broman, D.; Gangopadhyay, S.

2017-12-01

The Bureau of Reclamation is a Federal agency tasked with developing and managing water supply and hydropower projects in the Western U.S. Climate and hydrologic variability and change significantly impact management actions and outcomes across Reclamation's programs and initiatives, including water resource planning and operations, infrastructure design and maintenance, hydropower generation, and ecosystem restoration, among others. Planning, design, and implementation of these programs therefore requires consideration of future climate and hydrologic conditions will impact program objectives. Over the past decade, Reclamation and other Federal agencies have adopted new guidelines, directives, and mandates that require consideration of climate change in water resources planning and decision making. Meanwhile, the scientific community has developed a large number of climate projections, along with an array of models, methods, and tools to facilitate consideration of climate projections in planning and decision making. However, water resources engineers, planners, and decision makers continue to face challenges regarding how best to use the available data and tools to support major decisions, including decisions regarding infrastructure investments and long-term operating criteria. This presentation will discuss recent and ongoing research towards understanding, improving, and expanding consideration of climate projections and related uncertainties in Federal water resources planning and decision making. These research efforts address a variety of challenges, including: How to choose between available climate projection datasets and related methods, models, and tools—many of which are considered experimental or research tools? How to select an appropriate decision framework when design or operating alternatives may differ between climate scenarios? How to effectively communicate results of a climate impacts analysis to decision makers? And, how to improve robustness and resilience of water resources systems in the face of significant uncertainty? Discussion will focus on the intersection between technical challenges and decision making paradigms and the need for improved scientist-decision maker engagement through the lens of this Federal water management agency.

Comparative Effectiveness of Minimally Invasive Surgery and Conventional Approaches to Major or Challenging Hepatectomy

PubMed Central

Thornblade, Lucas W; Shi, Xu; Ruiz, Alex; Flum, David R; Park, James O

2017-01-01

Background The benefits of minimally invasive surgery (MIS) for low-risk or minor liver resection are well established. There is growing interest in MIS for major hepatectomy (MH) and other challenging resections, but there remain unanswered questions of safety that prevent broad adoption of this technique. Study Design Retrospective cohort study of patients undergoing hepatectomy at 65 hospitals participating in the NSQIP Hepatopancreatobiliary Collaborative in 2014. We assessed serious morbidity or mortality (SMM, including organ-space infection and organ failure). Secondary outcomes included transfusion, bile leak, liver failure, reoperation or intervention, and 30-day readmission. We also measured factors considered to make resection more challenging (large tumors, cirrhosis, ≥3 concurrent resections, prior neoadjuvant chemotherapy, or morbid obesity). Results 2819 patients underwent hepatectomy (age 58±14 years, 53% female; 25% MIS). After adjusting for clinical and operative factors, the odds of SMM (OR=0.57, 95%CI: 0.34–0.96, p=0.03) and reoperation or intervention (OR=0.52 (0.29–0.93), p=0.03) were significantly lower for patients undergoing MIS compared with open. In the MH group (n=1,015; 13% MIS), there was no difference in the odds of SMM after MIS (OR=0.37, (0.13–1.11), p=0.08) however MIS MH met criteria for non-inferiority. There were no differences in liver-specific complications or readmission between the groups. Odds of SMM were significantly lower following MIS among patients who had received neoadjuvant chemotherapy (OR 0.33 (0.15–0.70), p=0.004). Conclusion In this large study of minimally invasive major hepatectomy, we demonstrate safety outcomes that are equivalent or superior to conventional open surgery. While the decision to offer MIS may be influenced by factors not included in this evaluation, (e.g. surgeon experience and other patient factors), these findings support its current use in major hepatectomies. PMID:28163089

The effects of central pro-and anti-inflammatory immune challenges on depressive-like behavior induced by chronic forced swim stress in rats.

PubMed

Pan, Yuqin; Lin, Wenjuan; Wang, Weiwen; Qi, Xiaoli; Wang, Donglin; Tang, Mingming

2013-06-15

Although increasing evidence demonstrates that both chronic stressors and inflammatory immune activation contribute to pathophysiology and behavioral alterations associated with major depression, little is known about the interaction effect of central inflammatory immune activation and stress on depressive-like behavior. Our previous work has shown that 14-day chronic forced swim stress induces significant depressive-like behavior. The present investigation assessed whether pro-inflammatory cytokine and anti-inflammatory cytokine challenges have differential interaction effect on depressive-like behavior induced by chronic forced swim stress in rats. The pro-inflammatory and anti-inflammatory immune challenges were achieved respectively by central administration of lipopolysaccharide (LPS), a pro-inflammatory cytokine inducer, and interleukin-10 (IL-10), an anti-inflammatory cytokine. It was found that either central LPS treatment alone or chronic forced swim stress alone significantly induced depressive-like behavior, including reduced body weight gain, reduced saccharin preference and reduced locomotor activity. However, there was no significant synergistic or additive effect of central LPS treatment and stress on depressive-like behavior. LPS treatment did not exacerbate the depressive-like behavior induced by forced swim stress. Nevertheless, IL-10 reversed depressive-like behavior induced by forced swim stress, a finding indicating that IL-10 has antidepressant effect on behavioral depression induced by stress. The present findings provide new insight into the complexity of the immunity-inflammation hypothesis of depression. Copyright © 2013 Elsevier B.V. All rights reserved.

Vaccination as a potential means to prevent plague in black-footed ferrets: Progress and continuing challenges

USGS Publications Warehouse

Rocke, Tonie E.; Nol, Pauline; Marinari, Paul E.; Kreeger, J.S.; Smith, Susan R.; Andrews, G.P.; Friedlander, A.W.

2006-01-01

This study was conducted to further assess the feasibility of vaccinating black-footed ferrets (Mustela nigripes) against plague (caused by the bacterium Yersinia pestis). On days 0 and 28, 17 postreproductive ferrets were immunized by subcutaneous injection with a recombinant fusion protein containing F1 and V antigens from Y. pestis. Another 17 animals received a placebo by the same route. Two weeks after the second immunization, mean antibody titers to Y. pestis F1 and V antigens were measured and found to be significantly higher in vaccinates than their preimmunization values (P < 0.0001) and significantly higher than the control values (P < 0.0001). Six months postimmunization, 16 vaccinates and eight controls were challenged with approximately 8,000 colony forming units of virulent plague by subcutaneous inoculation. Eleven of 16 vaccinates (69 percent) survived with no ill effects whereas all eight control animals died within 3a??6 days. Two months later, the 11 surviving vaccinates were challenged again by ingestion of a plague-infected mouse. None of the animals showed any ill effects and all survived. In contrast, seven control ferrets fed infected mice died within 2a??4 days, including one animal that did not actually ingest the mouse but was likely exposed to it. This study demonstrates that immunization of ferrets with the recombinant F1-V fusion protein can induce significant antibody responses and reduce their susceptibility to plague infection.

Challenges faced by multidisplinary new investigators on addressing grand challenges in global health

PubMed Central

2014-01-01

Background The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an ‘Integrated Innovation™’ approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the ‘Rising Stars in Global Health’ award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Discussion Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors’ visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Conclusions Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators. We propose a more balanced way forward that can harness technology to foster mentorship across time and space to support the development of such skills and ideas among new investigators. PMID:24735677

Nurses in the workplace: expectations and needs.

PubMed

DeCola, P R; Riggins, P

2010-09-01

It is important to understand nurses' attitudes toward their work environment. Prior studies in this area have been conducted. The interest was to identify a relative assessment of workplace challenges by studying nurses within developed and developing economies. A representative survey of 2203 nurses in 11 countries was conducted via a structured survey. Data from open-ended questions were content analysed and grouped thematically. The overall margin of error is +/-2.1% and +/-6.9% for country level results. Key findings included that 92% of nurses say they face time constraints and 96% say that spending more time with individual patients would have a significant impact on patient health. Forty-six per cent of nurses say their workload is worse today than it was 5 years ago. While only 53% of nurses say it is very likely they will be practising nursing in 5 years, national differences existed. Statistically significant parameters influencing the likelihood to stay in nursing included having greater independence and control over their practice area, sufficient staff, greater involvement in decisions impacting their work and patient care, and improved work-life balance. There is agreement across the surveyed countries regarding the existence of high workloads that are contributing to time constraints and the belief that patient outcomes are significantly impacted. These conditions contribute to nurses' lack of firm commitment to their profession. The systemic changes required to deliver quality health care to patients require these challenges to be addressed.

Early exposure to probiotics in a canine model of atopic dermatitis has long-term clinical and immunological effects.

PubMed

Marsella, Rosanna; Santoro, Domenico; Ahrens, Kim

2012-04-15

Probiotics modulate the immune response and may have protective effects against atopic dermatitis (AD). Clinical trials using dogs with spontaneous disease are limited by confounding factors such as different diets, environments and sensitizations while a more controlled evaluation is possible using experimental models. A validated model of canine AD showed that early exposure to Lactobacillus rhamnosus GG (LGG) significantly decreases allergen-specific IgE and partially prevents AD in the first 6 months of life. This study is a follow-up three years after discontinuation of LGG. Clinical signs were evaluated after allergen challenge with ragweed, timothy, Dermatophagoides farinae. Allergen-specific IgE, IL-10 and TGF-β were measured on the 1st day of challenge, before allergen exposure. Normal dogs were included as controls. Analyses included seven dogs in the non-probiotic and nine in the probiotic litter. For clinical scores, a 2-Group × 9-Time Analysis of Variance showed significant effects of group (p=0.0003, probiotic

Lactobacillus acidophilus alleviates the inflammatory response to enterotoxigenic Escherichia coli K88 via inhibition of the NF-κB and p38 mitogen-activated protein kinase signaling pathways in piglets.

PubMed

Li, Haihua; Zhang, Lei; Chen, Longbin; Zhu, Qi; Wang, Wenjie; Qiao, Jiayun

2016-11-10

A newly isolated L. acidophilus strain has been reported to have potential anti-inflammatory activities against lipopolysaccharide (LPS) challenge in piglet, while the details of the related inflammatory responses are limited. Here we aimed to analysis the ability of L. acidophilus to regulate inflammatory responses and to elucidate the mechanisms involved in its anti-inflammatory activity. The ETEC (enterotoxigenic Escherichia coli) K88-induced up-regulations of IL-1β, IL-8 and TNF-α were obviously inhibited by L. acidophilus while IL-10 was significantly increased. Moreover, L. acidophilus down-regulated pattern recognition receptors TLR (Toll-like receptor) 2 and TLR4 expression in both spleen and mesenteric lymph nodes of ETEC-challenged piglets, in accompanied with the reduced phosphorylation levels of nuclear factor kappa B (NF-κB) p65 and mitogen-activated protein kinase (MAPK) p38 as well in spleen of ETEC-infected piglets. Furthermore, L.acidophilus significantly increased the expression of the negative regulators of TLRs signaling, including Tollip, IRAK-M, A20 and Bcl-3 in spleen of ETEC-challenged piglets. Our findings suggested that L. acidophilus regulated inflammatory response to ETEC via impairing both NF-κB and MAPK signaling pathways in piglets.

Challenges to Computational Aerothermodynamic Simulation and Validation for Planetary Entry Vehicle Analysis

NASA Technical Reports Server (NTRS)

Gnoffo, Peter A.; Johnston, Christopher O.; Kleb, Bil

2010-01-01

Challenges to computational aerothermodynamic (CA) simulation and validation of hypersonic flow over planetary entry vehicles are discussed. Entry, descent, and landing (EDL) of high mass to Mars is a significant driver of new simulation requirements. These requirements include simulation of large deployable, flexible structures and interactions with reaction control system (RCS) and retro-thruster jets. Simulation of radiation and ablation coupled to the flow solver continues to be a high priority for planetary entry analyses, especially for return to Earth and outer planet missions. Three research areas addressing these challenges are emphasized. The first addresses the need to obtain accurate heating on unstructured tetrahedral grid systems to take advantage of flexibility in grid generation and grid adaptation. A multi-dimensional inviscid flux reconstruction algorithm is defined that is oriented with local flow topology as opposed to grid. The second addresses coupling of radiation and ablation to the hypersonic flow solver - flight- and ground-based data are used to provide limited validation of these multi-physics simulations. The third addresses the challenges of retro-propulsion simulation and the criticality of grid adaptation in this application. The evolution of CA to become a tool for innovation of EDL systems requires a successful resolution of these challenges.

Occupational asthma due to turpentine in art painter--case report.

PubMed

Dudek, Wojciech; Wittczak, Tomasz; Swierczyńska-Machura, Dominika; Walusiak-Skorupa, Jolanta; Pałczyński, Cezary

2009-01-01

Turpentine is a fluid obtained by distillation of wood resins containing mixture of terpens. It can act as an irritant and sensitiser. Most common health problem among workers exposed to turpentine is contact dermatitis. Little is know about turpentine to cause type I hypersensitivity reaction. We present a case of a 27-year old art painter using turpentine as a thinner for oil-based paints. She developed asthmatic reactions after 5 years of working with turpentine. A number of clinical procedures were performed, including clinical examination, routine laboratory tests, total serum IgE, skin prick tests to common aeroallergens, metal salts, oil-based paints and balsamic turpentine, resting spirometry test, histamine challenge, and a single-blind, placebo-controlled specific inhalation challenge with balsamic turpentine. Clinical findings and laboratory test results were normal but a significant bronchial hyperreactivity was found. During the specific challenge, dyspnoea and decreased forced expiratory volume (FEV1) were observed in late phase of asthmatic reaction. An increased proportion of eosinophils in induced sputum could also be noted 24 h after the challenge. Positive clinical response to the specific challenge as well as the morphological changes found in induced sputum served as the basis for diagnosing occupational asthma. To our knowledge, this is the first well-documented case of turpentine-induced occupational asthma.

Potential of insulin nanoparticle formulations for oral delivery and diabetes treatment.

PubMed

Wong, Chun Y; Al-Salami, Hani; Dass, Crispin R

2017-10-28

Nanoparticles have demonstrated significant advancements in potential oral delivery of insulin. In this publication, we review the current status of polymeric, inorganic and solid-lipid nanoparticles designed for oral administration of insulin. Firstly, the structure and physiological function of insulin are examined. Then, the efficiency and shortcomings of insulin nanoparticle are discussed. These include the susceptibility to digestive enzyme degradation, instability in the acidic pH environment, poor mucus diffusion and inadequate permeation through the gastrointestinal epithelium. In order to optimise the nanocarriers, the following considerations, including polymer nature, surface charge, size, polydispersity index and morphology of nanoparticles, have to be taken into account. Some novel designs such as chitosan-based glucose-responsive nanoparticles, layer by layer technique-based nanoparticles and zwitterion nanoparticles are being adopted to overcome the physiological challenges. The review ends with some future directions and challenges to be addressed for the success of oral delivery of insulin-loaded nanoparticle formulation. Copyright © 2017 Elsevier B.V. All rights reserved.

Li- and Mn-Rich Cathode Materials: Challenges to Commercialization

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

Zheng, Jianming; Myeong, Seungjun; Cho, Woongrae

2016-12-14

The lithium- and manganese-rich (LMR) layered structure cathode exhibit one of the highest specific energy (~900 Wh kg-1) among all the cathode materials. However, the practical applications of LMR cathodes are still hindered by several significant challenges including voltage fade, large initial capacity loss, poor rate capability and limited cycle life. Herein, we review the recent progresses and understandings on the application of LMR cathode materials from practical point of view. Several key parameters of LMR cathodes that affect the LMR/graphite full cell operation are systematically analysed. These factors include the first cycle capacity loss, voltage fade, powder tap density,more » electrode density of LMR based cathode etc. New approaches to minimize the detrimental effect of these factors are highlighted in this work. We also provided the perspectives for the future research on LMR cathode materials, focusing on addressing the fundamental problems of LMR cathodes while always keeping practical considerations in mind.« less

Exposing the Backstage: Critical Reflections on a Longitudinal Qualitative Study of Residents’ Care Networks in Assisted Living

PubMed Central

Kemp, Candace L.; Ball, Mary M.; Morgan, Jennifer Craft; Doyle, Patrick J.; Burgess, Elisabeth O.; Dillard, Joy A.; Barmon, Christina E.; Fitzroy, Andrea F.; Helmly, Victoria E.; Avent, Elizabeth S.; Perkins, Molly M.

2018-01-01

In this article, we analyze the research experiences associated with a longitudinal qualitative study of residents’ care networks in assisted living. Using data from researcher meetings, field notes, and memos, we critically examine our design and decision making and accompanying methodological implications. We focus on one complete wave of data collection involving 28 residents and 114 care network members in four diverse settings followed for 2 years. We identify study features that make our research innovative, but that also represent significant challenges. They include the focus and topic; settings and participants; scope and design complexity; nature, modes, frequency, and duration of data collection; and analytic approach. Each feature has methodological implications, including benefits and challenges pertaining to recruitment, retention, data collection, quality, and management, research team work, researcher roles, ethics, and dissemination. Our analysis demonstrates the value of our approach and of reflecting on and sharing methodological processes for cumulative knowledge building. PMID:27651072

Immunology of Bats and Their Viruses: Challenges and Opportunities

PubMed Central

Schountz, Tony

2014-01-01

Bats are reservoir hosts of several high-impact viruses that cause significant human diseases, including Nipah virus, Marburg virus and rabies virus. They also harbor many other viruses that are thought to have caused disease in humans after spillover into intermediate hosts, including SARS and MERS coronaviruses. As is usual with reservoir hosts, these viruses apparently cause little or no pathology in bats. Despite the importance of bats as reservoir hosts of zoonotic and potentially zoonotic agents, virtually nothing is known about the host/virus relationships; principally because few colonies of bats are available for experimental infections, a lack of reagents, methods and expertise for studying bat antiviral responses and immunology, and the difficulty of conducting meaningful field work. These challenges can be addressed, in part, with new technologies that are species-independent that can provide insight into the interactions of bats and viruses, which should clarify how the viruses persist in nature, and what risk factors might facilitate transmission to humans and livestock. PMID:25494448

'Growing Old' in Shelters and 'On the Street': Experiences of Older Homeless People.

PubMed

Grenier, Amanda; Sussman, Tamara; Barken, Rachel; Bourgeois-Guérin, Valerie; Rothwell, David

2016-01-01

Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.

Immunology of bats and their viruses: challenges and opportunities.

PubMed

Schountz, Tony

2014-12-01

Bats are reservoir hosts of several high-impact viruses that cause significant human diseases, including Nipah virus, Marburg virus and rabies virus. They also harbor many other viruses that are thought to have caused disease in humans after spillover into intermediate hosts, including SARS and MERS coronaviruses. As is usual with reservoir hosts, these viruses apparently cause little or no pathology in bats. Despite the importance of bats as reservoir hosts of zoonotic and potentially zoonotic agents, virtually nothing is known about the host/virus relationships; principally because few colonies of bats are available for experimental infections, a lack of reagents, methods and expertise for studying bat antiviral responses and immunology, and the difficulty of conducting meaningful field work. These challenges can be addressed, in part, with new technologies that are species-independent that can provide insight into the interactions of bats and viruses, which should clarify how the viruses persist in nature, and what risk factors might facilitate transmission to humans and livestock.

Coming of Age on the Margins: Mental Health and Wellbeing Among Latino Immigrant Young Adults Eligible for Deferred Action for Childhood Arrivals (DACA).

PubMed

Siemons, Rachel; Raymond-Flesch, Marissa; Auerswald, Colette L; Brindis, Claire D

2017-06-01

Undocumented immigrant young adults growing up in the United States face significant challenges. For those qualified, the Deferred Action for Childhood Arrivals (DACA) program's protections may alleviate stressors, with implications for their mental health and wellbeing (MHWB). We conducted nine focus groups with 61 DACA-eligible Latinos (ages 18-31) in California to investigate their health needs. Participants reported MHWB as their greatest health concern and viewed DACA as beneficial through increasing access to opportunities and promoting belonging and peer support. Participants found that DACA also introduced unanticipated challenges, including greater adult responsibilities and a new precarious identity. Thus, immigration policies such as DACA may influence undocumented young adults' MHWB in expected and unexpected ways. Research into the impacts of policy changes on young immigrants' MHWB can guide stakeholders to better address this population's health needs. MHWB implications include the need to reduce fear of deportation and increase access to services.

Exposing the Backstage: Critical Reflections on a Longitudinal Qualitative Study of Residents' Care Networks in Assisted Living.

PubMed

Kemp, Candace L; Ball, Mary M; Morgan, Jennifer Craft; Doyle, Patrick J; Burgess, Elisabeth O; Dillard, Joy A; Barmon, Christina E; Fitzroy, Andrea F; Helmly, Victoria E; Avent, Elizabeth S; Perkins, Molly M

2017-07-01

In this article, we analyze the research experiences associated with a longitudinal qualitative study of residents' care networks in assisted living. Using data from researcher meetings, field notes, and memos, we critically examine our design and decision making and accompanying methodological implications. We focus on one complete wave of data collection involving 28 residents and 114 care network members in four diverse settings followed for 2 years. We identify study features that make our research innovative, but that also represent significant challenges. They include the focus and topic; settings and participants; scope and design complexity; nature, modes, frequency, and duration of data collection; and analytic approach. Each feature has methodological implications, including benefits and challenges pertaining to recruitment, retention, data collection, quality, and management, research team work, researcher roles, ethics, and dissemination. Our analysis demonstrates the value of our approach and of reflecting on and sharing methodological processes for cumulative knowledge building.

Demographic aspects of climate change mitigation and adaptation.

PubMed

Lutz, Wolfgang; Striessnig, Erich

2015-01-01

This paper addresses the contribution of changes in population size and structures to greenhouse gas emissions and to the capacity to adapt to climate change. The paper goes beyond the conventional focus on the changing composition by age and sex. It does so by addressing explicitly the changing composition of the population by level of educational attainment, taking into account new evidence about the effect of educational attainment in reducing significantly the vulnerability of populations to climatic challenges. This evidence, which has inspired a new generation of socio-economic climate change scenarios, is summarized. While the earlier IPCC-SRES (Intergovernmental Panel on Climate Change-Special Report on Emissions Scenarios) scenarios only included alternative trajectories for total population size (treating population essentially as a scaling parameter), the Shared Socio-economic Pathways (SSPs) in the new scenarios were designed to capture the socio-economic challenges to climate change mitigation and adaptation, and include full age, sex, and education details for all countries.

Enabling large-scale next-generation sequence assembly with Blacklight

PubMed Central

Couger, M. Brian; Pipes, Lenore; Squina, Fabio; Prade, Rolf; Siepel, Adam; Palermo, Robert; Katze, Michael G.; Mason, Christopher E.; Blood, Philip D.

2014-01-01

Summary A variety of extremely challenging biological sequence analyses were conducted on the XSEDE large shared memory resource Blacklight, using current bioinformatics tools and encompassing a wide range of scientific applications. These include genomic sequence assembly, very large metagenomic sequence assembly, transcriptome assembly, and sequencing error correction. The data sets used in these analyses included uncategorized fungal species, reference microbial data, very large soil and human gut microbiome sequence data, and primate transcriptomes, composed of both short-read and long-read sequence data. A new parallel command execution program was developed on the Blacklight resource to handle some of these analyses. These results, initially reported previously at XSEDE13 and expanded here, represent significant advances for their respective scientific communities. The breadth and depth of the results achieved demonstrate the ease of use, versatility, and unique capabilities of the Blacklight XSEDE resource for scientific analysis of genomic and transcriptomic sequence data, and the power of these resources, together with XSEDE support, in meeting the most challenging scientific problems. PMID:25294974

Stresses and Challenges for New Graduates in Hospitals.

ERIC Educational Resources Information Center

Oermann, Marilyn H.; Garvin, Michael F.

2002-01-01

Recent nursing graduates (n=46) rated stresses and challenges in clinical practice. Stressors included not feeling competent/confident, making mistakes due to increased workload, and encountering new situations. Challenges included applying knowledge to practice and acquiring new skills. Most emotions were positive but anxiety was frequent. Ways…

Rethinking voluntary euthanasia.

PubMed

Stoyles, Byron J; Costreie, Sorin

2013-12-01

Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient's care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails to reflect what is important from the patient's perspective and (2) fails to reflect the significance of health care providers' interests, including their autonomy and integrity.

Matching phenotypes to whole genomes: Lessons learned from four iterations of the personal genome project community challenges.

PubMed

Cai, Binghuang; Li, Biao; Kiga, Nikki; Thusberg, Janita; Bergquist, Timothy; Chen, Yun-Ching; Niknafs, Noushin; Carter, Hannah; Tokheim, Collin; Beleva-Guthrie, Violeta; Douville, Christopher; Bhattacharya, Rohit; Yeo, Hui Ting Grace; Fan, Jean; Sengupta, Sohini; Kim, Dewey; Cline, Melissa; Turner, Tychele; Diekhans, Mark; Zaucha, Jan; Pal, Lipika R; Cao, Chen; Yu, Chen-Hsin; Yin, Yizhou; Carraro, Marco; Giollo, Manuel; Ferrari, Carlo; Leonardi, Emanuela; Tosatto, Silvio C E; Bobe, Jason; Ball, Madeleine; Hoskins, Roger A; Repo, Susanna; Church, George; Brenner, Steven E; Moult, John; Gough, Julian; Stanke, Mario; Karchin, Rachel; Mooney, Sean D

2017-09-01

The advent of next-generation sequencing has dramatically decreased the cost for whole-genome sequencing and increased the viability for its application in research and clinical care. The Personal Genome Project (PGP) provides unrestricted access to genomes of individuals and their associated phenotypes. This resource enabled the Critical Assessment of Genome Interpretation (CAGI) to create a community challenge to assess the bioinformatics community's ability to predict traits from whole genomes. In the CAGI PGP challenge, researchers were asked to predict whether an individual had a particular trait or profile based on their whole genome. Several approaches were used to assess submissions, including ROC AUC (area under receiver operating characteristic curve), probability rankings, the number of correct predictions, and statistical significance simulations. Overall, we found that prediction of individual traits is difficult, relying on a strong knowledge of trait frequency within the general population, whereas matching genomes to trait profiles relies heavily upon a small number of common traits including ancestry, blood type, and eye color. When a rare genetic disorder is present, profiles can be matched when one or more pathogenic variants are identified. Prediction accuracy has improved substantially over the last 6 years due to improved methodology and a better understanding of features. © 2017 Wiley Periodicals, Inc.

The Challenge of Efflux-Mediated Antibiotic Resistance in Gram-Negative Bacteria

PubMed Central

Plésiat, Patrick

2015-01-01

SUMMARY The global emergence of multidrug-resistant Gram-negative bacteria is a growing threat to antibiotic therapy. The chromosomally encoded drug efflux mechanisms that are ubiquitous in these bacteria greatly contribute to antibiotic resistance and present a major challenge for antibiotic development. Multidrug pumps, particularly those represented by the clinically relevant AcrAB-TolC and Mex pumps of the resistance-nodulation-division (RND) superfamily, not only mediate intrinsic and acquired multidrug resistance (MDR) but also are involved in other functions, including the bacterial stress response and pathogenicity. Additionally, efflux pumps interact synergistically with other resistance mechanisms (e.g., with the outer membrane permeability barrier) to increase resistance levels. Since the discovery of RND pumps in the early 1990s, remarkable scientific and technological advances have allowed for an in-depth understanding of the structural and biochemical basis, substrate profiles, molecular regulation, and inhibition of MDR pumps. However, the development of clinically useful efflux pump inhibitors and/or new antibiotics that can bypass pump effects continues to be a challenge. Plasmid-borne efflux pump genes (including those for RND pumps) have increasingly been identified. This article highlights the recent progress obtained for organisms of clinical significance, together with methodological considerations for the characterization of MDR pumps. PMID:25788514

Fathering after military deployment: parenting challenges and goals of fathers of young children.

PubMed

Walsh, Tova B; Dayton, Carolyn J; Erwin, Michael S; Muzik, Maria; Busuito, Alexandra; Rosenblum, Katherine L

2014-02-01

Although often eagerly anticipated, reunification after deployment poses challenges for families, including adjusting to the parent-soldier's return, re-establishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological effects. Fourteen male service members, previously deployed to a combat zone, parent to at least one child under seven years of age, were interviewed about their relationships with their young children. Principles of grounded theory guided data analysis to identify key themes related to parenting young children after deployment. Participants reported significant levels of parenting stress and identified specific challenges, including difficulty reconnecting with children, adapting expectations from military to family life, and coparenting. Fathers acknowledged regret about missing an important period in their child's development and indicated a strong desire to improve their parenting skills. They described a need for support in expressing emotions, nurturing, and managing their tempers. Results affirm the need for support to military families during reintegration and demonstrate that military fathers are receptive to opportunities to engage in parenting interventions. Helping fathers understand their children's behavior in the context of age-typical responses to separation and reunion may help them to renew parent-child relationships and reengage in optimal parenting of their young children.

NCCN Oncology Risk Evaluation and Mitigation Strategies White Paper: Recommendations for Stakeholders.

PubMed

Johnson, Philip E; Dahlman, George; Eng, Kirby; Garg, Rekha; Gottlieb, Scott; Hoffman, James M; Howell, Peyton; Jahanzeb, Mohammad; Johnson, Shirley; Mackler, Emily; Rubino, Mark; Sarokhan, Brenda; Marc Stewart, F; Tyler, Tim; Vose, Julie M; Weinstein, Sharon; Li, Edward C; Demartino, Jessica

2010-09-01

REMS are a particularly important issue for oncology and the National Comprehensive Cancer Network (NCCN). A disproportionate number of drugs with complex REMS are used in patients with cancer or hematologic disorders. REMS policies and processes within oncology may act as a model for other clinical areas. A breadth of experience and access to a wide knowledge base exists within oncology that will ensure appropriate development and consideration of the practical implications of REMS. NCCN is uniquely positioned to assume a leadership role in this process given its status as the arbiter of high-quality cancer care based on its world-leading institutions and clinicians. Notwithstanding the potential benefits, the successful design, implementation, and analysis of the FDA's recent requirement for REMS for some high-risk drugs and biologics will present significant challenges for stakeholders, including patients, providers, cancer centers, manufacturers, payors, health information technology vendors, and regulatory agencies. To provide guidance to these stakeholders regarding REMS challenges, the NCCN assembled a work group comprised of thought leaders from NCCN Member Institutions and other outside experts. The Work Group identified challenges across the REMS spectrum, including the areas of standardization, development and assessment of REMS programs, medication guides, provider knowledge and impact on prescribing, provider burden and compensation, and incorporation of REMS into clinical practice.

Coarse Grained Model for Biological Simulations: Recent Refinements and Validation

PubMed Central

Vicatos, Spyridon; Rychkova, Anna; Mukherjee, Shayantani; Warshel, Arieh

2014-01-01

Exploring the free energy landscape of proteins and modeling the corresponding functional aspects presents a major challenge for computer simulation approaches. This challenge is due to the complexity of the landscape and the enormous computer time needed for converging simulations. The use of various simplified coarse grained (CG) models offers an effective way of sampling the landscape, but most current models are not expected to give a reliable description of protein stability and functional aspects. The main problem is associated with insufficient focus on the electrostatic features of the model. In this respect our recent CG model offers significant advantage as it has been refined while focusing on its electrostatic free energy. Here we review the current state of our model, describing recent refinement, extensions and validation studies while focusing on demonstrating key applications. These include studies of protein stability, extending the model to include membranes and electrolytes and electrodes as well as studies of voltage activated proteins, protein insertion trough the translocon, the action of molecular motors and even the coupling of the stalled ribosome and the translocon. Our example illustrates the general potential of our approach in overcoming major challenges in studies of structure function correlation in proteins and large macromolecular complexes. PMID:25050439

Systems engingeering for the Kepler Mission : a search for terrestrial planets

NASA Technical Reports Server (NTRS)

Duren, Riley M.; Dragon, Karen; Gunter, Steve Z.; Gautier, Nick; Koch, Dave; Harvey, Adam; Enos, Alan; Borucki, Bill; Sobeck, Charlie; Mayer, Dave;

Peripheral erythrocytes decrease upon specific respiratory challenge with grass pollen allergen in sensitized mice and in human subjects.

PubMed

Jordakieva, Galateja; Wallmann, Julia; Schmutz, René; Lemell, Patrick; Wegmann, Michael; Nittke, Thomas; Mittlböck, Martina; Fehrenbach, Heinz; Godnic-Cvar, Jasminka; Zieglmayer, René; Jensen-Jarolim, Erika

2014-01-01

Specific hyper-responsiveness towards an allergen and non-specific airway hyperreactivity both impair quality of life in patients with respiratory allergic diseases. We aimed to investigate cellular responses following specific and non-specific airway challenges locally and systemically in i) sensitized BALB/c mice challenged with grass pollen allergen Phl p 5, and in ii) grass pollen sensitized allergic rhinitis subjects undergoing specific airway challenge in the Vienna Challenge Chamber (VCC). BALB/c mice (n = 20) were intraperitoneally immunized with grass pollen allergen Phl p 5 and afterwards aerosol challenged with either the specific allergen Phl p 5 (n = 10) or the non-specific antigen ovalbumin (OVA) (n = 10). A protocol for inducing allergic asthma as well as allergic rhinitis, according to the united airway concept, was used. Both groups of exposed mice showed significantly reduced physical activity after airway challenge. Specific airway challenge further resulted in goblet cell hyperplasia, enhanced mucous secretion, intrapulmonary leukocyte infiltration and lymphoid follicle formation, associated with significant expression of IL-4, IL-5 and IL-13 in splenocytes and also partially in lung tissue. Concerning circulating blood cell dynamics, we observed a significant drop of erythrocyte counts, hemoglobin and hematocrit levels in both mouse groups, challenged with allergen or OVA. A significant decrease in circulating erythrocytes and hematocrit levels after airway challenges with grass pollen allergen was also found in grass pollen sensitized human rhinitis subjects (n = 42) at the VCC. The effects on peripheral leukocyte counts in mice and humans however were opposed, possibly due to the different primary inflammation sites. Our data revealed that, besides significant leukocyte dynamics, particularly erythrocytes are involved in acute hypersensitivity reactions to respiratory allergens. A rapid recruitment of erythrocytes to the lungs to compensate for hypoxia is a possible explanation for these findings.

Women with epilepsy: clinically relevant issues

PubMed Central

Bangar, Santosh; Shastri, Abhishek; El-Sayeh, Hany; Cavanna, Andrea E.

2016-01-01

Summary Women with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population. PMID:27678205

Expressive communication of children with autism: the use of challenging behaviour.

PubMed

Chiang, Hsu-Min

2008-11-01

There is a lack of empirical research investigating challenging behaviour in children with autism with severe speech impairments in naturalistic settings. The aim of the present study was to investigate challenging behaviour among Australian and Taiwanese children with autism who are non-verbal or have limited speech (i.e. less than five functional words) in school settings and to address the following questions: (1) What are the communicative characteristics (e.g. communicative functions, partners, activities and partner's responses) of challenging behaviour? (2) Do sample characteristics (e.g. age, severity of autism, adaptive behaviour level, the use of graphic symbols, the use of non-symbolic acts, the use of speech) associate with the amount of challenging behaviour? (3) Do cultural differences exist in communicative variables of challenging behaviour? Naturalistic observations were used to investigate challenging behaviour in children with autism. A total of 32 (17 Australian and 15 Taiwanese) children with autism who were non-verbal or had limited speech participated in the current study and each participant was videotaped for 2 h during his/her everyday school routines. Sixteen out of 32 children had challenging behaviour. Challenging behaviour was used for requesting and rejecting communicative functions. A paired-samples t-test revealed that no significant differences existed in the frequency of occurrence between request and reject. Challenging behaviour was directed to adults and peers. A paired-samples t-test revealed that challenging behaviour was directed to adults significantly more frequently than to peers. Communicative partners showed different responses (e.g. deny, no response, delivered, removed, acknowledge) to challenging behaviour. A repeated-measures analysis of variance (ANOVA) revealed a main effect for partner response. Deny was the most common response. Challenging behaviour occurred across a variety of classroom activities (e.g. academic activities, morning circle, morning tea, lunch, free time). A repeated-measures ANOVA revealed a main effect for activity. Challenging behaviour occurred most often during academic activities. A set of correlation analyses indicated a significant correlation existed between the use of graphic symbols and the amount of challenging behaviour. A series of Mann-Whitney U-tests revealed significant differences between Australian and Taiwanese children on the amount of challenging behaviour, communicative functions and partners. A Chi-squared test revealed that there were significantly more Australian children with autism who displayed challenging behaviour than Taiwanese children. The current study shows that a high proportion of children with autism with severe speech impairments used challenging behaviour as a form of expressive communication in their school environments. The findings from the present study may have implications for practitioners who work with children with autism.

Efficacy of Antimicrobial Treatments and Vaccination Regimens for Control of Porcine Reproductive and Respiratory Syndrome Virus and Streptococcus suis Coinfection of Nursery Pigs

PubMed Central

Halbur, P.; Thanawongnuwech, R.; Brown, G.; Kinyon, J.; Roth, J.; Thacker, E.; Thacker, B.

2000-01-01

Seventy-six, crossbred, porcine reproductive and respiratory syndrome virus (PRRSV)-free pigs were weaned at 12 days of age and randomly assigned to seven groups of 10 to 11 pigs each. Pigs in group 1 served as unchallenged controls. Pigs in groups 2 to 7 were challenged intranasally with 2 ml of high-virulence PRRSV isolate VR-2385 (104.47 50% tissue culture infective doses per 2 ml) on day 0 of the study (30 days of age). Seven days after PRRSV challenge, pigs in groups 2 to 7 were challenged intranasally with 2 ml of Streptococcus suis serotype 2 (108.30 CFU/2 ml). Group 2 pigs served as untreated positive controls. Antimicrobial treatments included daily intramuscular injection with 66,000 IU of procaine penicillin G per kg of body weight on days 8 to 10 (group 3), drinking water medication with 23.1 mg of tiamulin per kg during days 8 to 10 (group 4), and daily intramuscular injection of 5.0 mg of ceftiofur hydrochloride per kg on days 8 to 10 (group 5). Vaccination regimens included two intramuscular doses of an autogenous killed S. suis vaccine (group 6) prior to S. suis challenge or a single 2-ml intramuscular dose of an attenuated live PRRSV vaccine (group 7) 2 weeks prior to PRRSV challenge. Mortality was 0, 63, 45, 54, 9, 40, and 81% in groups 1 to 7, respectively. Ceftiofur treatment was the only regimen that significantly (P < 0.05) reduced mortality associated with PRRSV and S. suis coinfection. The other treatments and vaccinations were less effective. We conclude that ceftiofur administered by injection for three consecutive days following S. suis challenge was the most effective regimen for minimizing disease associated with PRRSV and S. suis coinfection. PMID:10699012

Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital, Dar es Salaam - Tanzania

PubMed Central

2012-01-01

Background It is estimated that world-wide up to 20 % of children suffer from debilitating mental illness. Mental disorders that pose a significant concern include learning disorders, hyperkinetic disorders (ADHD), depression, psychosis, pervasive development disorders, attachment disorders, anxiety disorders, conduct disorder, substance abuse and eating disorders. Living with such children can be very stressful for caregivers in the family. Therefore, determination of challenges of living with these children is important in the process of finding ways to help or support caregivers to provide proper care for their children. The purpose of this study was to explore the psychological and emotional, social, and economic challenges that parents or guardians experience when caring for mentally ill children and what they do to address or deal with them. Methodology A qualitative study design using in-depth interviews and focus group discussions was applied. The study was conducted at the psychiatric unit of Muhimbili National Hospital in Tanzania. Two focus groups discussions (FGDs) and 8 in-depth interviews were conducted with caregivers who attended the psychiatric clinic with their children. Data analysis was done using content analysis. Results The study revealed psychological and emotional, social, and economic challenges caregivers endure while living with mentally ill children. Psychological and emotional challenges included being stressed by caring tasks and having worries about the present and future life of their children. They had feelings of sadness, and inner pain or bitterness due to the disturbing behaviour of the children. They also experienced some communication problems with their children due to their inability to talk. Social challenges were inadequate social services for their children, stigma, burden of caring task, lack of public awareness of mental illness, lack of social support, and problems with social life. The economic challenges were poverty, child care interfering with various income generating activities in the family, and extra expenses associated with the child’s illness. Conclusion Caregivers of mentally ill children experience various psychological and emotional, social, and economic challenges. Professional assistance, public awareness of mental illnesses in children, social support by the government, private sector, and non-governmental organizations (NGOs) are important in addressing these challenges. PMID:22559084

Quiescent complement in nonhuman primates during E coli Shiga toxin-induced hemolytic uremic syndrome and thrombotic microangiopathy.

PubMed

Lee, Benjamin C; Mayer, Chad L; Leibowitz, Caitlin S; Stearns-Kurosawa, D J; Kurosawa, Shinichiro

2013-08-01

Enterohemorrhagic Escherichia coli (EHEC) produce ribosome-inactivating Shiga toxins (Stx1, Stx2) responsible for development of hemolytic uremic syndrome (HUS) and acute kidney injury (AKI). Some patients show complement activation during EHEC infection, raising the possibility of therapeutic targeting of complement for relief. Our juvenile nonhuman primate (Papio baboons) models of endotoxin-free Stx challenge exhibit full spectrum HUS, including thrombocytopenia, hemolytic anemia, and AKI with glomerular thrombotic microangiopathy. There were no significant increases in soluble terminal complement complex (C5b-9) levels after challenge with lethal Stx1 (n = 6) or Stx2 (n = 5) in plasma samples from T0 to euthanasia at 49.5 to 128 hours post-challenge. d-dimer and cell injury markers (HMGB1, histones) confirmed coagulopathy and cell injury. Thus, complement activation is not required for the development of thrombotic microangiopathy and HUS induced by EHEC Shiga toxins in these preclinical models, and benefits or risks of complement inhibition should be studied further for this infection.

Event recognition in personal photo collections via multiple instance learning-based classification of multiple images

NASA Astrophysics Data System (ADS)

Ahmad, Kashif; Conci, Nicola; Boato, Giulia; De Natale, Francesco G. B.

2017-11-01

Over the last few years, a rapid growth has been witnessed in the number of digital photos produced per year. This rapid process poses challenges in the organization and management of multimedia collections, and one viable solution consists of arranging the media on the basis of the underlying events. However, album-level annotation and the presence of irrelevant pictures in photo collections make event-based organization of personal photo albums a more challenging task. To tackle these challenges, in contrast to conventional approaches relying on supervised learning, we propose a pipeline for event recognition in personal photo collections relying on a multiple instance-learning (MIL) strategy. MIL is a modified form of supervised learning and fits well for such applications with weakly labeled data. The experimental evaluation of the proposed approach is carried out on two large-scale datasets including a self-collected and a benchmark dataset. On both, our approach significantly outperforms the existing state-of-the-art.

Immunoprotection of recombinant Eg.myophilin against Echinococcus granulosus infection in sheep.

PubMed

Zhu, Mingxing; Gao, Fu; Li, Zihua; Wang, Xiuqing; Wang, Hao; Wang, Zhisheng; Zhao, Jiaqing; Zhao, Wei

2016-09-01

The aims of the present study were to investigate the immunoprotection of recombinant Echinococcus granulosus myophilin (rEg.myophilin) against the establishment of a challenge oral infection with E. granulosus eggs, as well as to determine the mechanisms underlying this protection. Sheep were subcutaneously immunized two times with rEg.myophilin, followed by the challenge with E. granulosus eggs orally. The animals were sacrificed 44 weeks after infection and the immunoglobulin (Ig) and cytokine levels were analyzed using ELISA. The results identified significant changes in several indexes of animal immune response subsequent to immunization with rEg.myophilin. These changes included reduced number of formed cysts, as well as elevated levels of IgG, IgA and cytokines. The present data suggest that immunization with rEg.myophilin in sheep can successfully reduce the formation of cysts caused by challenge E. granulosus infection and stimulate immune response, suggesting that rEg.myophilin a has potential value as a candidate vaccine against E. granulosus .

More people than ever before are receiving behavioral health care in the United States, but gaps and challenges remain.

PubMed

Mechanic, David

2014-08-01

The high prevalence of mental illness and substance abuse disorders and their significant impact on disability, mortality, and other chronic diseases have encouraged new initiatives in mental health policy including important provisions of the Affordable Care Act and changes in Medicaid. This article examines the development and status of the behavioral health services system, gaps in access to and quality of care, and the challenges to implementing aspirations for improved behavioral and related medical services. Although many more people than ever before are receiving behavioral health services in the United States-predominantly pharmaceutical treatments-care is poorly allocated and rarely meets evidence-based standards, particularly in the primary care sector. Ideologies, finances, and pharmaceutical marketing have shaped the provision of services more than treatment advances or guidance from a growing evidence base. Among the many challenges to overcome are organizational and financial realignments and improved training of primary care physicians and the behavioral health workforce. Project HOPE—The People-to-People Health Foundation, Inc.

A Survey of Recent Advances in Particle Filters and Remaining Challenges for Multitarget Tracking

PubMed Central

Wang, Xuedong; Sun, Shudong; Corchado, Juan M.

2017-01-01

We review some advances of the particle filtering (PF) algorithm that have been achieved in the last decade in the context of target tracking, with regard to either a single target or multiple targets in the presence of false or missing data. The first part of our review is on remarkable achievements that have been made for the single-target PF from several aspects including importance proposal, computing efficiency, particle degeneracy/impoverishment and constrained/multi-modal systems. The second part of our review is on analyzing the intractable challenges raised within the general multitarget (multi-sensor) tracking due to random target birth and termination, false alarm, misdetection, measurement-to-track (M2T) uncertainty and track uncertainty. The mainstream multitarget PF approaches consist of two main classes, one based on M2T association approaches and the other not such as the finite set statistics-based PF. In either case, significant challenges remain due to unknown tracking scenarios and integrated tracking management. PMID:29168772

Quality and clinical supply considerations of Paediatric Investigation Plans for IV preparations-A case study with the FP7 CloSed project.

PubMed

Hanning, Sara M; Orlu Gul, Mine; Winslade, Jackie; Baarslag, Manuel A; Neubert, Antje; Tuleu, Catherine

2016-09-25

A Paediatric Investigation Plan (PIP) is a development plan that aims to ensure that sufficient data are obtained through studies in paediatrics to support the generation of marketing authorisation of medicines for children. This paper highlights some practical considerations and challenges with respect to PIP submissions and paediatric clinical trials during the pharmaceutical development phase, using the FP7-funded Clonidine for Sedation of Paediatric Patients in the Intensive Care Unit (CloSed) project as a case study. Examples discussed include challenges and considerations regarding formulation development, blinding and randomisation, product labelling and shipment and clinical trial requirements versus requirements for marketing authorisation. A significant quantity of information is required for PIP submissions and it is hoped that future applicants may benefit from an insight into some critical considerations and challenges faced in the CloSed project. Copyright © 2016 Elsevier B.V. All rights reserved.

Identification of usual interstitial pneumonia pattern using RNA-Seq and machine learning: challenges and solutions.

PubMed

Choi, Yoonha; Liu, Tiffany Ting; Pankratz, Daniel G; Colby, Thomas V; Barth, Neil M; Lynch, David A; Walsh, P Sean; Raghu, Ganesh; Kennedy, Giulia C; Huang, Jing

2018-05-09

We developed a classifier using RNA sequencing data that identifies the usual interstitial pneumonia (UIP) pattern for the diagnosis of idiopathic pulmonary fibrosis. We addressed significant challenges, including limited sample size, biological and technical sample heterogeneity, and reagent and assay batch effects. We identified inter- and intra-patient heterogeneity, particularly within the non-UIP group. The models classified UIP on transbronchial biopsy samples with a receiver-operating characteristic area under the curve of ~ 0.9 in cross-validation. Using in silico mixed samples in training, we prospectively defined a decision boundary to optimize specificity at ≥85%. The penalized logistic regression model showed greater reproducibility across technical replicates and was chosen as the final model. The final model showed sensitivity of 70% and specificity of 88% in the test set. We demonstrated that the suggested methodologies appropriately addressed challenges of the sample size, disease heterogeneity and technical batch effects and developed a highly accurate and robust classifier leveraging RNA sequencing for the classification of UIP.

Post-Traumatic Stress Symptoms in Post-ICU Family Members: Review and Methodological Challenges.

PubMed

Petrinec, Amy B; Daly, Barbara J

2016-01-01

Family members of intensive care unit (ICU) patients are at risk for symptoms of post-traumatic stress disorder (PTSD) following ICU discharge. The aim of this systematic review is to examine the current literature regarding post-ICU family PTSD symptoms with an emphasis on methodological issues in conducting research on this challenging phenomenon. An extensive review of the literature was performed confining the search to English language studies reporting PTSD symptoms in adult family members of adult ICU patients. Ten studies were identified for review published from 2004 to 2012. Findings demonstrate a significant prevalence of family PTSD symptoms in the months following ICU hospitalization. However, there are several methodological challenges to the interpretation of existing studies and to the conduct of future research including differences in sampling, identification of risk factors and covariates of PTSD, and lack of consensus regarding the most appropriate PTSD symptom measurement tools and timing. © The Author(s) 2014.

Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding.

PubMed

Hickman, DaShawn A; Pawlowski, Christa L; Sekhon, Ujjal D S; Marks, Joyann; Gupta, Anirban Sen

2018-01-01

Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders. In contrast, treatment of internal noncompressible hemorrhage still heavily depends on transfusion of whole blood or blood's hemostatic components (platelets, fibrinogen, and coagulation factors). Transfusion of platelets poses significant challenges of limited availability, high cost, contamination risks, short shelf-life, low portability, performance variability, and immunological side effects, while use of fibrinogen or coagulation factors provides only partial mechanisms for hemostasis. With such considerations, significant interdisciplinary research endeavors have been focused on developing materials and technologies that can be manufactured conveniently, sterilized to minimize contamination and enhance shelf-life, and administered intravenously to mimic, leverage, and amplify physiological hemostatic mechanisms. Here, a comprehensive review regarding the various topical, intracavitary, and intravenous hemostatic technologies in terms of materials, mechanisms, and state-of-art is provided, and challenges and opportunities to help advancement of the field are discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Aboriginal and Torres Strait Islander Public Health: Online and Integrated into Core Master of Public Health Subjects

PubMed Central

Angus, Lynnell; Ewen, Shaun; Coombe, Leanne

2016-01-01

The Master of Public Health (MPH) is an internationally recognised post-graduate qualification for building the public health workforce. In Australia, MPH graduate attributes include six Indigenous public health (IPH) competencies. The University of Melbourne MPH program includes five core subjects and ten specialisation streams, of which one is Indigenous health. Unless students complete this specialisation or electives in Indigenous health, it is possible for students to graduate without attaining the IPH competencies. To address this issue in a crowded and competitive curriculum an innovative approach to integrating the IPH competencies in core MPH subjects was developed. Five online modules that corresponded with the learning outcomes of the core public health subjects were developed, implemented and evaluated in 2015. This brief report outlines the conceptualisation, development, and description of the curriculum content; it also provides preliminary student evaluation and staff feedback on the integration project. Significance for public health This approach to a comprehensive, online, integrated Indigenous public health (IPH) curriculum is significant, as it ensures that all University of Melbourne Master of Public Health (MPH) graduates will have the competencies to positively contribute to Indigenous health status. A workforce that is attuned not only to the challenges of IPH, but also to the principles of self-determination, Indigenous agency and collaboration is better equipped to be comprised of ethical and judgment-safe practitioners. Additionally, the outlined approach of utilizing IPH content and examples into core MPH subjects ensures both the Australian relevance for an Australian-based health professional course and international appeal through the modules inclusion of International Indigenous case-studies and content. Furthermore, approaches learned in a challenging Indigenous Australian context are transferable and applicable to other IPH challenges in a local, national and global context. PMID:27190981

Medical management of epileptic seizures: challenges and solutions.

PubMed

Sarma, Anand K; Khandker, Nabil; Kurczewski, Lisa; Brophy, Gretchen M

2016-01-01

Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs), with many more currently in development. Other advances have been achieved in terms of diagnostic modalities like electroencephalography technology, treatment devices like vagal nerve and deep-brain stimulators, novel alternate routes of drug administration, and improvement in surgical techniques. Specific patient populations, such as the pregnant, elderly, those with HIV/AIDS, and those with psychiatric illness, present their own unique challenges, with AED side effects, drug interactions, and medical-psychiatric comorbidities adding to the conundrum. The purpose of this article is to review the latest literature guiding the management of acute epileptic seizures, focusing on the current challenges across different practice settings, and it discusses studies in various patient populations, including the pregnant, geriatric, those with HIV/AIDS, comatose, psychiatric, and "pseudoseizure" patients, and offers possible evidence-based solutions or the expert opinion of the authors. Also included is information on newer AEDs, routes of administration, and significant AED-related drug-interaction tables. This review has tried to address only some of these issues that any practitioner who deals with the acute management of seizures may encounter. The document also highlights the numerous avenues for new research that would help practitioners optimize epilepsy management.

Towards Increased Engagement of Geoscientists in Global Development Frameworks

NASA Astrophysics Data System (ADS)

Gill, Joel

2016-04-01

Geoscientists have the potential to make a significant contribution to tackling some of the major socio-environmental challenges of today, including extreme poverty, sustainable development, disaster risk reduction and climate change. This presentation explores the importance and social responsibility of geoscientists to engage in such work through understanding and supporting key global development frameworks. During 2015 the international community agreed three important agendas for change. Each framework relates to the intersection of environmental processes with human activities and behaviours, addressing significant challenges affecting society. The frameworks are (i) the UN Global Goals for Sustainable Development, (ii) the Sendai Framework for Disaster Risk Reduction 2015-2030, and (iii) subject to final confirmation at the time of writing, an agreement on climate change at the Paris Conference of the Parties - COP21. The UN Global Goals for Sustainable Development, for example, includes 17 goals aiming to end extreme poverty, fight inequality and ensure environmental sustainability. Specific goals relate to clean water and sanitation, clean and affordable energy, the development of resilient infrastructure, and the need for climate action. Given this context, here (i) a synthesis is presented of the role of geoscience in successfully achieving these major global development frameworks agreed in 2015, (ii) the ethical and social understanding that underpins effective engagement by geoscientists in the science-policy-practice interface is discussed, and (iii) this required ethical understanding is placed into the context of geoscience training and development needs. This approach demonstrates the importance of geoscientists from across all sectors and specialisms, engaging in the implementation, monitoring and evaluation of global development frameworks. It highlights the importance of a greater awareness and consideration of our ethical responsibilities in order to better support efforts to tackle major societal challenges.

Vagal afferents contribute to exacerbated airway responses following ozone and allergen challenge.

PubMed

Schelegle, Edward S; Walby, William F

2012-05-31

Brown-Norway rats (n=113) sensitized and challenged with nDer f 1 allergen were used to examine the contribution of lung sensory nerves to ozone (O(3)) exacerbation of asthma. Prior to their third challenge rats inhaled 1.0ppm O(3) for 8h. There were three groups: (1) control; (2) vagus perineural capsaicin treatment (PCT) with or without hexamethonium; and (3) vagotomy. O(3) inhalation resulted in a significant increase in lung resistance (R(L)) and an exaggerated response to subsequent allergen challenge. PCT abolished the O(3)-induced increase in R(L) and significantly reduced the increase in R(L) induced by a subsequent allergen challenge, while hexamethonium treatment reestablished bronchoconstriction induced by allergen challenge. Vagotomy resulted in a significant increase in the bronchoconstriction induced by O(3) inhalation and subsequent challenge with allergen. In this model of O(3) exacerbation of asthma, vagal C-fibers initiate reflex bronchoconstriction, vagal myelinated fibers initiate reflex bronchodilation, and mediators released within the airway initiate bronchoconstriction. Copyright © 2012 Elsevier B.V. All rights reserved.

Oral care experiences and challenges in children with autism spectrum disorders.

PubMed

Stein, Leah I; Polido, José C; Najera, Sandy Oliver Lopez; Cermak, Sharon A

2012-01-01

The purpose of this study was to investigate the differences between children with autism spectrum disorders (ASD) and their typically developing peers in relation to aspects of oral care. Participants included 396 parents of ASD children or typically developing 2- to 18-year-olds. Parents completed a 37-item questionnaire designed by authors to elicit information about oral care in the home and dental office. Descriptive, bivariate, and multivariate regression analyses were conducted to examine the association between diagnostic group and oral care variables. Significantly more parents of ASD children than parents of typically developing children reported difficulty across almost all oral care variables explored, including oral care in the home, oral care at the dentist, and access to oral care. Following multivariate regression to control for possible confounders-including age, gender, Hispanic status, and paternal education level-all previously significant variables remained significant. This study indicates that children with autism spectrum disorders experience greater difficulties and barriers to care in both the home and dental office settings than their typically developing peers.

The Challenge of Learning Physics Before Mathematics: A Case Study of Curriculum Change in Taiwan

NASA Astrophysics Data System (ADS)

Chiu, Mei-Shiu

2016-12-01

The aim of this study was to identify challenges in implementing a physics-before- 10 mathematics curriculum. Obviously, students need to learn necessary mathematics skills in order to develop advanced physics knowledge. In the 2010 high school curriculum in Taiwan, however, grade 11 science students study two-dimensional motion in physics without prior learning experiences of trigonometry in mathematics. The perspectives of three curriculum developers, 22 mathematics and physics teachers, two principals, and 45 science students were obtained by interview. The results of qualitative data analysis revealed six challenges and suggested likely solutions. The national level includes political and social challenges, resolved by respecting teachers as professionals; the teacher level includes knowledge and teaching challenges, resolved by increasing teacher trans-literal capacities; and the student level includes learning and justice challenges, resolved by focusing on students' diverse developments in cross-domain learning.

A single dose of a MIV-150/Zinc acetate gel provides 24 h of protection against vaginal simian human immunodeficiency virus reverse transcriptase infection, with more limited protection rectally 8-24 h after gel use.

PubMed

Kenney, Jessica; Singer, Rachel; Derby, Nina; Aravantinou, Meropi; Abraham, Ciby J; Menon, Radhika; Seidor, Samantha; Zhang, Shimin; Gettie, Agegnehu; Blanchard, James; Piatak, Michael; Lifson, Jeffrey D; Fernández-Romero, José A; Zydowsky, Thomas M; Robbiani, Melissa

2012-11-01

Previously we showed that repeated vaginal application of a MIV-150/zinc acetate carrageenan (MIV-150/ZA/CG) gel and a zinc acetate carrageenan (ZA/CG) gel significantly protected macaques from vaginal simian human immunodeficiency virus reverse transcriptase (SHIV-RT) infection. Gels were applied either daily for 2 weeks or every other day for 4 weeks, and the animals were challenged 4-24 h later. Herein, we examined the effects of a single vaginal dose administered either before or after virus challenge. Encouraged by the vaginal protection seen with MIV-150/ZA/CG, we also tested it rectally. Vaginal applications of MIV-150/ZA/CG, ZA/CG, and CG gel were performed once 8-24 h before, 1 h after, or 24 h before and 1 h after vaginal challenge. Rectal applications of MIV-150/ZA/CG and CG gel were performed once 8 or 24 h before rectal challenge. While vaginal pre-challenge and pre/post-challenge application of MIV-150/ZA/CG gel offered significant protection (88%, p<0.002), post-challenge application alone did not significantly protect. ZA/CG gel reduced infection prechallenge, but not significantly, and the effect was completely lost post-challenge. Rectal application of MIV-150/ZA/CG gel afforded limited protection against rectal challenge when applied 8-24 h before challenge. Thus, MIV-150/ZA/CG gel is a highly effective vaginal microbicide that demonstrates 24 h of protection from vaginal infection and may demonstrate efficacy against rectal infection when given close to the time of HIV exposure.

A Single Dose of a MIV-150/Zinc Acetate Gel Provides 24 h of Protection Against Vaginal Simian Human Immunodeficiency Virus Reverse Transcriptase Infection, with More Limited Protection Rectally 8–24 h After Gel Use

PubMed Central

Kenney, Jessica; Singer, Rachel; Derby, Nina; Aravantinou, Meropi; Abraham, Ciby J.; Menon, Radhika; Seidor, Samantha; Zhang, Shimin; Gettie, Agegnehu; Blanchard, James; Piatak, Michael; Lifson, Jeffrey D.; Fernández-Romero, José A.; Zydowsky, Thomas M.

2012-01-01

Abstract Previously we showed that repeated vaginal application of a MIV-150/zinc acetate carrageenan (MIV-150/ZA/CG) gel and a zinc acetate carrageenan (ZA/CG) gel significantly protected macaques from vaginal simian human immunodeficiency virus reverse transcriptase (SHIV-RT) infection. Gels were applied either daily for 2 weeks or every other day for 4 weeks, and the animals were challenged 4–24 h later. Herein, we examined the effects of a single vaginal dose administered either before or after virus challenge. Encouraged by the vaginal protection seen with MIV-150/ZA/CG, we also tested it rectally. Vaginal applications of MIV-150/ZA/CG, ZA/CG, and CG gel were performed once 8–24 h before, 1 h after, or 24 h before and 1 h after vaginal challenge. Rectal applications of MIV-150/ZA/CG and CG gel were performed once 8 or 24 h before rectal challenge. While vaginal pre-challenge and pre/post-challenge application of MIV-150/ZA/CG gel offered significant protection (88%, p<0.002), post-challenge application alone did not significantly protect. ZA/CG gel reduced infection prechallenge, but not significantly, and the effect was completely lost post-challenge. Rectal application of MIV-150/ZA/CG gel afforded limited protection against rectal challenge when applied 8–24 h before challenge. Thus, MIV-150/ZA/CG gel is a highly effective vaginal microbicide that demonstrates 24 h of protection from vaginal infection and may demonstrate efficacy against rectal infection when given close to the time of HIV exposure. PMID:22737981

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

Perception of care and barriers to treatment in individuals with diabetic retinopathy in India: 11-city 9-state study

PubMed Central

Shukla, Rajan; Gudlavalleti, Murthy V. S.; Bandyopadhyay, Souvik; Anchala, Raghupathy; Gudlavalleti, Aashrai Sai Venkat; Jotheeswaran, A. T.; Ramachandra, Srikrishna S.; Singh, Vivek; Vashist, Praveen; Allagh, Komal; Ballabh, Hira Pant; Gilbert, Clare E.

2016-01-01

Background: Diabetic retinopathy is a leading cause of visual impairment. Low awareness about the disease and inequitable distribution of care are major challenges in India. Objectives: Assess perception of care and challenges faced in availing care among diabetics. Materials and Methods: The cross-sectional, hospital based survey was conducted in eleven cities. In each city, public and private providers of eye-care were identified. Both multispecialty and standalone facilities were included. Specially designed semi-open ended questionnaires were administered to the clients. Results: 376 diabetics were interviewed in the eye clinics, of whom 62.8% (236) were selected from facilities in cities with a population of 7 million or more. The mean duration of known diabetes was 11.1 (±7.7) years. Half the respondents understood the meaning of adequate glycemic control and 45% reported that they had visual loss when they first presented to an eye facility. Facilities in smaller cities and those with higher educational status were found to be statistically significant predictors of self-reported good/adequate control of diabetes. The correct awareness of glycemic control was significantly high among attending privately-funded facilities and higher educational status. Self-monitoring of glycemic status at home was significantly associated with respondents from larger cities, privately-funded facilities, those who were better educated and reported longer duration of diabetes. Duration of diabetes (41%), poor glycemic control (39.4%) and age (20.7%) were identified as the leading causes of DR. The commonest challenges faced were lifestyle/behavior related. Conclusions: The findings have significant implications for the organization of diabetes services in India. PMID:27144135

Development of a model to assess orthostatic responses

NASA Technical Reports Server (NTRS)

Rubin, Marilyn

1993-01-01

A major change for crewmembers during weightlessness in microgravity is the redistribution of body fluids from the legs into the abdomen, thorax, and head. The fluids continue to be sequestered in these areas throughout the flight. Upon reentry into gravity on landing, these same body fluids are displaced again to their normal locations, however, not without hazardous incidence to the crewmembers. The problem remains that upon landing, crewmembers are subject to orthostasis, that is, the blood flowing into the legs reduces the blood supply to the brain and may result in the crewmember fainting. The purpose of this study was to develop a model of testing orthostatic responses of blood pressure regulating mechanisms of the cardiovascular system, when challenged, to maintain blood pressure to the brain. To accomplish this, subjects' responses were assessed as they proceeded from the supine position of progressive head-up tilt positions of 30 deg, 60 deg, and 90 deg angles. A convenience sample consisted of 21 subjects, females (N=11) and males (N=10), selected from a list of potential subjects available through the NASA subject screening office. The methodology included all non-invasive measurements of blood pressure, heart rate, echocardiograms, cardiac output, cardiac stroke volume, fluid shifts in the thorax, ventricular ejection and velocity times, and skin blood perfusion. The Fischer statistical analysis was done of all data with the significance level at .05. Significant differences were demonstrated in many instances of changes of posture for all variables. Based on the significance of the findings of this study, this model for assessing orthostatic responses does provide an adequate challenge to the blood pressure regulatory systems. While individuals may use different adaptations to incremental changes in gravity, the subjects, in aggregate, demonstrated significant adaptive cardiovascular changes to orthostatic challenges which were presented to them.

Are We on the Right Track: Can Our Understanding of Abscission in Model Systems Promote or Derail Making Improvements in Less Studied Crops?

PubMed Central

Patterson, Sara E.; Bolivar-Medina, Jenny L.; Falbel, Tanya G.; Hedtcke, Janet L.; Nevarez-McBride, Danielle; Maule, Andrew F.; Zalapa, Juan E.

2016-01-01

As the world population grows and resources and climate conditions change, crop improvement continues to be one of the most important challenges for agriculturalists. The yield and quality of many crops is affected by abscission or shattering, and environmental stresses often hasten or alter the abscission process. Understanding this process can not only lead to genetic improvement, but also changes in cultural practices and management that will contribute to higher yields, improved quality and greater sustainability. As plant scientists, we have learned significant amounts about this process through the study of model plants such as Arabidopsis, tomato, rice, and maize. While these model systems have provided significant valuable information, we are sometimes challenged to use this knowledge effectively as variables including the economic value of the crop, the uniformity of the crop, ploidy levels, flowering and crossing mechanisms, ethylene responses, cultural requirements, responses to changes in environment, and cellular and tissue specific morphological differences can significantly influence outcomes. The value of genomic resources for lesser-studied crops such as cranberries and grapes and the orphan crop fonio will also be considered. PMID:26858730

Are We on the Right Track: Can Our Understanding of Abscission in Model Systems Promote or Derail Making Improvements in Less Studied Crops?

PubMed

Patterson, Sara E; Bolivar-Medina, Jenny L; Falbel, Tanya G; Hedtcke, Janet L; Nevarez-McBride, Danielle; Maule, Andrew F; Zalapa, Juan E

2015-01-01

As the world population grows and resources and climate conditions change, crop improvement continues to be one of the most important challenges for agriculturalists. The yield and quality of many crops is affected by abscission or shattering, and environmental stresses often hasten or alter the abscission process. Understanding this process can not only lead to genetic improvement, but also changes in cultural practices and management that will contribute to higher yields, improved quality and greater sustainability. As plant scientists, we have learned significant amounts about this process through the study of model plants such as Arabidopsis, tomato, rice, and maize. While these model systems have provided significant valuable information, we are sometimes challenged to use this knowledge effectively as variables including the economic value of the crop, the uniformity of the crop, ploidy levels, flowering and crossing mechanisms, ethylene responses, cultural requirements, responses to changes in environment, and cellular and tissue specific morphological differences can significantly influence outcomes. The value of genomic resources for lesser-studied crops such as cranberries and grapes and the orphan crop fonio will also be considered.

Females have stronger neurogenic response than males after non-specific nasal challenge in patients with seasonal allergic rhinitis.

PubMed

Tomljenovic, Dejan; Baudoin, Tomislav; Megla, Zeljka Bukovec; Geber, Goran; Scadding, Glenis; Kalogjera, Livije

2018-07-01

Epidemiological studies show female predominance in the prevalence of non- allergic rhinitis (NAR) and local allergic rhinitis (LAR). Experimental studies show female patients with allergic rhinitis (AR) demonstrate higher levels of sensitivity to irritants and airway hyperresponsiveness than males. Bronchial asthma shows female predominance in post-puberty patients, and gender interaction with severe asthma endotypes. Fibromyalgia, chronic fatigue syndrome, migraine and chronic cough, syndromes, which are commonly related to neurokinin substance P (SP) in the literature, also show strong female predominance. Studies have demonstrated that sex hormones, primarily oestrogens, affect mast cell activation. Mast cell proteases can amplify neurogenic inflammatory responses including the release of SP. Based on human epidemiological data and animal experimental data we hypothesized that female patients have different interaction between mast cell activation and neurogenic inflammation, i.e. substance P release, resulting in a different nasal symptom profile. To test the hypothesis we performed allergen and non-specific nasal challenges in patients with seasonal allergic rhinitis (SAR) out of season and looked for gender differences in subjective and objective responses. The interaction between subjective and objective reactivity was evaluated through the comparison of subjective symptom scores, concentrations of neurokinin substance P (SP) and cellular markers in nasal lavages after low doses of nasal allergen challenges. Female allergic subjects tended to have higher substance P (SP) concentrations both before and after non-specific challenges. The difference between post-allergen and post - hypertonic saline (HTS) challenge was highly significant in female patients (p = 0.001), while insignificant in male subjects (p = 0.14). Female patients had significantly stronger burning sensation after HTS challenge than male. These data indicate difference in the interaction between inflammatory cells and the neurogenic response, which is gender- related, and which may affect symptom profiles after challenges. Different regulation of neurogenic inflammation in females may have impact on symptoms and endotyping in respiratory disorders, not only in allergic rhinitis, but also asthma, chronic rhinosinusitis and irritant -induced cough. Copyright © 2018 Elsevier Ltd. All rights reserved.

Child Care Teachers' Perspectives on Including Children with Challenging Behavior in Child Care Settings

ERIC Educational Resources Information Center

Quesenberry, Amanda C.; Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Hamann, Kira

2014-01-01

In this study, 9 teachers from 5 child care centers were interviewed to examine their perceptions on including children with challenging behavior in their classrooms. The findings provide a firsthand view into how child care teachers support children's social and emotional development and address challenging behavior. Results confirm previous…

The Challenge of Drug Trafficking to Democratic Governance and Human Security in West Africa

DTIC Science & Technology

2013-05-01

Washing ton, DC, as the Director of the Office of Environmental Policy; as Economic Officer in the Bu- reau of Econom ic and Business Affairs... Colombian cartels established links with Mexican syndicates after the United States significantly choked off the old Ca- ribbean drug...transportation corridor and forced the Colombians to start moving their drug loads across the southwest border of the United States.48 Mexican DTOs, including

Developing a Viable Approach for Effective Tiered Systems

DTIC Science & Technology

2007-01-17

TERMS 16. SECURITY CLASSIFICATION OF: a. REPORT 19a. NAME OF RESPONSIBLE PERSON 19b. TELEPHONE NUMBER (include area code ) b. ABSTRACT c. THIS PAGE 18...is changing the world. Now deal with it” (New Scientist 2006). If true, this significant message is one that would extend well beyond the realm of...system-of-systems poses formidable challenges for the acquisitions bureaucracy and the defense industries” (Dombrowski et al. 2002). “TRLs

Peyronie's Disease: Still a Surgical Disease

PubMed Central

Martinez, Daniel; Ercole, Cesar E.; Hakky, Tariq S.; Kramer, Andrew; Carrion, Rafael

2012-01-01

Peyronie's Disease (PD) remains a challenging and clinically significant morbid condition. Since its first description by François Gigot de la Peyronie, much of the treatment for PD remains nonstandardized. PD is characterized by the formation of fibrous plaques at the level of the tunica albuginea. Clinical manifestations include morphologic changes, such as curvatures and hourglass deformities. Here, we review the common surgical techniques for the management of patients with PD. PMID:22956943

Qigong in Injured Military Service Members.

PubMed

Reb, Anne Marie; Saum, Nancy Seaby; Murphy, Deborah Ann; Breckenridge-Sproat, Sara Todd; Su, Xiaogang; Bormann, Jill Ellen

2017-03-01

Wounded, ill, and injured (WII) Military Service members experience significant stress and are at risk for developing chronic conditions including posttraumatic stress disorder and depression. Qigong, a meditative movement practice, may positively affect their ability to engage in successful rehabilitation. We assessed the feasibility of Qigong practice in WII Service members returning from combat; effects on stress, sleep, and somatic symptoms; satisfaction; and participants' experience with the practice. Single-group, pre- and posttest, mixed methods approach. Twenty-six WII were enrolled. The program was designed to include 20 classes over 10 weeks. Participants completed self-report questionnaires, practice logs, and an exit interview. Average attendance was 8.14 classes ( SD = 4.9); mean engagement was 5.7 ( SD = 3.5) weeks. Participants endorsed a high level of satisfaction with the practice. Qualitative themes included coping with stress; feeling more resilient and empowered; improvement in symptoms including sleep and physical function; and factors affecting practice. Participant-reported facilitators included accessibility and portability of the practice; barriers included scheduling conflicts and personal challenges. Participants recommended offering shorter programs with flexible scheduling options, increasing program awareness, and including significant others in future classes. Qigong was safe, portable, and easily adapted for WII Service members.

The Impact of Living with Klinefelter Syndrome: A Qualitative Exploration of Adolescents and Adults.

PubMed

Turriff, Amy; Macnamara, Ellen; Levy, Howard P; Biesecker, Barbara

2017-08-01

Klinefelter syndrome (XXY) is a common yet significantly underdiagnosed condition with considerable medical, psychological and social implications. Many health care providers lack familiarity with XXY, resulting in medical management challenges and a limited understanding of the personal impact of the condition. Genetic counselors benefit from understanding the challenges adolescents and men with XXY face to effectively address their medical and psychosocial needs. The purpose of this study was to understand the impact of living with XXY as an adolescent or an adult. Individuals aged 14 to 75 years with self-reported XXY were recruited from online support networks to complete a web-based survey that included open-ended questions. Open-ended responses were coded and analyzed thematically (n = 169 to 210 for each open-ended question). Over half of respondents to the open-ended questions reported challenges in finding health care providers who are knowledgeable about XXY, with many describing an extensive diagnostic odyssey and relief when receiving a diagnosis. Individuals sought support coping with the challenges they face and acknowledgement of the positive aspects of XXY. Recommendations are made for how genetic counseling can enhance quality of life for individuals living with XXY.

'Half the fun is getting there': a beginner's guide to doctoral study.

PubMed

Green, Elyce

2016-07-01

There is a significant need for more nurses to enrol in doctoral studies and to improve attrition rates in these courses. It is therefore important that those who consider undertaking doctoral studies are prepared for the many challenges associated with pursuing a higher degree by research. To present a personal reflection of the first year of doctoral study to inform others about the challenges and joys associated with beginning a doctorate, as well as to demystify some of the challenges of studying a PhD, and to encourage nurses and other healthcare professionals to pursue a doctorate. Issues discussed include the changing identity of a doctoral student, how to select and manage the supervisory team, and some of the barriers that will be faced in the first year of candidature and ways to overcome them. 'Imposter syndrome' and threshold concepts are also discussed. Embarking on a PhD is a challenging and transformative journey. Those who wish to undertake doctoral studies must plan carefully and pursue a topic they are passionate about. Research is essential in contemporary nursing practice. Greater numbers of nurses enrolled in doctoral studies would increase generation of new nursing knowledge and translation of research to practice.

Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer.

PubMed

Taft, Angela; Colombini, Manuela

2017-07-12

The damage to health caused by intimate partner violence demands effective responses from healthcare providers and healthcare systems worldwide. To date, most evidence for the few existing, effective interventions in use comes from high-income countries. Gupta et al. provide rare evidence of a nurse-delivered intimate partner violence screening, supportive care and referral intervention from a large-scale randomised trial in Mexican public health clinics. No difference was found in the primary outcome of reduction in intimate partner violence. There were significant short-term benefits in safety planning and mental health (secondary outcomes) for women in the intervention arm, but these were not sustained.This important study highlights the challenges of primary outcome choices in such studies, and further challenges for the sustainability of healthcare systems and healthcare provider interventions. These challenges include the role of theory for sustainability and the risk that baseline measures of intimate partner violence can wash out intervention effects. We emphasise the importance of studying the processes of adaptation, integration and coordination in the context of the wider healthcare system.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0880-y.

Effect of ozone exposure on antigen-induced airway hyperresponsiveness in guinea pigs

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

Vargas, M.H.; Segura, P.; Campos, M.G.

1994-12-31

Airway hyperresponsiveness can be induced by several stimuli including antigen and ozone, both of which may be present in the air of polluted cities. Though the effect of ozone on the bronchoconstrictor response to antigen has been well described, the combined effect of these stimuli on airway hyperresponsiveness has not yet been studied. Sensitized guinea pigs with or without ozone exposure for 1 h at 3 ppm, 18 h prior to study, were challenged with a dose-response curve to histamine (0.01-1.8 {mu}g/kg, iv), and then by a second histamine dose-response curve 1 h later. Airway responses were measured as themore » increase in pulmonary insufflation pressure. In sensitized guinea pigs, the histamine ED50 significantly decreased after antigen challenge, demonstrating the development of airway hyperresponsiveness. Sensitized guinea pigs exposed to ozone showed airway hyperresponsiveness to histamine when compared with nonexposed animals, and such hyperresponsiveness was further enhanced after antigen challenge. We conclude that in this guinea pig model of acute allergic bronchoconstriction both antigen challenge and ozone induce airway hyperresponsiveness, while ozone exposure does not modify the development of antigen-induced hyperresponsiveness. 25 refs., 1 fig., 1 tab.« less

The Liquid Fluoride Thorium Reactor: Energy Cheaper Than Coal

NASA Astrophysics Data System (ADS)

Stone, Cavan

2011-11-01

This century, we face significant environmental challenges. Our demand for limited natural resources is rapidly increasing and much of humanity is concerned about the consequences. Our unsustainably growing population drives these challenges, and humanely stabilizing it would alleviate these pressures. Demographic data clearly shows that prosperity stabilizes population and it also shows that prosperity critically requires energy. In spite of the pressing and demonstrable nature of these challenges however, politically there is no international consensus on global energy policy. Developing nations simply will not accept a policy that will hamper their economic growth. Yet, we do have a solution to these challenges, an idea conceived and experimentally tested by Alvin Weinberg at Oak Ridge National Laboratory, the Liquid Fluoride Thorium Reactor. Presently, various laboratories and start-up companies, including the Chinese Academy of Sciences have begun efforts to commercialize the technology. By delivering the promise of inexpensive energy it will be in the economic interest of the developing nations to use this carbon-free energy source. By delivering superior performance on longstanding public concerns about nuclear energy, it will be technologically and politically feasible for developing nations to stabilize their population with the bounty of energy cheaper than coal.

Donor Research in Australia: Challenges and Promise

PubMed Central

Masser, Barbara; Smith, Geoff; Williams, Lisa A.

2014-01-01

Summary Donors are the key to the core business of Blood Collection Agencies (BCAs). However, historically, they have not been a focus of research undertaken by these organizations. This model is now changing, with significant donor research groups established in a number of countries, including Australia. Donor research in the Australian Red Cross Blood Service (Blood Service) is concentrated in the Donor and Community Research (DCR) team. Cognizant of the complex and ever-changing landscape with regard to optimal donor management, the DCR team collaborates with academics located at universities around Australia to coordinate a broad program of research that addresses both short- and-long term challenges to the blood supply. This type of collaboration is not, however, without challenges. Two major collaborative programs of the Blood Service's research, focusing on i) the recruitment and retention of plasmapheresis donors and ii) the role of the emotion pride in donor motivation and return, are showcased to elucidate how the challenges of conducting collaborative BCA research can be met. In so doing, these and the other research programs described herein demonstrate how the Blood Service supports and contributes to research that not only revises operational procedures but also contributes to advances in basic science. PMID:25254025

Top-down Proteomics in Health and Disease: Challenges and Opportunities

PubMed Central

Gregorich, Zachery R.; Ge, Ying

2014-01-01

Proteomics is essential for deciphering how molecules interact as a system and for understanding the functions of cellular systems in human disease; however, the unique characteristics of the human proteome, which include a high dynamic range of protein expression and extreme complexity due to a plethora of post-translational modifications (PTMs) and sequence variations, make such analyses challenging. An emerging “top-down” mass spectrometry (MS)-based proteomics approach, which provides a “bird’s eye” view of all proteoforms, has unique advantages for the assessment of PTMs and sequence variations. Recently, a number of studies have showcased the potential of top-down proteomics for unraveling of disease mechanisms and discovery of new biomarkers. Nevertheless, the top-down approach still faces significant challenges in terms of protein solubility, separation, and the detection of large intact proteins, as well as the under-developed data analysis tools. Consequently, new technological developments are urgently needed to advance the field of top-down proteomics. Herein, we intend to provide an overview of the recent applications of top-down proteomics in biomedical research. Moreover, we will outline the challenges and opportunities facing top-down proteomics strategies aimed at understanding and diagnosing human diseases. PMID:24723472

Challenges with the implementation of an Integrated Disease Surveillance and Response (IDSR) system: systematic review of the lessons learned.

PubMed

Phalkey, Revati K; Yamamoto, Shelby; Awate, Pradip; Marx, Michael

2015-02-01

Despite a realistic strategy and availability of resources, multiple challenges still overwhelm countries grappling with the challenges of communicable disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy is by far the most pragmatic strategy in resource-poor settings. The objective of this study was to systematically review and document the lessons learned and the challenges identified with the implementation of the IDSR in low- and middle-income countries and to identify the main barriers that contribute to its sub-optimal functioning. A systematic review of literature published in English using Web of Knowledge, PubMed, and databases of the World Health Organization (WHO) and the Centers for Disease Control (CDC) between 1998 and 2012 was undertaken. Additionally, manual reference and grey literature searches were conducted. Citations describing core and support functions or the quality attributes of the IDSR as described by WHO and CDC were included in the review. Thirty-three assessment studies met the inclusion criteria. IDSR strategy has been best adopted and implemented in the WHO-AFRO region. Although significant progress is made in overcoming the challenges identified with vertical disease surveillance strategies, gaps still exist. Mixed challenges with core and support IDSR functions were observed across countries. Main issues identified include non-sustainable financial resources, lack of co-ordination, inadequate training and turnover of peripheral staff, erratic feedback, inadequate supervision from the next level, weak laboratory capacities coupled with unavailability of job aids (case definitions/reporting formats), and poor availability of communication and transport systems particularly at the periphery. Best outcomes in core functions and system attributes were reported when support surveillance functions performed optimally. Apart from technical and technological issues, human resources and the health care system structures that receive the IDSR determine its output. The challenges identified with IDSR implementation are largely 'systemic'. IDSR will best benefit from skill-based training of personnel and strengthening of the support surveillance functions alongside health care infrastructures at the district level. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

2010 Panel on the Biomaterials Grand Challenges

PubMed Central

Reichert, William “Monty”; Ratner, Buddy D.; Anderson, James; Coury, Art; Hoffman, Allan S.; Laurencin, Cato T.; Tirrell, David

2014-01-01

In 2009, the National Academy for Engineering issued the Grand Challenges for Engineering in the 21st Century comprised of 14 technical challenges that must be addressed to build a healthy, profitable, sustainable, and secure global community (http://www.engineeringchallenges.org). Although crucial, none of the NEA Grand Challenges adequately addressed the challenges that face the biomaterials community. In response to the NAE Grand Challenges, Monty Reichert of Duke University organized a panel entitled Grand Challenges in Biomaterials at the at the 2010 Society for Biomaterials Annual Meeting in Seattle. Six members of the National Academies—Buddy Ratner, James Anderson, Allan Hoffman, Art Coury, Cato Laurencin, and David Tirrell—were asked to propose a grand challenge to the audience that, if met, would significantly impact the future of biomaterials and medical devices. Successfully meeting these challenges will speed the 60-plus year transition from commodity, off-the-shelf biomaterials to bioengineered chemistries, and biomaterial devices that will significantly advance our ability to address patient needs and also to create new market opportunities. PMID:21171147

Perceptions of caring for children with disabilities: Experiences from Moshi, Tanzania

PubMed Central

McNally, Anna

2013-01-01

Background Although there exist laws, policies and standards in Tanzania that serve to protect and improve the lives of children with disabilities, the individual human experiences and feelings of the carers and parents still remain the realities of caring for children with disabilities. There is a lack of qualitative studies examining experiences in a developing context. This research aimed to fill that gap. Objectives The objective of this research was to gain an insight into how having a child with a disability impacts upon participants lives and to examine both negative and positive experiences of care through the use of qualitative methods. Method This was a qualitative, exploratory study and followed a phenomenological method. Purposive convenience sampling methods were used to recruit 14 carers in Moshi, Tanzania. Qualitative, semi-structured interviews were undertaken with all 14 participants. Results Five main themes emerged from the data which shed light on the carers experiences, namely, objective challenges in terms of financial challenges, employment issues and demands of care; subjective challenges in the form of stigma, isolation and pity; positive experiences such as the child’s progress, respect and happiness; material and financial needs; and coping mechanisms which included beliefs, support and attitudes. Conclusion The findings of this research were that objective challenges are common and more significant than subjective challenges. Positive experiences were not as easily identified by the participants as the challenges faced. However, having analysed the data, carers do not experience their roles as entirely negative. They simply need the resources to deal with objective challenges which in a developing context are not easily attainable. PMID:28729981

Dissociation between history and challenge in patients with physical urticaria.

PubMed

Komarow, Hirsh D; Arceo, Sarah; Young, Michael; Nelson, Celeste; Metcalfe, Dean D

2014-01-01

Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus. To evaluate the consistency between a history of physical urticaria and results of challenge testing. Seventy-six subjects, ages 3 to 77 years old, were referred with the diagnosis of a physical urticaria and were evaluated by using challenge testing directed toward the presenting diagnosis, yet included other stimuli based on history. The majority of subjects were tested to 3 or more stimuli, thus 294 provocation tests were performed. Fifty-seven subjects were surveyed for the status of their physical urticaria at least 1 year after initial evaluation. Of the 76 subjects with a positive history of a physical urticaria, 38% (n = 29) were challenge negative to the presenting diagnosis. Eight subjects within the challenge negative group reacted positively to additional testing, thus 28% (n = 21) remained negative to all challenge testing, which allowed discontinuation of medications and avoidance behavior. A negative challenge result was less likely with subjects who presented with cold-induced urticaria (25%), delayed pressure urticaria (25%), and dermatographism (29%), yet more common with cholinergic (65%) and solar urticaria (67%). A 1-year follow-up survey of 57 subjects was consistent with initial results. Nineteen of this subgroup were rechallenged for the presenting diagnosis, and the outcome was unchanged in 17 subjects and, in 2 subjects the urticaria had resolved. The diagnosis by history of a physical urticaria should be verified by testing whenever possible and particularly if the condition is judged as severe and thus requires both significant life-style changes and pharmacologic intervention. Published by Elsevier Inc.

Benefit of the basophil activation test in deciding when to reintroduce cow's milk in allergic children.

PubMed

Rubio, A; Vivinus-Nébot, M; Bourrier, T; Saggio, B; Albertini, M; Bernard, A

2011-01-01

Oral challenges are required to establish the persistence or resolution of IgE-mediated cow's milk allergy (CMA). Determining the appropriate timing for challenging is the main difficulty. The benefit of the basophil activation test (BAT) in predicting a child's reaction to the oral challenge was evaluated and compared to the specific IgE and skin prick tests' (SPT) results. One hundred and twelve consecutive children with CMA admitted for an oral challenge to reassess their allergy were included. Allergen-induced basophil activation was detected as a CD63-upregulation by flow cytometry. Thirty-six children (32%) had a positive oral challenge. The percentage of activated basophils in patients with a positive challenge (mean = 20.9; SD = 18.8) was significantly higher than that of patients with a negative challenge (mean = 3.9; SD = 9.8, P < 0.0001), and was well correlated with the eliciting dose of cow's milk (P < 0.0001). The BAT had an efficiency of 90%, a sensitivity of 91%, a specificity of 90%, and positive and negative predictive values of 81% and 96% in detecting persistently allergic patients. The area under the ROC curve was 0.866. These scores were higher than those obtained with SPT and IgE values, whichever positivity cut-point was chosen. Referring to a decisional algorithm combining BAT, specific IgE and SPT allowed the correct identification of 94% of patients as tolerant or persistently allergic to cow's milk proteins (CMP) in our cohort. The BAT could be a valuable tool in the management of paediatric CMA in addition to specific IgE quantification and SPT, by contributing in determining whether an oral challenge can safely be undertaken. © 2010 John Wiley & Sons A/S.

Candidate hepatitis C vaccine trials and people who inject drugs: Challenges and opportunities

PubMed Central

Maher, Lisa; White, Bethany; Hellard, Margaret; Madden, Annie; Prins, Maria; Kerr, Thomas; Page, Kimberly

2013-01-01

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright People who inject drugs (PWID) are at high risk of HCV. Limited evidence of the effectiveness of prevention interventions and low uptake of treatment in this group highlight the need for increased investment in biomedical interventions, notably safe and efficacious vaccines. While several candidates are currently in development, field trials in PWID present challenges, including ethical issues associated with trial literacy, informed consent and standards of care. Significant biological and social factors and differences between HIV and HCV suggest that HCV warrants targeted vaccine preparedness research to lay the groundwork for successful implementation of future trials. PMID:20831914

Bioprospecting of Marine Macrophytes Using MS-Based Lipidomics as a New Approach

PubMed Central

Maciel, Elisabete; Leal, Miguel Costa; Lillebø, Ana Isabel; Domingues, Pedro; Domingues, Maria Rosário; Calado, Ricardo

2016-01-01

The marine environment supports a remarkable diversity of organisms which are a potential source of natural products with biological activities. These organisms include a wide variety of marine plants (from micro- to macrophytes), which have been used in the food and pharmaceutical industry. However, the biochemistry and biological activities of many of these macrophytes (namely macroalgae and halophytes, including seagrasses) are still far from being fully explored. Most popular bioactive components include polysaccharides, peptides, phenolics and fatty acids (FAs). Polar lipids (glycolipids, phospholipids and betaine lipids) are emerging as novel value-added bioactive phytochemicals, rich in n-3 FA, with high nutritional value and health beneficial effects for the prevention of chronic diseases. Polar lipids account various combinations of polar groups, fatty acyl chains and backbone structures. The polar lipidome of macrophytes is remarkably diverse, and its screening represents a significant analytical challenge. Modern research platforms, particularly mass spectrometry (MS)-based lipidomic approaches, have been recently used to address this challenge and are here reviewed. The application of lipidomics to address lipid composition of marine macrophytes will contribute to the stimulation of further research on this group and foster the exploration of novel applications. PMID:27005634

Pain Control in the Presence of Drug Addiction.

PubMed

Vadivelu, Nalini; Lumermann, Leandro; Zhu, Richard; Kodumudi, Gopal; Elhassan, Amir O; Kaye, Alan David

2016-05-01

Drug addiction is present in a significant proportion of the population in the USA and worldwide. Drug addiction can occur with the abuse of many types of substances including cocaine, marijuana, stimulants, alcohol, opioids, and tranquilizers. There is a high likelihood that clinicians will encounter patients with substance abuse disorders on a regular basis with the prevalence of the use of illicit substances and the high rate of abuse of prescription drugs. The use of abuse deterrent formulations of prescription opioid agents, pill counts, and urine drug abuse screenings are all useful strategies. Optimum pain management of patients with addiction in the outpatient and inpatient setting is essential to minimize pain states. Careful selection of medications and appropriate oversight, including drug agreements, can reduce drug-induced impairments, including sleep deficits and diminished physical, social, and sexual functioning. This review, therefore, discusses the prevalence of illicit and prescription drug addiction, the challenges of achieving optimum pain control, and the therapeutic approaches to be considered in this challenging population. More research is warranted to develop improved therapies and routes of treatments for optimum pain relief and to prevent the development of central sensitization, chronic pain, and impaired physical and social functioning in patients with drug addiction.

The challenges and opportunities in cumulative effects assessment

USGS Publications Warehouse

Foley, Melissa M.; Mease, Lindley A; Martone, Rebecca G; Prahler, Erin E; Morrison, Tiffany H; Clarke Murray, Cathryn; Wojcik, Deborah

2016-01-01

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

The challenges and opportunities in cumulative effects assessment

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

Foley, Melissa M., E-mail: mfoley@usgs.gov; Center for Ocean Solutions, Stanford University, 99 Pacific St., Monterey, CA 93940; Mease, Lindley A., E-mail: lamease@stanford.edu

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmentalmore » assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.« less

Personal and Relationship Challenges of Adults With Type 1 Diabetes

PubMed Central

Trief, Paula M.; Sandberg, Jonathan G.; Dimmock, Jacqueline A.; Forken, Patricia J.; Weinstock, Ruth S.

2013-01-01

OBJECTIVE Little is known about the psychosocial challenges of adults living with type 1 diabetes or its impact on partner relationships. This qualitative study was undertaken to gain better understanding of these issues. RESEARCH DESIGN AND METHODS Four focus groups were held, two with adult type 1 diabetic patients (n = 16) and two with partners (n = 14). Two broad questions were posed: “What are the emotional and interpersonal challenges you have experienced because you have (your partner has) type 1 diabetes?” and “How does the fact that you have (your partner has) type 1 diabetes affect your relationship with your partner, positively and/or negatively?” Sessions were recorded and transcribed, and analyzed by a team of four researchers, using constant comparative methods to identify core domains and concepts. RESULTS Four main domains were identified: 1) impact of diabetes on the relationship, including level of partner involvement, emotional impact of diabetes on the relationship, and concerns about child-rearing; 2) understanding the impact of hypoglycemia; 3) stress of potential complications; and 4) benefits of technology. Themes suggest that, although partner involvement varies (very little to significant), there exists significant anxiety about hypoglycemia and future complications and sources of conflict that may increase relationship stress. Partner support is highly valued, and technology has a positive influence. CONCLUSIONS Adults with type 1 diabetes face unique emotional and interpersonal challenges. Future research should focus on gaining a better understanding of how they cope and the effect of psychosocial stressors and coping on adherence, quality of life, and glycemic control. PMID:23474590

Cancer-related fatigue and depression in breast cancer patients postchemotherapy: Different associations with optimism and stress appraisals.

PubMed

Levkovich, Inbar; Cohen, Miri; Pollack, Shimon; Drumea, Karen; Fried, Georgeta

2015-10-01

Symptoms of depression and cancer-related fatigue (CRF) are common among breast cancer patients postchemotherapy and may seriously impair quality of life (QoL). This study aimed to assess the relationship between depression and CRF in breast cancer patients postchemotherapy and to examine their relationships to optimism and to threat and challenge appraisals. Participants included 95 breast cancer patients (stages 1-3) 1 to 6 months after completion of chemotherapy. Patients submitted personal and medical details and completed the following: physical symptom questionnaires (EORTC QLQ-C30, and QLQ-BR23), a symptoms of depression questionnaire (CES-D), the Fatigue Symptom Inventory (FSI), the Life Orientation Test (LOT-R), and a stress appraisals questionnaire. We found levels of depression, CRF, and appraisals of cancer as a threat to bemoderate and levels of optimism and appraisals of cancer as a challenge to be high. Depression and CRF were positively associated. A multivariate regression analysis revealed that 51% of the CRF variancewas explained; physical symptoms and threat appraisal were significantly associated with CRF. A 67% of the CRF variance of depression was explained; challenge and threat appraisals were significantly associated with depression [corrected]. Although CRF and depression were often experienced simultaneously and both were found to be higher among individuals who gave higher appraisals of cancer as a threat, only depression was related to optimism and challenge appraisals, while CRF was related mainly to intensity of physical symptoms. The different pattern of associations between optimism and appraisals warrants further clinical attention as well as future study.

Using a Human Challenge Model of Infection to Measure Vaccine Efficacy: A Randomised, Controlled Trial Comparing the Typhoid Vaccines M01ZH09 with Placebo and Ty21a.

PubMed

Darton, Thomas C; Jones, Claire; Blohmke, Christoph J; Waddington, Claire S; Zhou, Liqing; Peters, Anna; Haworth, Kathryn; Sie, Rebecca; Green, Christopher A; Jeppesen, Catherine A; Moore, Maria; Thompson, Ben A V; John, Tessa; Kingsley, Robert A; Yu, Ly-Mee; Voysey, Merryn; Hindle, Zoe; Lockhart, Stephen; Sztein, Marcelo B; Dougan, Gordon; Angus, Brian; Levine, Myron M; Pollard, Andrew J

2016-08-01

Typhoid persists as a major cause of global morbidity. While several licensed vaccines to prevent typhoid are available, they are of only moderate efficacy and unsuitable for use in children less than two years of age. Development of new efficacious vaccines is complicated by the human host-restriction of Salmonella enterica serovar Typhi (S. Typhi) and lack of clear correlates of protection. In this study, we aimed to evaluate the protective efficacy of a single dose of the oral vaccine candidate, M01ZH09, in susceptible volunteers by direct typhoid challenge. We performed a randomised, double-blind, placebo-controlled trial in healthy adult participants at a single centre in Oxford (UK). Participants were allocated to receive one dose of double-blinded M01ZH09 or placebo or 3-doses of open-label Ty21a. Twenty-eight days after vaccination, participants were challenged with 104CFU S. Typhi Quailes strain. The efficacy of M01ZH09 compared with placebo (primary outcome) was assessed as the percentage of participants reaching pre-defined endpoints constituting typhoid diagnosis (fever and/or bacteraemia) during the 14 days after challenge. Ninety-nine participants were randomised to receive M01ZH09 (n = 33), placebo (n = 33) or 3-doses of Ty21a (n = 33). After challenge, typhoid was diagnosed in 18/31 (58.1% [95% CI 39.1 to 75.5]) M01ZH09, 20/30 (66.7% [47.2 to 87.2]) placebo, and 13/30 (43.3% [25.5 to 62.6]) Ty21a vaccine recipients. Vaccine efficacy (VE) for one dose of M01ZH09 was 13% [95% CI -29 to 41] and 35% [-5 to 60] for 3-doses of Ty21a. Retrospective multivariable analyses demonstrated that pre-existing anti-Vi antibody significantly reduced susceptibility to infection after challenge; a 1 log increase in anti-Vi IgG resulting in a 71% decrease in the hazard ratio of typhoid diagnosis ([95% CI 30 to 88%], p = 0.006) during the 14 day challenge period. Limitations to the study included the requirement to limit the challenge period prior to treatment to 2 weeks, the intensity of the study procedures and the high challenge dose used resulting in a stringent model. Despite successfully demonstrating the use of a human challenge study to directly evaluate vaccine efficacy, a single-dose M01ZH09 failed to demonstrate significant protection after challenge with virulent Salmonella Typhi in this model. Anti-Vi antibody detected prior to vaccination played a major role in outcome after challenge. ClinicalTrials.gov (NCT01405521) and EudraCT (number 2011-000381-35).

Implementation and impact of ICD-10 (Part II).

PubMed

Rahmathulla, Gazanfar; Deen, H Gordon; Dokken, Judith A; Pirris, Stephen M; Pichelmann, Mark A; Nottmeier, Eric W; Reimer, Ronald; Wharen, Robert E

2014-01-01

The transition from the International Classification of Disease-9(th) clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices.

Current advancements and challenges in soil-root interactions modelling

NASA Astrophysics Data System (ADS)

Schnepf, Andrea; Huber, Katrin; Abesha, Betiglu; Meunier, Felicien; Leitner, Daniel; Roose, Tiina; Javaux, Mathieu; Vanderborght, Jan; Vereecken, Harry

2015-04-01

Roots change their surrounding soil chemically, physically and biologically. This includes changes in soil moisture and solute concentration, the exudation of organic substances into the rhizosphere, increased growth of soil microorganisms, or changes in soil structure. The fate of water and solutes in the root zone is highly determined by these root-soil interactions. Mathematical models of soil-root systems in combination with non-invasive techniques able to characterize root systems are a promising tool to understand and predict the behaviour of water and solutes in the root zone. With respect to different fields of applications, predictive mathematical models can contribute to the solution of optimal control problems in plant recourse efficiency. This may result in significant gains in productivity, efficiency and environmental sustainability in various land use activities. Major challenges include the coupling of model parameters of the relevant processes with the surrounding environment such as temperature, nutrient concentration or soil water content. A further challenge is the mathematical description of the different spatial and temporal scales involved. This includes in particular the branched structures formed by root systems or the external mycelium of mycorrhizal fungi. Here, reducing complexity as well as bridging between spatial scales is required. Furthermore, the combination of experimental and mathematical techniques may advance the field enormously. Here, the use of root system, soil and rhizosphere models is presented through a number of modelling case studies, including image based modelling of phosphate uptake by a root with hairs, model-based optimization of root architecture for phosphate uptake from soil, upscaling of rhizosphere models, modelling root growth in structured soil, and the effect of root hydraulic architecture on plant water uptake efficiency and drought resistance.

Current Advancements and Challenges in Soil-Root Interactions Modelling

NASA Astrophysics Data System (ADS)

Schnepf, A.; Huber, K.; Abesha, B.; Meunier, F.; Leitner, D.; Roose, T.; Javaux, M.; Vanderborght, J.; Vereecken, H.

2014-12-01

Roots change their surrounding soil chemically, physically and biologically. This includes changes in soil moisture and solute concentration, the exudation of organic substances into the rhizosphere, increased growth of soil microorganisms, or changes in soil structure. The fate of water and solutes in the root zone is highly determined by these root-soil interactions. Mathematical models of soil-root systems in combination with non-invasive techniques able to characterize root systems are a promising tool to understand and predict the behaviour of water and solutes in the root zone. With respect to different fields of applications, predictive mathematical models can contribute to the solution of optimal control problems in plant recourse efficiency. This may result in significant gains in productivity, efficiency and environmental sustainability in various land use activities. Major challenges include the coupling of model parameters of the relevant processes with the surrounding environment such as temperature, nutrient concentration or soil water content. A further challenge is the mathematical description of the different spatial and temporal scales involved. This includes in particular the branched structures formed by root systems or the external mycelium of mycorrhizal fungi. Here, reducing complexity as well as bridging between spatial scales is required. Furthermore, the combination of experimental and mathematical techniques may advance the field enormously. Here, the use of root system, soil and rhizosphere models is presented through a number of modelling case studies, including image based modelling of phosphate uptake by a root with hairs, model-based optimization of root architecture for phosphate uptake from soil, upscaling of rhizosphere models, modelling root growth in structured soil, and the effect of root hydraulic architecture on plant water uptake efficiency and drought resistance.

Induction of Protective Immune Responses Against Schistosomiasis haematobium in Hamsters and Mice Using Cysteine Peptidase-Based Vaccine

PubMed Central

Tallima, Hatem; Dalton, John P.; El Ridi, Rashika

2015-01-01

One of the major lessons we learned from the radiation-attenuated cercariae vaccine studies is that protective immunity against schistosomiasis is dependent on the induction of T helper (Th)1-/Th2-related immune responses. Since most schistosome larval and adult-worm-derived molecules used for vaccination uniformly induce a polarized Th1 response, it was essential to include a type 2 immune response-inducing molecule, such as cysteine peptidases, in the vaccine formula. Here, we demonstrate that a single subcutaneous injection of Syrian hamsters with 200 μg active papain, 1 h before percutaneous exposure to 150 cercariae of Schistosoma haematobium, led to highly significant (P < 0.005) reduction of >50% in worm burden and worm egg counts in intestine. Immunization of hamsters with 20 μg recombinant glyceraldehyde 3-phosphate dehydrogenase (rSG3PDH) and 20 μg 2-cys peroxiredoxin-derived peptide in a multiple antigen peptide construct (PRX MAP) together with papain (20 μg/hamster), as adjuvant led to considerable (64%) protection against challenge S. haematobium infection, similar to the levels reported with irradiated cercariae. Cysteine peptidases-based vaccination was also effective in protecting outbred mice against a percutaneous challenge infection with S. haematobium cercariae. In two experiments, a mixture of Schistosoma mansoni cathepsin B1 (SmCB1) and Fasciola hepatica cathepsin L1 (FhCL1) led to highly significant (P < 0.005) reduction of 70% in challenge S. haematobium worm burden and 60% reduction in liver egg counts. Mice vaccinated with SmCB1/FhCL1/rSG3PDH mixture and challenged with S. haematobium cercariae 3 weeks after the second immunization displayed highly significant (P < 0.005) reduction of 72% in challenge worm burden and no eggs in liver of 8–10 mice/group, as compared to unimmunized mice, associated with production of a mixture of type 1- and type 2-related cytokines and antibody responses. PMID:25852696

Absence of somatization in non-coeliac gluten sensitivity.

PubMed

Brottveit, Margit; Vandvik, Per Olav; Wojniusz, Slawomir; Løvik, Astrid; Lundin, Knut Ea; Boye, Birgitte

2012-07-01

In contrast to coeliac disease (CD), the mechanism behind non-coeliac gluten sensitivity (NCGS) is unclear. The aims of the study were to measure the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS individuals compared with CD patients and healthy controls, and to compare the response to gluten challenge between NCGS and CD patients. We examined 22 CD patients and 31 HLA-DQ2+ NCGS patients without CD, all on a gluten-free diet. All but five CD patients were challenged orally for 3 days with gluten; symptom registration was performed during challenge. A comparison group of 40 healthy controls was included. Patients and healthy controls completed questionnaires regarding anxiety, depression, neuroticism and lie, hostility and aggression, alexithymia and health locus of control, physical complaints, and health-related quality of life. The NCGS patients reported more abdominal (p = 0.01) and non-abdominal (p < 0.01) symptoms after gluten challenge than CD patients. There were no significant differences between CD and NCGS patients regarding personality traits, level of somatization, quality of life, anxiety, and depressive symptoms. The somatization level was low in CD and NCGS groups. Symptom increase after gluten challenge was not related to personality in NCGS patients. NCGS patients did not exhibit a tendency for general somatization. Personality and quality of life did not differ between NCGS and CD patients, and were mostly at the same level as in healthy controls. NCGS patients reported more symptoms than CD patients after gluten challenge.

Challenges to quantitative applications of Landsat observations for the urban thermal environment.

PubMed

Chen, Feng; Yang, Song; Yin, Kai; Chan, Paul

2017-09-01

Since the launch of its first satellite in 1972, the Landsat program has operated continuously for more than forty years. A large data archive collected by the Landsat program significantly benefits both the academic community and society. Thermal imagery from Landsat sensors, provided with relatively high spatial resolution, is suitable for monitoring urban thermal environment. Growing use of Landsat data in monitoring urban thermal environment is demonstrated by increasing publications on this subject, especially over the last decade. Urban thermal environment is usually delineated by land surface temperature (LST). However, the quantitative and accurate estimation of LST from Landsat data is still a challenge, especially for urban areas. This paper will discuss the main challenges for urban LST retrieval, including urban surface emissivity, atmospheric correction, radiometric calibration, and validation. In addition, we will discuss general challenges confronting the continuity of quantitative applications of Landsat observations. These challenges arise mainly from the scan line corrector failure of the Landsat 7 ETM+ and channel differences among sensors. Based on these investigations, the concerns are to: (1) show general users the limitation and possible uncertainty of the retrieved urban LST from the single thermal channel of Landsat sensors; (2) emphasize efforts which should be done for the quantitative applications of Landsat data; and (3) understand the potential challenges for the continuity of Landsat observation (i.e., thermal infrared) for global change monitoring, while several climate data record programs being in progress. Copyright © 2017. Published by Elsevier B.V.

In-Space Assembly Capability Assessment for Potential Human Exploration and Science Applications

NASA Technical Reports Server (NTRS)

Jefferies, Sharon A.; Jones, Christopher A.; Arney, Dale C.; Stillwagen, Frederic H.; Chai, Patrick R.; Hutchinson, Craig D.; Stafford, Matthew A.; Moses, Robert W.; Dempsey, James A.; Rodgers, Erica M.;

The Role of Medication in Supporting Emotional Wellbeing in Young People with Long-Term Needs

PubMed Central

Gray, Nicola J.; Wood, Damian M.

2017-01-01

Young people frequently use and access prescribed medications for a range of health problems. Medications aimed at treating both common health problems and long-term physical and mental health needs in adolescence can have a significant effect on a young person’s emotional well-being. We use a series of case studies to illustrate the challenges for healthcare professionals supporting young people with medication use. The studies illustrate the efficacy and limitations of medication on improving emotional well-being by alleviating illness and distress, and how this efficacy must be balanced against both the adverse effects and the burden of treatment. There are specific challenges for medication management during adolescence including issues of adherence/concordance, facilitating autonomy and participation in decision making, and promoting independence. PMID:29099742

Getting educated: e-learning resources in the design and execution of surgical trials.

PubMed

Bains, Simrit

2009-01-01

An evidence-based approach to research, which includes important aspects such as critical appraisal, is essential for the effective conduct of clinical trials. Researchers who are interested in educating themselves about its principles in order to incorporate them into their trials face challenges when attempting to acquire this information from traditional learning sources. E-learning resources offer an intriguing possibility of overcoming the challenges posed by traditional learning, and show promise as a way to expand accessibility to quality education about evidence-based principles. An assessment of existing e-learning resources reveals positive educational avenues for researchers, although significant flaws exist. The Global EducatorTM by Global Research Solutions addresses many of these flaws and is an e-learning resource that combines convenience with comprehensiveness.

International Myeloma Working Group recommendations for global myeloma care.

PubMed

Ludwig, H; Miguel, J S; Dimopoulos, M A; Palumbo, A; Garcia Sanz, R; Powles, R; Lentzsch, S; Ming Chen, W; Hou, J; Jurczyszyn, A; Romeril, K; Hajek, R; Terpos, E; Shimizu, K; Joshua, D; Hungria, V; Rodriguez Morales, A; Ben-Yehuda, D; Sondergeld, P; Zamagni, E; Durie, B

2014-05-01

Recent developments have led to remarkable improvements in the assessment and treatment of patients with multiple myeloma (MM). New technologies have become available to precisely evaluate the biology and extent of the disease, including information about cytogenetics and genetic abnormalities, extramedullary manifestations and minimal residual disease. New, more effective drugs have been introduced into clinical practice, which enable clinicians to significantly improve the outcome of patients but also pose new challenges for the prevention and management of their specific side effects. Given these various new options and challenges, it is important to identify the minimal requirements for diagnosis and treatment of patients, as access to the most sophisticated advances may vary depending on local circumstances. Here, we propose the minimal requirements and possible options for diagnosis, monitoring and treatment of patients with multiple myeloma.

Implementation of diverse tree hydraulics in a land surface model

NASA Astrophysics Data System (ADS)

Wolf, A.; Shevliakova, E.; Malyshev, S.; Weng, E.; Pacala, S. W.

2013-12-01

Increasing attention has been devoted to the occurence of drought kill in forests worldwide. These mortality events are significant disruptions to the terrestrial carbon cycle, but the mechanisms required to represent drought kill are not represented in terrestrial carbon cycle models. In part, this is due to the challenge of representing the diversity of hydraulic strategies, which include stomatal sensitivity to water deficit and woody tissue vulnerability to cavitation at low water potential. In part, this is due to the challenge of representing this boundary value problem numerically, because the hydraulic components determine water potential at the leaf, but the stomatal conductance on the leaf also determines the hydraulic gradients within the plant. This poster will describe the development of a land surface model parameterization of diverse tree hydraulic strategies.

Low carbon transition and sustainable development path of tourism industry

NASA Astrophysics Data System (ADS)

Zhu, Hongbing; Zhang, Jing; Zhao, Lei; Jin, Shenglang

2017-05-01

The low carbon transition is as much a transformative technology shift as it represents a response to global environment challenges. The low carbon paradigm presents a new direction of change for tourism industry. However, the lack of theoretical frameworks on low carbon transformation in tourism industry context provides a significant knowledge gap. This paper firstly investigates the relationships between low carbon and sustainable development, followed by exploring the existing challenges of tourism sustainable development. At last, this paper presents a sustainable development path framework for low carbon transition of tourism industry, which include accelerating deployment of renewable energy, energy-saving green building construction, improving green growth investment, and adopting a sustainable consumption and production system, in order to promote energy and water efficiency, waste management, GHG emissions mitigation and eventually enhance its sustainability.

Technology transfer for adaptation

NASA Astrophysics Data System (ADS)

Biagini, Bonizella; Kuhl, Laura; Gallagher, Kelly Sims; Ortiz, Claudia

2014-09-01

Technology alone will not be able to solve adaptation challenges, but it is likely to play an important role. As a result of the role of technology in adaptation and the importance of international collaboration for climate change, technology transfer for adaptation is a critical but understudied issue. Through an analysis of Global Environment Facility-managed adaptation projects, we find there is significantly more technology transfer occurring in adaptation projects than might be expected given the pessimistic rhetoric surrounding technology transfer for adaptation. Most projects focused on demonstration and early deployment/niche formation for existing technologies rather than earlier stages of innovation, which is understandable considering the pilot nature of the projects. Key challenges for the transfer process, including technology selection and appropriateness under climate change, markets and access to technology, and diffusion strategies are discussed in more detail.

Presidential address, 1995. Surgery 2000: a look back to the future

PubMed Central

Heughan, Christopher

1996-01-01

The present demoralized state of Canadian surgery is due to a number of short-term influences. They include financial restraints, the desire of government agencies to off-load blame for unpopular decisions onto doctors and altered public expectations. The major long-term challenge will be a shortage of physicians and a severe shortage of general surgeons because of the superimposition of longer-term trends in medical demographics on short-term political reactions to a perceived oversupply of doctors. General surgeons need to identify the significant, long-term threats and challenges. If they can do this and plan their responses knowledgably, with some measure of altruism, the future in general surgery will be a bright one for present and future residents and medical students. PMID:8640616

Systems biology solutions for biochemical production challenges.

PubMed

Hansen, Anne Sofie Lærke; Lennen, Rebecca M; Sonnenschein, Nikolaus; Herrgård, Markus J

2017-06-01

There is an urgent need to significantly accelerate the development of microbial cell factories to produce fuels and chemicals from renewable feedstocks in order to facilitate the transition to a biobased society. Methods commonly used within the field of systems biology including omics characterization, genome-scale metabolic modeling, and adaptive laboratory evolution can be readily deployed in metabolic engineering projects. However, high performance strains usually carry tens of genetic modifications and need to operate in challenging environmental conditions. This additional complexity compared to basic science research requires pushing systems biology strategies to their limits and often spurs innovative developments that benefit fields outside metabolic engineering. Here we survey recent advanced applications of systems biology methods in engineering microbial production strains for biofuels and -chemicals. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Uncertainty Management in Remote Sensing of Climate Data. Summary of A Workshop

NASA Technical Reports Server (NTRS)

McConnell, M.; Weidman, S.

2009-01-01

Great advances have been made in our understanding of the climate system over the past few decades, and remotely sensed data have played a key role in supporting many of these advances. Improvements in satellites and in computational and data-handling techniques have yielded high quality, readily accessible data. However, rapid increases in data volume have also led to large and complex datasets that pose significant challenges in data analysis (NRC, 2007). Uncertainty characterization is needed for every satellite mission and scientists continue to be challenged by the need to reduce the uncertainty in remotely sensed climate records and projections. The approaches currently used to quantify the uncertainty in remotely sensed data, including statistical methods used to calibrate and validate satellite instruments, lack an overall mathematically based framework.

Development of a waterborne challenge model for Flavobacterium psychrophilum.

PubMed

Long, Amy; Fehringer, Tyson R; LaFrentz, Benjamin R; Call, Douglas R; Cain, Kenneth D

2014-10-01

Flavobacterium psychrophilum is the causative agent of bacterial coldwater disease and can cause significant mortality in salmonid aquaculture. To better evaluate disease prevention or treatment methods for F. psychrophilum in the laboratory, a waterborne challenge model that mimics a natural outbreak is needed. Here we report on the development of a waterborne challenge model for F. psychrophilum in which we incorporated variables that may influence challenge success: specifically, scarification prior to bacterial exposure and culture of F. psychrophilum under iron-limited culture conditions to potentially increase the probability of establishing disease. Additionally, two F. psychrophilum strains, CSF 259-93 and THC 02-90, were used in this model to test whether there were virulence differences between strains. Mortality was significantly higher in scarred fish than unscarred fish (81.5 vs. 19.4%), supporting the hypothesis that disruptions in the dermal layer enhance mortality in F. psychrophilum waterborne challenges. Although mortality differences were not significant between iron-replete and iron-limited treatments, mortality was high overall (> 30%). There was a significant difference in mortality between CSF 259-93 and THC 02-90 treatments, although both strains caused high mortality in injection challenges. In conclusion, this waterborne challenge model can be used to evaluate potential disease prevention and treatment methods. © 2014 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

Genetics in primary health care and the National Policy on Comprehensive Care for People with Rare Diseases in Brazil: opportunities and challenges for professional education.

PubMed

Melo, Débora Gusmão; de Paula, Pamela Karen; de Araujo Rodrigues, Stephania; da Silva de Avó, Lucimar Retto; Germano, Carla Maria Ramos; Demarzo, Marcelo Marcos Piva

2015-07-01

As discoveries regarding the genetic contribution to disease have grown rapidly, health care professionals are expected to incorporate genetic and genomic perspectives into health education and practice. Genetic competencies common to all health professionals have been identified by the US National Coalition for Health Professional Education in Genetics (NCHPEG), which defined the knowledge, skills, and attitudes required to achieve these competencies. The aim of this study is to analyze genetic competencies of primary health care professionals in Brazil. It is a descriptive survey study, whereby doctors, nurses, and dentists were invited to participate by answering a questionnaire including 11 issues based on competencies established by the NCHPEG. Data were presented as percentages. Differences between groups of participants were assessed by the Fisher exact test, with the level of significance set at p < 0.05. Results showed that concerning knowledge, about 80 % of the participants recognized basic genetics terminology, but practitioners had difficulty in identifying patterns of inheritance. Regarding clinical skills, practitioners were able to recognize facial dysmorphias and identify situations where referral of patients to specialists was necessary. Nevertheless, there were challenges in the process of valuing and gathering information about family history. Regarding attitudes, 68.9 % of the participants thought about the comprehensiveness of care but faced challenges in counselling parents. The results of this study may contribute to developing an ongoing education program for primary health care professionals, leading to a strategy to overcome the challenges of including genetics in the Brazilian Unified Health System.

Race to the Top - Early Learning Challenge: 2014 Annual Performance Report. Delaware

ERIC Educational Resources Information Center

Race to the Top - Early Learning Challenge, 2015

2015-01-01

This Race to the Top - Early Learning Challenge (RTT-ELC) annual performance report for the year 2014 describes Delaware's accomplishments, lessons learned, challenges, and strategies Delaware will implement to address those challenges. At the end of Year Three of the Early Learning Challenge Grant, Delaware continues to make significant progress…

Live Attenuated Tularemia Vaccines for Protection Against Respiratory Challenge With Virulent F. tularensis subsp. tularensis

PubMed Central

Jia, Qingmei; Horwitz, Marcus A.

2018-01-01

Francisella tularensis is the causative agent of tularemia and a Tier I bioterrorism agent. In the 1900s, several vaccines were developed against tularemia including the killed “Foshay” vaccine, subunit vaccines comprising F. tularensis protein(s) or lipoproteins(s) in an adjuvant formulation, and the F. tularensis Live Vaccine Strain (LVS); none were licensed in the U.S.A. or European Union. The LVS vaccine retains toxicity in humans and animals—especially mice—but has demonstrated efficacy in humans, and thus serves as the current gold standard for vaccine efficacy studies. The U.S.A. 2001 anthrax bioterrorism attack spawned renewed interest in vaccines against potential biowarfare agents including F. tularensis. Since live attenuated—but not killed or subunit—vaccines have shown promising efficacy and since vaccine efficacy against respiratory challenge with less virulent subspecies holarctica or F. novicida, or against non-respiratory challenge with virulent subsp. tularensis (Type A) does not reliably predict vaccine efficacy against respiratory challenge with virulent subsp. tularensis, the route of transmission and species of greatest concern in a bioterrorist attack, in this review, we focus on live attenuated tularemia vaccine candidates tested against respiratory challenge with virulent Type A strains, including homologous vaccines derived from mutants of subsp. holarctica, F. novicida, and subsp. tularensis, and heterologous vaccines developed using viral or bacterial vectors to express F. tularensis immunoprotective antigens. We compare the virulence and efficacy of these vaccine candidates with that of LVS and discuss factors that can significantly impact the development and evaluation of live attenuated tularemia vaccines. Several vaccines meet what we would consider the minimum criteria for vaccines to go forward into clinical development—safety greater than LVS and efficacy at least as great as LVS, and of these, several meet the higher standard of having efficacy ≥LVS in the demanding mouse model of tularemia. These latter include LVS with deletions in purMCD, sodBFt, capB or wzy; LVS ΔcapB that also overexpresses Type VI Secretion System (T6SS) proteins; FSC200 with a deletion in clpB; the single deletional purMCD mutant of F. tularensis SCHU S4, and a heterologous prime-boost vaccine comprising LVS ΔcapB and Listeria monocytogenes expressing T6SS proteins. PMID:29868510

Efficacy of Fostera® PRRS modified live virus (MLV) vaccination strategy against a Thai highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV) infection.

PubMed

Charoenchanikran, Ponlakrit; Kedkovid, Roongtham; Sirisereewan, Chaitawat; Woonwong, Yonlayong; Arunorat, Jirapat; Sitthichareonchai, Panchan; Sopipan, Natthawan; Jittimanee, Suphattra; Kesdangsakonwut, Sawang; Thanawongnuwech, Roongroje

2016-10-01

Recently, the Chinese highly pathogenic porcine reproductive and respiratory syndrome virus (PRRSV) (HP-PRRSV) belonging to lineage 8 causes severe symptom with high morbidity and high mortality rates to the Asian pig industry. A recent study showed that pigs immunized with Fostera® PRRS modified live virus (MLV) of lineage 8 could provide a degree of protection against a Vietnamese HP-PRRSV infection. It should be noted that PRRSV commonly found after weaning causes porcine respiratory disease complex (PRDC). Vaccination strategy should be evaluated in each farm scenario. Eighty-one PRRSV-free piglets obtained from a PRRS-free herd were divided into two experiments with the major difference of infection timing after vaccination, 42 days in experiment 1 (n = 42) and 28 days in experiment 2 (n = 39). Each experiment had similar protocol containing three groups including a negative control, unvaccinated challenged, and vaccinated challenged groups. Pigs in vaccination groups were immunized with Fostera® PRRS MLV vaccine at 3 weeks of age. Then, unvaccinated challenged and vaccinated challenged groups were intranasally inoculated with a Thai HP-PRRSV (10PL01). Vaccinated challenged pigs showed significantly lower levels of mean rectal temperatures, clinical severity, lung lesion scores, and viral titers in serum and lung tissue compared to the unvaccinated challenged pigs (p < 0.05). Vaccinated challenged pigs had higher survival rate than those of unvaccinated challenged pigs in both experiments. It should be noted that pigs challenged 42 days after vaccination showed a better performance than pigs challenged 28 days after vaccination. In conclusion, Fostera® PRRS MLV vaccine was able to improve the survival rate against the Thai HP-PRRSV infection in both 42- and 28-day vaccination-to-infection protocols.

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg

PubMed Central

Cortot, Catherine F.; Sheehan, William J.; Permaul, Perdita; Friedlander, James L.; Baxi, Sachin N.; Gaffin, Jonathan M.; Dioun, Anahita F.; Hoffman, Elaine B.; Schneider, Lynda C.

2012-01-01

Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. We examined egg white–specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes. We conducted a retrospective chart review of children, aged 2–18 years, receiving an egg white–specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0–35 mm) for passed challenges and 17 mm (range, 10–30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white–specific IgE was 2.02 kU/L (range, <0.35–13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51–6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white–specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white–specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size. PMID:22584194

Identifying the challenges and facilitators of implementing a COPD care bundle

PubMed Central

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Background Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. Methods An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Results Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Conclusions Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges. PMID:25478183

Laboratory Diagnosis of Infections in Cancer Patients: Challenges and Opportunities

PubMed Central

2016-01-01

Infections remain a significant cause of morbidity and mortality in cancer patients. The differential diagnosis for these patients is often wide, and the timely selection of the right clinical tests can have a significant impact on their survival. However, laboratory findings with current methodologies are often negative, challenging clinicians and laboratorians to continue the search for the responsible pathogen. Novel methodologies are providing increased sensitivity and rapid turnaround time to results but also challenging our interpretation of what is a clinically significant pathogen in cancer patients. This minireview provides an overview of the most common infections in cancer patients and discusses some of the challenges and opportunities for the clinical microbiologist supporting the care of cancer patients. PMID:27280421

Supplementation of Vitamin E Protects Chickens from Newcastle Disease Virus-Mediated Exacerbation of Intestinal Oxidative Stress and Tissue Damage.

PubMed

Rehman, Zaib Ur; Che, Luping; Ren, Shanhui; Liao, Ying; Qiu, Xusheng; Yu, Shengqing; Sun, Yingjie; Tan, Lei; Song, Cuiping; Liu, Weiwei; Ding, Zhuang; Munir, Muhammad; Nair, Venugopal; Meng, Chunchun; Ding, Chan

2018-06-27

Newcastle disease virus (NDV) causes a highly devastating and contagious disease in poultry, which is mainly attributed to extensive tissue damages in the digestive, respiratory and nervous systems. However, nature and dynamics of NDV-induced oxidative stresses in the intestine of chickens remain elusive. In this study, we examined the magnitude of intestinal oxidative stress and histopathological changes caused by the virulent NDV infection, and explored the protective roles of vitamin E (vit. E) in ameliorating these pathological changes. For these purposes, chickens were divided into four groups namely i) non supplemented and non-challenged (negative control, CON); ii) no supplementation of vit. E but challenged with ZJ1 (positive control, NS+CHA); iii) vit. E supplementation at the dose of 50 IU/day/Kg body weight and ZJ1 challenge (VE50+CHA); and 4) vit. E supplementation at the dose of 100 IU/day/Kg body weight and ZJ1 challenge (VE100+CHA). In all groups, we analyzed concentrations of glutathione (GSH), malondialdehyde (MDA), nitric oxide (NO), total antioxidant capacity (T-AOC), and activity of glutathione S-transferase (GST), superoxide dismutase (SOD), catalase (CAT) using biochemical methods. The virus loads were determined by quantitative RT-PCR and antibody titers by hemagglutination inhibition assays. We also examined the histopathological changes in the duodenal and jejunal mucosa at 3 and 5-day post infection (dpi) with NDV. A significant elevation in the NO level was observed in NDV challenged chickens compared to the CON chickens at 2 dpi. The MDA contents were significantly increased whereas GSH was significantly decreased in NDV-challenged chickens compared to control. Furthermore, activities of GST, CAT, SOD, as well as the TOAC were markedly decreased in challenged chickens in comparison with control. Virus copy numbers were higher in NDV infected NS+CHA group compared to other groups. Severe histopathological changes including inflammation, degeneration and broken villi were observed in the intestine of NDV challenged chickens. However, all these malfunctions of antioxidant system and pathological changes in the intestine were partially or completely reversed by the vit. E supplementation. Our results suggest that NDV infection causes oxidative stress and histopathological changes in the duodenum and jejunum of chickens, which can be partially or fully ameliorated by supplementation of vit. E. Additionally, these findings suggest that oxidative stress contributes to the intestinal damages in NDV infected chickens. These findings will help to understand the pathogenesis of NDV and further investigation of therapeutic agents for control of Newcastle disease. © 2018 The Author(s). Published by S. Karger AG, Basel.

Development of therapeutic antibodies to G protein-coupled receptors and ion channels: Opportunities, challenges and their therapeutic potential in respiratory diseases.

PubMed

Douthwaite, Julie A; Finch, Donna K; Mustelin, Tomas; Wilkinson, Trevor C I

2017-01-01

The development of recombinant antibody therapeutics continues to be a significant area of growth in the pharmaceutical industry with almost 50 approved monoclonal antibodies on the market in the US and Europe. Therapeutic drug targets such as soluble cytokines, growth factors and single transmembrane spanning receptors have been successfully targeted by recombinant monoclonal antibodies and the development of new product candidates continues. Despite this growth, however, certain classes of important disease targets have remained intractable to therapeutic antibodies due to the complexity of the target molecules. These complex target molecules include G protein-coupled receptors and ion channels which represent a large target class for therapeutic intervention with monoclonal antibodies. Although these targets have typically been addressed by small molecule approaches, the exquisite specificity of antibodies provides a significant opportunity to provide selective modulation of these important regulators of cell function. Given this opportunity, a significant effort has been applied to address the challenges of targeting these complex molecules and a number of targets are linked to the pathophysiology of respiratory diseases. In this review, we provide a summary of the importance of GPCRs and ion channels involved in respiratory disease and discuss advantages offered by antibodies as therapeutics at these targets. We highlight some recent GPCRs and ion channels linked to respiratory disease mechanisms and describe in detail recent progress made in the strategies for discovery of functional antibodies against challenging membrane protein targets such as GPCRs and ion channels. Copyright © 2016 Elsevier Inc. All rights reserved.

Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema.

PubMed

Errichetti, Enzo; Stinco, Giuseppe

2016-04-01

Clinical differentiation between palmar psoriasis and chronic hand eczema may sometimes be a diagnostic challenge; in such cases histopathological analysis helps to differentiate the two conditions. In the present study, palmar psoriasis and chronic hand eczema were investigated using dermoscopy and the significance of specific dermoscopic features was assessed in order to improve their non-invasive differentiation. Ten patients with biopsy-proven palmar psoriasis and 11 patients with biopsy-proven chronic hand eczema were included in the study. We found that the presence of diffuse white scales was significant in palmar psoriasis whereas the presence of yellowish scales, brownish-orange dots/globules and yellowish-orange crusts was significant in chronic hand eczema. © 2015 Japanese Dermatological Association.