How Unique Are Our Users? Part 2: Comparing Responses Regarding the Information-Seeking Habits of Education Faculty

ERIC Educational Resources Information Center

Robbins, Sarah; Rupp-Serrano, Karen

2013-01-01

This follow-up study examines whether or not findings of single institution studies are applicable to other institutions by performing an institution-to-institution comparison of the results obtained from an information-seeking behavior survey sent to education faculty at twenty research institutions. The results from this study corroborated what…

Developing an institutional framework to incorporate ecosystem services into decision making-Proceedings of a workshop

USGS Publications Warehouse

Hogan, Dianna; Arthaud, Greg; Brookshire, David; Gunther, Tom; Pincetl, Stephanie; Shapiro, Carl; Van Horne, Bea

2011-01-01

The appropriate use of institutional structures, including markets, to integrate ecosystem services into decision making depends on the players and characteristics of the specific situation (such as stakeholders, the ecosystem, resources, and the political environment). Incorporating ecosystem service values into decisions requires consideration of place-based social, cultural, economic, and landscape characteristics and institutions. Thus, a single, prescribed solution will not work-various institutional strategies must be used in different situations. Market-based approaches require appropriate regulations, monitoring, and enforcement, depending on the situation and place. Further, market approaches will need to be coupled with nonmarket approaches into an integrated institutional framework.

Publication performance and research output of Neurology and Neurosurgery training institutes in India: A 5-year analysis.

PubMed

Madhugiri, Venkatesh S

2015-01-01

Scientific publications are a reflection of the quality of the clinical and academic work being carried out in an institute. Training in the process of research and scientific writing are important components of the residency curriculum. The publication performance and research output of institutes training residents in neurology and neurosurgery were evaluated. Internet-based study. This study was based on the data available on the websites of the Medical Council of India and the National Board of Examinations. The PubMed search interface was used to determine the publication output of institutes over the past 5 years (2010-2014). Google Scholar was used to determine the citation performance of each paper. The publication parameters were normalized to the number of faculty members in each institute as listed on the institutional web page. The normalized publication performance for an institute was computed by comparing the figures for that institute with the national average. Institutes could be ranked on several criteria. There was a high degree of clustering of output from the top 5% of the institutes. About 13% of the neurology intake and 30.9% of neurosurgery intake over the past 5 years has been into the institutes that have not published a single paper during this period. This evaluation of the publication performance and research output of neurology and neurosurgery training institutes would serve as a baseline data for future evaluations and comparisons. The absence of any publication and research output from several training institutes is a matter of concern.

How Unique Are Our Users? Comparing Responses Regarding the Information-Seeking Habits of Engineering Faculty

ERIC Educational Resources Information Center

Robbins, Sarah; Engel, Debra; Kulp, Christina

2011-01-01

Studies of information-seeking behaviors are common in the professional literature for library and information studies. This study examines the generalizability of findings of single-institution studies to other institutions by performing an institution-to-institution comparison of the results obtained from an information-seeking behavior survey…

Structural Design of Dual-Mode Ramjets and Associated System Issues (Conception structurale des statoreacteurs mixtes et defis systeme associes)

DTIC Science & Technology

2010-09-01

Institute PAO Protection Against Oxidation RBCC Rocket Based Combined Cycle RSL Reusable Space Launchers SSTO Single Stage to Orbit TOW Take-Off Weight...Orbit) or Single Stage To Orbit ( SSTO ) vehicles, or other kind of hypersonic vehicles. For example, in the scope of the French PREPHA program, the...study of a generic SSTO vehicle led to conclusion that the best type of airbreathing engine could be the dual-mode ramjet (subsonic then supersonic

Trends in the volume of operative treatment of midshaft clavicle fractures in children and adolescents: a retrospective, 12-year, single-institution analysis.

PubMed

Suppan, Catherine A; Bae, Donald S; Donohue, Kyna S; Miller, Patricia E; Kocher, Mininder S; Heyworth, Benton E

2016-07-01

The purpose of this study was to examine institutional trends in the volume of clavicle fractures in children and adolescents. Medical records were retrospectively reviewed to identify patients aged 10-18 years treated for a clavicle fracture between 1999 and 2011 at a single tertiary-care pediatric hospital. There were significant increases in the number of clavicle fractures seen annually, of midshaft clavicle fractures, and of midshaft clavicle fractures treated operatively. The percentage of midshaft clavicle fractures treated with fixation also increased significantly. The volumes of clavicle fractures and midshaft clavicle fractures treated operatively appear to be increasing. Despite a lack of evidence-based support, the frequency of fixation of midshaft clavicle fractures appear to be increasing in the pediatric population.

The Engaged Learning Index: Implications for Faculty Development

ERIC Educational Resources Information Center

Schreiner, L. A.; Louis, M. C.

2011-01-01

The Engaged Learning Index was designed by the authors to assess students' emotional, intellectual, and behavioral engagement in learning in a brief format that can be used in single courses or across multiple courses and institutions. In this study, evidence is presented for the reliability and predictive validity of the instrument based on a…

Introducing Whole-Systems Design to First-Year Engineering Students with Case Studies

ERIC Educational Resources Information Center

Blizzard, Jackie; Klotz, Leidy; Pradhan, Alok; Dukes, Michael

2012-01-01

Purpose: A whole-systems approach, which seeks to optimize an entire system for multiple benefits, not isolated components for single benefits, is essential to engineering design for radically improved sustainability performance. Based on real-world applications of whole-systems design, the Rocky Mountain Institute (RMI) is developing educational…

Information and organization in public health institutes: an ontology-based modeling of the entities in the reception-analysis-report phases.

PubMed

Pozza, Giandomenico; Borgo, Stefano; Oltramari, Alessandro; Contalbrigo, Laura; Marangon, Stefano

2016-09-08

Ontologies are widely used both in the life sciences and in the management of public and private companies. Typically, the different offices in an organization develop their own models and related ontologies to capture specific tasks and goals. Although there might be an overall coordination, the use of distinct ontologies can jeopardize the integration of data across the organization since data sharing and reusability are sensitive to modeling choices. The paper provides a study of the entities that are typically found at the reception, analysis and report phases in public institutes in the life science domain. Ontological considerations and techniques are introduced and their implementation exemplified by studying the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), a public veterinarian institute with different geographical locations and several laboratories. Different modeling issues are discussed like the identification and characterization of the main entities in these phases; the classification of the (types of) data; the clarification of the contexts and the roles of the involved entities. The study is based on a foundational ontology and shows how it can be extended to a comprehensive and coherent framework comprising the different institute's roles, processes and data. In particular, it shows how to use notions lying at the borderline between ontology and applications, like that of knowledge object. The paper aims to help the modeler to understand the core viewpoint of the organization and to improve data transparency. The study shows that the entities at play can be analyzed within a single ontological perspective allowing us to isolate a single ontological framework for the whole organization. This facilitates the development of coherent representations of the entities and related data, and fosters the use of integrated software for data management and reasoning across the company.

Social structure of Facebook networks

NASA Astrophysics Data System (ADS)

Traud, Amanda L.; Mucha, Peter J.; Porter, Mason A.

2012-08-01

We study the social structure of Facebook “friendship” networks at one hundred American colleges and universities at a single point in time, and we examine the roles of user attributes-gender, class year, major, high school, and residence-at these institutions. We investigate the influence of common attributes at the dyad level in terms of assortativity coefficients and regression models. We then examine larger-scale groupings by detecting communities algorithmically and comparing them to network partitions based on user characteristics. We thereby examine the relative importance of different characteristics at different institutions, finding for example that common high school is more important to the social organization of large institutions and that the importance of common major varies significantly between institutions. Our calculations illustrate how microscopic and macroscopic perspectives give complementary insights on the social organization at universities and suggest future studies to investigate such phenomena further.

Epidemiological features of gastroenteropancreatic neuroendocrine tumors in Chengdu city with a population of 14 million based on data from a single institution.

PubMed

Guo, Lin-Jie; Wang, Chun-Hui; Tang, Cheng-Wei

2016-09-01

Recent studies on gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in the United States as well as the European studies demonstrate an increasing GEP-NETs incidence. Most information on the epidemiology of neuroendocrine tumors comes from western countries. However, the epidemiological profile of GEP-NETs in West China is still unclear. The aim of study was to reflect the regional features of GEP-NETs in Chengdu city of West China based on data from a single institution. West China Hospital (WCH), the largest university hospital located in Chengdu (West China) with population of 14.04 million, has established a serial of databases in recent years. According to the data from Medical Records Section of WCH and Chengdu Health Bureau, the total patients per year in WCH covered about 25.6-28% patients of Chengdu city during the 5 years. Therefore, we have used GEP-NETs diagnosed in WCH from 2009 to 2013 to reflect the regional epidemiological profile of GEP-NETs. GEP-NETs proportion in WCH increased 1.6-folds during past 5 years from 1.28/10(5) to 2.03/10(5) , P < 0.05. The average duration of symptom before diagnosis was 16.8 months. About 46.6% (115/248) of GEP-NETs were metastatic. Seventy-seven percent (190/248) of patients were over 40 years. Proportions of GEP-NETs from primary sites were rectum 30.6% (76/248), pancreas 23.4% (58/248), gastric 13.3% (33/248) and esophagus 11.3% (28/248). Proportions of insulinoma, vipoma and nonfunctional pancreatic neuroendocrine tumors (P-NETs) were 43.1% (25/58), 1.7% (1/58) and 55.2% (32/58) separately in the P-NETs. There is a distinct epidemiologic profile between West China and western countries based on a single institution data. The delayed diagnosis reflects inadequate disease awareness of GEP-NETs and paucity of research funding. © 2016 John Wiley & Sons Australia, Ltd.

Trends in survival of multiple myeloma: a thirty-year population-based study in a single institution.

PubMed

Ríos-Tamayo, Rafael; Sánchez, María José; Puerta, José Manuel; Sáinz, Juan; Chang, Daysi-Yoe-Ling; Rodríguez, Teresa; López, Pilar; de Pablos, José María; Navarro, Pilar; de Veas, José Luís García; Romero, Antonio; Garrido, Pilar; Moratalla, Lucía; Alarcón-Payer, Carolina; López-Fernández, Elisa; González, Pedro Antonio; Jiménez-Moleón, José Juan; Calleja-Hernández, Miguel Ángel; Jurado, Manuel

2015-10-01

Despite the progress made in recent years, multiple myeloma is still considered an incurable disease. Most survival data come from clinical trials. Little is known about the outcome in unselected real-life patients. Overall survival was analyzed in a cohort of newly diagnosed symptomatic multiple myeloma patients, over the last three decades, in a single institution population-based study. 582 consecutive myeloma patients were included in the study. Survival increased over time in patients younger than 65 years but did not reach statistical significance in patients with 65 years or older. The prognostic factors associated with overall survival were the International Staging System, the serum lactate dehydrogenase level, the renal impairment, the realization of autologous stem cell transplantation, and the presence of concomitant amyloidosis. Overall survival shows a steady improvement over time. The survival of myeloma is improving progressively in real-life patients, particularly after the widespread use of the novel agents. A comprehensive assessment of comorbidity can help to explain the huge heterogeneity of myeloma outcome. The optimization of current therapeutic resources as well as the incorporation of new drugs will allow further improvement of survival in the coming years. Copyright © 2015 Elsevier Ltd. All rights reserved.

Venous thromboprophylaxis in general surgery ward admissions: strategies for improvement.

PubMed

Galante, Mariana; Languasco, Agustín; Gotta, Daniel; Bell, Soledad; Lancelotti, Tomás; Knaze, Viktoria; Saubidet, Cristián Lopez; Grand, Beatriz; Milberg, Matías

2012-12-01

To estimate the adherence to institutional venous thromboprophylaxis clinical practice guidelines (CPGs) in general surgery patients and to assess the effectiveness of a multi-strategy improvement intervention. A prospective before-after study. Two teaching hospitals located in the city of Buenos Aires, Argentina. Prescriptions belonging to patients admitted to the general surgery wards were evaluated. A multi-strategy intervention that included (i) simplification of institutional CPGs for venous thromboprophylaxis using a single drug at a single dose, based on the American College of Chest Physicians recommendations, (ii) distribution of pocket cards with an algorithm for the implementation of new recommendations to both, physicians and nurses, working in the general surgery units, (iii) educational talks, (iv) paper-based reminders and (v) audit and feedback. The adherence of the venous thromboprophylaxis prescription to the institutional recommendations. The prescriptions of 100 admitted patients before and 90 after the intervention were included in the analysis. The initial rate of adherence was 31%. After the intervention this rate rose to 71.1% (P< 0.001). The major improvement observed was the reduction in omitted prophylaxis in patients at risk of venous thromboembolism from 45 to 13.3% (P< 0.001). In the adjusted model, prescribing compliance with CPGs was five times more likely during the second stage than during the first stage (OR = 5.60, 95% CI = 2.92-10.74). Simple and economical interventions such as those described in this study can improve general surgeons compliance with the institutional and international guidelines, thus assuring patient safety and quality of health care.

The Statistical Knowledge Gap in Higher Degree by Research Students: The Supervisors' Perspective

ERIC Educational Resources Information Center

Baglin, James; Hart, Claire; Stow, Sarah

2017-01-01

This study sought to gain an understanding of the current statistical training and support needs for Australian Higher Degree by Research (HDR) students and their supervisors. The data reported herein are based on the survey responses of 191 (18.7%) eligible supervisors from a single Australian institution. The survey was composed of both…

Sexual Behavior Among Orphaned Adolescents in Western Kenya: A Comparison of Institutional- and Family-Based Care Settings.

PubMed

Embleton, Lonnie; Nyandat, Joram; Ayuku, David; Sang, Edwin; Kamanda, Allan; Ayaya, Samuel; Nyandiko, Winstone; Gisore, Peter; Vreeman, Rachel; Atwoli, Lukoye; Galarraga, Omar; Ott, Mary A; Braitstein, Paula

2017-04-01

This study sought to assess whether risky sexual behaviors and sexual exploitation of orphaned adolescents differed between family-based and institutional care environments in Uasin Gishu County, Kenya. We analyzed baseline data from a cohort of orphaned adolescents aged 10-18 years living in 300 randomly selected households and 19 charitable children's institutions. The primary outcomes were having ever had consensual sex, number of sex partners, transactional sex, and forced sex. Multivariate logistic regression compared these between participants in institutional care and family-based care while adjusting for age, sex, orphan status, importance of religion, caregiver support and supervision, school attendance, and alcohol and drug use. This analysis included 1,365 participants aged ≥10 years: 712 (52%) living in institutional environments and 653 (48%) in family-based care. Participants in institutional care were significantly less likely to report engaging in transactional sex (adjusted odds ratio, .46; 95% confidence interval, .3-.72) or to have experienced forced sex (adjusted odds ratio, .57; 95% confidence interval, .38-.88) when controlling for age, sex, and orphan status. These associations remained when adjusting for additional variables. Orphaned adolescents living in family-based care in Uasin Gishu, Kenya, may be at increased risk of transactional sex and sexual violence compared to those in institutional care. Institutional care may reduce vulnerabilities through the provision of basic material needs and adequate standards of living that influence adolescents' sexual risk-taking behaviors. The use of single items to assess outcomes and nonexplicit definition of sex suggest the findings should be interpreted with caution. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Sexual behaviour among orphaned adolescents in western Kenya: a comparison of institutional- and family-based care settings

PubMed Central

Embleton, Lonnie; Nyandat, Joram; Ayuku, David; Sang, Edwin; Kamanda, Allan; Ayaya, Samuel; Nyandiko, Winstone; Gisore, Peter; Vreeman, Rachel; Atwoli, Lukoye; Galarraga, Omar; Ott, Mary A.; Braitstein, Paula

2016-01-01

Purpose This study sought to assess whether risky sexual behaviours and sexual exploitation of orphaned adolescents differed between family-based and institutional care environments in Uasin Gishu County, Kenya. Methods We analyzed baseline data from a cohort of orphaned adolescents aged 10–18 years living in 300 randomly-selected households and 19 Charitable Children’s Institutions. The primary outcomes were having ever had consensual sex, number of sex partners, transactional sex, and forced sex. Multivariable logistic regression compared these between participants in institutional care and family-based care, while adjusting for age, sex, orphan status, importance of religion, caregiver support and supervision, school attendance, and alcohol and drug use. Results This analysis included 1,365 participants aged ≥10 years; 712 (52%) living in institutional environments and 653 (48%) in family-based care. Participants in institutional care were significantly less likely to report engaging in transactional sex (AOR 0.46 95% CI: 0.3–0.72) or to have experienced forced sex (AOR=0.57 95% CI: 0.38–0.88) when controlling for age, sex, and orphan status. These associations remained when adjusting for additional variables. Conclusion Orphaned adolescents living in family-based care in Uasin Gishu, Kenya, may be at increased risk of transactional sex and sexual violence compared to those in institutional care. Institutional care may reduce vulnerabilities through the provision of basic material needs and adequate standards of living that influence adolescents’ sexual risk-taking behaviours. The use of single items to assess outcomes and non-explicit definition of sex suggest the findings should be interpreted with caution. PMID:28110864

Cost-effectiveness analysis of flexible optical scopes for tracheal intubation: a descriptive comparative study of reusable and single-use scopes.

PubMed

Gupta, Deepak; Wang, Hong

2011-12-01

To calculate the costs per intubation of reusable fiberoptic scopes versus single-use intubation scopes. Open-label retrospective study. University-affiliated hospital. The one-year intubation records of intubations performed with reusable intubation scopes, the one-year maintenance costs of these scopes, and their three-year repair cost records were analyzed. A total of 166 intubations were performed with reusable fiberoptic scopes in 2009. Calculations to assess the costs per intubation based on the documented records at our institution were made. The total cost of an intubation, the repair-to-intubation ratio, and the repair cost per intubation were determined. The total cost of an intubation at our institution in 2009, using reusable scopes, was $119.75 [US dollars (USD)], which included $20.15 (purchasing), $53.48 (repair), $33.16 (maintenance), and $12.96 (labor). The repair-to-intubation ratio was 1:55. Repair costs were $53.48 per intubation and $2,959.44 per instance of repair. The Ambu aScope, a single-use intubation scope, is a new addition to video laryngoscopy. The price should range within 10% of our intubation cost ($120.00 to $132.00 per single-use intubation scope). Copyright © 2011 Elsevier Inc. All rights reserved.

Understanding the experiences and perceptions of African American female STEM majors at a single-sex HBCU

NASA Astrophysics Data System (ADS)

Wilson, Rahshida S.

This study uses qualitative methods to explore and understand the experiences of African American female STEM majors at a single-sex historically Black university (HBCU). The study focuses on the perspectives of Black women and how they perceive the strategies and practices utilized at a single-sex HBCU that aid in fostering the successful development of Black women in STEM fields. Although limited to one institution, the findings shed light on the ways in which African American women experience the single-sex HBCU, and how the institution aids in their persistence in STEM majors. This study also discusses how such strategies and practices at a single-sex HBCU aid in mitigating the challenges and barriers that limit the attainment of African American women in STEM fields, and provides an opportunity for them to develop strong identities in STEM. Drawing on the findings, the paper concludes with recommendations for improving implementation of strategies revealed in historically Black colleges/universities and predominantly White colleges/ universities (PWIs). Recommendations for future research suggest that the experiences of African American women in single-sex and co-educational historically Black and predominantly White institutions could be further explored.

PET/CT and contrast enhanced CT in single vs. two separate sessions: a cost analysis study.

PubMed

Picchio, M; Mansueto, M; Crivellaro, C; Guerra, L; Marcelli, S; Arosio, M; Sironi, S; Gianolli, L; Grimaldi, A; Messa, C

2012-06-01

Aim of the study was to quantify the economic impact of PET/CT and contrast enhanced (c.e.) CT performed in a single session examination vs. stand-alone modalities in oncological patients. One-hundred-forty-five cancer patients referred to both PET/CT and c.e. CT, to either stage (N.=46) or re-stage (N.=99) the disease, were included. Seventy-two/145 performed both studies in a single session (innovative method) and 73/145 in two different sessions (traditional method). The cost-minimization analysis was performed by evaluating: 1) institutional costs, data obtained by hospital accountability (staff, medical materials, equipment maintenance and depreciation, departments utilities); 2) patients costs, data obtained by a specific survey provided to patients (travel, food, accommodation costs, productivity loss). Economic data analysis showed that the costs for innovative method was lower than those of traditional method, both for Institution (106 € less per test) and for patient (21 € less per patient). The loss of productivity for patient and caregivers resulted lower for the innovative method than the traditional method (3 work-hour less per person). PET/CT and c.e. CT performed in a single session is more cost-effective than stand-alone modalities, by reducing both Institutional and patients costs. These advantages are mainly due to lower Institutional cost (single procedure) and to lower cost related to travel and housing.

Prior Learning Assessment: How Institutions Use Portfolio Assessments

ERIC Educational Resources Information Center

Klein-Collins, Becky; Hain, Patrick

2009-01-01

The term Prior Learning Assessment (PLA) refers not to a single kind of assessment but rather an entire family of assessment methods that can be used by institutions. Some of these methods are exam-based. In addition, there are other methods of PLA. One of the more innovative methods of offering PLA, however, is through the development of student…

Universities as Communities of Fate: Institutional Rhetoric and Student Retention Policy

ERIC Educational Resources Information Center

Waggoner, David; Goldman, Paul

2005-01-01

Purpose: What is the rhetoric that higher education institutions use when they develop and publish policies to improve student retention? Using the organization literature on institutional environments, this study examines the nature and evolution of institutional rhetoric used by three public universities in a single state over a 20-year period.…

Racial Identity Attitudes, Womanist Identity Attitudes, and Self-Esteem in African American College Women Attending Historically Black Single-Sex and Coeducational Institutions

ERIC Educational Resources Information Center

Watt, Sherry Kay

2006-01-01

This study examines racial identity attitudes, womanist identity attitudes, and self-esteem of 111 African American college women attending two historically Black higher educational institutions, one coeducational and one single-sex. The major findings indicate that pre-encounter and encounter attitudes of racial and womanist identity are…

Initial experience with ketamine-based analgesia in patients undergoing robotic radical cystectomy and diversion.

PubMed

Jacobsohn, Kenneth; Davis, Tanya D; El-Arabi, Ahmad M; Tlachac, Jonathan; Langenstroer, Peter; O'Connor, R Corey; Guralnick, Michael L; See, William A; Schlosser, Robert

2015-01-01

We instituted a ketamine-predominant analgesic regimen in the peri- and postoperative periods to limit the effects of narcotic analgesia on bowel function in patients undergoing radical cystectomy. The primary end points of interest were time to return of bowel function, time to discharge, and efficacy of the analgesic regimen. We performed a retrospective chart review of patients undergoing robotic-assisted laparoscopic cystectomy (RARC) with urinary diversion by a single surgeon at our institution from January 1, 2011 to June 30, 2012. Patients receiving the opioid-minimizing ketamine protocol were compared to a cohort of patients undergoing RARC with an opioid-predominant analgesic regimen. In total, 15 patients (Group A) were included in the ketamine-predominant regimen and 25 patients (Group B) in the opioid-predominant control group. Three patients (19%) in Group A discontinued the protocol due to ketamine side effects. The mean time to bowel movement and length of stay in Group A versus Group B was 3 versus 6 days (p < 0.001), and 4 versus 8 days, respectively (p < 0.001). Group A patients received an average of 13.0 mg of morphine versus 97.5 mg in Group B (p < 0.001). Patients who received our ketamine pain control regimen had a shorter time to return of bowel function and length of hospitalization after RARC. Our study has its limitations as a retrospective, single surgeon, single institution study and the non-randomization of patients. Notwithstanding these limitations, this study was not designed to show inferiority of one approach, but instead to show that our protocol is safe and efficacious, warranting further study in a prospective fashion.

Research priorities for multi-institutional collaborative research in surgical education.

PubMed

Stefanidis, Dimitrios; Cochran, Amalia; Sevdalis, Nick; Mellinger, John; Phitayakorn, Roy; Sullivan, Maura; Barney, Linda

2015-01-01

Research in surgical education has seen unprecedented growth but originates from single institutions and remains uncoordinated; this study aimed to generate a list of research priorities in surgical educational topics. The membership of the Association for Surgical Education was asked to submit up to 5 research questions concerned with multi-institutional collaborative surgical education research and to identify challenges faced by surgical education researchers. A modified Delphi methodology was used to create the research agenda based on these responses. Surgical educators responded to 3 survey rounds. Categories of submitted questions included teaching methods and curriculum development; assessment and competency; simulation; medical student preparation and selection; impact of work hour restrictions; and faculty development. Participants cited institutional culture and practice variability and lack of institutional review board coordination as common barriers to collaborative research, while identifying extensive planning, frequent communication, and availability of dedicated research coordinators as the most important facilitators. Using a Delphi methodology, a prioritized agenda for multi-institutional surgical education research was developed that may help advance surgeon education. Copyright © 2015 Elsevier Inc. All rights reserved.

Shared Governance and Regional Accreditation: Institutional Processes and Perceptions

ERIC Educational Resources Information Center

McGrane, Wendy L.

2013-01-01

This qualitative single-case research study was conducted to gain deeper understanding of the institutional processes to address shared governance accreditation criteria and to determine whether institutional processes altered stakeholder perceptions of shared governance. The data collection strategies were archival records and personal…

An Open Letter to the Cancer Community Regarding Community Clinical Trials

Cancer.gov

The National Cancer Institute (NCI) is in the process of combining its two community-based research networks to create a single network that builds on the strengths of the Community Clinical Oncology Program/Minority-Based Community Clinical Oncology Prog

Bridging the Divide: Developing the Institutional Structures That Most Effectively Deliver Cross-Sectoral Education and Training.

ERIC Educational Resources Information Center

Wheelahan, Leesa

Issues in developing the institutional structures to deliver cross-sectoral education and training were examined in a study of five Australian single-sector higher education institutions with various institutional arrangements with the vocational education and training (VET) sector and five dual-sector universities. Data were collected from the…

A Case Study Using Principal-Agent Theory to Explore How a Public, Four Year University Interacts with a System Office

ERIC Educational Resources Information Center

Macias, Anaraquel

2012-01-01

The focus of this research was to examine the funding relationship between a single public institution of higher education and its accompanying system office. Such a study is important in order to obtain insight into the relationship between a System Office and an institution, and thus how institutions carry out their fiscal responsibilities, not…

Localizing College Retention Efforts: The Distance between Theoretical Orientation and Institution-Specific Needs

ERIC Educational Resources Information Center

Xu, Yonghong Jade

2017-01-01

The study used a theoretically guided questionnaire to examine student experience in college and to gain a better understanding about how college environment affects student persistence. Data were collected from a single four-year institution; the findings suggest that institutional control over academic quality is the most critical factor in…

Large-Scale Mixed Temperate Forest Mapping at the Single Tree Level using Airborne Laser Scanning

NASA Astrophysics Data System (ADS)

Scholl, V.; Morsdorf, F.; Ginzler, C.; Schaepman, M. E.

2017-12-01

Monitoring vegetation on a single tree level is critical to understand and model a variety of processes, functions, and changes in forest systems. Remote sensing technologies are increasingly utilized to complement and upscale the field-based measurements of forest inventories. Airborne laser scanning (ALS) systems provide valuable information in the vertical dimension for effective vegetation structure mapping. Although many algorithms exist to extract single tree segments from forest scans, they are often tuned to perform well in homogeneous coniferous or deciduous areas and are not successful in mixed forests. Other methods are too computationally expensive to apply operationally. The aim of this study was to develop a single tree detection workflow using leaf-off ALS data for the canton of Aargau in Switzerland. Aargau covers an area of over 1,400km2 and features mixed forests with various development stages and topography. Forest type was classified using random forests to guide local parameter selection. Canopy height model-based treetop maxima were detected and maintained based on the relationship between tree height and window size, used as a proxy to crown diameter. Watershed segmentation was used to generate crown polygons surrounding each maximum. The location, height, and crown dimensions of single trees were derived from the ALS returns within each polygon. Validation was performed through comparison with field measurements and extrapolated estimates from long-term monitoring plots of the Swiss National Forest Inventory within the framework of the Swiss Federal Institute for Forest, Snow, and Landscape Research. This method shows promise for robust, large-scale single tree detection in mixed forests. The single tree data will aid ecological studies as well as forest management practices. Figure description: Height-normalized ALS point cloud data (top) and resulting single tree segments (bottom) on the Laegeren mountain in Switzerland.

Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study.

PubMed

Rosenson, Jonathan; Clements, Carter; Simon, Barry; Vieaux, Jules; Graffman, Sarah; Vahidnia, Farnaz; Cisse, Bitou; Lam, Joseph; Alter, Harrison

2013-03-01

Acute alcohol withdrawal syndrome (AAWS) is encountered in patients presenting acutely to the Emergency Department (ED) and often requires pharmacologic management. We investigated whether a single dose of intravenous (i.v.) phenobarbital combined with a standardized lorazepam-based alcohol withdrawal protocol decreases intensive care unit (ICU) admission in ED patients with acute alcohol withdrawal. This was a prospective, randomized, double-blind, placebo-controlled study. Patients were randomized to receive either a single dose of i.v. phenobarbital (10 mg/kg in 100 mL normal saline) or placebo (100 mL normal saline). All patients were placed on the institutional symptom-guided lorazepam-based alcohol withdrawal protocol. The primary outcome was initial level of hospital admission (ICU vs. telemetry vs. floor ward). There were 198 patients enrolled in the study, and 102 met inclusion criteria for analysis. Fifty-one patients received phenobarbital and 51 received placebo. Baseline characteristics and severity were similar in both groups. Patients that received phenobarbital had fewer ICU admissions (8% vs. 25%, 95% confidence interval 4-32). There were no differences in adverse events. A single dose of i.v. phenobarbital combined with a symptom-guided lorazepam-based alcohol withdrawal protocol resulted in decreased ICU admission and did not cause increased adverse outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

PubMed

Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L

2018-03-06

In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.

Deinstitutionalisation from the perspective of sensemaking: An empirical investigation of the Electricity of Vietnam Corporation

NASA Astrophysics Data System (ADS)

Tham, H. A.

This thesis is a study of deinstitutionalisation seeking to understand the evolvement of deinstitutionalisation process via the lens of sensemaking. It does so by conducting an in-depth qualitative, case study-based empirical study of the processual nature of deinstitutionalisation and the significance of organisational sensemaking during the deinstitutionalisation process. An interdisciplinary approach is adopted drawing insights from various literatures including institutional theory, sensemaking and social psychology. The need for greater understanding of the deinstitutionalisation phenomenon, especially its process is acknowledged after relevant literatures are reviewed. The potential of using microanalysis in examining the deinstitutionalisation process is demonstrated. The sensemaking perspective is thus used to facilitate this processual research. Findings have important implications for the theoretical development of institutional changes, sensemaking and especially deinstitutionalisation. First of all, the model and evidence sheds some light on the nature and development of the deinstitutionalisation process. Secondly, the analytic capacity of the institutional theory especially its descriptive and predictive contents are tested in the context of evolving institutions. The relative strengths of regulative, cognitive and normative influences in non-conventional cultural and institutional contexts extend our knowledge of institutional change and effects. Using sensemaking perspective, the findings also demonstrate the role and power of resistance during institutional processes and explain the possibility of multiple paces and outcomes within a single deinstitutionalisation process. As for sensemaking, crisis sensemaking will be examined in a new context: disaster-struck but not life-threatening. In practical terms, this study is carried out in an organisational context therefore it has relevant managerial implications.

Instituting a standards-based K--12 science curriculum supplement program at the National Institutes of Health: A case study

NASA Astrophysics Data System (ADS)

Witherly, Jeffre

Research on student achievement indicates the U.S. K-12 education system is not adequately preparing American students to compete in the 21st century global economy in the areas of science and mathematics. Congress has asked the scientific entities of the federal government to help increase K-12 science learning by creating standards-based learning tools for science classrooms as part of a "voluntary curriculum." One problem facing federal entities, such as the National Institutes of Health (NIH), is the need to create science-learning tools that conform to the National Science Education Standards (NSES) for curriculum materials and, therefore, are standards-based and applicable to the K-12 curriculum. This case study sought to better understand the change process at one federal agency as it went from producing K-12 learning tools that were educational in nature to a program that produced K-12 standards-based learning tools: the NIH Science Curriculum Supplement Program (NIH SCSP). The NIH SCSP was studied to gain insight into how this change in educational approach occurred, what factors enabled or inhibited the change process, and what the long-term benefits of the NIH SCSP are to the NIH. Kurt Lewin's three-step theory of change guided data gathering and data analysis. Semi-structured interviews and programmatic document review served as the major data gathering sources. Details describing the process of organizational change at the NIH were revealed during analysis of these data following the coding of interview transcripts and written record documents. The study found the process of change at the NIH proceeded in a manner generally predicted by the Lewinian change model. Enablers to the change were cost-sharing with individual institutes, support of senior leadership, and crediting the role of individual institutes prominently in each supplement. The cost of creating a supplement was reported as the single inhibitor to the program. This case study yielded a detailed description of the process of change at this federal institution that may offer valuable insights to similar federal organizations confronting educational change. The study may also contribute to the existing body of knowledge regarding the process of organizational change in a federal setting.

Analysis of phase II studies on targeted agents and subsequent phase III trials: what are the predictors for success?

PubMed

Chan, John K; Ueda, Stefanie M; Sugiyama, Valerie E; Stave, Christopher D; Shin, Jacob Y; Monk, Bradley J; Sikic, Branimir I; Osann, Kathryn; Kapp, Daniel S

2008-03-20

To identify the characteristics of phase II studies that predict for subsequent "positive" phase III trials (those that reached the proposed primary end points of study or those wherein the study drug was superior to the standard regimen investigating targeted agents in advanced tumors. We identified all phase III clinical trials of targeted therapies against advanced cancers published from 1985 to 2005. Characteristics of the preceding phase II studies were reviewed to identify predictive factors for success of the subsequent phase III trial. Data were analyzed using the chi(2) test and logistic regression models. Of 351 phase II studies, 167 (47.6%) subsequent phase III trials were positive and 184 (52.4%) negative. Phase II studies from multiple rather than single institutions were more likely to precede a successful trial (60.4% v 39.4%; P < .001). Positive phase II results were more likely to lead to a successful phase III trial (50.8% v 22.5%; P = .003). The percentage of successful trials from pharmaceutical companies was significantly higher compared with academic, cooperative groups, and research institutes (89.5% v 44.2%, 45.2%, and 46.3%, respectively; P = .002). On multivariate analysis, these factors and shorter time interval between publication of phase II results and III study publication were independent predictive factors for a positive phase III trial. In phase II studies of targeted agents, multiple- versus single-institution participation, positive phase II trial, pharmaceutical company-based trials, and shorter time period between publication of phase II to phase III trial were independent predictive factors of success in a phase III trial. Investigators should be cognizant of these factors in phase II studies before designing phase III trials.

Assessing Factors Influencing Student Academic Success in Law School

ERIC Educational Resources Information Center

Detwiler, Robert R.

2011-01-01

The literature on student academic success of law students is limited to mostly single institution studies, and as such, a nationwide, multi-institutional empirical study of the factors that predict student academic success is greatly needed by higher education scholars, law school admission officers, faculty, and administrators. This dissertation…

Multi-institutional study of self-reported attitudes and behaviors of general surgery residents about ethical academic practices in test taking.

PubMed

Grignol, Valerie P; Grannan, Kevin; Sabra, John; Cromer, Robert M; Jarman, Benjamin; Dent, Daniel; Sticca, Robert P; Nelson, Timothy M; Kukora, John S; Daley, Brian J; Treat, Robert W; Termuhlen, Paula M

2013-01-01

Correlation exists between people who engage in academic dishonesty as students and unethical behavior once in practice. Previously, we assessed the attitudes of general surgery residents and ethical practices in test taking at a single institution. Most residents had not participated in activities they felt were unethical, yet what constituted unethical behavior was unclear. We sought to verify these results in a multi-institutional study. A scenario-based survey describing potentially unethical activities related to the American Board of Surgery In-training Examination (ABSITE) was administered. Participants were asked about their knowledge of or participation in the activities and whether the activity was unethical. Program directors were surveyed about the use of ABSITE results for resident evaluation and promotion. Ten programs participated in the study. The resident response rate was 67% (186/277). Of the respondents, 43% felt that memorizing questions to study for future examinations was unethical and 50% felt that using questions another resident memorized was unethical. Most felt that buying (86%) or selling (79%) questions was unethical. Significantly more senior than junior residents have memorized (30% vs 16%; p = 0.04) or used questions others memorized (33% vs 12%; p = 0.002) to study for future ABSITE examinations and know of other residents who have done so (42% vs 20%; p = 0.004). Most programs used results of the ABSITE in promotion (80%) and set minimum score expectations and consequences (70%). Similar to our single-institution study, residents had not participated in activities they felt to be unethical; however the definition of what constitutes cheating remains unclear. Differences were identified between senior and junior residents with regard to memorizing questions for study. Cheating and unethical behavior is not always clear to the learner and represents an area for further education. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Institutional Factors That Positively Impact First-Year Students' Sense of Well-Being

ERIC Educational Resources Information Center

Harmening, Debra S.; Jacob, Stacy A.

2015-01-01

This qualitative case study conducted at a single institution in the Midwest examines how institutional context and environment impact college students' sense of well-being. Twenty-seven first-year students participated in one to two hour, in-depth interviews where they talked about their first-year experiences, their concepts of well-being, and…

A pilot study of MD (psychiatry) theses-based research.

PubMed

Srivastava, Shrikant; Agarwal, Vivek; Subramanyam, Alka; Srivastava, Mona; Sathyanarayana Rao, T S; Rao, G Prasad; Khurana, Hitesh; Singh, Archana

2018-01-01

Undertaking a research project is mandatory for MD Psychiatry trainees. The present study was undertaken to assess the type of research activity being undertaken as part of MD Psychiatry dissertation, and its contribution to national and international literature. Three medical colleges supplied the data about the topic, names of the supervisor and the candidate, collaboration, funding accrued, and publication details of MD-based research carried out between years 2000 and 2010 inclusive; 95 records were collected for the final analysis. The details of the publications provided were cross-checked on the internet, which would have taken care of missed publications as well. Most studies were single-point assessment clinical studies. Only 2 studies had been funded, 11 had collaboration with other departments within the same institute, and 5 had inter-institute collaborations. Majority of the studies were not published. Only 30 were published as full paper and 9 as abstracts. Of these 30 full publications, only 3 were published in journals having JCI impact factor values (1.4, 1.3, and 1.4, respectively). The main finding of this pilot study was that MD-based research has low contribution to the national and international literature, and those articles which are published are in low impact journals. Suggestions for modifying this state of affairs are discussed.

Frail elderly patients. New model for integrated service delivery.

PubMed Central

Hébert, Rejean; Durand, Pierre J.; Dubuc, Nicole; Tourigny, André

2003-01-01

PROBLEM BEING ADDRESSED: Given the complex needs of frail older people and the multiplicity of care providers and services, care for this clientele lacks continuity. OBJECTIVE OF PROGRAM: Integrated service delivery (ISD) systems have been developed to improve continuity and increase the efficacy and efficiency of services. PROGRAM DESCRIPTION: The Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) is an innovative ISD model based on coordination. It includes coordination between decision makers and managers of different organizations and services; a single entry point; a case-management process; individualized service plans; a single assessment instrument based on clients' functional autonomy, coupled with a case-mix classification system; and a computerized clinical chart for communicating between institutions and professionals for client monitoring. CONCLUSION: Preliminary results on the efficacy of this model showed a decreased incidence of functional decline, a decreased burden for caregivers, and a smaller proportion of older people wishing to enter institutions. PMID:12943358

Universality of Citation Distributions for Academic Institutions and Journals

PubMed Central

Chatterjee, Arnab; Ghosh, Asim; Chakrabarti, Bikas K.

2016-01-01

Citations measure the importance of a publication, and may serve as a proxy for its popularity and quality of its contents. Here we study the distributions of citations to publications from individual academic institutions for a single year. The average number of citations have large variations between different institutions across the world, but the probability distributions of citations for individual institutions can be rescaled to a common form by scaling the citations by the average number of citations for that institution. We find this feature seems to be universal for a broad selection of institutions irrespective of the average number of citations per article. A similar analysis for citations to publications in a particular journal in a single year reveals similar results. We find high absolute inequality for both these sets, Gini coefficients being around 0.66 and 0.58 for institutions and journals respectively. We also find that the top 25% of the articles hold about 75% of the total citations for institutions and the top 29% of the articles hold about 71% of the total citations for journals. PMID:26751563

Universality of Citation Distributions for Academic Institutions and Journals.

PubMed

Chatterjee, Arnab; Ghosh, Asim; Chakrabarti, Bikas K

2016-01-01

Citations measure the importance of a publication, and may serve as a proxy for its popularity and quality of its contents. Here we study the distributions of citations to publications from individual academic institutions for a single year. The average number of citations have large variations between different institutions across the world, but the probability distributions of citations for individual institutions can be rescaled to a common form by scaling the citations by the average number of citations for that institution. We find this feature seems to be universal for a broad selection of institutions irrespective of the average number of citations per article. A similar analysis for citations to publications in a particular journal in a single year reveals similar results. We find high absolute inequality for both these sets, Gini coefficients being around 0.66 and 0.58 for institutions and journals respectively. We also find that the top 25% of the articles hold about 75% of the total citations for institutions and the top 29% of the articles hold about 71% of the total citations for journals.

Internet-based profiler system as integrative framework to support translational research

PubMed Central

Kim, Robert; Demichelis, Francesca; Tang, Jeffery; Riva, Alberto; Shen, Ronglai; Gibbs, Doug F; Mahavishno, Vasudeva; Chinnaiyan, Arul M; Rubin, Mark A

2005-01-01

Background Translational research requires taking basic science observations and developing them into clinically useful tests and therapeutics. We have developed a process to develop molecular biomarkers for diagnosis and prognosis by integrating tissue microarray (TMA) technology and an internet-database tool, Profiler. TMA technology allows investigators to study hundreds of patient samples on a single glass slide resulting in the conservation of tissue and the reduction in inter-experimental variability. The Profiler system allows investigator to reliably track, store, and evaluate TMA experiments. Here within we describe the process that has evolved through an empirical basis over the past 5 years at two academic institutions. Results The generic design of this system makes it compatible with multiple organ system (e.g., prostate, breast, lung, renal, and hematopoietic system,). Studies and folders are restricted to authorized users as required. Over the past 5 years, investigators at 2 academic institutions have scanned 656 TMA experiments and collected 63,311 digital images of these tissue samples. 68 pathologists from 12 major user groups have accessed the system. Two groups directly link clinical data from over 500 patients for immediate access and the remaining groups choose to maintain clinical and pathology data on separate systems. Profiler currently has 170 K data points such as staining intensity, tumor grade, and nuclear size. Due to the relational database structure, analysis can be easily performed on single or multiple TMA experimental results. The TMA module of Profiler can maintain images acquired from multiple systems. Conclusion We have developed a robust process to develop molecular biomarkers using TMA technology and an internet-based database system to track all steps of this process. This system is extendable to other types of molecular data as separate modules and is freely available to academic institutions for licensing. PMID:16364175

Internet-based Profiler system as integrative framework to support translational research.

PubMed

Kim, Robert; Demichelis, Francesca; Tang, Jeffery; Riva, Alberto; Shen, Ronglai; Gibbs, Doug F; Mahavishno, Vasudeva; Chinnaiyan, Arul M; Rubin, Mark A

2005-12-19

Translational research requires taking basic science observations and developing them into clinically useful tests and therapeutics. We have developed a process to develop molecular biomarkers for diagnosis and prognosis by integrating tissue microarray (TMA) technology and an internet-database tool, Profiler. TMA technology allows investigators to study hundreds of patient samples on a single glass slide resulting in the conservation of tissue and the reduction in inter-experimental variability. The Profiler system allows investigator to reliably track, store, and evaluate TMA experiments. Here within we describe the process that has evolved through an empirical basis over the past 5 years at two academic institutions. The generic design of this system makes it compatible with multiple organ system (e.g., prostate, breast, lung, renal, and hematopoietic system,). Studies and folders are restricted to authorized users as required. Over the past 5 years, investigators at 2 academic institutions have scanned 656 TMA experiments and collected 63,311 digital images of these tissue samples. 68 pathologists from 12 major user groups have accessed the system. Two groups directly link clinical data from over 500 patients for immediate access and the remaining groups choose to maintain clinical and pathology data on separate systems. Profiler currently has 170 K data points such as staining intensity, tumor grade, and nuclear size. Due to the relational database structure, analysis can be easily performed on single or multiple TMA experimental results. The TMA module of Profiler can maintain images acquired from multiple systems. We have developed a robust process to develop molecular biomarkers using TMA technology and an internet-based database system to track all steps of this process. This system is extendable to other types of molecular data as separate modules and is freely available to academic institutions for licensing.

Compendium of Current Single Event Effects for Candidate Spacecraft Electronics for NASA

NASA Technical Reports Server (NTRS)

O'Bryan, Martha V.; Label, Kenneth A.; Chen, Dakai; Campola, Michael J.; Casey, Megan C.; Lauenstein, Jean-Marie; Pellish, Jonathan A.; Ladbury, Raymond L.; Berg, Melanie D.

2015-01-01

NASA spacecraft are subjected to a harsh space environment that includes exposure to various types of ionizing radiation. The performance of electronic devices in a space radiation environment are often limited by their susceptibility to single event effects (SEE). Ground-based testing is used to evaluate candidate spacecraft electronics to determine risk to spaceflight applications. Interpreting the results of radiation testing of complex devices is and adequate understanding of the test condition is critical. Studies discussed herein were undertaken to establish the application-specific sensitivities of candidate spacecraft and emerging electronic devices to single-event upset (SEU), single-event latchup (SEL), single-event gate rupture (SEGR), single-event burnout (SEB), and single-event transient (SET). For total ionizing dose (TID) and displacement damage dose (DDD) results, see a companion paper submitted to the 2015 Institute of Electrical and Electronics Engineers (IEEE) Nuclear and Space Radiation Effects Conference (NSREC) Radiation Effects Data Workshop (REDW) entitled "compendium of Current Total Ionizing Dose and Displacement Damage for Candidate Spacecraft Electronics for NASA by M. Campola, et al.

Teaching mathematical word problem solving: the quality of evidence for strategy instruction priming the problem structure.

PubMed

Jitendra, Asha K; Petersen-Brown, Shawna; Lein, Amy E; Zaslofsky, Anne F; Kunkel, Amy K; Jung, Pyung-Gang; Egan, Andrea M

2015-01-01

This study examined the quality of the research base related to strategy instruction priming the underlying mathematical problem structure for students with learning disabilities and those at risk for mathematics difficulties. We evaluated the quality of methodological rigor of 18 group research studies using the criteria proposed by Gersten et al. and 10 single case design (SCD) research studies using criteria suggested by Horner et al. and the What Works Clearinghouse. Results indicated that 14 group design studies met the criteria for high-quality or acceptable research, whereas SCD studies did not meet the standards for an evidence-based practice. Based on these findings, strategy instruction priming the mathematics problem structure is considered an evidence-based practice using only group design methodological criteria. Implications for future research and for practice are discussed. © Hammill Institute on Disabilities 2013.

The Influence of Public Pedagogy on Adult and Higher Education Learners' Perceptions of and Motivations to Study Abroad at a Hispanic Serving Institution

ERIC Educational Resources Information Center

Nguyen, Shelbee Rhea

2012-01-01

This study utilized qualitative single-case study design to provide rich description and offer new understandings within a socio-cultural theoretical frame about how adult and higher education learners perceive and are motivated to participate in study abroad programs. Three faculty-led study abroad courses at a Hispanic serving institution in the…

[Changing the internal cost allocation (ICA) on DRG shares : Example of computed tomography in a university radiology setting].

PubMed

Wirth, K; Zielinski, P; Trinter, T; Stahl, R; Mück, F; Reiser, M; Wirth, S

2016-08-01

In hospitals, the radiological services provided to non-privately insured in-house patients are mostly distributed to requesting disciplines through internal cost allocation (ICA). In many institutions, computed tomography (CT) is the modality with the largest amount of allocation credits. The aim of this work is to compare the ICA to respective DRG (Diagnosis Related Groups) shares for diagnostic CT services in a university hospital setting. The data from four CT scanners in a large university hospital were processed for the 2012 fiscal year. For each of the 50 DRG groups with the most case-mix points, all diagnostic CT services were documented including their respective amount of GOÄ allocation credits and invoiced ICA value. As the German Institute for Reimbursement of Hospitals (InEK) database groups the radiation disciplines (radiology, nuclear medicine and radiation therapy) together and also lacks any modality differentiation, the determination of the diagnostic CT component was based on the existing institutional distribution of ICA allocations. Within the included 24,854 cases, 63,062,060 GOÄ-based performance credits were counted. The ICA relieved these diagnostic CT services by € 819,029 (single credit value of 1.30 Eurocent), whereas accounting by using DRG shares would have resulted in € 1,127,591 (single credit value of 1.79 Eurocent). The GOÄ single credit value is 5.62 Eurocent. The diagnostic CT service was basically rendered as relatively inexpensive. In addition to a better financial result, changing the current ICA to DRG shares might also mean a chance for real revenues. However, the attractiveness considerably depends on how the DRG shares are distributed to the different radiation disciplines of one institution.

Mediator infrastructure for information integration and semantic data integration environment for biomedical research.

PubMed

Grethe, Jeffrey S; Ross, Edward; Little, David; Sanders, Brian; Gupta, Amarnath; Astakhov, Vadim

2009-01-01

This paper presents current progress in the development of semantic data integration environment which is a part of the Biomedical Informatics Research Network (BIRN; http://www.nbirn.net) project. BIRN is sponsored by the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH). A goal is the development of a cyberinfrastructure for biomedical research that supports advance data acquisition, data storage, data management, data integration, data mining, data visualization, and other computing and information processing services over the Internet. Each participating institution maintains storage of their experimental or computationally derived data. Mediator-based data integration system performs semantic integration over the databases to enable researchers to perform analyses based on larger and broader datasets than would be available from any single institution's data. This paper describes recent revision of the system architecture, implementation, and capabilities of the semantically based data integration environment for BIRN.

They Have Gone, and Now What? Understanding Re-Enrolment Patterns in the Catalan Public Higher Education System

ERIC Educational Resources Information Center

Rodríguez-Gómez, David; Meneses, Julio; Gairín, Joaquín; Feixas, Mònica; Muñoz, José Luís

2016-01-01

Studies of student re-enrolment patterns in higher education constitute, along with traditional studies of persistence and dropout, a key element for improving the quality of higher education institutions. However, these studies tend to be limited as they are centred on a single institution, due to the lack of national-scale data sets for…

Pressure induced phase transitions studies using advanced synchrotron techniques

NASA Astrophysics Data System (ADS)

Liu, Haozhe; Liu, Lisa; Zhao, Jinggeng; HIT Overseas Collaborative Base at Argonne Collaboration

2013-06-01

In this presentation, the joint effort on high pressure research through program of Harbin Institute of Technology (HIT) Overseas Collaborative Base at Argonne will be introduced. Selected research projects on pressure induced phase transitions at room temperature and high/low temperature conditions, such as A2B3 type topological insulators, iron arsenide superconductors, piezoelectric/ferroelectric materials, ABO3 type single crystals and metallic glasses, will be presented. Recent development on imaging and diffraction tomography techniques in diamond anvil cell will be reviewed as well.

In Vivo Imaging of Tissue Physiological Function using EPR Spectroscopy | NCI Technology Transfer Center | TTC

Cancer.gov

Electron paramagnetic resonance (EPR) is a technique for studying chemical species that have one or more unpaired electrons.  The current invention describes Echo-based Single Point Imaging (ESPI), a novel EPR image formation strategy that allows in vivo imaging of physiological function.  The National Cancer Institute's Radiation Biology Branch is seeking statements of capability or interest from parties interested in in-licensing an in vivo imaging using Electron paramagnetic resonance (EPR) to measure active oxygen species.

Integrated studies of uncultured microbes in the global ocean (Invited)

NASA Astrophysics Data System (ADS)

Dupont, C.; Rusch, D.; Martiny, A.; Lasken, R.

2010-12-01

The Global Ocean Sampling (GOS) initiative at the J. Craig Venter Institute represents the most extensive metagenomic study of a single environment. Early findings highlighted the potential of shotgun metagenomics to expand our knowledge of marine microbial biodiversity and physiology. However, it also became clear that many of the abundant marine microbes remain uncultured, hindering a direct connection between phylogeny and ecophysiology. In two recent studies, a combination of single cell genomics and aggressive assembly of binned metagenomic data have resulted in the acquisition of multiple genomes for two uncultured but globally relevant organisms. Metabolic reconstructions of the whole genomes revealed unique physiological adaptations in marine Prochlorococcus to high nutrient, low Fe regions of the global ocean and illuminated the potential ecological role of the gamma-proteobacterial 16S clade SAR86. The internal reference genomes also facilitate fragment recruitment based biogeographical studies, both at the whole genome level and the protein level.

Performance evaluation of a permanent ring magnet based helicon plasma source for negative ion source research

NASA Astrophysics Data System (ADS)

Pandey, Arun; Bandyopadhyay, M.; Sudhir, Dass; Chakraborty, A.

2017-10-01

Helicon wave heated plasmas are much more efficient in terms of ionization per unit power consumed. A permanent magnet based compact helicon wave heated plasma source is developed in the Institute for Plasma Research, after carefully optimizing the geometry, the frequency of the RF power, and the magnetic field conditions. The HELicon Experiment for Negative ion-I source is the single driver helicon plasma source that is being studied for the development of a large sized, multi-driver negative hydrogen ion source. In this paper, the details about the single driver machine and the results from the characterization of the device are presented. A parametric study at different pressures and magnetic field values using a 13.56 MHz RF source has been carried out in argon plasma, as an initial step towards source characterization. A theoretical model is also presented for the particle and power balance in the plasma. The ambipolar diffusion process taking place in a magnetized helicon plasma is also discussed.

Performance evaluation of a permanent ring magnet based helicon plasma source for negative ion source research.

PubMed

Pandey, Arun; Bandyopadhyay, M; Sudhir, Dass; Chakraborty, A

2017-10-01

Helicon wave heated plasmas are much more efficient in terms of ionization per unit power consumed. A permanent magnet based compact helicon wave heated plasma source is developed in the Institute for Plasma Research, after carefully optimizing the geometry, the frequency of the RF power, and the magnetic field conditions. The HELicon Experiment for Negative ion-I source is the single driver helicon plasma source that is being studied for the development of a large sized, multi-driver negative hydrogen ion source. In this paper, the details about the single driver machine and the results from the characterization of the device are presented. A parametric study at different pressures and magnetic field values using a 13.56 MHz RF source has been carried out in argon plasma, as an initial step towards source characterization. A theoretical model is also presented for the particle and power balance in the plasma. The ambipolar diffusion process taking place in a magnetized helicon plasma is also discussed.

Primary aldosteronism: results of adrenalectomy for nonsingle adenoma.

PubMed

Quillo, Amy R; Grant, Clive S; Thompson, Geoffrey B; Farley, David R; Richards, Melanie L; Young, William F

2011-07-01

Historically, treatment of confirmed primary aldosteronism has been adrenalectomy for unilateral adenoma; bilateral hypersecretion is treated medically. Increasingly, we use adrenal venous sampling (AVS) to define unilateral hypersecretion. Histology of glands resected based on AVS often reveals multiple nodules or hyperplasia. The aim of this study was to compare patients with multiple nodules or hyperplasia with those with single adenoma with regard to cure, preoperative imaging, AVS ratio, and biochemical evaluation to determine if a nonsingle adenoma (NSA) process could be predicted to impact extent of adrenalectomy. This was a retrospective study reviewing a single-institutional surgical experience at a tertiary academic center from 1993 to 2008, during which 215 patients with primary aldosteronism underwent unilateral adrenalectomy based on imaging of a single adenoma (normal contralateral gland) or AVS ratios. Histology included single adenoma versus NSA; cure was defined as normal immediate postoperative plasma or urine aldosterone level, normal aldosterone:renin ratio, or normotension without antihypertensive medications. Follow-up (mean 13 months, range 0 to 185 months) was available for 167 patients: 132 (79%) single adenoma and 35 (21%) NSA. All 35 patients with NSA and 128 patients (97%) with single adenoma were cured. Imaging studies correctly predicted NSA in 29% and 57% when combined with AVS. Identifying patients with NSA preoperatively was impossible biochemically: mean serum and urinary aldosterone levels and AVS ratios were not different than those of the single adenoma group. Twenty-one percent of patients had NSA, all cured by unilateral adrenalectomy. No preoperative evaluation reliably predicted NSA. Therefore, total unilateral adrenalectomy was safest given the potential for incomplete resection with partial adrenalectomy. Accurate AVS is highly predictive of cure irrespective of the unilateral adrenal histology. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Theoretical modeling and experimental analysis of solar still integrated with evacuated tubes

NASA Astrophysics Data System (ADS)

Panchal, Hitesh; Awasthi, Anuradha

2017-06-01

In this present research work, theoretical modeling of single slope, single basin solar still integrated with evacuated tubes has been performed based on energy balance equations. Major variables like water temperature, inner glass cover temperature and distillate output has been computed based on theoretical modeling. The experimental setup has been made from locally available materials and installed at Gujarat Power Engineering and Research Institute, Mehsana, Gujarat, India (23.5880°N, 72.3693°E) with 0.04 m depth during 6 months of time interval. From the series of experiments, it is found considerable increment in average distillate output of a solar still when integrated with evacuated tubes not only during daytime but also from night time. In all experimental cases, the correlation of coefficient (r) and root mean square percentage deviation of theoretical modeling and experimental study found good agreement with 0.97 < r < 0.98 and 10.22 < e < 38.4% respectively.

Dose-response relationships in multifunctional food design: assembling the evidence.

PubMed

Aggett, Peter J

2012-03-01

Demonstrating single and multiple functions attributable to foods or specific food components is a challenge. The International Life Sciences Institute Europe co-ordinated EU concerted actions, Functional Food Science in Europe (FUFOSE) and the Process for the Assessment of Scientific Support for Claims on Food (PASSCLAIM), respectively, addressed the soundness of the evidence and its coherence with a mechanistic schema comprising valid markers of exposure, intermediate and final outcomes and the quality and integrity of the evidence overall. Demonstrating causality often relies on randomized controlled trials (RCTs). However, in public health and biomedical science there is concern about the suitability of RCTs as sole standards of evidence-based approaches. Alternative and complementary approaches using updated Hill's viewpoints for appraising the evidence can be used in conjunction with evidence-based mechanistic reasoning and the quality criteria proposed in FUFOSE and PASSCLAIM to design studies and to assemble evidence exploring single or multiple benefits from food components and foods.

Meeting the Challenge: The National Cancer Institute's Central Institutional Review Board for Multi-Site Research.

PubMed

Massett, Holly A; Hampp, Sharon L; Goldberg, Jacquelyn L; Mooney, Margaret; Parreco, Linda K; Minasian, Lori; Montello, Mike; Mishkin, Grace E; Davis, Catasha; Abrams, Jeffrey S

2018-03-10

The National Institutes of Health (NIH) issued a new policy that requires a single institutional review board (IRB) of record be used for all protocols funded by the NIH that are carried out at more than one site in the United States, effective January 2018. This policy affects several hundred clinical trials opened annually across the NIH. Limited data exist to compare the use of a single IRB to that of multiple local IRBs, so some institutions are resistant to or distrustful of single IRBs. Since 2001, the National Cancer Institute (NCI) has funded a central IRB (CIRB) that provides human patient reviews for its extensive national cancer clinical trials program. This paper presents data to show the adoption, efficiencies gained, and satisfaction of the CIRB among NCI trial networks and reviews key lessons gleaned from 16 years of experience that may be informative for others charged with implementation of the new NIH single-IRB policy.

Re-irradiation stereotactic body radiotherapy for spinal metastases: a multi-institutional outcome analysis.

PubMed

Hashmi, Ahmed; Guckenberger, Matthias; Kersh, Ron; Gerszten, Peter C; Mantel, Frederick; Grills, Inga S; Flickinger, John C; Shin, John H; Fahim, Daniel K; Winey, Brian; Oh, Kevin; John Cho, B C; Létourneau, Daniel; Sheehan, Jason; Sahgal, Arjun

2016-11-01

OBJECTIVE This study is a multi-institutional pooled analysis specific to imaging-based local control of spinal metastases in patients previously treated with conventional external beam radiation therapy (cEBRT) and then treated with re-irradiation stereotactic body radiotherapy (SBRT) to the spine as salvage therapy, the largest such study to date. METHODS The authors reviewed cases involving 215 patients with 247 spinal target volumes treated at 7 institutions. Overall survival was calculated on a patient basis, while local control was calculated based on the spinal target volume treated, both using the Kaplan-Meier method. Local control was defined as imaging-based progression within the SBRT target volume. Equivalent dose in 2-Gy fractions (EQD2) was calculated for the cEBRT and SBRT course using an α/β of 10 for tumor and 2 for both spinal cord and cauda equina. RESULTS The median total dose/number of fractions of the initial cEBRT was 30 Gy/10. The median SBRT total dose and number of fractions were 18 Gy and 1, respectively. Sixty percent of spinal target volumes were treated with single-fraction SBRT (median, 16.6 Gy and EQD2/10 = 36.8 Gy), and 40% with multiple-fraction SBRT (median 24 Gy in 3 fractions, EQD2/10 = 36 Gy). The median time interval from cEBRT to re-irradiation SBRT was 13.5 months, and the median duration of patient follow-up was 8.1 months. Kaplan-Meier estimates of 6- and 12-month overall survival rates were 64% and 48%, respectively; 13% of patients suffered a local failure, and the 6- and 12-month local control rates were 93% and 83%, respectively. Multivariate analysis identified Karnofsky Performance Status (KPS) < 70 as a significant prognostic factor for worse overall survival, and single-fraction SBRT as a significant predictive factor for better local control. There were no cases of radiation myelopathy, and the vertebral compression fracture rate was 4.5%. CONCLUSIONS Re-irradiation spine SBRT is effective in yielding imaging-based local control with a clinically acceptable safety profile. A randomized trial would be required to determine the optimal fractionation.

Report on Quality Control Review of the Raich Ende Malter & Co. LLP FY 2009 Single Audit of the Riverside Research Institute

DTIC Science & Technology

2012-03-07

compliance was based on a determination that 10 of the 14 compliance requirements were applicable to the Institute. However, the audit working papers...for all 14 of the compliance requirements were not adequate to support conclusions on applicability, internal control, and the audit opinion on...compliance with laws, regulations, and award provisions applicable to the R&D cluster program. In addition, the audit firm did not appropriately report an

A Common Set of Core Values - The Foundation for a More Effective Joint Force

DTIC Science & Technology

2015-05-18

these codes stopped short of codifying a set of core values and instead focused on right and wrong behaviors. This adherence to sets of rules and...Armed Forces independently recognized the limitations of compliance-based rules and the criticality of establishing a strong foundation with core...institutional values vice core values? The knee -jerk reaction of the 1990s and a subsequent lack of a formal effort to institute a single set of core

Multiclass classification of obstructive sleep apnea/hypopnea based on a convolutional neural network from a single-lead electrocardiogram.

PubMed

Urtnasan, Erdenebayar; Park, Jong-Uk; Lee, Kyoung-Joung

2018-05-24

In this paper, we propose a convolutional neural network (CNN)-based deep learning architecture for multiclass classification of obstructive sleep apnea and hypopnea (OSAH) using single-lead electrocardiogram (ECG) recordings. OSAH is the most common sleep-related breathing disorder. Many subjects who suffer from OSAH remain undiagnosed; thus, early detection of OSAH is important. In this study, automatic classification of three classes-normal, hypopnea, and apnea-based on a CNN is performed. An optimal six-layer CNN model is trained on a training dataset (45,096 events) and evaluated on a test dataset (11,274 events). The training set (69 subjects) and test set (17 subjects) were collected from 86 subjects with length of approximately 6 h and segmented into 10 s durations. The proposed CNN model reaches a mean -score of 93.0 for the training dataset and 87.0 for the test dataset. Thus, proposed deep learning architecture achieved a high performance for multiclass classification of OSAH using single-lead ECG recordings. The proposed method can be employed in screening of patients suspected of having OSAH. © 2018 Institute of Physics and Engineering in Medicine.

Gender and Body Concerns in Adolescent Females: Single Sex and Coeducational School Environments.

ERIC Educational Resources Information Center

Mensinger, Janell

This paper involves focus group research with adolescent women from coeducational and single sex independent schools. First, it discusses research that finds girls who attend single sex institutions to be at a distinct advantage with respect to gender issues and academics. In order to obtain a better understanding of these differences, a study is…

“That’s a good question”: University researchers’ views on ownership and retention of human genetic specimens

PubMed Central

Cadigan, R. Jean; Easter, Michele M.; Dobson, Allison W.; Davis, Arlene M.; Rothschild, Barbra B.; Zimmer, Catherine; Sterling, Rene; Henderson, Gail

2012-01-01

Purpose To explore the views of university-based investigators conducting genetic research with human specimens regarding ownership and retention of specimens, and knowledge of related institutional review board and university policies. Methods Data were collected in three phases: a qualitative pilot study of 14 investigators; a web-based survey taken by 80 investigators; and follow-up, in-depth interviews with 12 survey respondents. Results Investigators named a variety of single or multiple owners of human specimens and often expressed confusion regarding specimen ownership. Most associated ownership with rights to control, and responsibilities to maintain, specimens. Investigators viewed specimens as “precious” resources whose value could be increased through long-term or infinite retention, particularly in light of anticipated technological advances in genome science. Their views on ownership and retention were shaped by perceptions of institutional review board policies as immortalized in subject informed consent documents, rather than knowledge of actual policies. Conclusion Long-term retention of human specimens makes confusion about ownership particularly problematic. Given findings that investigators’ views on ownership and retention are largely guided by their perception of university policies, the need for clear, consistent policies at the institution level is urgent. PMID:21659952

Pediatric Critical Care Telemedicine Program: A Single Institution Review.

PubMed

Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

2016-01-01

Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

Technical Communications in OSS Content Management Systems: An Academic Institutional Case Study

ERIC Educational Resources Information Center

Cripps, Michael J.

2011-01-01

Single sourcing through a content management system (CMS) is altering technical communication practices in many organizations, including institutions of higher education. Open source software (OSS) solutions are currently among the most popular content management platforms adopted by colleges and universities in the United States and abroad. The…

Establishment of Local Trip Generation Rates or Equations for Mixed-Use Developments in Kansas

DOT National Transportation Integrated Search

2012-10-01

Currently, the trip generation rates and equations contained in the Institute of Transportation Engineers (ITE) : Trip Generation Manual, 8th Edition are based on the information collected at single-use, free-standing sites and cannot : be directly a...

Current status of psychiatric rehabilitation in Portugal: A national survey.

PubMed

Teixeira, Carina; Santos, Eduardo; Abreu, Manuel Viegas; Rogers, E Sally

2015-09-01

This article reports on the current state of psychiatric rehabilitation in Portugal. A paper-and-pencil survey was sent to 70 institutions to inquire about the provision of psychiatric rehabilitation services and programs. With a response rate of 40%, 14% of institutions indicated that supported education was provided, 36% offered nonmainstream vocational training, and 29% provided supported employment; none provided evidence-based Individual Placement and Support. Permanent group homes in the community (29%) followed by transitional group homes on institutional grounds (18%) were the most common residential services, with supported housing services (14%) offered less frequently. Finally, 93% of institutions offered occupational activities, 61% provided multifamily psychoeducation, and 36% provided single-family psychoeducation. Despite recent national initiatives promoting effective psychiatric rehabilitation services, supported employment, supported education, and supported housing are not widely implemented in Portugal. To achieve better outcomes for clients, it is critical that evidence-based and promising practices be extensively disseminated. (c) 2015 APA, all rights reserved).

Support for hands-on optics immersions (Conference Presentation)

NASA Astrophysics Data System (ADS)

Spalding, Gabriel C.; McCann, Lowell I.

2016-09-01

The Advanced Laboratory Physics Association (ALPhA) is an official affiliate organization of the AAPT, supporting upper-level undergraduate instructional lab education in physics. The ALPhA Immersions program is intended to be an efficient use of an instructor's time: with expert colleague-mentors on hand they spend 2.5 days learning a key new instructional experiment (of their choice) well enough to confidently teach it to the students at their home institutions. At an ALPhA Immersion, participants work in groups of no more than three per experimental setup. Our follow-up surveys support the notion that this individualized, concentrated focus directly results in significant updating and improvement of undergraduate laboratory instruction in physics across the country. Such programs have the effect of encouraging investment, on the part of individual institutions. For example, we have disseminated ideas, training, and equipment for contemporary single-photon-based instructional labs dealing with core, contemporary issues in Quantum Mechanics. By the time this paper is presented, ALPhA will have delivered at least 420 single-photon detectors to a wide variety of educational institutions. We have also partnered with the non-profit Jonathan F. Reichert Foundation to support equipment acquisition by institutions participating in our wide variety of training programs.

Public and Private Lives: Institutional Structures and Personal Supports in Low-Income Single Mothers' Educational Pursuits

ERIC Educational Resources Information Center

Cerven, Christine

2013-01-01

Drawing on a case study of 60 low-income single mothers in California, I present a grounded account of the barriers and supports single mothers encounter in their pursuit of postsecondary education (PSE) and detail what the women themselves attributed to their success. I highlight the role both significant others (peers, family, friends) and…

The Sex Composition of Selective Colleges and Gender Differences in Career Aspirations.

ERIC Educational Resources Information Center

Bressler, Marvin; Wendell, Peter

1980-01-01

Selective single-sex colleges provide a more favorable environment than comparable coeducational institutions for influencing White, middle-class, academically capable undergraduates of both sexes to disregard conventional occupational prescriptions based on gender. Sexually segregated academic settings are instrumental in reducing male-female…

Establishment of Local Trip Generation Rates or Equations for Mixed-Use Developments in Kansas : Technical Summary

DOT National Transportation Integrated Search

2012-10-01

Currently, the trip generation rates and equations contained in the Institute of Transportation Engineers (ITE) Trip Generation Manual, 8th Edition are based on the information collected at single-use, free-standing sites and cannot be directly appli...

Global scientific collaboration in COPD research.

PubMed

Su, Yanbing; Long, Chao; Yu, Qi; Zhang, Juan; Wu, Daisy; Duan, Zhiguang

2017-01-01

This study aimed to investigate the multiple collaboration types, quantitatively evaluate the publication trends and review the performance of institutions or countries (regions) across the world in COPD research. Scientometric methods and social network analysis were used to survey the development of publication trends and understand current collaboration in the field of COPD research based on the Web of Science publications during the past 18 years. The number of publications developed through different collaboration types has increased. Growth trends indicate that the percentage of papers authored through multinational and domestic multi-institutional collaboration (DMIC) have also increased. However, the percentage of intra-institutional collaboration and single-authored (SA) studies has reduced. The papers that produced the highest academic impact result from international collaboration. The second highest academic impact papers are produced by DMIC. Out of the three, the papers that are produced by SA studies have the least amount of impact upon the scientific community. A handful of internationally renowned institutions not only take the leading role in the development of the research within their country (region) but also play a crucial role in international research collaboration in COPD. Both the amount of papers produced and the amount of cooperation that occurs in each study are disproportionally distributed between high-income countries (regions) and low-income countries (regions). Growing attention has been generated toward research on COPD from more and more different academic domains. Despite the rapid development in COPD research, collaboration in the field of COPD research still has room to grow, especially between different institutions or countries (regions), which would promote the progress of global COPD research.

The Readiness of Lecturers in Embedding Soft Skills in the Bachelor's Degree Program in Malaysian Institutes of Teacher Education

ERIC Educational Resources Information Center

Hassan, Aminuddin; Maharoff, Marina; Abiddin, Norhasni Zainal

2014-01-01

This is a preliminary research to obtain information to formulate a problem statement for an overall study of the embedding of soft skills in the program courses in higher learning institutions. This research was conducted in the form of single case and multi-case studies. The research data was attained through mixed methods; the quantitative…

Efficacy and Toxicity of Chemoradiotherapy Using Intensity-Modulated Radiotherapy for Unknown Primary of Head and Neck

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

Sher, David J., E-mail: dsher@lroc.harvard.edu; Balboni, Tracy A.; Haddad, Robert I.

2011-08-01

Purpose: No single standard treatment paradigm is available for head-and-neck squamous cell carcinoma of an unknown primary (HNCUP). Bilateral neck radiotherapy with mucosal axis irradiation is widely used, with or without chemotherapy and/or surgical resection. Intensity-modulated radiotherapy (IMRT) is a highly conformal method for delivering radiation that is becoming the standard of care and might reduce the long-term treatment-related sequelae. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for HNCUP. Patients and Materials: A retrospective study of all patients treated at the Dana-Farber Cancer Institute for HNCUP with IMRT between August 2004 and January 2009. The primary endpointmore » was overall survival; the secondary endpoints were locoregional and distant control, and acute and chronic toxicity. Results: A total of 24 patients with HNCUP were included. Of these patients, 22 had Stage N2 disease or greater. All patients underwent neck computed tomography, positron emission tomography-computed tomography, and examination under anesthesia with directed biopsies. Of the 24 patients, 22 received concurrent chemotherapy, and 7 (29%) also underwent induction chemotherapy. The median involved nodal dose was 70 Gy, and the median mucosal dose was 60 Gy. With a median follow-up of 2.1 years, the 2-year actuarial overall survival and locoregional control rate was 92% and 100%, respectively. Only 25% of the patients had Grade 2 xerostomia, although 11 patients (46%) required esophageal dilation for stricture. Conclusion: In a single-institution series, IMRT-based chemoradiotherapy for HNCUP was associated with superb overall survival and locoregional control. The xerostomia rates were promising, but the aggressive therapy was associated with significant rates of esophageal stenosis.« less

Institutional Expansion: The Case of Grid Computing

ERIC Educational Resources Information Center

Kertcher, Zack

2010-01-01

Evolutionary and revolutionary approaches have dominated the study of scientific, technological and institutional change. Yet, being focused on change within a single field, these approaches have been mute about a third, pervasive process. This process is found in a variety of cases that range from open source software to the Monte Carlo method to…

Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation

PubMed Central

Bambini, Deborah; Emery, Matthew; de Voest, Margaret; Meny, Lisa; Shoemaker, Michael J.

2016-01-01

There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES) Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality. PMID:28970407

Do We Need a Single Standard of Value for Institutional Assessment? An Essay Response to Asao Inoue's "Community-Based Assessment Pedagogy"

ERIC Educational Resources Information Center

Elbow, Peter

2006-01-01

Inoue [Inoue, A. B. (2005). "Community-based assessment pedagogy." "Assessing Writing: An International Journal, 3", 208-238] sets up a radically experimental writing class as a kind of laboratory of assessment. He seeks to avoid the standard situation where a teacher unilaterally assesses and grades student writing, using only his or her own…

An institutional six-year trend analysis of the neurological outcome after lateral lumbar interbody fusion: a 6-year trend analysis of a single institution.

PubMed

Aichmair, Alexander; Lykissas, Marios G; Girardi, Federico P; Sama, Andrew A; Lebl, Darren R; Taher, Fadi; Cammisa, Frank P; Hughes, Alexander P

2013-11-01

Retrospective case series. To evaluate the proportional trend over time of neurological deficits after lateral lumbar interbody fusion (LLIF) at a single institution. Because lumbar nerve roots converge to run as the lumbar plexus within or less frequently underneath the posterior part of the psoas muscle, they are prone to iatrogenic damage during the transpsoas approach in LLIF, and adverse postoperative neurological sequelae remain a major concern. The electronic medical records and office notes of 451 patients who had consecutively undergone LLIF between March 2006 and April 2012 at a single institution were retrospectively reviewed for reports on postoperative neurological deficits. A total of 293 patients (173 females and 120 males) met the study inclusion criteria and were followed postoperatively for a mean period of 15.4 ± 9.2 months (range: 6-53 mo). The number of included patients who underwent LLIF at our institution was 47 in the years 2006 to 2008 (group A), 155 in 2009 to 2010 (group B), and 91 in 2011 to 2012 (group C). Our data indicate a decreasing proportional trend during the past 6 years for postoperative sensory deficits (SDs), motor deficits (MDs), and anterior thigh pain (TP). The decreasing trends were statistically significant for the proportion of SDs in the immediate postoperative setting (P = 0.018) and close to statistically significant for SDs at last follow-up (P = 0.126), TP immediately after surgery (P = 0.098), and TP at last follow-up (P = 0.136). To the authors' best knowledge, this study constitutes the largest series of this sort to date, with regard to both sample size and study period. The present data indicate a decreasing proportional trend over time for SDs, MDs, and anterior TP, which can be considered a representation of an institutional learning curve during a 6-year time period of performing LLIF.

Simulating Issue Networks in Small Classes using the World Wide Web.

ERIC Educational Resources Information Center

Josefson, Jim; Casey, Kelly

2000-01-01

Provides background information on simulations and active learning. Discusses the use of simulations in political science courses. Describes a simulation exercise where students performed specific institutional role playing, simulating the workings of a single congressional issue network, based on the reauthorization of the Endangered Species Act.…

A Comparison of Two Online Learning Systems

ERIC Educational Resources Information Center

Nichols, Mark

2016-01-01

Open Polytechnic is a single-mode provider of distance education with a rich history of print-based provision. Strategically, the institution is rapidly adopting an online-only approach, with some exceptions for programmes that require student contact. A recent and internal review of Moodle, the Open Polytechnic's learning management system (LMS)…

Comparison of conventional and cadmium-zinc-telluride single-photon emission computed tomography for analysis of thallium-201 myocardial perfusion imaging: an exploratory study in normal databases for different ethnicities.

PubMed

Ishihara, Masaru; Onoguchi, Masahisa; Taniguchi, Yasuyo; Shibutani, Takayuki

2017-12-01

The aim of this study was to clarify the differences in thallium-201-chloride (thallium-201) myocardial perfusion imaging (MPI) scans evaluated by conventional anger-type single-photon emission computed tomography (conventional SPECT) versus cadmium-zinc-telluride SPECT (CZT SPECT) imaging in normal databases for different ethnic groups. MPI scans from 81 consecutive Japanese patients were examined using conventional SPECT and CZT SPECT and analyzed with the pre-installed quantitative perfusion SPECT (QPS) software. We compared the summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) for the two SPECT devices. For a normal MPI reference, we usually use Japanese databases for MPI created by the Japanese Society of Nuclear Medicine, which can be used with conventional SPECT but not with CZT SPECT. In this study, we used new Japanese normal databases constructed in our institution to compare conventional and CZT SPECT. Compared with conventional SPECT, CZT SPECT showed lower SSS (p < 0.001), SRS (p = 0.001), and SDS (p = 0.189) using the pre-installed SPECT database. In contrast, CZT SPECT showed no significant difference from conventional SPECT in QPS analysis using the normal databases from our institution. Myocardial perfusion analyses by CZT SPECT should be evaluated using normal databases based on the ethnic group being evaluated.

Forecasting Strategies for Predicting Peak Electric Load Days

NASA Astrophysics Data System (ADS)

Saxena, Harshit

Academic institutions spend thousands of dollars every month on their electric power consumption. Some of these institutions follow a demand charges pricing structure; here the amount a customer pays to the utility is decided based on the total energy consumed during the month, with an additional charge based on the highest average power load required by the customer over a moving window of time as decided by the utility. Therefore, it is crucial for these institutions to minimize the time periods where a high amount of electric load is demanded over a short duration of time. In order to reduce the peak loads and have more uniform energy consumption, it is imperative to predict when these peaks occur, so that appropriate mitigation strategies can be developed. The research work presented in this thesis has been conducted for Rochester Institute of Technology (RIT), where the demand charges are decided based on a 15 minute sliding window panned over the entire month. This case study makes use of different statistical and machine learning algorithms to develop a forecasting strategy for predicting the peak electric load days of the month. The proposed strategy was tested for a whole year starting May 2015 to April 2016 during which a total of 57 peak days were observed. The model predicted a total of 74 peak days during this period, 40 of these cases were true positives, hence achieving an accuracy level of 70 percent. The results obtained with the proposed forecasting strategy are promising and demonstrate an annual savings potential worth about $80,000 for a single submeter of RIT.

Family Policies and Academic Achievement by Young Children in Single-Parent Families: An International Comparison. Population Research Institute Working Paper.

ERIC Educational Resources Information Center

Pong, Suet-ling; Dronkers, Jaap; Hampden-Thompson, Gillian

This study investigates the differences in the degree of low academic achievement of third and fourth graders living with single-parent families from 11 industrialized countries. The United States ranks first among the countries compared in terms of the achievement gap for children in single- and two-parent families. After controlling for…

Spanning the genomics era: the vital role of a single institution biorepository for childhood cancer research over a decade

PubMed Central

Zhou, Li

2015-01-01

The ‘genomics era’ is considered to have begun with the commencement of the Human Genome Project. As translational genomic studies can only be established when human tissue samples are available for analysis, biospecimens are now proven to be an essential element for their success. During the genomics era the necessity for more extensive biobanking infrastructure has been highlighted. With the increased number of genomic studies into cancer, it is considered that the availability of biospecimens will become the rate limiting step. Despite the efforts in international biobanking, translational genomics is hampered when there low numbers of biospecimens for a particular rare diseases and is most apparent for paediatric cancer. As there is a call for biobanking practice to be responsive to the current experimental needs of the time and for more expansive systems of tissue procurement to be established we have asked the question what role does a single institution biorepository play in the current highly networked world of translational genomics. Here we describe such a case. The Tumour Bank at The Children’s Hospital at Westmead (TB-CHW) in the western suburbs of Sydney was formally established in 1998 as a key resource for translational paediatric cancer research. During the genomics era, we show that the TB-CHW has developed into a key biospecimen repository for the cancer research community, during which time it has increasingly found itself having a vital role in the establishment of translational genomics for paediatric cancer. Here we detail metrics that demonstrate how as a single institution biorepository, the TB-CHW has been a strong participant in the advancement of translational genomics throughout the genomics era. This paper describes the significant contribution of a single institutional hospital embedded tumour biobank to the genomic research community. Despite the increased stringencies placed on biobanking practice, the TB-CHW has shown that a single institution biorespository can have a consistent and effective contribution to translational research into rare paediatric malignancy demonstrating its long term benefit throughout the genomics era. PMID:26835365

Evaluation of competence-based teaching in higher education: From theory to practice.

PubMed

Bergsmann, Evelyn; Schultes, Marie-Therese; Winter, Petra; Schober, Barbara; Spiel, Christiane

2015-10-01

Competence-based teaching in higher education institutions and its evaluation have become a prevalent topic especially in the European Union. However, evaluation instruments are often limited, for example to single student competencies or specific elements of the teaching process. The present paper provides a more comprehensive evaluation concept that contributes to sustainable improvement of competence-based teaching in higher education institutions. The evaluation concept considers competence research developments as well as the participatory evaluation approach. The evaluation concept consists of three stages. The first stage evaluates whether the competencies students are supposed to acquire within the curriculum (ideal situation) are well defined. The second stage evaluates the teaching process and the competencies students have actually acquired (real situation). The third stage evaluates concrete aspects of the teaching process. Additionally, an implementation strategy is introduced to support the transfer from the theoretical evaluation concept to practice. The evaluation concept and its implementation strategy are designed for internal evaluations in higher education and primarily address higher education institutions that have already developed and conducted a competence-based curriculum. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using statistical process control for monitoring the prevalence of hospital-acquired pressure ulcers.

PubMed

Kottner, Jan; Halfens, Ruud

2010-05-01

Institutionally acquired pressure ulcers are used as outcome indicators to assess the quality of pressure ulcer prevention programs. Determining whether quality improvement projects that aim to decrease the proportions of institutionally acquired pressure ulcers lead to real changes in clinical practice depends on the measurement method and statistical analysis used. To examine whether nosocomial pressure ulcer prevalence rates in hospitals in the Netherlands changed, a secondary data analysis using different statistical approaches was conducted of annual (1998-2008) nationwide nursing-sensitive health problem prevalence studies in the Netherlands. Institutions that participated regularly in all survey years were identified. Risk-adjusted nosocomial pressure ulcers prevalence rates, grade 2 to 4 (European Pressure Ulcer Advisory Panel system) were calculated per year and hospital. Descriptive statistics, chi-square trend tests, and P charts based on statistical process control (SPC) were applied and compared. Six of the 905 healthcare institutions participated in every survey year and 11,444 patients in these six hospitals were identified as being at risk for pressure ulcers. Prevalence rates per year ranged from 0.05 to 0.22. Chi-square trend tests revealed statistically significant downward trends in four hospitals but based on SPC methods, prevalence rates of five hospitals varied by chance only. Results of chi-square trend tests and SPC methods were not comparable, making it impossible to decide which approach is more appropriate. P charts provide more valuable information than single P values and are more helpful for monitoring institutional performance. Empirical evidence about the decrease of nosocomial pressure ulcer prevalence rates in the Netherlands is contradictory and limited.

Pediatric colonic volvulus: A single-institution experience and review.

PubMed

Tannouri, Sami; Hendi, Aditi; Gilje, Elizabeth; Grissom, Leslie; Katz, Douglas

2017-06-01

Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11) over 15 years at a single institution, focusing on workup and diagnosis. This was an institutional review board approved single-institution retrospective chart review of 11 cases of large bowel volvulus occurring over 15 years (2000-2015). In our series, the most common presenting symptoms were abdominal pain and distention. Afflicted patients often had prior abdominal surgery, a neurodevelopmental disorder or chronic constipation. Of the imaging modalities utilized in the 11 patients studied, colonic volvulus was correctly diagnosed by barium enema in 100% of both cases, CT in 55.6% of cases and by plain radiography of the abdomen in only 22.2%of cases. Colonic volvulus was confirmed by laparotomy in all cases. The cecum (n=5) was the most often affected colonic segment, followed by the sigmoid (n=3). Operative treatment mainly consisted of resection (63.6%) and ostomy creation (36.4%). Colopexy was performed in 18.2% of cases. Plain abdominal radiography may be performed as an initial diagnostic study, however, it should be followed CT or air or contrast enema in children where there is high clinical suspicion and who do not have indications for immediate laparotomy. CT may be the most specific and useful test in diagnosis of colonic volvulus and has the added advantage of detection of complications including bowel ischemia. We demonstrate a range of diagnostic and therapeutic modalities for pediatric colonic volvulus. This underscores the need for further study to draft standard best practices for this life-threatening condition. Prognosis Study: Level IV. Study of a Diagnostic Test: Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

A Belief-based Trust Model for Dynamic Service Selection

NASA Astrophysics Data System (ADS)

Ali, Ali Shaikh; Rana, Omer F.

Provision of services across institutional boundaries has become an active research area. Many such services encode access to computational and data resources (comprising single machines to computational clusters). Such services can also be informational, and integrate different resources within an institution. Consequently, we envision a service rich environment in the future, where service consumers can intelligently decide between which services to select. If interaction between service providers/users is automated, it is necessary for these service clients to be able to automatically chose between a set of equivalent (or similar) services. In such a scenario trust serves as a benchmark to differentiate between service providers. One might therefore prioritize potential cooperative partners based on the established trust. Although many approaches exist in literature about trust between online communities, the exact nature of trust for multi-institutional service sharing remains undefined. Therefore, the concept of trust suffers from an imperfect understanding, a plethora of definitions, and informal use in the literature. We present a formalism for describing trust within multi-institutional service sharing, and provide an implementation of this; enabling the agent to make trust-based decision. We evaluate our formalism through simulation.

Modalities of Generalization Through Single Case Studies.

PubMed

Zittoun, Tania

2017-06-01

The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

Risks and responses to universal drinking water security.

PubMed

Hope, Robert; Rouse, Michael

2013-11-13

Risks to universal drinking water security are accelerating due to rapid demographic, climate and economic change. Policy responses are slow, uneven and largely inadequate to address the nature and scale of the global challenges. The challenges relate both to maintaining water security in increasingly fragile supply systems and to accelerating reliable access to the hundreds of millions who remain water-insecure. A conceptual framework illustrates the relationship between institutional, operational and financial risks and drinking water security outcomes. We apply the framework to nine case studies from rural and urban contexts in South Asia and sub-Saharan Africa. Case studies are purposively selected based on established and emerging examples of political, technological or institutional reforms that address water security risks. We find broad evidence that improved information flows reduce institutional costs and promote stronger and more transparent operational performance to increase financial sustainability. However, political barriers need to be overcome in all cases through internal or external interventions that require often decadal time frames and catalytic investments. No single model exists, though there is sufficient evidence to demonstrate that risks to drinking water security can be reduced even in the most difficult and challenging contexts.

Impact of case type, length of stay, institution type, and comorbidities on Medicare diagnosis-related group reimbursement for adult spinal deformity surgery.

PubMed

Nunley, Pierce D; Mundis, Gregory M; Fessler, Richard G; Park, Paul; Zavatsky, Joseph M; Uribe, Juan S; Eastlack, Robert K; Chou, Dean; Wang, Michael Y; Anand, Neel; Frank, Kelly A; Stone, Marcus B; Kanter, Adam S; Shaffrey, Christopher I; Mummaneni, Praveen V

2017-12-01

OBJECTIVE The aim of this study was to educate medical professionals about potential financial impacts of improper diagnosis-related group (DRG) coding in adult spinal deformity (ASD) surgery. METHODS Medicare's Inpatient Prospective Payment System PC Pricer database was used to collect 2015 reimbursement data for ASD procedures from 12 hospitals. Case type, hospital type/location, number of operative levels, proper coding, length of stay, and complications/comorbidities (CCs) were analyzed for effects on reimbursement. DRGs were used to categorize cases into 3 types: 1) anterior or posterior only fusion, 2) anterior fusion with posterior percutaneous fixation with no dorsal fusion, and 3) combined anterior and posterior fixation and fusion. RESULTS Pooling institutions, cases were reimbursed the same for single-level and multilevel ASD surgery. Longer stay, from 3 to 8 days, resulted in an additional $1400 per stay. Posterior fusion was an additional $6588, while CCs increased reimbursement by approximately $13,000. Academic institutions received higher reimbursement than private institutions, i.e., approximately $14,000 (Case Types 1 and 2) and approximately $16,000 (Case Type 3). Urban institutions received higher reimbursement than suburban institutions, i.e., approximately $3000 (Case Types 1 and 2) and approximately $3500 (Case Type 3). Longer stay, from 3 to 8 days, increased reimbursement between $208 and $494 for private institutions and between $1397 and $1879 for academic institutions per stay. CONCLUSIONS Reimbursement is based on many factors not controlled by surgeons or hospitals, but proper DRG coding can significantly impact the financial health of hospitals and availability of quality patient care.

Superconductivity in iron-based compounds (Scientific session of the Physical Sciences Division of the Russian Academy of Sciences, 29 January 2014)

NASA Astrophysics Data System (ADS)

2014-08-01

A scientific session of the Physical Sciences Division of the Russian Academy of Sciences (RAS), entitled 'Superconductivity in iron-based compounds', was held on 29 January 2014 at the conference hall of the Lebedev Physical Institute, RAS. The agenda of the session, announced on the website http://www.gpad.ac.ru of the RAS Physical Sciences Division listed the following reports: (1) Eremin I M (Institut für Theoretische Physik III, Ruhr-Universität Bochum, Bochum, Deutschland; Kazan (Volga region) Federal University, Kazan, Russian Federation) "Antiferromagnetism in iron-based superconductors: interaction of the magnetic, orbital, and lattice degrees of freedom"; (2) Korshunov M M (Kirenskii Institute of Physics, Siberian Branch of the Russian Academy of Sciences, Krasnoyarsk) "Superconducting state in iron-based materials and spin-fluctuation pairing theory"; (3) Kuzmicheva T E (Lebedev Physical Institute, Russian Academy of Sciences, Moscow; Lomonosov Moscow State University) "Andreev spectroscopy of iron-based superconductors: temperature dependence of the order parameters and scaling of Δ_L, S with T_C"; (4) Eltsev Yu F (Lebedev Physical Institute, Russian Academy of Sciences, Moscow) "Synthesis and study of the magnetic and transport properties of iron-based superconductors of the 122 family". Papers written on the basis of oral presentations 1-4 are published below. • Antiferromagnetism in iron-based superconductors: magnetic order in the model of delocalized electrons, I M Eremin Physics-Uspekhi, 2014, Volume 57, Number 8, Pages 807-813 • Superconducting state in iron-based materials and spin-fluctuation pairing theory, M M Korshunov Physics-Uspekhi, 2014, Volume 57, Number 8, Pages 813-819 • Andreev spectroscopy of iron-based superconductors: temperature dependence of the order parameters and scaling of Δ_L, S with T_C, T E Kuzmicheva, S A Kuzmichev, M G Mikheev, Ya G Ponomarev, S N Tchesnokov, V M Pudalov, E P Khlybov, N D Zhigadlo Physics-Uspekhi, 2014, Volume 57, Number 8, Pages 819-827 • Magnetic and transport properties of single crystals of Fe-based superconductors of the 122 family, Yu F Eltsev, K S Pervakov, V A Vlasenko, S Yu Gavrilkin, E P Khlybov, V M Pudalov Physics-Uspekhi, 2014, Volume 57, Number 8, Pages 827-832

Google Wave: Have CTSA-Minded Institutions Caught It?

PubMed

Donahue, Amy

2010-01-01

BACKGROUND: Google Wave was touted as the next big communication tool-combining e-mail, social networking, and chat within a single "wave"-with the potential to create a new world for collaboration. Information professionals who are knowledgeable of this tool and its capabilities could become uniquely situated to use it, evaluate it, and teach it. This seemed especially true for those working within Clinical and Translational Science Award (CTSA)-minded institutions, given the promise of interdisciplinary collaboration between investigators and the potential for creating new authorship models. This case study on Google Wave users who are affiliated with CTSA-minded institutions, was designed for and presented at the Evidence-Based Scholarly Communication Conference held by the University of New Mexico Health Sciences Library and Information Center. It provides an early evidence based evaluation of Google Wave's potential. METHODS: Two "waves" were created. The first consisted of five survey questions designed to collect demographic data on the respondents' roles, a general impression of Wave, the specific tools within Wave that might be useful, and potential collaborators with whom the respondents might use Wave. The second wave was a private, guided discussion on Wave's collaboration potential. Individuals from CTSA-minded institutions were invited to participate with messages on Twitter, forums, blogs, and electronic mail lists, although there were difficulties reaching out to these institutions as a group. RESULTS: By the conclusion of the study, only a small number of people (n=11, with a viable n=9) had responded to the survey. Given this small result set, it made sense to group the responses by the respondents' roles (CTSA staff and researchers, support staff, medical librarian, or general public) and to treat them as individual cases. Most of the respondents were librarians and support staff who felt that Wave might have potential for collaboration; there were no CTSA researcher respondents. For the second part of the study, the discussion wave, only one participant explicitly expressed interest in joining. All were invited to join, but there was no participation in the discussion wave at the conclusion of the study. CONCLUSIONS: The results of this study implied that Google Wave was not on the forefront of CTSA-minded institutions' communication strategies. However, it was being used, and it did demonstrate new collaboration and authorship capabilities. Being generally aware of these capabilities may be useful to information professionals who seek to be current and informed regarding developing technology and to those interested in scholarly communication practices. In addition, the difficulties encountered during this case study in attempting to reach out to CTSA-minded institutions raised the question of how members currently communicate with each other as institutions and as individuals. There was a lesson learned in the usefulness of doing case-study research to evaluate new technologies; the cost in terms of time was relatively low, and knowledge about the technology itself was gained while establishing a base level of evidence to potentially build on in the future.

TORCH (toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus) screening of small for gestational age and intrauterine growth restricted neonates: efficacy study in a single institute in Korea.

PubMed

Chung, Mi Hae; Shin, Chan Ok; Lee, Juyoung

2018-04-01

Routine screening for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (TORCH) in intrauterine growth restriction (IUGR) and small for gestational age (SGA) neonates has become a common practice. However, the incidence of TORCH varies across countries, and the cost of TORCH testing may be disadvantageous compared to disease-specific screening. To evaluate the efficacy of TORCH screening, the medical charts of IUGR or SGA neonates born in a single institution in Bucheon, Korea from 2011 to 2015 were reviewed. The clinical data of the 126 IUGR or SGA neonates were gathered, including gestational age, Apgar scores, neonatal sonographic findings, chromosome study, morbidities, developmental follow-up, and growth catch-up. Maternal factors including underlying maternal disease and fetal sonography were collected, and placental findings were recorded when available. TORCH screening was done using serum IgM, CMV urine culture, quantification of CMV DNA with real-time polymerase chain reaction, and rapid plasma reagin qualitative test for syphilis. Tests were repeated only for those with positive results. Of the 119 TORCH screenings, only one was positive for toxoplasmosis IgM. This result was deemed false positive due to negative IgM on repeated testing and the absence of clinical symptoms. Considering the incidence and risk of TORCH in Korea, the financial burden of TORCH screening, and the single positive TORCH finding in our study, we suggest disease-specific screening based on maternal history and the clinical symptoms of the neonate. Regarding CMV, which may present asymptomatically, universal screening may be appropriate upon cost-benefit analysis.

TORCH (toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus) screening of small for gestational age and intrauterine growth restricted neonates: efficacy study in a single institute in Korea

PubMed Central

Chung, Mi Hae; Shin, Chan Ok

2018-01-01

Purpose Routine screening for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (TORCH) in intrauterine growth restriction (IUGR) and small for gestational age (SGA) neonates has become a common practice. However, the incidence of TORCH varies across countries, and the cost of TORCH testing may be disadvantageous compared to disease-specific screening. To evaluate the efficacy of TORCH screening, the medical charts of IUGR or SGA neonates born in a single institution in Bucheon, Korea from 2011 to 2015 were reviewed. Methods The clinical data of the 126 IUGR or SGA neonates were gathered, including gestational age, Apgar scores, neonatal sonographic findings, chromosome study, morbidities, developmental follow-up, and growth catch-up. Maternal factors including underlying maternal disease and fetal sonography were collected, and placental findings were recorded when available. TORCH screening was done using serum IgM, CMV urine culture, quantification of CMV DNA with real-time polymerase chain reaction, and rapid plasma reagin qualitative test for syphilis. Tests were repeated only for those with positive results. Results Of the 119 TORCH screenings, only one was positive for toxoplasmosis IgM. This result was deemed false positive due to negative IgM on repeated testing and the absence of clinical symptoms. Conclusion Considering the incidence and risk of TORCH in Korea, the financial burden of TORCH screening, and the single positive TORCH finding in our study, we suggest disease-specific screening based on maternal history and the clinical symptoms of the neonate. Regarding CMV, which may present asymptomatically, universal screening may be appropriate upon cost-benefit analysis. PMID:29713357

Perceived stigma and associated factors among people with epilepsy at Gondar University Hospital, Northwest Ethiopia: a cross-sectional institution based study.

PubMed

Bifftu, Berhanu Boru; Dachew, Berihun Assefa; Tiruneh, Bewket Tadesse

2015-12-01

Epilepsy is the world's most common neurological disorder, affecting approximately 69 million people worldwide. Perceived stigma affects many domains of the lives of people with epilepsy. However, in Ethiopia there is dearth of study on perceived stigma specifically among people with epilepsy. To assess the prevalence of perceived stigma and associated factors among people with epilepsy (PWE) attending the outpatient department of the University of Gondar hospital, Northwest Ethiopia, 2014. Institution based quantitative cross - sectional study was employed among 408 individuals people with epilepsy. Single population proportion formula was used utilized to calculate sample size. The participants were selected using systematic random sampling technique. Perceived stigma was measured using by the modified Family Interview Schedule (FIS) tool. Binary logistic regression analysis and adjusted odds ratio with 95% confidence interval were used to identify the associated factors with perceived stigma.. Overall, the prevalence of perceived stigma was found to be 71.6%. Marital status [single (AOR = 0.23, CI: 0.25, 0.90), widowed ( AOR = 0.37, CI: 0.15, 0.90) duration of illness [2-5 years (AOR = 4.38, CI:1.98,9.62, 6-10 years (AOR =4.29, CI:1.90,9.64, ≥11 years (AOR = 4.31,CI:1.84,10.00) and seizure frequency of [1-11per year (AOR=2.34, CI:2.21,3.56), ≥1per month (AOR = 5.63, CI:3.42,10.32)] were factors associated with perceived stigma. Overall, the prevalence of perceived stigma was found to be high. Marital status, long duration of illness and seizure frequency were factors associated with perceived stigma.

Factors Contributing to the Educational Success of Single-Mother Welfare Recipients at an Urban Southwestern Community College Case Studies of Six Success Stories

ERIC Educational Resources Information Center

Faul, Rhonda

2012-01-01

This study gave voice to the issues, needs, and concerns of economically disadvantaged single mothers and determined the motivational and institutional factors that helped lead them to their successful completion of a community college degree or certificate program while at the same time coping with the challenges of financially surviving on…

Theoretical study on the lasing plasmon of a split ring for label-free detection of single molecules and single nanoparticles

NASA Astrophysics Data System (ADS)

Zheng, Chunjie; Jia, Tianqing; Zhao, Hua; Xia, Yingjie; Zhang, Shian; Sun, Zhenrong

2018-05-01

Not Available Project supported by the National Natural Science Foundation of China (Grant Nos. 11474097, 11374099, and 11274116) and the Open Fund of the State Key Laboratory of High Field Laser Physics (Shanghai Institute of Optics and Fine Mechanics), China.

Exercise recommendations for childhood cancer survivors exposed to cardiotoxic therapies: an institutional clinical practice initiative.

PubMed

Okada, Maki; Meeske, Kathleen A; Menteer, Jondavid; Freyer, David R

2012-01-01

Childhood cancer survivors who have received treatment with anthracyclines are at risk for developing cardiomyopathy in dose-dependent fashion. Historically, restrictions on certain types of physical activity that were intended to preserve cardiac function have been recommended, based on a mixture of evidence-based and consensus-based recommendations. In the LIFE Cancer Survivorship & Transition Program at Children's Hospital Los Angeles, the authors reevaluated their recommendations for exercise in survivors who were exposed to anthracyclines, with or without irradiation in proximity to the myocardium. The primary goal was to develop consistent, specific, practical, safe, and (where possible) evidence-based recommendations for at-risk survivors in the program. To accomplish this, the authors referred to current exercise guidelines for childhood cancer survivors, consulted recent literature for relevant populations, and obtained input from the program's pediatric cardiology consultant. The resulting risk-based exercise recommendations are designed to complement current published guidelines, maximize safe exercise, and help childhood cancer survivors return to a normal life that emphasizes overall wellness and physical activity. This article describes a single institution's experience in modifying exercise recommendations for at-risk childhood survivors and includes the methods, findings, and current institutional practice recommendations along with sample education materials.

Global scientific collaboration in COPD research

PubMed Central

Su, Yanbing; Long, Chao; Yu, Qi; Zhang, Juan; Wu, Daisy; Duan, Zhiguang

2017-01-01

Purpose This study aimed to investigate the multiple collaboration types, quantitatively evaluate the publication trends and review the performance of institutions or countries (regions) across the world in COPD research. Materials and methods Scientometric methods and social network analysis were used to survey the development of publication trends and understand current collaboration in the field of COPD research based on the Web of Science publications during the past 18 years. Results The number of publications developed through different collaboration types has increased. Growth trends indicate that the percentage of papers authored through multinational and domestic multi-institutional collaboration (DMIC) have also increased. However, the percentage of intra-institutional collaboration and single-authored (SA) studies has reduced. The papers that produced the highest academic impact result from international collaboration. The second highest academic impact papers are produced by DMIC. Out of the three, the papers that are produced by SA studies have the least amount of impact upon the scientific community. A handful of internationally renowned institutions not only take the leading role in the development of the research within their country (region) but also play a crucial role in international research collaboration in COPD. Both the amount of papers produced and the amount of cooperation that occurs in each study are disproportionally distributed between high-income countries (regions) and low-income countries (regions). Growing attention has been generated toward research on COPD from more and more different academic domains. Conclusion Despite the rapid development in COPD research, collaboration in the field of COPD research still has room to grow, especially between different institutions or countries (regions), which would promote the progress of global COPD research. PMID:28123294

Effects of total body irradiation-based conditioning on allogeneic stem cell transplantation for pediatric acute leukemia: a single-institution study

PubMed Central

Park, Jongmoo; Choi, Eun Kyung; Kim, Jong Hoon; Lee, Sang-wook; Song, Si Yeol; Yoon, Sang Min; Kim, Young Seok; Kim, Su Ssan; Park, Jin-hong; Park, Jaehyeon

2014-01-01

Purpose To evaluate the effects of total body irradiation (TBI), as a conditioning regimen prior to allogeneic stem cell transplantation (allo-SCT), in pediatric acute leukemia patients. Materials and Methods From January 2001 to December 2011, 28 patients, aged less than 18 years, were treated with TBI-based conditioning for allo-SCT in our institution. Of the 28 patients, 21 patients were diagnosed with acute lymphoblastic leukemia (ALL, 75%) and 7 were diagnosed with acute myeloid leukemia (AML, 25%). TBI was completed 4 days or 1 day before stem cell infusion. Patients underwent radiation therapy with bilateral parallel opposing fields and 6-MV X-rays. The Kaplan-Meier method was used to calculate survival outcomes. Results The 2-year event-free survival and overall survival rates were 66% and 56%, respectively (71.4% and 60.0% in AML patients vs. 64.3% and 52.4% in ALL patients, respectively). Treatment related mortality rate were 25%. Acute and chronic graft-versus-host disease was a major complication; other complications included endocrine dysfunction and pulmonary complications. Common complications from TBI were nausea (89%) and cataracts (7.1%). Conclusion The efficacy and toxicity data in this study of TBI-based conditioning to pediatric acute leukemia patients were comparable with previous studies. However, clinicians need to focus on the acute and chronic complications related to allo-SCT. PMID:25324992

Intracranial metastatic disease rarely involves the pituitary: retrospective analysis of 935 metastases in 155 patients and review of the literature.

PubMed

Marsh, James C; Garg, Shalini; Wendt, Julie A; Gielda, Benjamin T; Turian, Julius V; Herskovic, Arnold M

2010-09-01

We present a case report of a patient recently treated at our institution for an isolated non-small cell lung cancer metastatic lesion to the sella, report the lack of involvement of the pituitary gland in a large single-institution series of treated intracranial parenchymal metastases, and review the pertinent literature. We reviewed cranial imaging studies (CT and MRI) for 935 metastases in 155 patients treated at our institution over the previous 3 years for intracranial metastatic disease. Special attention was paid to the skull base to document the presence of any metastatic disease involving the pituitary gland, infundibular stalk, sella turcica (including anterior and posterior clinoids), or diaphragm sellae. We found no other involvement of the pituitary gland or other sellar structures by metastatic disease in this series. Intracranial metastatic disease rarely involves the pituitary gland and infundibular stalk parenchyma, suggesting that this structure may be safely omitted from the treatment field during WBRT and prophylactic cranial irradiation (PCI). This treatment approach should reduce the late sequelae of treatment to this critical organ.

Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus.

PubMed

Palanivelu, Praveenraj; Patil, Kedar Pratap; Parthasarathi, Ramakrishnan; Viswambharan, Jaiganesh K; Senthilnathan, Palanisami; Palanivelu, Chinnusamy

2015-01-01

The main aspect of concern for upper GI procedures has been the retraction of the liver especially large left lobes as commonly encountered in Bariatric surgery. Not doing so would compromise the view of the hiatus, hence theoretically reducing the quality of the surgery and increasing the possibility of complications. The aim of this study was to review the various liver retraction techniques in single incision surgery being done at our institute and analyze them. A retrospective study of the various techniques and a subsequent analysis was made based on advantages and disadvantages of each method. Objectively a quantitative measure of hiatal exposure was done using a scoring system based on the grade of exposure after reviewing the surgical videos. From January 2011 to January 2013 total 104 patients underwent single incision surgery with the various liver retraction techniques with following grades of exposure -liver suspension tube technique with naso gastric tubing (2.11) and with corrugated drain (2.09) needlescopic method (1.2), Umbilical tape sling (1.95), crural stitch method (2.5). Needeloscopic method has the best grade of exposure and is the easiest to start with. The average time to create the liver retraction was 2.8 to 8.6 min.There was no procedure related morbidity or mortality. The mentioned liver retraction techniques are cost effective and easy to learn. We recommend using these techniques to have a good exposure of hiatus, without compromising the safety of surgery in single incision surgery.

Combined use of a new SNP-based assay and multilocus SSR markers to assess genetic diversity of Xylella fastidiosa subsp. pauca infecting citrus and coffee plants.

PubMed

Montes-Borrego, Miguel; Lopes, Joao R S; Jiménez-Díaz, Rafael M; Landa, Blanca B

2015-03-01

Two haplotypes of Xylella fastidiosa subsp. pauca (Xfp) that correlated with their host of origin were identified in a collection of 90 isolates infecting citrus and coffee plants in Brazil, based on a single-nucleotide polymorphism in the gyrB sequence. A new single-nucleotide primer extension (SNuPE) protocol was designed for rapid identification of Xfp according to the host source. The protocol proved to be robust for the prediction of the Xfp host source in blind tests using DNA from cultures of the bacterium, infected plants, and insect vectors allowed to feed on Xfp-infected citrus plants. AMOVA and STRUCTURE analyses of microsatellite data separated most Xfp populations on the basis of their host source, indicating that they were genetically distinct. The combined use of the SNaPshot protocol and three previously developed multilocus SSR markers showed that two haplotypes and distinct isolates of Xfp infect citrus and coffee in Brazil and that multiple, genetically different isolates can be present in a single orchard or infect a single tree. This combined approach will be very useful in studies of the epidemiology of Xfp-induced diseases, host specificity of bacterial genotypes, the occurrence of Xfp host jumping, vector feeding habits, etc., in economically important cultivated plants or weed host reservoirs of Xfp in Brazil and elsewhere. Copyright© by the Spanish Society for Microbiology and Institute for Catalan Studies.

Voices from Around the World: International Undergraduate Student Experiences. Professional File Number 104, Summer 2007

ERIC Educational Resources Information Center

Terkla, Dawn Geronimo; Etish-Andrews, Jane; Roscoe, Heather S.

2007-01-01

This paper explores how students adjust to life at universities outside their home countries. Much of the current research was conducted prior to the 9/11 tragedy and focuses primarily on studies within a single U.S. institution. This project expands the boundaries by including multiple institutions from around the globe post-9/11. Findings…

Distributed deep learning networks among institutions for medical imaging.

PubMed

Chang, Ken; Balachandar, Niranjan; Lam, Carson; Yi, Darvin; Brown, James; Beers, Andrew; Rosen, Bruce; Rubin, Daniel L; Kalpathy-Cramer, Jayashree

2018-03-29

Deep learning has become a promising approach for automated support for clinical diagnosis. When medical data samples are limited, collaboration among multiple institutions is necessary to achieve high algorithm performance. However, sharing patient data often has limitations due to technical, legal, or ethical concerns. In this study, we propose methods of distributing deep learning models as an attractive alternative to sharing patient data. We simulate the distribution of deep learning models across 4 institutions using various training heuristics and compare the results with a deep learning model trained on centrally hosted patient data. The training heuristics investigated include ensembling single institution models, single weight transfer, and cyclical weight transfer. We evaluated these approaches for image classification in 3 independent image collections (retinal fundus photos, mammography, and ImageNet). We find that cyclical weight transfer resulted in a performance that was comparable to that of centrally hosted patient data. We also found that there is an improvement in the performance of cyclical weight transfer heuristic with a high frequency of weight transfer. We show that distributing deep learning models is an effective alternative to sharing patient data. This finding has implications for any collaborative deep learning study.

Impacts of curricular change: Implications from 8 years of data in introductory physics

NASA Astrophysics Data System (ADS)

Pollock, Steven J.; Finkelstein, Noah

2013-01-01

Introductory calculus-based physics classes at the University of Colorado Boulder were significantly transformed beginning in 2004. They now regularly include: interactive engagement using clickers in large lecture settings, Tutorials in Introductory Physics with use of undergraduate Learning Assistants in recitation sections, and a staffed help-room setting where students work on personalized CAPA homework. We compile and summarize conceptual (FMCE and BEMA) pre- and post-data from over 9,000 unique students after 16 semesters of both Physics 1 and 2. Within a single institution with stable pre-test scores, we reproduce results of Hake's 1998 study that demonstrate the positive impacts of interactive engagement on student performance. We link the degree of faculty's use of interactive engagement techniques and their experience levels on student outcomes, and argue for the role of such systematic data collection in sustained course and institutional transformations.

Changing Children’s Understanding of the Brain: A Longitudinal Study of the Royal Institution Christmas Lectures as a Measure of Public Engagement

PubMed Central

Gjersoe, Nathalia L.; Hood, Bruce

2013-01-01

Demonstrating the impact of public engagement is an increasingly important activity for today’s academics and researchers. The difficulty is that many areas of interest do not lend themselves well to evaluation because the impact of each single intervention can be hard to trace and take time to become manifest. With this in mind, we evaluated a lecture based around the 2011 Royal Institution Christmas Lectures, ”Meet Your Brain,” delivered to school children from low performing schools. We compared knowledge about four neuroscience facts one week before, one week after and six weeks after the lecture. Analysis revealed significant knowledge transfer one week after the lecture that was retained five weeks later. We conclude that public engagement through tailored lectures can have significant impact in the moderate term with the potential to leave a lasting impression over a longer period. PMID:24260513

Current status and future perspectives in laparoendoscopic single-site and natural orifice transluminal endoscopic urological surgery.

PubMed

Autorino, Riccardo; Stein, Robert J; Lima, Estevão; Damiano, Rocco; Khanna, Rakesh; Haber, Georges-Pascal; White, Michael A; Kaouk, Jihad H

2010-05-01

Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been successfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

Institutional games played by confined juveniles.

PubMed

Bartollas, C; Sieverdes, C M

1983-01-01

This study examined the games played by 561 juvenile offenders confined in six coeducational correctional facilities in one state. The types of games these residents used against staff and peers within the confines of the institution varied considerably. The study documented nineteen games used by males and females, twelve to deal with staff and seven to deal with peers. The games were defined as therapeutic games, material games, psychological games, and physical games. Peer-oriented games included attention-seeking activities and a variety of dominance games. Additionally, these games were described and tabulated according to the sex and race of the residents. The conclusion was that game-playing behavior was no less frequent in coeducational institutions than it was in single-sex institutions.

The use of fund accounting and the need for single fund reporting by institutional healthcare providers. Principles and Practices Board Statement No. 8. Healthcare Financial Management Association.

PubMed

1986-06-01

For many years, hospitals and other institutional healthcare providers used fund accounting as a basis for presenting their financial statements. Recently, authoritative literature has placed less emphasis on separate fund reporting. This is evidenced by the reduction of fund classifications specified in the literature. This trend seems to follow the recognition that institutional healthcare activities should be reported in a manner comparable to other businesses. The Principles and Practices Board (P&P Board) of the Healthcare Financial management Association believes that general purpose financial statements of institutional healthcare providers should be comparable to reporting by other businesses. That is, all assets, liabilities, and equity are presented in a single aggregated balance sheet without differentiation by fund. This form of presentation, referred to in this statement as single fund reporting, should be used by all institutional healthcare providers including those that are part of HMOs, universities, municipalities, and other larger entities when separate reports of the provider are issued. The P&P Board is studying other significant issues concerning the reporting of revenues and components of equity and changes therein. The conclusion in this statement can be implemented even though conclusions on these related subjects are not yet complete. The P&P Board recognizes that certain circumstances may require detailed records and reports for special purposes. This statement deals only with those general purpose financial statements on which an independent accountant's opinion is expressed.

Efficient Solutions for New Homes Case Study: Savannah Gardens

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

None

2016-03-15

The Savannah Housing Department is leading sustainable and affordable housing development in Georgia. It partnered with Southface Energy Institute, a member of the U.S. Department of Energy’s Partnership for Home Innovation Building America research team, to seek cost-effective solutions for increasing the energy efficiency of the Savannah Housing Department’s standard single-family home plans in the Savannah Gardens Community. Based on engineering, cost, and constructability analyses, the combined research team chose to pilot two technologies to evaluate efficiency and comfort impacts for homeowners: a heat-pump water heater in an encapsulated attic and an insulated exterior wall sheathing.

Multi-objective Optimization on Helium Liquefier Using Genetic Algorithm

NASA Astrophysics Data System (ADS)

Wang, H. R.; Xiong, L. Y.; Peng, N.; Meng, Y. R.; Liu, L. Q.

2017-02-01

Research on optimization of helium liquefier is limited at home and abroad, and most of the optimization is single-objective based on Collins cycle. In this paper, a multi-objective optimization is conducted using genetic algorithm (GA) on the 40 L/h helium liquefier developed by Technical Institute of Physics and Chemistry of the Chinese Academy of Science (TIPC, CAS), steady solutions are obtained in the end. In addition, the exergy loss of the optimized system is studied in the case of with and without liquid nitrogen pre-cooling. The results have guiding significance for the future design of large helium liquefier.

Readability of patient education materials in ophthalmology: a single-institution study and systematic review.

PubMed

Williams, Andrew M; Muir, Kelly W; Rosdahl, Jullia A

2016-08-03

Patient education materials should be written at a level that is understandable for patients with low health literacy. The aims of this study are (1) to review the literature on readability of ophthalmic patient education materials and (2) to evaluate and revise our institution's patient education materials about glaucoma using evidence-based guidelines on writing for patients with low health literacy. A systematic search was conducted on the PubMed/MEDLINE database for studies that have evaluated readability level of ophthalmic patient education materials, and the reported readability scores were assessed. Additionally, we collected evidence-based guidelines for writing easy-to-read patient education materials, and these recommendations were applied to revise 12 patient education handouts on various glaucoma topics at our institution. Readability measures, including Flesch-Kincaid Grade Level (FKGL), and word count were calculated for the original and revised documents. The original and revised versions of the handouts were then scored in random order by two glaucoma specialists using the Suitability Assessment of Materials (SAM) instrument, a grading scale used to evaluate suitability of health information materials for patients. Paired t test was used to analyze changes in readability measures, word count, and SAM score between original and revised handouts. Finally, five glaucoma patients were interviewed to discuss the revised materials, and patient feedback was analyzed qualitatively. Our literature search included 13 studies that evaluated a total of 950 educational materials. Among the mean FKGL readability scores reported in these studies, the median was 11 (representing an eleventh-grade reading level). At our institution, handouts' readability averaged a tenth-grade reading level (FKGL = 10.0 ± 1.6), but revising the handouts improved their readability to a sixth-grade reading level (FKGL = 6.4 ± 1.2) (p < 0.001). Additionally, the mean SAM score of our institution's handouts improved from 60 ± 7 % (adequate) for the original versions to 88 ± 4 % (superior) for the revised handouts (p < 0.001). Our systematic review of the literature reveals that ophthalmic patient education materials are consistently written at a level that is too high for many patients to understand. Our institution's experience suggests that applying guidelines on writing easy-to-understand material can improve the readability and suitability of educational materials for patients with low health literacy.

Validation of the 2012 Fukuoka Consensus Guideline for Intraductal Papillary Mucinous Neoplasm of the Pancreas From a Single Institution Experience.

PubMed

Yu, Songfeng; Takasu, Naoki; Watanabe, Toshihiro; Fukumoto, Tsuyoshi; Okazaki, Shinji; Tezuka, Koji; Sugawara, Shuichiro; Hirai, Ichiro; Kimura, Wataru

2017-08-01

The 2012 Fukuoka consensus guideline has stratified the risks of malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas into "high-risk stigmata" (HRS) and "worrisome feature" (WF). This study aimed to evaluate its clinical validity based on a single institution experience. Eighty-nine patients who underwent surgical resection with pathological diagnosis of IPMN were retrospectively studied. High-risk stigmata was significantly correlated with the prevalence of malignant IPMN as compared with WF. The positive predictive values of HRS and WF were 66.7% and 35.7% for branch duct IPMN and 80% and 38.1% for main duct IPMN, respectively. Univariate analysis indicated that all the factors in HRS and WF had statistical significance. Whereas multivariate analysis revealed only enhanced solid component (odds ratio [OR], 50.01; P = 0.008), presence of mural nodule (OR, 73.83; P < 0.001) and lymphadenopathy (OR, 20.85; P = 0.03) were independent predictors. Scoring HRS and WF by different numbers of positive factors resulted in improved predictive value. The area under the curve of HRS score was significantly lower than that of WF or HRS + WF score (0.680 vs 0.900 or 0.902, respectively; P < 0.001). As supplementary to the 2012 Fukuoka guideline, we suggest that calculating scores of WF and HRS may have superior diagnostic accuracy in predicting malignant IPMN.

A Boon for the Architect Engineer

NASA Technical Reports Server (NTRS)

1992-01-01

Langley Research Center's need for an improved construction specification system led to an automated system called SPECSINTACT. A catalog of specifications, the system enables designers to retrieve relevant sections from computer storage and modify them as needed. SPECSINTACT has also been adopted by government agencies. The system is an integral part of the Construction Criteria Base (CCB), a single disc containing design and construction information for 10 government agencies including the American Institute of Architects' MASTERSPEC. CCB employs CD- ROM technologies and is available from the National Institute of Building Sciences. Users report substantial savings in time and productivity.

Single-site Laparoscopic Colorectal Surgery Provides Similar Clinical Outcomes Compared to Standard Laparoscopic Surgery: An Analysis of 626 Patients

PubMed Central

Sangster, William; Messaris, Evangelos; Berg, Arthur S.; Stewart, David B.

2015-01-01

BACKGROUND Compared to standard laparoscopy, single-site laparoscopic colorectal surgerymay potentially offer advantages by creating fewer surgical incisions and providing a multi-functional trocar. Previous comparisons, however, have been limited by small sample sizes and selection bias. OBJECTIVE To compare 60-day outcomes between standard laparoscopic and single-site laparoscopic colorectal surgery patients undergoing elective and urgent surgeries. DESIGN This was an unselected retrospective cohort study comparing patients who underwent elective and unplanned standard laparoscopic or single-site laparoscopic colorectal resections for benign and malignant disease between 2008 and 2014. Outcomes were compared using univariate analyses. SETTING This study was conducted at a single institution. PATIENTS A total of 626 consecutive patients undergoing laparoscopic colorectal surgery were included. MAIN OUTCOME MEASURES Morbidity and mortality within 60 postoperative days. RESULTS 318 (51%) and 308 (49%) patients underwent standard laparoscopic and single-site laparoscopic procedures, respectively. No significant difference was noted in mean operative time (Standard laparoscopy 182.1 ± 81.3 vs. Single-site laparoscopy 177±86.5, p=0.30) and postoperative length of stay (Standard laparoscopy 4.8±3.4 vs. Single-site laparoscopy 5.5 ± 6.9, p=0.14). Conversions to laparotomy and 60-day readmissions were also similar for both cohorts across all procedures performed. A significant difference was identified in the number of patients who developed postoperative complications (Standard laparoscopy 19.2% vs. Single-site laparoscopy 10.7%, p=0.004), especially with respect to surgical-site infections (Standard laparoscopy 11.3% vs. Single-site laparoscopy 5.8%, p=0.02). LIMITATIONS This was a retrospective, single institution study. CONCLUSIONS Single-site laparoscopic colorectal surgery demonstrates similar results to standard laparoscopic colorectal surgery in regards to operative time, length of stay and readmissions. Single-site laparoscopic colorectal surgery may provide advantages in limiting the development of certain complications such as superficial surgical-site infections. PMID:26252848

Incrementally Approaching an Inquiry Lab Curriculum: Can Changing a Single Laboratory Experiment Improve Student Performance in General Chemistry?

ERIC Educational Resources Information Center

Cacciatore, Kristen L.; Sevian, Hannah

2009-01-01

Many institutions are responding to current research about how students learn science by transforming their general chemistry laboratory curricula to be inquiry-oriented. We present a comparison study of student performance after completing either a traditional or an inquiry stoichiometry experiment. This single laboratory experience was the only…

The Incidence of Complications in Single-stage Endoscopic Stone Removal for Patients with Common Bile Duct Stones: A Propensity Score Analysis.

PubMed

Saito, Hirokazu; Kadono, Yoshihiro; Kamikawa, Kentaro; Urata, Atsushi; Imamura, Haruo; Matsushita, Ikuo; Kakuma, Tatsuyuki; Tada, Shuji

2018-02-15

Objective Single-stage endoscopic stone removal for choledocholithiasis is an advantageous approach because it is associated with a shorter hospital stay; however, few studies have reported the incidence of complications related to this procedure in detail. The aim of this study was to examine the incidence of complications and efficacy of this procedure. Methods This retrospective study investigated the incidence of complications in 345 patients with naive papilla who underwent therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis at three institutions between April 2014 and March 2016 by a propensity score analysis. The efficacy of single-stage endoscopic stone removal was assessed based on a hospital stay of within 7 days and the number of ERCP attempts. Results Among 114 patients who underwent single-stage endoscopic stone removal, 15 patients (13.2%) experienced complications. Among the remaining 231 patients in the two-stage endoscopic stone removal group, complications were observed in 17 patients (7.4%). The propensity score analysis, which was adjusted for confounding factors, revealed that single-stage endoscopic stone removal was not a significant risk factor for complications (p=0.52). In patients in whom >10 min was required for deep cannulation, single-stage endoscopic stone removal was not a significant risk factor for complications in the propensity score analysis (p=0.37). In the single-stage group, the proportion of patients with a hospital stay of within 7 days was significantly higher and the number of ERCP attempts was significantly lower in comparison to the two-stage group (p <0.0001 and <0.0001, respectively). Conclusion Single-stage endoscopic stone removal did not increase the incidence of complications associated with ERCP and was effective for reducing the hospital stay and the number of ERCP attempts.

The Incidence of Complications in Single-stage Endoscopic Stone Removal for Patients with Common Bile Duct Stones: A Propensity Score Analysis

PubMed Central

Saito, Hirokazu; Kadono, Yoshihiro; Kamikawa, Kentaro; Urata, Atsushi; Imamura, Haruo; Matsushita, Ikuo; Kakuma, Tatsuyuki; Tada, Shuji

2017-01-01

Objective Single-stage endoscopic stone removal for choledocholithiasis is an advantageous approach because it is associated with a shorter hospital stay; however, few studies have reported the incidence of complications related to this procedure in detail. The aim of this study was to examine the incidence of complications and efficacy of this procedure. Methods This retrospective study investigated the incidence of complications in 345 patients with naive papilla who underwent therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis at three institutions between April 2014 and March 2016 by a propensity score analysis. The efficacy of single-stage endoscopic stone removal was assessed based on a hospital stay of within 7 days and the number of ERCP attempts. Results Among 114 patients who underwent single-stage endoscopic stone removal, 15 patients (13.2%) experienced complications. Among the remaining 231 patients in the two-stage endoscopic stone removal group, complications were observed in 17 patients (7.4%). The propensity score analysis, which was adjusted for confounding factors, revealed that single-stage endoscopic stone removal was not a significant risk factor for complications (p=0.52). In patients in whom >10 min was required for deep cannulation, single-stage endoscopic stone removal was not a significant risk factor for complications in the propensity score analysis (p=0.37). In the single-stage group, the proportion of patients with a hospital stay of within 7 days was significantly higher and the number of ERCP attempts was significantly lower in comparison to the two-stage group (p <0.0001 and <0.0001, respectively). Conclusion Single-stage endoscopic stone removal did not increase the incidence of complications associated with ERCP and was effective for reducing the hospital stay and the number of ERCP attempts. PMID:29151506

Interprofessional education and collaboration: A simulation-based learning experience focused on common and complementary skills in an acute care environment.

PubMed

Cunningham, S; Foote, L; Sowder, M; Cunningham, C

2018-05-01

The purpose of this mixed-methods study was to explore from the participant's perspective the influence of an interprofessional simulation-based learning experience on understanding the roles and responsibilities of healthcare professionals in the acute care setting, interprofessional collaboration, and communication. Participating students from two professional programs completed the Readiness for Interprofessional Learning Scale (RIPLS) prior to and following the simulation experience to explore the influence of the simulation experience on students' perceptions of readiness to learn together. A Wilcoxon signed rank analysis was performed for each of the four subscales of the RIPLS: shared learning (<.001), teamwork and collaboration (<.001), professional identity (.042), and roles and responsibilities (.001). In addition, participating students were invited to participate in focus group interviews to discuss the effectiveness of the simulation experience. Three key themes were discovered: interprofessional teamwork, discovering roles and responsibilities, and increased confidence in treatment skills. The integration of interprofessional education through a simulation-based learning experience within the nursing and physical therapy professional programs provided a positive experience for the students. Simulation-based learning experiences may provide an opportunity for institutions to collaborate and provide additional engagement with healthcare professions that may not be represented within a single institution.

Two Frameworks for Preparing Teachers for the Shift from Local to Global Educational Environments

ERIC Educational Resources Information Center

Craig, Barbara; Stevens, Ken

2012-01-01

The research outlined in this paper is based on the convergence of two conceptual frameworks that guide the transfer of knowledge and skills from traditional teacher education, which focused on teaching in single classrooms, to open networked learning environments that include both inter-institutional teaching and learning and local and global…

Combination of Logical Conditions and Arithmetic Operations to Assign a Mark to a Course Based on Multidimensional Learning Outcomes

ERIC Educational Resources Information Center

Sérandour, Guillaume; Illanes, Alfredo; Maturana, Jorge; Cádiz, Janet

2016-01-01

Assessment is a notorious source of preoccupation for faculty and university governing bodies, especially when an institution initiates curricular reforms which shift the programme learning outcomes for knowledge to competencies. One obstacle to acceptance arises from a culture of quantitative assessment (often represented by a single mark), which…

The Educational Validity and Utility of Single-Case Design Research in Building Evidence-Based Practices in Education

ERIC Educational Resources Information Center

Kourea, Lefki; Lo, Ya-yu

2016-01-01

Improving academic, behavioural, and social outcomes of students through empirical research has been a firm commitment among researchers, policy-makers, and other professionals in education across Europe and the United States (U.S.). To assist in building scientific evidences, executive bodies such as the European Commission and the Institute for…

Mechanisms before Reactions: A Mechanistic Approach to the Organic Chemistry Curriculum Based on Patterns of Electron Flow

ERIC Educational Resources Information Center

Flynn, Alison B.; Ogilvie, William W.

2015-01-01

A significant redesign of the introductory organic chemistry curriculum at the authors' institution is described. There are two aspects that differ greatly from a typical functional group approach. First, organic reaction mechanisms and the electron-pushing formalism are taught before students have learned a single reaction. The conservation of…

Collaborative Orthopaedic Research Between and Within Institutions.

PubMed

Wolf, Brian R; Verma, Nikhil N; Spindler, Kurt P; Wright, Rick W

2017-02-15

Collaborative research is common in many medical disciplines; however, the field of orthopaedics has been relatively slow to adopt this type of research approach. Collaborative research efforts can occur between multiple institutions and, in some instances, may benefit from subspecialty society sponsorship. Collaborative research efforts between several research spheres within a single institution also can be advantageous. Collaborative research has many benefits, including a larger number of patients in studies, more power in the research, and better generalizability. In addition, collaborative research efforts allow resources to be pooled within and between institutions. The challenges of collaborative research include data management, funding, and the publication of manuscripts that have many authors.

A multi-institutional approach to delivering shared curricula for developing a next-generation energy workforce

DOE PAGES

Holloway, Lawrence E.; Qu, Zhihua; Mohr-Schroeder, Margaret J.; ...

2017-02-06

In this study, we consider collaborative power systems education through the FEEDER consortium. To increase students' access to power engineering educational content, the consortium of seven universities was formed. A framework is presented to characterize different collaborative education activities among the universities. Three of these approaches of collaborative educational activities are presented and discussed. These include 1) cross-institutional blended courses ("MS-MD''); 2) cross-institutional distance courses ("SS-MD''); and 3) single-site special experiential courses and concentrated on-site programs available to students across consortium institutions ("MS-SD''). As a result, this paper presents the advantages and disadvantages of each approach.

Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

PubMed

Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

2016-04-01

Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

Multilevel corporate environmental responsibility.

PubMed

Karassin, Orr; Bar-Haim, Aviad

2016-12-01

The multilevel empirical study of the antecedents of corporate social responsibility (CSR) has been identified as "the first knowledge gap" in CSR research. Based on an extensive literature review, the present study outlines a conceptual multilevel model of CSR, then designs and empirically validates an operational multilevel model of the principal driving factors affecting corporate environmental responsibility (CER), as a measure of CSR. Both conceptual and operational models incorporate three levels of analysis: institutional, organizational, and individual. The multilevel nature of the design allows for the assessment of the relative importance of the levels and of their components in the achievement of CER. Unweighted least squares (ULS) regression analysis reveals that the institutional-level variables have medium relationships with CER, some variables having a negative effect. The organizational level is revealed as having strong and positive significant relationships with CER, with organizational culture and managers' attitudes and behaviors as significant driving forces. The study demonstrates the importance of multilevel analysis in improving the understanding of CSR drivers, relative to single level models, even if the significance of specific drivers and levels may vary by context. Copyright © 2016 Elsevier Ltd. All rights reserved.

Associations between Medical Student Empathy and Personality: A Multi-Institutional Study

PubMed Central

Costa, Patrício; Alves, Raquel; Neto, Isabel; Marvão, Pedro; Portela, Miguel; Costa, Manuel João

2014-01-01

Background More empathetic physicians are more likely to achieve higher patient satisfaction, adherence to treatments, and health outcomes. In the context of medical education, it is thus important to understand how personality might condition the empathetic development of medical students. Single institutional evidence shows associations between students' personality and empathy. This multi-institutional study aimed to assess such associations across institutions, looking for personality differences between students with high empathy and low empathy levels. Methods Participants were 472 students from three medical schools in Portugal. They completed validated adaptations to Portuguese of self-report measures of the NEO-Five Factor Inventory(NEO-FFI) and the Jefferson Scale of Physician Empathy(JSPE-spv). Students were categorized into two groups: “Bottom” (low empathy, N = 165) and “Top” (high empathy, N = 169) according to their empathy JSPE-spv total score terciles. Correlation analysis, binary logistic regression analysis and ROC curve analysis were conducted. Results A regression model with gender, age and university had a predictive power (pseudo R2) for belonging to the top or bottom group of 6.4%. The addition of personality dimensions improved the predictive power to 16.8%. Openness to experience and Agreeableness were important to predict top or bottom empathy scores when gender, age and university were considered.” Based on the considered predictors the model correctly classified 69.3% of all students. Conclusions The present multi-institutional cross-sectional study in Portugal revealed across-school associations between the Big5 dimensions Agreeableness and Openness to experience and the empathy of medical students and that personality made a significant contribution to identify the more empathic students. Therefore, medical schools may need to pay attention to the personality of medical students to understand how to enhance the empathy of medical students. PMID:24637613

The Use of Correctional “NO!” Approach to Reduce Destructive Behavior on Autism Student of CANDA Educational Institution in Surakarta

NASA Astrophysics Data System (ADS)

Anggraini, N.

2017-02-01

This research aims to reduce the destructive behavior such as throwing the learning materials on autism student by using correctional “NO!” approach in CANDA educational institution Surakarta. This research uses Single Subject Research (SSR) method with A-B design, it is baseline and intervention. Subject of this research is one autism student of CANDA educational institution named G.A.P. Data were collected through recording in direct observation in the form of recording events at the time of implementation baseline and intervention. Data were analyzed by simple descriptive statistical analysis and is displayed in graphical form. Based on the result of data analysis, it could be concluded that destructive behavior such as throwing the learning material on autism student was significantly reduced after given an intervention. Based on the research results, using correctional “NO!” approach can be used by teacher or therapist to reduce the destructive behavior on autism student.

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

Holloway, Lawrence E.; Qu, Zhihua; Mohr-Schroeder, Margaret J.

In this study, we consider collaborative power systems education through the FEEDER consortium. To increase students' access to power engineering educational content, the consortium of seven universities was formed. A framework is presented to characterize different collaborative education activities among the universities. Three of these approaches of collaborative educational activities are presented and discussed. These include 1) cross-institutional blended courses ("MS-MD''); 2) cross-institutional distance courses ("SS-MD''); and 3) single-site special experiential courses and concentrated on-site programs available to students across consortium institutions ("MS-SD''). As a result, this paper presents the advantages and disadvantages of each approach.

Magnetic and Structural Characterization of Fe-Ga Using Kerr Microscopy and Neutron Scattering

DTIC Science & Technology

2010-01-01

117 4.6 Schematic of triple axes single crystal neutron diffractometer (left). TriCS intrument at Paul Scherrer Institut, Switzerland (right...Therefore, USANS data is one-dimensional. 4.3.3 Single Crystal Neutron Diffraction The single crystal neutron diffractometer, TriCS at Paul Scherrer...crystal neutron diffractometer (left). TriCS intrument at Paul Scherrer Institut, Switzerland (right) [106] 4.4 Unpolarized SANS In this section, SANS

Evaluating the toxicity of bDtBPP on CHO-K1 cells for testing of single-use bioprocessing systems considering media selection, cell culture volume, mixing, and exposure duration.

PubMed

Shah, Rhythm R; Linville, Taylor W; Whynot, Andrew D; Brazel, Christopher S

2016-09-01

Single-use bioprocessing bags are gaining popularity due to ease of use, lower risk of contamination, and ease of process scale-up. Bis(2,4-di-tert-butylphenyl)phosphate (bDtBPP), a degradant of tris(2,4-di-tert-butylphenyl)phosphite, marketed as Irgafos 168®, which is an antioxidant stabilizer added to resins, has been identified as a potentially toxic leachate which may impact the performance of single-use, multilayer bioprocessing bags. In this study, the toxicity of bDtBPP was tested on CHO-K1 cells grown as adherent or suspended cells. The EC50 (effective concentration to cause 50% cell death) for adherent cells was found to be one order of magnitude higher than that for suspended CHO-K1 cells. While CHO-K1 cells had good cell viability when exposed to moderate concentrations of bDtBPP, the degradant was shown to impact the viable cell density (VCD) at much lower concentrations. Hence, in developing an industry-standard assay for testing the cytotoxicity of leachates, suspended cells (as commonly used in the bioprocessing industry) would likely be most sensitive, particularly when reporting EC50 values based on VCD. The effects of mixing, cell culture volume, and exposure duration were also evaluated for suspended CHO-K1 cells. It was found that the sensitivity of cell culture to leachates from single-use plastic bags was enhanced for suspended cells cultured for longer exposure times and when the cells were subjected to continuous agitation, both of which are important considerations in the production of biopharmaceuticals. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:1318-1323, 2016. © 2016 American Institute of Chemical Engineers.

Establishment of institutional diagnostic reference level for computed tomography with automated dose-tracking software.

PubMed

Liang, Chong R; Chen, Priscilla X H; Kapur, Jeevesh; Ong, Michael K L; Quek, Swee T; Kapur, Subhash C

2017-06-01

The aim of this study was to establish institutional diagnostic reference levels (DRLs) by summarising doses collected across the five computed tomography (CT) system in our institution. CT dose data of 15940 patients were collected retrospectively from May 2015 to October 2015 in five institutional scanners. The mean, 75th percentile and 90th percentile of the dose spread were calculated according to anatomic region. The common CT examinations such as head, chest, combined abdomen/pelvis (A/P), and combined chest/abdomen/pelvis (C/A/P) were reviewed. Distribution of CT dose index (CTDIvol), dose-length product (DLP) and effective dose (ED) were extracted from the data for single-phasic and multiphasic examinations. The institutional DRL for our CT units were established as mean (50th percentile) of CTDIvol (mGy), DLP (mGy.cm) and ED (mSv) for single and multiphasic studies using the dose-tracking software. In single phasic examination, Head: (49.0 mGy), (978.0 mGy.cm), (2.4 mSv) respectively; Chest: (6.0 mGy), (254.0 mGy.cm), (4.9 mSv) respectively; CT A/P (10.0 mGy), (514.0 mGy.cm), (8.9 mSv) respectively; CT C/A/P (10.0 mGy), (674.0 mGy.cm), (11.8 mSv) respectively. In multiphasic studies: Head (45.0 mGy), (1822.0 mGy.cm), (5.0 mSv) respectively; Chest (8.0 mGy), (577.0 mGy.cm), (10.0 mSv) respectively; CT A/P: (10.0 mGy), (1153.0 mGy.cm), (20.2 mSv) respectively; CT C/A/P: (11.0 mGy), (1090.0 mGy.cm), (19.2 mSv) respectively. The reported metrics offer a variety of information that institutions can use for quality improvement activities. The variations in dose between scanners suggest a large potential for optimisation of radiation dose. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

The Scintillation Prediction Observations Research Task (SPORT): an International Science Mission Using a Cubesat

NASA Technical Reports Server (NTRS)

Spann, James; Swenson, Charles; Durao, Otavio; Loures, Luis; Heelis, Rod; Bishop, Rebecca; Le, Guan; Abdu, Mangalathayil; Krause, Linda; Fry, Craig;

Improved prediction of biochemical recurrence after radical prostatectomy by genetic polymorphisms.

PubMed

Morote, Juan; Del Amo, Jokin; Borque, Angel; Ars, Elisabet; Hernández, Carlos; Herranz, Felipe; Arruza, Antonio; Llarena, Roberto; Planas, Jacques; Viso, María J; Palou, Joan; Raventós, Carles X; Tejedor, Diego; Artieda, Marta; Simón, Laureano; Martínez, Antonio; Rioja, Luis A

2010-08-01

Single nucleotide polymorphisms are inherited genetic variations that can predispose or protect individuals against clinical events. We hypothesized that single nucleotide polymorphism profiling may improve the prediction of biochemical recurrence after radical prostatectomy. We performed a retrospective, multi-institutional study of 703 patients treated with radical prostatectomy for clinically localized prostate cancer who had at least 5 years of followup after surgery. All patients were genotyped for 83 prostate cancer related single nucleotide polymorphisms using a low density oligonucleotide microarray. Baseline clinicopathological variables and single nucleotide polymorphisms were analyzed to predict biochemical recurrence within 5 years using stepwise logistic regression. Discrimination was measured by ROC curve AUC, specificity, sensitivity, predictive values, net reclassification improvement and integrated discrimination index. The overall biochemical recurrence rate was 35%. The model with the best fit combined 8 covariates, including the 5 clinicopathological variables prostate specific antigen, Gleason score, pathological stage, lymph node involvement and margin status, and 3 single nucleotide polymorphisms at the KLK2, SULT1A1 and TLR4 genes. Model predictive power was defined by 80% positive predictive value, 74% negative predictive value and an AUC of 0.78. The model based on clinicopathological variables plus single nucleotide polymorphisms showed significant improvement over the model without single nucleotide polymorphisms, as indicated by 23.3% net reclassification improvement (p = 0.003), integrated discrimination index (p <0.001) and likelihood ratio test (p <0.001). Internal validation proved model robustness (bootstrap corrected AUC 0.78, range 0.74 to 0.82). The calibration plot showed close agreement between biochemical recurrence observed and predicted probabilities. Predicting biochemical recurrence after radical prostatectomy based on clinicopathological data can be significantly improved by including patient genetic information. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Single-Sex Classrooms Are Succeeding

ERIC Educational Resources Information Center

Gurian, Michael; Stevens, Kathy; Daniels, Peggy

2009-01-01

Over the past decade, the Gurian Institute has trained more than forty thousand teachers in more than two thousand schools and districts, both coed and single-sex. The institute's trainers have worked with public and private schools, Montessori schools, and a variety of charter and independent schools in fifteen countries; it has therefore been…

Google Wave: Have CTSA-Minded Institutions Caught It?

PubMed Central

Donahue, Amy

2011-01-01

Background Google Wave was touted as the next big communication tool—combining e-mail, social networking, and chat within a single “wave”—with the potential to create a new world for collaboration. Information professionals who are knowledgeable of this tool and its capabilities could become uniquely situated to use it, evaluate it, and teach it. This seemed especially true for those working within Clinical and Translational Science Award (CTSA)-minded institutions, given the promise of interdisciplinary collaboration between investigators and the potential for creating new authorship models. This case study on Google Wave users who are affiliated with CTSA-minded institutions, was designed for and presented at the Evidence-Based Scholarly Communication Conference held by the University of New Mexico Health Sciences Library and Information Center. It provides an early evidence based evaluation of Google Wave's potential. Methods Two “waves” were created. The first consisted of five survey questions designed to collect demographic data on the respondents' roles, a general impression of Wave, the specific tools within Wave that might be useful, and potential collaborators with whom the respondents might use Wave. The second wave was a private, guided discussion on Wave's collaboration potential. Individuals from CTSA-minded institutions were invited to participate with messages on Twitter, forums, blogs, and electronic mail lists, although there were difficulties reaching out to these institutions as a group. Results By the conclusion of the study, only a small number of people (n=11, with a viable n=9) had responded to the survey. Given this small result set, it made sense to group the responses by the respondents' roles (CTSA staff and researchers, support staff, medical librarian, or general public) and to treat them as individual cases. Most of the respondents were librarians and support staff who felt that Wave might have potential for collaboration; there were no CTSA researcher respondents. For the second part of the study, the discussion wave, only one participant explicitly expressed interest in joining. All were invited to join, but there was no participation in the discussion wave at the conclusion of the study. Conclusions The results of this study implied that Google Wave was not on the forefront of CTSA-minded institutions' communication strategies. However, it was being used, and it did demonstrate new collaboration and authorship capabilities. Being generally aware of these capabilities may be useful to information professionals who seek to be current and informed regarding developing technology and to those interested in scholarly communication practices. In addition, the difficulties encountered during this case study in attempting to reach out to CTSA-minded institutions raised the question of how members currently communicate with each other as institutions and as individuals. There was a lesson learned in the usefulness of doing case-study research to evaluate new technologies; the cost in terms of time was relatively low, and knowledge about the technology itself was gained while establishing a base level of evidence to potentially build on in the future. PMID:21461135

The Effect of Collective Bargaining on the Issue of "Excellence or Equality" in Higher Education.

ERIC Educational Resources Information Center

Kaufman, Jacob J.; Flanary, Patricia E.

What is the effect of collective bargaining on the issue of excellence or equality in higher education? Relevant to this discussion are: (1) institutions of higher education vary so greatly in goals, student bodies, and products that we cannot study higher education as a single industry producing a single product; (2) the economic and political…

Development of a new injury cost scale.

PubMed

Zeidler, F; Pletschen, B; Scheunert, D; Mattern, B; Alt, B; Miksch, T; Eichendorf, W; Reiss, S

1993-12-01

The Automobile Technique Research Association at Frankfurt, the Institute for Forensic Medicine at Mainz, the Federal Highway Research Institute at Bergisch-Gladbach, the German Motor Vehicle Inspection Association at Stuttgart, and the German Worker's Compensation at St. Augustin have completed a joint research project dealing with injury costs due to automobile accidents. The data for this social cost analysis were based on costs for administrative expenses, medical treatment, rehabilitation measures, social security payment, and loss of income, which were all paid by Worker's Compensation for single, well-documented injuries to the working population in West Germany (15 to 65 years old). The data base used included 15,407 injured and 1,026 fatal road accident victims. Tables are presented which show the costs associated with various injury levels. The result is an injury cost scale (ICS) that might be a base for establishing priorities of safety measures. The ICS has to be seen as supplemental to the AIS.

Multiphoton-generated localized electron plasma for membrane permeability modification in single cells

NASA Astrophysics Data System (ADS)

Merritt, T.; Leblanc, M.; McMillan, J.; Westwood, J.; Khodaparast, G. A.

2014-03-01

Successful incorporation of a specific macromolecule into a single cell would be ideal for characterizing trafficking dynamics through plasmodesmata or for studying intracellular localizations. Here, we demonstrate NIR femtosecond laser-mediated infiltration of a membrane impermeable dextran-conjugated dye into living cells of Arabidopsis thaliana seedling stems. Based on the reactions of fluorescing vacuoles of transgenic cells and artificial cell walls comprised of nanocellulose, laser intensity and exposure time were adjusted to avoid deleterious effects. Using these plant-tailored laser parameters, cells were injected with the fluorophores and long-term dye retention was observed, all while preserving vital cell functions. This method is ideal for studies concerning cell-to-cell interactions and potentially paves the way for introducing transgenes to specific cells. This work was supported by NSF award IOS-0843372 to JHW, with additional support from and U.S. Department of Agriculture Hatch Project no. 135997, and by the Institute of Critical Technology and Applied Sciences (ICTAS) at Virginia Tech.

Exploring Teacher Induction: Collaborative Self-Studies across Institutions

ERIC Educational Resources Information Center

Smith, Déirdre; Engemann, Joe

2015-01-01

Educators from eight institutions engaged in collaborative self-studies of their own practices to gain deeper insight into the significance of narrative-based writing supporting the process of teacher induction. A series of teacher induction institutes based on narrative writing processes provided the context for critical exploration of the lived…

Transforming the Gray Factory: The Presidential Leadership of Charles M. Vest and the Architecture of Change at Massachusetts Institute of Technology

ERIC Educational Resources Information Center

Daas, Mahesh

2013-01-01

The single-site exemplar study presents an in-depth account of the presidential leadership of Charles M. Vest of MIT--the second longest presidency in the Institute's history--and his leadership team's journey between 1990 and 2004 into campus architectural changes that involved over a billion dollars, added a quarter of floor space to MIT's…

Anesthesia for awake craniotomy: a how-to guide for the occasional practitioner.

PubMed

Meng, Lingzhong; McDonagh, David L; Berger, Mitchel S; Gelb, Adrian W

2017-05-01

Awake craniotomy (AC), defined as the performance of at least part of an open cranial procedure with the patient awake, has been tied to beneficial outcomes compared with similar surgery under general anesthesia. Improved anesthetic techniques have made a major contribution to the increasing popularity of AC. However, the heterogeneity of practice among institutions doing large numbers of ACs raises questions (often among those who only occasionally perform AC - i.e., practitioners in low-volume AC institutions) as to the ideal anesthetic technique for AC. The procedure presents a variety of decision-making dilemmas, the origins of which are the varying institutional preferences, lack of quality evidence, and several practice controversies. Evidence-based data that support a single anesthetic algorithm for AC are sparse. In this narrative review, the technical nuances of 13 aspects of anesthetic care for AC are discussed based on institutional preferences and available evidence, and the various controversies and research priorities are discussed. The skills, experience, and commitment of both the surgeon and the anesthesiologist are large variables that are likely more important than what the literature suggests about "best" techniques for AC. Optimizing patient outcome is the fundamental goal of the anesthesiologist.

Weekly Cisplatin-Based Concurrent Chemoradiotherapy for Treatment of Locally Advanced Head and Neck Cancer: a Single Institution Study.

PubMed

Ghosh, Saptarshi; Rao, Pamidimukkala Brahmananda; Kumar, P Ravindra; Manam, Surendra

2015-01-01

The organ preservation approach of choice for the treatment of locally advanced head and neck cancers is concurrent chemoradiation with three weekly high doses of cisplatin. Although this is an efficacious treatment policy, it has high acute systemic and mucosal toxicities, which lead to frequent treatment breaks and increased overall treatment time. Hence, the current study was undertaken to evaluate the efficacy of concurrent chemoradiation using 40 mg/m2 weekly cisplatin. This is a single institutional retrospective study including the data of 266 locally advanced head and neck cancer patients who were treated with concurrent chemoradiation using 40 mg/m2 weekly cisplatin from January 2012 to January 2014. A p-value of < 0.05 was taken to be significant statistically for all purposes in the study. The mean age of the study patients was 48.8 years. Some 36.1% of the patients had oral cavity primary tumors. The mean overall treatment time was 57.2 days. With a mean follow up of 15.2 months for all study patients and 17.5 months for survivors, 3 year local control, locoregional control and disease free survival were seen in 62.8%, 42.8% and 42.1% of the study patients. Primary tumor site, nodal stage of disease, AJCC stage of the disease and number of cycles of weekly cisplatin demonstrated statistically significant correlations with 3 year local control, locoregional control and disease free survival. Concurrent chemoradiotherapy with moderate dose weekly cisplatin is an efficacious treatment regime for locally advanced head and neck cancers with tolerable toxicity which can be used in developing countries with limited resources.

Characteristics and trends of clinical trials funded by the National Institutes of Health between 2005 and 2015.

PubMed

Gresham, Gillian K; Ehrhardt, Stephan; Meinert, Jill L; Appel, Lawrence J; Meinert, Curtis L

2018-02-01

Background The National Institutes of Health is one of the largest biomedical research agencies in the world. Clinical trials are an important component of National Institutes of Health research efforts. Given the recent updates in National Institutes of Health trial reporting requirements, more information regarding the current state of National Institutes of Health-funded clinical trials is warranted. The objective of this analysis was to describe characteristics and trends of clinical trials funded by the National Institutes of Health over time and by Institutes and Centers of the National Institutes of Health. Methods Interventional studies funded by the National Institutes of Health and registered in ClinicalTrials.gov between 2005 and 2015 were included in the analysis. Trials were identified from the 27 March 2016 Clinical Trials Transformation Initiative Aggregate Analysis of ClinicalTrials.gov database. A descriptive analysis of trials by year and National Institutes of Health Institute/Center was performed. Results There were 12,987 National Institutes of Health-funded clinical trials registered between 2005 and 2015. There were 1,580, 1,116, and 930 trials registered in 2005, 2010, and 2015, respectively. The majority were early-development trials (phases 0, 1, or 2; 53%), randomized (61%), and single-center (63%). Trial demographics have remained unchanged over time. Median trial sample size was 64 (interquartile range 29-192) with 10% of trials enrolling ≥500 participants. Most trials were completed within 5 years of enrollment start (69%). Trial characteristics varied considerably across National Institutes of Health Institutes and Centers. Results were reported under the assumptions that most National Institutes of Health-funded trials are registered in ClinicalTrials.gov and that trials are being registered completely and accurately. Conclusion In conclusion, there has been a decline in the number of trials being funded over time, explained in part by a relatively constant budget, increases in trial costs, or other factors that cannot be quantified. National Institutes of Health-funded trials are relatively small and tend to be single-centered. There are substantial differences in the number and types of trials done by Institutes and Centers within the National Institutes of Health.

Development and dosimetry of a small animal lung irradiation platform

PubMed Central

McGurk, Ross; Hadley, Caroline; Jackson, Isabel L.; Vujaskovic, Zeljko

2015-01-01

Advances in large scale screening of medical counter measures for radiation-induced normal tissue toxicity are currently hampered by animal irradiation paradigms that are both inefficient and highly variable among institutions. Here, we introduce a novel high-throughput small animal irradiation platform for use in orthovoltage small animal irradiators. We used radiochromic film and metal oxide semiconductor field effect transistor detectors to examine several parameters, including 2D field uniformity, dose rate consistency, and shielding transmission. We posit that this setup will improve efficiency of drug screens by allowing for simultaneous, targeted irradiation of multiple animals, improving efficiency within a single institution. Additionally, we suggest that measurement of the described parameters in all centers conducting counter measure studies will improve the translatability of findings among institutions. We also investigated the use of tissue equivalent phantoms in performing dosimetry measurements for small animal irradiation experiments. Though these phantoms are commonly used in dosimetry, we recorded a significant difference in both the entrance and target tissue dose rates between euthanized rats and mice with implanted detectors and the corresponding phantom measurement. This suggests that measurements using these phantoms may not provide accurate dosimetry for in vivo experiments. Based on these measurements, we propose that this small animal irradiation platform can increase the capacity of animal studies by allowing for more efficient animal irradiation. We also suggest that researchers fully characterize the parameters of whatever radiation setup is in use in order to facilitate better comparison among institutions. PMID:23091878

A Data Management System Integrating Web-based Training and Randomized Trials: Requirements, Experiences and Recommendations.

PubMed

Muroff, Jordana; Amodeo, Maryann; Larson, Mary Jo; Carey, Margaret; Loftin, Ralph D

2011-01-01

This article describes a data management system (DMS) developed to support a large-scale randomized study of an innovative web-course that was designed to improve substance abuse counselors' knowledge and skills in applying a substance abuse treatment method (i.e., cognitive behavioral therapy; CBT). The randomized trial compared the performance of web-course-trained participants (intervention group) and printed-manual-trained participants (comparison group) to determine the effectiveness of the web-course in teaching CBT skills. A single DMS was needed to support all aspects of the study: web-course delivery and management, as well as randomized trial management. The authors briefly reviewed several other systems that were described as built either to handle randomized trials or to deliver and evaluate web-based training. However it was clear that these systems fell short of meeting our needs for simultaneous, coordinated management of the web-course and the randomized trial. New England Research Institute's (NERI) proprietary Advanced Data Entry and Protocol Tracking (ADEPT) system was coupled with the web-programmed course and customized for our purposes. This article highlights the requirements for a DMS that operates at the intersection of web-based course management systems and randomized clinical trial systems, and the extent to which the coupled, customized ADEPT satisfied those requirements. Recommendations are included for institutions and individuals considering conducting randomized trials and web-based training programs, and seeking a DMS that can meet similar requirements.

Implementing a University E-Learning Strategy: Levers for Change within Academic Schools

ERIC Educational Resources Information Center

Sharpe, Rhona; Benfield, Greg; Francis, Richard

2006-01-01

This paper describes the implementation of an e-learning strategy at a single higher education institution in terms of the levers used to promote effective uptake and ensure sustainable embedding. The focus of this work was at the level of the academic school using a range of change practices including the appointment of school-based learning…

Complications and Short-Term Explantation Rate Following Artificial Urinary Sphincter Implantation: Results from a Large Middle European Multi-Institutional Case Series.

PubMed

Kretschmer, Alexander; Hüsch, Tanja; Thomsen, Frauke; Kronlachner, Dominik; Obaje, Alice; Anding, Ralf; Pottek, Tobias; Rose, Achim; Olianas, Roberto; Friedl, Alexander; Hübner, Wilhelm; Homberg, Roland; Pfitzenmaier, Jesco; Grein, Ulrich; Queissert, Fabian; Naumann, Carsten Maik; Schweiger, Josef; Wotzka, Carola; Nyarangi-Dix, Joanne N; Hofmann, Torben; Seiler, Roland; Haferkamp, Axel; Bauer, Ricarda M

2016-01-01

Background/Aims/Objectives: To analyze perioperative complication and short-term explantation rates after perineal or penoscrotal single-cuff and double-cuff artificial urinary sphincter (AUS) implantation in a large middle European multi-institutional patient cohort. 467 male patients with stress urinary incontinence underwent implantation of a perineal single-cuff (n = 152), penoscrotal single-cuff (n = 99), or perineal double-cuff (n = 216) AUS between 2010 and 2012. Postoperative complications and 6-month explantation rates were assessed. For statistical analysis, Fisher's exact test and Kruskal-Wallis rank sum test, and a multiple logistic regression model were used (p < 0.05). Compared to perineal single-cuff AUS, penoscrotal single-cuff implantation led to significantly increased short-term explantation rates (8.6% (perineal) vs. 19.2% (penoscrotal), p = 0.019). The postoperative infection rate was significantly higher after double-cuff compared to single-cuff implantation (6.0% (single-cuff) vs. 13.9% (double-cuff), p = 0.019). The short-term explantation rate after primary double-cuff placement was 6.5% (p = 0.543 vs. perineal single-cuff). In multivariate analysis, the penoscrotal approach (p = 0.004), intraoperative complications (p = 0.005), postoperative bleeding (p = 0.011), and perioperative infection (p < 0.001) were independent risk factors for short-term explantation. Providing data from a large contemporary multi-institutional patient cohort from high-volume and low-volume institutions, our results reflect the current standard of care in middle Europe. We indicate that the penoscrotal approach is an independent risk factor for increased short-term explantation rates. © 2016 S. Karger AG, Basel.

Perioperative strategies and technical modifications to the Nuss repair for pectus excavatum in pediatric patients: a large volume, single institution experience.

PubMed

Sacco Casamassima, Maria Grazia; Goldstein, Seth D; Salazar, Jose H; McIltrot, Kimberly H; Abdullah, Fizan; Colombani, Paul M

2014-04-01

The safety and efficacy of minimally invasive pectus excavatum repair have been demonstrated over the last twenty years. However, technical details and perioperative management strategies continue to be debated. The aim of the present study is to review a large single-institution experience with the modified Nuss procedure. A retrospective review was performed of patients who underwent primary pectus excavatum repair at a single tertiary hospital via a modified Nuss procedure that included: no thoracoscopy, retrosternal dissection achieved via a left-to-right thoracic approach, four-point stabilization of the bar, and no routine epidural analgesia. Data collected included demographics, preoperative symptoms, operative characteristics, hospital charges and postoperative outcomes. A total of 336 pediatric patients were identified. No cardiac perforations occurred and the rate of pericarditis was 0.6%. Contemporary rates of bar displacement have fallen to 1.2%. Routine use of chlorhexidine scrub reduced superficial site infections to 0.7%. Two patients (0.6%) with severe recurrence required reoperation. Bars were removed after an average period of 31.7(SD 13.2) months, with satisfactory cosmetic and functional results in 94.9% of cases. We report here a single-institution large volume experience, including modifications to the Nuss procedure that make the technique simpler and safer, improve results, and minimize hospital charges. Copyright © 2014 Elsevier Inc. All rights reserved.

Automatic lesion detection in capsule endoscopy based on color saliency: closer to an essential adjunct for reviewing software.

PubMed

Iakovidis, Dimitris K; Koulaouzidis, Anastasios

2014-11-01

The advent of wireless capsule endoscopy (WCE) has revolutionized the diagnostic approach to small-bowel disease. However, the task of reviewing WCE video sequences is laborious and time-consuming; software tools offering automated video analysis would enable a timelier and potentially a more accurate diagnosis. To assess the validity of innovative, automatic lesion-detection software in WCE. A color feature-based pattern recognition methodology was devised and applied to the aforementioned image group. This study was performed at the Royal Infirmary of Edinburgh, United Kingdom, and the Technological Educational Institute of Central Greece, Lamia, Greece. A total of 137 deidentified WCE single images, 77 showing pathology and 60 normal images. The proposed methodology, unlike state-of-the-art approaches, is capable of detecting several different types of lesions. The average performance, in terms of the area under the receiver-operating characteristic curve, reached 89.2 ± 0.9%. The best average performance was obtained for angiectasias (97.5 ± 2.4%) and nodular lymphangiectasias (96.3 ± 3.6%). Single expert for annotation of pathologies, single type of WCE model, use of single images instead of entire WCE videos. A simple, yet effective, approach allowing automatic detection of all types of abnormalities in capsule endoscopy is presented. Based on color pattern recognition, it outperforms previous state-of-the-art approaches. Moreover, it is robust in the presence of luminal contents and is capable of detecting even very small lesions. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

76 FR 50226 - Announcement of a Single Source Grant Award to the Tribal Law and Policy Institute

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-12

... and support for the planning, development and implementation of the Tribal Maternal, Infant and Early... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Announcement of a Single Source Grant Award to the Tribal Law and Policy Institute AGENCY: Children's Bureau...

77 FR 58398 - Announcement of the Award of a Single-Source Program Expansion Supplement Grant to the University...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... of Boston for the Institute for Community Inclusion (ICI) in Boston, MA AGENCY: Administration on Developmental and Intellectual Disabilities (AIDD), ACF, HHS. ACTION: Announcing the award a single-source program expansion supplement to the University of Massachusetts for the Institute for Community Inclusion...

Benchmarking: applications to transfusion medicine.

PubMed

Apelseth, Torunn Oveland; Molnar, Laura; Arnold, Emmy; Heddle, Nancy M

2012-10-01

Benchmarking is as a structured continuous collaborative process in which comparisons for selected indicators are used to identify factors that, when implemented, will improve transfusion practices. This study aimed to identify transfusion medicine studies reporting on benchmarking, summarize the benchmarking approaches used, and identify important considerations to move the concept of benchmarking forward in the field of transfusion medicine. A systematic review of published literature was performed to identify transfusion medicine-related studies that compared at least 2 separate institutions or regions with the intention of benchmarking focusing on 4 areas: blood utilization, safety, operational aspects, and blood donation. Forty-five studies were included: blood utilization (n = 35), safety (n = 5), operational aspects of transfusion medicine (n = 5), and blood donation (n = 0). Based on predefined criteria, 7 publications were classified as benchmarking, 2 as trending, and 36 as single-event studies. Three models of benchmarking are described: (1) a regional benchmarking program that collects and links relevant data from existing electronic sources, (2) a sentinel site model where data from a limited number of sites are collected, and (3) an institutional-initiated model where a site identifies indicators of interest and approaches other institutions. Benchmarking approaches are needed in the field of transfusion medicine. Major challenges include defining best practices and developing cost-effective methods of data collection. For those interested in initiating a benchmarking program, the sentinel site model may be most effective and sustainable as a starting point, although the regional model would be the ideal goal. Copyright © 2012 Elsevier Inc. All rights reserved.

Patterns of Recent National Institutes of Health (NIH) Funding to Diagnostic Radiology Departments: Analysis Using the NIH RePORTER System.

PubMed

Franceschi, Ana M; Rosenkrantz, Andrew B

2017-09-01

This study aimed to characterize recent National Institutes of Health (NIH) funding for diagnostic radiology departments at US medical schools. This retrospective study did not use private identifiable information and thus did not constitute human subjects research. The public NIH Research Portfolio Online Reporting Tools Expenditure and Results system was used to extract information regarding 887 NIH awards in 2015 to departments of "Radiation-Diagnostic/Oncology." Internet searches were conducted to identify each primary investigator (PI)'s university web page, which was used to identify the PI's departmental affiliation, gender, degree, and academic rank. A total of 649 awards to diagnostic radiology departments, based on these web searches, were included; awards to radiation oncology departments were excluded. Characteristics were summarized descriptively. A total of 61 unique institutions received awards. The top five funded institutions represented 33.6% of all funding. The most common institutes administering these awards were the National Cancer Institute (29.0%) and the National Institute of Biomedical Imaging and Bioengineering (21.6%). Women received 15.9% of awards and 13.3% of funding, with average funding per award of $353,512 compared to $434,572 for men. PhDs received 77.7% of all awards, with average funding per award of $457,413 compared to $505,516 for MDs. Full professors received 51.2% of awards (average funding per award of $532,668), compared to assistant professors who received 18.4% of awards ($260,177). Average funding was $499,859 for multiple-PI awards vs. $397,932 for single-PI awards. Common spending categories included "neurosciences," "cancer," "prevention," and "aging." NIH funding for diagnostic radiology departments has largely been awarded to senior-ranking male PhD investigators, commonly at large major academic medical centers. Initiatives are warranted to address such disparities and promote greater diversity in NIH funding among diagnostic radiology investigators. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Single case studies as a means for developing psychological theories.

PubMed

Skvortsov, Anatoliy; Romashchuk, Alexander

2015-12-01

The Socratic function of single case studies (SCSs) is described in its relation to the problem of scientific theory development. Contrary to the traditional point of view, the single case study is not a demonstration or verification of theoretical concepts, but a method of their generation and opportunity for analysis of their interrelations. Considering the case study from the perspective of the Socratic function brings to light important conclusions about the ecological validity of theory development. The essential features of the Socratic function are illustrated using the example of the famous Romantic Essays of Alexandr Luria. © 2015 The Institute of Psychology, Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

A contemporary, single-institutional experience of surgical versus expectant management of congenital heart disease in trisomy 13 and 18 patients.

PubMed

Costello, John P; Weiderhold, Allison; Louis, Clauden; Shaughnessy, Conner; Peer, Syed M; Zurakowski, David; Jonas, Richard A; Nath, Dilip S

2015-06-01

The objective of this study was to examine a large institutional experience of patients with trisomy 13 and trisomy 18 in the setting of comorbid congenital heart disease and present the outcomes of surgical versus expectant management. It is a retrospective single-institution cohort study. Institutional review board approved this study. Thirteen consecutive trisomy 18 patients and three consecutive trisomy 13 patients (sixteen patients in total) with comorbid congenital heart disease who were evaluated by our institution's Division of Cardiovascular Surgery between January 2008 and December 2013 were included in the study. The primary outcome measures evaluated were operative mortality (for patients who received surgical management), overall mortality (for patients who received expectant management), and total length of survival during follow-up. Of the thirteen trisomy 18 patients, seven underwent surgical management and six received expectant management. With surgical management, operative mortality was 29 %, and 80 % of patients were alive after a median follow-up of 116 days. With expectant management, 50 % of patients died before hospital discharge. Of the three patients with trisomy 13, one patient underwent surgical management and two received expectant management. The patient who received surgical management with complete repair was alive at last follow-up over 2 years after surgery; both patients managed expectantly died before hospital discharge. Trisomy 13 and trisomy 18 patients with comorbid congenital heart disease can undergo successful cardiac surgical intervention. In this population, we advocate that nearly all patients with cardiovascular indications for operative congenital heart disease intervention should be offered complete surgical repair over palliative approaches for moderately complex congenital cardiac anomalies.

An agent based simulation tool for scheduling emergency department physicians.

PubMed

Jones, Spencer S; Evans, R Scott

2008-11-06

Emergency department overcrowding is a problem that threatens the public health of communities and compromises the quality of care given to individual patients. The Institute of Medicine recommends that hospitals employ information technology and operations research methods to reduce overcrowding. This paper describes the development of an agent based simulation tool that has been designed to evaluate the impact of various physician staffing configurations on patient waiting times in the emergency department. We evaluate the feasibility of this tool at a single hospital emergency department.

A single-center experience and review of the literature: 64 cases of phyllodes tumors to better understand risk factors and disease management.

PubMed

Lightner, Amy L; Shurell, Elizabeth; Dawson, Nicole; Omidvar, Yasaman; Foster, Nova

2015-03-01

Phyllodes tumors of the breast are rare fibroepithelial tumors that are characterized as benign, borderline, or malignant based on cellular characteristics such as stromal overgrowth and number of mitoses. Currently, there is a lack of consensus on risk factors and management of patients with phyllodes tumors, which has led to variation in treatment patterns as well as patient outcomes across many institutions. This study seeks to understand the clinicopathologic features, risk factors for local and metastatic recurrence, and clinical outcomes of patients with phyllodes tumors to better define optimal treatment patterns.

Chemical Shift MR Imaging Methods for the Quantification of Transcatheter Lipiodol Delivery to the Liver: Preclinical Feasibility Studies in a Rodent Model

PubMed Central

Yin, Xiaoming; Guo, Yang; Li, Weiguo; Huo, Eugene; Zhang, Zhuoli; Nicolai, Jodi; Kleps, Robert A.; Hernando, Diego; Katsaggelos, Aggelos K.; Omary, Reed A.

2012-01-01

Purpose: To demonstrate the feasibility of using chemical shift magnetic resonance (MR) imaging fat-water separation methods for quantitative estimation of transcatheter lipiodol delivery to liver tissues. Materials and Methods: Studies were performed in accordance with institutional Animal Care and Use Committee guidelines. Proton nuclear MR spectroscopy was first performed to identify lipiodol spectral peaks and relative amplitudes. Next, phantoms were constructed with increasing lipiodol-water volume fractions. A multiecho chemical shift–based fat-water separation method was used to quantify lipiodol concentration within each phantom. Six rats served as controls; 18 rats underwent catheterization with digital subtraction angiography guidance for intraportal infusion of a 15%, 30%, or 50% by volume lipiodol-saline mixture. MR imaging measurements were used to quantify lipiodol delivery to each rat liver. Lipiodol concentration maps were reconstructed by using both single-peak and multipeak chemical shift models. Intraclass and Spearman correlation coefficients were calculated for statistical comparison of MR imaging–based lipiodol concentration and volume measurements to reference standards (known lipiodol phantom compositions and the infused lipiodol dose during rat studies). Results: Both single-peak and multipeak measurements were well correlated to phantom lipiodol concentrations (r2 > 0.99). Lipiodol volume measurements were progressively and significantly higher when comparing between animals receiving different doses (P < .05 for each comparison). MR imaging–based lipiodol volume measurements strongly correlated with infused dose (intraclass correlation coefficients > 0.93, P < .001) with both single- and multipeak approaches. Conclusion: Chemical shift MR imaging fat-water separation methods can be used for quantitative measurements of lipiodol delivery to liver tissues. © RSNA, 2012 PMID:22623693

The use of numerical programs in research and academic institutions

NASA Astrophysics Data System (ADS)

Scupi, A. A.

2016-08-01

This paper is conceived on the idea that numerical programs using computer models of physical processes can be used both for scientific research and academic teaching to study different phenomena. Computational Fluid Dynamics (CFD) is used today on a large scale in research and academic institutions. CFD development is not limited to computer simulations of fluid flow phenomena. Analytical solutions for most fluid dynamics problems are already available for ideal or simplified situations for different situations. CFD is based on the Navier- Stokes (N-S) equations characterizing the flow of a single phase of any liquid. For multiphase flows the integrated N-S equations are complemented with equations of the Volume of Fluid Model (VOF) and with energy equations. Different turbulent models were used in the paper, each one of them with practical engineering applications: the flow around aerodynamic surfaces used as unconventional propulsion system, multiphase flows in a settling chamber and pneumatic transport systems, heat transfer in a heat exchanger etc. Some of them numerical results were validated by experimental results. Numerical programs are also used in academic institutions where certain aspects of various phenomena are presented to students (Bachelor, Master and PhD) for a better understanding of the phenomenon itself.

Shiga toxin-producing Escherichia coli: a single-center, 11-year pediatric experience.

PubMed

Schindler, Emily I; Sellenriek, Patricia; Storch, Gregory A; Tarr, Phillip I; Burnham, Carey-Ann D

2014-10-01

The aim of this study was to identify the best practices for the detection of Shiga toxin-producing Escherichia coli (STEC) in children with diarrheal illness treated at a tertiary care center, i.e., sorbitol-MacConkey (SMAC) agar culture, enzyme immunoassay (EIA) for Shiga toxin, or the simultaneous use of both methods. STEC was detected in 100 of 14,997 stool specimens submitted for enteric culture (0.7%), with 65 cases of E. coli O157. Among E. coli O157 isolates, 57 (88%) were identified by both SMAC agar culture and EIA, 6 (9%) by SMAC agar culture alone, and 2 (3%) by EIA alone. Of the 62 individuals with diarrheal hemolytic uremic syndrome (HUS) seen at our institution during the study period, 16 (26%) had STEC isolated from cultures at our institution and 15 (24%) had STEC isolated at other institutions. No STEC was recovered in 31 cases (50%). Of the HUS cases in which STEC was isolated, 28 (90%) were attributable to E. coli O157 and 3 (10%) were attributable to non-O157 STEC. Consistent with previous studies, we have determined that a subset of E. coli O157 infections will not be detected if an agar-based method is excluded from the enteric culture workup; this has both clinical and public health implications. The best practice would be concomitant use of an agar-based method and a Shiga toxin EIA, but a Shiga toxin EIA should not be considered to be an adequate stand-alone test for detection of E. coli O157 in clinical samples. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study.

PubMed

Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B

2018-04-01

As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p < 0.0001). Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p < 0.0001) and death (HR 0.80, p < 0.0001). Subgroup analyses revealed that home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p < 0.01), Heart & Vascular (adjusted savings of $11,453, p < 0.0001), Medicine (readmission HR 0.71, p < 0.0001), and Neurological (readmission HR 0.67, p < 0.0001) Institutes. Discharge with home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.

Training Pediatric Fellows in Palliative Care: A Pilot Comparison of Simulation Training and Didactic Education.

PubMed

Brock, Katharine E; Cohen, Harvey J; Sourkes, Barbara M; Good, Julie J; Halamek, Louis P

2017-10-01

Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills. In this pilot study, we assessed (1) the relative effectiveness of simulation-based versus didactic education, (2) communication skill retention, and (3) effect on PC consultation rates. Thirty-five pediatric fellows in cardiology, critical care, hematology/oncology, and neonatology at two institutions enrolled: 17 in the intervention (simulation-based) group (single institution) and 18 in the control (didactic education) group (second institution). Intervention group participants participated in a two-day program over three months (three simulations and videotaped PC panel). Control group participants received written education designed to be similar in content and time. (1) Self-assessment questionnaires were completed at baseline, post-intervention and three months; mean between-group differences for each outcome measure were assessed. (2) External reviewers rated simulation-group encounters on nine communication domains. Within-group changes over time were assessed. (3) The simulation-based site's PC consultations were compared in the six months pre- and post-intervention. Compared to the control group, participants in the intervention group improved in self-efficacy (p = 0.003) and perceived adequacy of medical education (p < 0.001), but not knowledge (p = 0.20). Reviewers noted nonsustained improvement in four domains: relationship building (p = 0.01), opening discussion (p = 0.03), gathering information (p = 0.01), and communicating accurate information (p = 0.04). PC consultation rate increased 64%, an improvement when normalized to average daily census (p = 0.04). This simulation-based curriculum is an effective method for improving PC comfort, education, and consults. More frequent practice is likely needed to lead to sustained improvements in communication competence.

The Power Within: Institution-Based Leadership Development Programs in Rural Community Colleges in Illinois

ERIC Educational Resources Information Center

Sherbini, Jaleh T.

2012-01-01

The purpose of this study was to examine institution-based leadership development programs in rural community colleges in Illinois, and the impact of these programs in supporting and preparing future community college leaders. The study also explored the efficacy of these programs and whether their implementation aligns with the institutions'…

Toward a Checklist for Exchange and Interpretation of Data froma Toxicology Study

EPA Science Inventory

With the advent of toxicogenomics came the need to share data across interdisciplinary teams and to deposit data associated with publications into public data repositories. Within a single institution, many variables associated with a study are standardized, for instance diet, an...

Molecular subgroups of adult medulloblastoma: a long-term single-institution study.

PubMed

Zhao, Fu; Ohgaki, Hiroko; Xu, Lei; Giangaspero, Felice; Li, Chunde; Li, Peng; Yang, Zhijun; Wang, Bo; Wang, Xingchao; Wang, Zhenmin; Ai, Lin; Zhang, Jing; Luo, Lin; Liu, Pinan

2016-07-01

Recent transcriptomic approaches have demonstrated that there are at least 4 distinct subgroups in medulloblastoma (MB); however, survival studies of molecular subgroups in adult MB have been inconclusive because of small sample sizes. The aim of this study is to investigate the molecular subgroups in adult MB and identify their clinical and prognostic implications in a large, single-institution cohort. We determined gene expression profiles for 13 primary adult MBs. Bioinformatics tools were used to establish distinct molecular subgroups based on the most informative genes in the dataset. Immunohistochemistry with subgroup-specific antibodies was then used for validation within an independent cohort of 201 formalin-fixed MB tumors, in conjunction with a systematic analysis of clinical and histological characteristics. Three distinct molecular variants of adult MB were identified: the SHH, WNT, and group 4 subgroups. Validation of these subgroups in the 201-tumor cohort by immunohistochemistry identified significant differences in subgroup-specific demographics, histology, and metastatic status. The SHH subgroup accounted for the majority of the tumors (62%), followed by the group 4 subgroup (28%) and the WNT subgroup (10%). Group 4 tumors had significantly worse progression-free and overall survival compared with tumors of the other molecular subtypes. We have identified 3 subgroups of adult MB, characterized by distinct expression profiles, clinical features, pathological features, and prognosis. Clinical variables incorporated with molecular subgroup are more significantly informative for predicting adult patient outcome. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Multi-Institution Research Centers: Planning and Management Challenges

ERIC Educational Resources Information Center

Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

2016-01-01

Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

Controlling Atomic, Solid-State and Hybrid Systems for Quantum Information Processing

DTIC Science & Technology

2013-09-04

PERFORMING ORGANIZATION NAMES AND ADDRESSES 8. PERFORMING ORGANIZATION REPORT Massachusetts Institute of Technology (MIT NUMBER 77 Massachusetts...for the graphene macro-atom. . . . . . . . . . . . . . 67 4.3 Performance of the graphene based single photon switch. . . . . . . . 68 5.1 All-optical...community of scientists, as well as the occasional pick up basketball, softball , volleyball, hockey and tennis team. Both past and present members have

Assessing Proposals for Interagency Reorganization

DTIC Science & Technology

2005-05-26

is useful to have a single entity responsible for operations. Though postmodernist theory is based on a diffusion of knowledge there is an... of knowledge …[for] the general good of mankind.”32 Their research tends to focus on technological solutions to complex information management issues...from an institutional perspective different from that of CSIS. The Markle Foundation was created in 1927 “to promote the advancement and diffusion

Single Fraction Versus Fractionated Linac-Based Stereotactic Radiotherapy for Vestibular Schwannoma: A Single-Institution Experience

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

Collen, Christine, E-mail: ccollen@uzbrussel.be; Ampe, Ben; Gevaert, Thierry

2011-11-15

Purpose: To evaluate and compare outcomes for patients with vestibular schwannoma (VS) treated in a single institution with linac-based stereotactic radiosurgery (SRS) or by fractionated stereotactic radiotherapy (SRT). Methods and Materials: One hundred and nineteen patients (SRS = 78, SRT = 41) were treated. For both SRS and SRT, beam shaping is performed by a mini-multileaf collimator. For SRS, a median single dose of 12.5 Gy (range, 11-14 Gy), prescribed to the 80% isodose line encompassing the target, was applied. Of the 42 SRT treatments, 32 treatments consisted of 10 fractions of 3-4 Gy, and 10 patients received 25 sessionsmore » of 2 Gy, prescribed to the 100% with the 95% isodose line encompassing the planning target volume. Mean largest tumor diameter was 16.6 mm in the SRS and 24.6 mm in the SRT group. Local tumor control, cranial nerve toxicity, and preservation of useful hearing were recorded. Any new treatment-induced cranial nerve neuropathy was scored as a complication. Results: Median follow-up was 62 months (range, 6-136 months), 5 patients progressed, resulting in an overall 5-year local tumor control of 95%. The overall 5-year facial nerve preservation probability was 88% and facial nerve neuropathy was statistically significantly higher after SRS, after prior surgery, for larger tumors, and in Koos Grade {>=}3. The overall 5-year trigeminal nerve preservation probability was 96%, not significantly influenced by any of the risk factors. The overall 4-year probability of preservation of useful hearing (Gardner-Robertson score 1 or 2) was 68%, not significantly different between SRS or SRT (59% vs. 82%, p = 0.089, log rank). Conclusion: Linac-based RT results in good local control and acceptable clinical outcome in small to medium-sized vestibular schwannomas (VSs). Radiosurgery for large VSs (Koos Grade {>=}3) remains a challenge because of increased facial nerve neuropathy.« less

Integrated management of land and water resources based on a collective approach to fragmented international conventions.

PubMed

Duda, Alfred M

2003-12-29

Interlinked crises of land degradation, food security, ecosystem decline, water quality and water flow depletion stand in the way of poverty reduction and sustainable development. These crises are made worse by increased fluctuations in climatic regimes. Single-purpose international conventions address these crises in a piecemeal, sectoral fashion and may not meet their objectives without greater attention to policy, legal, and institutional reforms related to: (i) balancing competing uses of land and water resources within hydrologic units; (ii) adopting integrated approaches to management; and (iii) establishing effective governance institutions for adaptive management within transboundary basins. This paper describes this global challenge and argues that peace, stability and security are all at stake when integrated approaches are not used. The paper presents encouraging results from a decade of transboundary water projects supported by the Global Environment Facility in developing countries that test practical applications of processes for facilitating reforms related to land and water that are underpinned by science-based approaches. Case studies of using these participative processes are described that collectively assist in the transition to integrated management. A new imperative for incorporating interlinkages among food, water, and environment security at the basin level is identified.

Integrated management of land and water resources based on a collective approach to fragmented international conventions.

PubMed Central

Duda, Alfred M

2003-01-01

Interlinked crises of land degradation, food security, ecosystem decline, water quality and water flow depletion stand in the way of poverty reduction and sustainable development. These crises are made worse by increased fluctuations in climatic regimes. Single-purpose international conventions address these crises in a piecemeal, sectoral fashion and may not meet their objectives without greater attention to policy, legal, and institutional reforms related to: (i) balancing competing uses of land and water resources within hydrologic units; (ii) adopting integrated approaches to management; and (iii) establishing effective governance institutions for adaptive management within transboundary basins. This paper describes this global challenge and argues that peace, stability and security are all at stake when integrated approaches are not used. The paper presents encouraging results from a decade of transboundary water projects supported by the Global Environment Facility in developing countries that test practical applications of processes for facilitating reforms related to land and water that are underpinned by science-based approaches. Case studies of using these participative processes are described that collectively assist in the transition to integrated management. A new imperative for incorporating interlinkages among food, water, and environment security at the basin level is identified. PMID:14728798

Patients come from populations and populations contain patients. A two-stage scientific and ethics review: The next adaptation for single institutional review boards.

PubMed

Knopman, David; Alford, Eli; Tate, Kaitlin; Long, Mark; Khachaturian, Ara S

2017-08-01

For nearly 50 years, institutional review boards (IRB) and independent ethics committees have featured local oversight as a core function of research ethics reviews. However growing complexity in Alzheimer's clinical research suggests current approaches to research volunteer safety is hampering development of new therapeutics. As a partial response to this challenge, the NIH has mandated that all NIH-funded multi-site studies will use a single Institutional Review Board. The perspective describes a joint program to provide a single IRB of record (sIRB) for phases of multi-site studies. The approach follows two steps. One, an expert Scientific Review Committee (SRC) of senior researchers in the field will conduct the review principally of scientific merit, significance, feasibility, and the likelihood of meaningful results. The second step will be the IRB's regulatory and ethics review. The IRB will apply appropriate regulatory criteria for approval including minimization of risks to subjects and risks reasonable in relation to anticipated benefits, equitable subject selection, informed consent, protections for vulnerable populations, and application of local context considerations, among others. There is a steady demand for scientific, ethical and regulatory review of planned Alzheimer's studies. As of January 15, 2017, there are nearly 400 open studies, Phase II and III, industry and NIH sponsored trials on disease indications affecting memory, movement and mood in the US. The effort will initially accept protocols for studies of Alzheimer's disease, dementia, and related disorders effecting memory, movement and mood. Future aims will be to provide scientific review and, where applicable, regulatory and ethical review in an international context outside North America with sites possibly in Asia, Europe and Australia. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Quantification of hepatic steatosis with T1-independent, T2-corrected MR imaging with spectral modeling of fat: blinded comparison with MR spectroscopy.

PubMed

Meisamy, Sina; Hines, Catherine D G; Hamilton, Gavin; Sirlin, Claude B; McKenzie, Charles A; Yu, Huanzhou; Brittain, Jean H; Reeder, Scott B

2011-03-01

To prospectively compare an investigational version of a complex-based chemical shift-based fat fraction magnetic resonance (MR) imaging method with MR spectroscopy for the quantification of hepatic steatosis. This study was approved by the institutional review board and was HIPAA compliant. Written informed consent was obtained before all studies. Fifty-five patients (31 women, 24 men; age range, 24-71 years) were prospectively imaged at 1.5 T with quantitative MR imaging and single-voxel MR spectroscopy, each within a single breath hold. The effects of T2 correction, spectral modeling of fat, and magnitude fitting for eddy current correction on fat quantification with MR imaging were investigated by reconstructing fat fraction images from the same source data with different combinations of error correction. Single-voxel T2-corrected MR spectroscopy was used to measure fat fraction and served as the reference standard. All MR spectroscopy data were postprocessed at a separate institution by an MR physicist who was blinded to MR imaging results. Fat fractions measured with MR imaging and MR spectroscopy were compared statistically to determine the correlation (r(2)), and the slope and intercept as measures of agreement between MR imaging and MR spectroscopy fat fraction measurements, to determine whether MR imaging can help quantify fat, and examine the importance of T2 correction, spectral modeling of fat, and eddy current correction. Two-sided t tests (significance level, P = .05) were used to determine whether estimated slopes and intercepts were significantly different from 1.0 and 0.0, respectively. Sensitivity and specificity for the classification of clinically significant steatosis were evaluated. Overall, there was excellent correlation between MR imaging and MR spectroscopy for all reconstruction combinations. However, agreement was only achieved when T2 correction, spectral modeling of fat, and magnitude fitting for eddy current correction were used (r(2) = 0.99; slope ± standard deviation = 1.00 ± 0.01, P = .77; intercept ± standard deviation = 0.2% ± 0.1, P = .19). T1-independent chemical shift-based water-fat separation MR imaging methods can accurately quantify fat over the entire liver, by using MR spectroscopy as the reference standard, when T2 correction, spectral modeling of fat, and eddy current correction methods are used. © RSNA, 2011.

Quantification of Hepatic Steatosis with T1-independent, T2*-corrected MR Imaging with Spectral Modeling of Fat: Blinded Comparison with MR Spectroscopy

PubMed Central

Hines, Catherine D. G.; Hamilton, Gavin; Sirlin, Claude B.; McKenzie, Charles A.; Yu, Huanzhou; Brittain, Jean H.; Reeder, Scott B.

2011-01-01

Purpose: To prospectively compare an investigational version of a complex-based chemical shift–based fat fraction magnetic resonance (MR) imaging method with MR spectroscopy for the quantification of hepatic steatosis. Materials and Methods: This study was approved by the institutional review board and was HIPAA compliant. Written informed consent was obtained before all studies. Fifty-five patients (31 women, 24 men; age range, 24–71 years) were prospectively imaged at 1.5 T with quantitative MR imaging and single-voxel MR spectroscopy, each within a single breath hold. The effects of T2* correction, spectral modeling of fat, and magnitude fitting for eddy current correction on fat quantification with MR imaging were investigated by reconstructing fat fraction images from the same source data with different combinations of error correction. Single-voxel T2-corrected MR spectroscopy was used to measure fat fraction and served as the reference standard. All MR spectroscopy data were postprocessed at a separate institution by an MR physicist who was blinded to MR imaging results. Fat fractions measured with MR imaging and MR spectroscopy were compared statistically to determine the correlation (r2), and the slope and intercept as measures of agreement between MR imaging and MR spectroscopy fat fraction measurements, to determine whether MR imaging can help quantify fat, and examine the importance of T2* correction, spectral modeling of fat, and eddy current correction. Two-sided t tests (significance level, P = .05) were used to determine whether estimated slopes and intercepts were significantly different from 1.0 and 0.0, respectively. Sensitivity and specificity for the classification of clinically significant steatosis were evaluated. Results: Overall, there was excellent correlation between MR imaging and MR spectroscopy for all reconstruction combinations. However, agreement was only achieved when T2* correction, spectral modeling of fat, and magnitude fitting for eddy current correction were used (r2 = 0.99; slope ± standard deviation = 1.00 ± 0.01, P = .77; intercept ± standard deviation = 0.2% ± 0.1, P = .19). Conclusion: T1-independent chemical shift–based water-fat separation MR imaging methods can accurately quantify fat over the entire liver, by using MR spectroscopy as the reference standard, when T2* correction, spectral modeling of fat, and eddy current correction methods are used. © RSNA, 2011 PMID:21248233

Adult Literacy: A Study of Community Based Literacy Programs. Revised and Updated. Volume II: Program Profiles.

ERIC Educational Resources Information Center

Association for Community Based Education, Washington, DC.

This volume accompanies a study of community-based approaches to literacy education for adults. It provides profiles of 26 community-based educational institutions that provided study data. Each profile provides name, address, and telephone number; contact; other project sites; institutional description; mission/purpose; approach; skills…

Child Care Support for Student Parents in Community College Is Crucial for Success, but Supply and Funding Are Inadequate. Fact Sheet #C375

ERIC Educational Resources Information Center

Miller, Kevin

2010-01-01

Of the over 6 million students earning college credit at community colleges, 1.7 million (27 percent) are parents. Of those, about 1 million (16 percent) are single parents, more than twice the proportion at 4-year institutions. Three-quarters of single parents in college are women. One study of student parents attending community college found…

Italian public health care organizations: specialization, institutional deintegration, and public networks relationships.

PubMed

Del Vecchio, Mario; De Pietro, Carlo

2011-01-01

The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation of a single public organization, the Local Health Unit, responsible for the health status of the population of its catchment area. At the beginning of the 1990s, the scenario radically changed. The creation of hospital trusts, the development of quasi-market mechanisms and management control tools, the adoption of a prospective payment system for reimbursing health care providers--all were signs of deintegration and institutional unbundling. Two structural changes have deeply sustained this deintegration: patients' empowerment and the increased possibilities for outsourcing practices. In more recent years, a new reintegration effort has occurred, often led by regional governments and based on institutional cooperation and network relationships. However, the earlier structural changes require innovative approaches and solutions if public health care organizations want to retain their leading role.

London Took the Lead: Institutes for Women.

ERIC Educational Resources Information Center

Hughes, Mary

1992-01-01

The creation in London of single-sex institutes for the education of women offered increased educational opportunities but did not widen their horizons. For working class women, educational policy regarding these institutes tended to support their domestic roles. (SK)

Single visit surgery for pediatric ambulatory surgical procedures: a satisfaction and cost analysis.

PubMed

Olson, Jacob K; Deming, Lisa A; King, Denis R; Rager, Terrence M; Gartner, Sarah; Huibregtse, Natalie; Moss, R Lawrence; Besner, Gail E

2017-10-10

Single visit surgery (SVS) consists of same-day pre-operative assessment and operation with telephone post-operative follow-up. This reduces family time commitment to 1 hospital trip rather than 2-3. We began SVS for ambulatory patients with clear surgical indications in 2013. We sought to determine family satisfaction, cost savings to families, and institutional financial feasibility of SVS. SVS patients were compared to age/case matched conventional surgery (CS) patients. Satisfaction was assessed by post-operative telephone survey. Family costs were calculated as the sum of lost revenue (based on median income) and transportation costs ($0.50/mile). Satisfaction was high in both groups (98% for SVS vs. 93% for CS; p=0.27). 40% of CS families indicated that they would have preferred SVS, whereas no SVS families indicated preference for the CS option (p<0.001). Distance from the hospital did not correlate with satisfaction. Estimated cost savings for an SVS family was $188. Reimbursement, hospital and physician charges, and day-of-surgery cancellation rates were similar. SVS provides substantial cost savings to families while maintaining patient satisfaction and equivalent institutional reimbursement. SVS is an effective approach to low-risk ambulatory surgical procedures that is less disruptive to families, facilitates access to pediatric surgical care, and reduces resource utilization. Cost Effectiveness Study. Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

An Exploration of the Use of Branding to Shape Institutional Image in the Marketing Activities of Faith-Based Higher Education Institutions

ERIC Educational Resources Information Center

Tolbert, Dawn

2014-01-01

Modern higher education includes student-consumers who shop for educational opportunities and institutions that actively market themselves. This study examined the marketing of faith-based institutions to determine how faith-related missions are reflected in the printed recruitment materials, Web sites, and admissions portals of the 112 member…

How Institutions Respond to Training Packages.

ERIC Educational Resources Information Center

Boorman, Andrew

The impact of the transition to training packages (TPs) on institutionally based training in Australia was examined. Information was gathered from 14 case studies of registered trade organizations (RTOs) delivering qualifications to institutionally based students in TPs in the following areas: administration, beauty therapy, community services,…

78 FR 46994 - Proposed Collection; 60-Day Comment Request: National Institute of Mental Health Recruitment and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... Project Clearance Liaison, Science Policy and Evaluation Branch, OSPPC, NIMH, NIH, Neuroscience Center... NIMH-sponsored clinical research studies that plan to enroll 150 or more human subjects in a single study. Clinical studies can have difficulty recruiting, and accurate and timely reporting is the best...

Rural Midwestern Public College Safe Ride Program Case Study

ERIC Educational Resources Information Center

Mohfeld, Kathy I.

2017-01-01

The central phenomenon researched in this case study was higher education administrators' decisions to institutionalize a safe ride program at a small, rural college. The purpose of this single/within-site case study was to describe the changes that happened at a rural public institution of higher education and the surrounding community in the…

Importance of multi-modal approaches to effectively identify cataract cases from electronic health records.

PubMed

Peissig, Peggy L; Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

2012-01-01

There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries.

An Examination of Crisis Preparedness of Christian-Affiliated Institutions of Higher Education

ERIC Educational Resources Information Center

Burrell, Stacy M.

2009-01-01

The purpose of this study was to examine crisis preparedness at Christian-affiliated institutions of higher education. Second, this study examined Christian-affiliated institutions of higher education presidents' perspective of their institution's ability to prepare for crises based upon the four critical indicators of organizational crisis…

Irradiation setup at the U-120M cyclotron facility

NASA Astrophysics Data System (ADS)

Křížek, F.; Ferencei, J.; Matlocha, T.; Pospíšil, J.; Príbeli, P.; Raskina, V.; Isakov, A.; Štursa, J.; Vaňát, T.; Vysoká, K.

2018-06-01

This paper describes parameters of the proton beams provided by the U-120M cyclotron and the related irradiation setup at the open access irradiation facility at the Nuclear Physics Institute of the Czech Academy of Sciences. The facility is suitable for testing radiation hardness of various electronic components. The use of the setup is illustrated by a measurement of an error rate for errors caused by Single Event Transients in an SRAM-based Xilinx XC3S200 FPGA. This measurement provides an estimate of a possible occurrence of Single Event Transients. Data suggest that the variation of error rate of the Single Event Effects for different clock phase shifts is not significant enough to use clock phase alignment with the beam as a fault mitigation technique.

How District Leaders Use Knowledge Management to Influence Principals' Instructional Leadership

ERIC Educational Resources Information Center

McGloughlin, Denise Marie

2016-01-01

The study of knowledge management, an integrated system of an organization's culture, conditions, and structure, as applied to educational institutions is limited. It was not known how district leaders use knowledge management to influence principals' instructional leadership performance. The purpose of this qualitative single-case study was to…

Stories from early-career women physicians who have left academic medicine: a qualitative study at a single institution.

PubMed

Levine, Rachel B; Lin, Fenny; Kern, David E; Wright, Scott M; Carrese, Joseph

2011-06-01

The number of women in academic medicine has steadily increased, although gender parity still does not exist and women leave academics at somewhat higher rates than men. The authors investigated the reasons why women leave careers in academic medicine. Semistructured, one-on-one interviews were conducted in 2007-2008 with 20 women physicians who had left a single academic institution to explore their reasons for opting out of academic careers. Data analysis was iterative, and an editing analysis style was used to derive themes. A lack of role models for combining career and family responsibilities, frustrations with research (funding difficulties, poor mentorship, competition), work-life balance, and the institutional environment (described as noncollaborative and biased in favor of male faculty) emerged as key factors associated with a decision to leave academic medicine for respondents. Faced with these challenges, respondents reevaluated their priorities and concluded that a discrepancy existed between their own and institutional priorities. Many respondents expressed divergent views with the institutional norms on how to measure success and, as a consequence, felt that they were undervalued at work. Participants report a disconnection between their own priorities and those of the dominant culture in academic medicine. Efforts to retain women faculty in academic medicine may include exploring the aspects of an academic career that they value most and providing support and recognition accordingly.

Concentrated solar power on demand demonstration: Construction and operation of a 25 kW prototype

NASA Astrophysics Data System (ADS)

Gil, Antoni; Codd, Daniel S.; Zhou, Lei; Trumper, David; Calvet, Nicolas; Slocum, Alexander H.

2016-05-01

Currently, the majority of concentrated solar power (CSP) plants built worldwide integrate thermal energy storage (TES) systems which enable dispatchable output and higher global plant efficiencies. TES systems are typically based on two tank molten salt technology which involves inherent drawbacks such as parasitic pumping losses and electric tracing of pipes, risk of solidification and high capital costs. The concept presented in this paper is based on a single tank where the concentrated sunlight is directly focused on the molten salt. Hot and cold volumes of salt (at 565 °C and 280 °C, respectively) are axially separated by an insulated divider plate which helps maintain the thermal gradient. The concept, based on existing technologies, seeks to avoid the listed drawbacks as well as reducing the final cost of the TES system. In order to demonstrate its feasibility, Masdar Institute (MI) and Massachusetts Institute of Technology are developing a 25 kW prototype to be tested in the Masdar Solar Platform beam down facility.

Seven Years Later. Education and Work: A 1977 Survey of Students Who Entered the University of California in 1970.

ERIC Educational Resources Information Center

Pace, C. Robert; Rosenstein, Carolyn

Based on a national followup survey of college freshmen conducted by the Higher Education Research Institute, the University of California (UC) respondents were singled out for examination. In the spring of 1977, the national survey was sent to freshmen who had entered college in the fall of 1970. The UC sample of 4,240 freshmen attended either…

Prototyping an institutional IAIMS/UMLS information environment for an academic medical center.

PubMed

Miller, P L; Paton, J A; Clyman, J I; Powsner, S M

1992-07-01

The paper describes a prototype information environment designed to link network-based information resources in an integrated fashion and thus enhance the information capabilities of an academic medical center. The prototype was implemented on a single Macintosh computer to permit exploration of the overall "information architecture" and to demonstrate the various desired capabilities prior to full-scale network-based implementation. At the heart of the prototype are two components: a diverse set of information resources available over an institutional computer network and an information sources map designed to assist users in finding and accessing information resources relevant to their needs. The paper describes these and other components of the prototype and presents a scenario illustrating its use. The prototype illustrates the link between the goals of two National Library of Medicine initiatives, the Integrated Academic Information Management System (IAIMS) and the Unified Medical Language System (UMLS).

The experimental results of AMTEC and a study of its terrestrial applications in IEE of China

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

Ni, Q.; Tong, J.; Kan, Y.

1997-12-31

The R and D activities in the field of AMTEC research at The Institute of Electrical Engineering, Chinese Academy of Sciences are introduced. The outline of experimental facility with a single tube cell is described. The experimental results so far are reported followed by an analysis of electrical characteristic, in particular, an evaluation of characteristic of BASE/porous electrode interface with the effective sheet resistivity and the electrode efficiency. The approaches for improving device performance are discussed. The terrestrial applications of AMTEC in China are considered as an alternative of conventional diesel-generators. The possibility of AMTEC power supply for some separatemore » sites is predicted.« less

Molecular epidemiology of camel trypanosomiasis based on ITS1 rDNA and RoTat 1.2 VSG gene in the Sudan

PubMed Central

2011-01-01

Background Internal transcribed spacer one (ITS1) of the ribosomal DNA is known to be a suitable target for PCR-based detection of trypanosomes. The analysis of this region provides a multi-species-specific diagnosis by a single PCR. Using ITS1 primer-based PCR, a cross sectional study was carried out in the period from September to November 2009 on samples collected from 687 camels from geographically distinct zones in the Sudan to detect all possible African trypanosomes, which can infect camels. Results The results showed that all PCR-positive camels were infected with a single parasite species; Trypanosoma evansi. The highest prevalence, 57.1% (117/205), was observed in the Butana plains of mid-Eastern Sudan and the lowest, 6.0% (4/67), was in the Umshadeeda eastern part of White Nile State. In another experiment, the RoTat 1.2 gene encoding the variable surface glycoprotein (VSG) of T. evansi was analyzed for its presence or absence by a polymerase chain reaction (PCR) using T. evansi species-specific primers. The study showed that the RoTat 1.2 VSG gene was absent in thirteen out of thirty T. evansi-positive samples. Conclusions It is concluded that camel trypanosomiasis in Sudan is apparently caused by a single parasite species T. evansi and there were no other typanosomes species detected. In addition, the disease is highly prevalent in the country, which strengthens the need to change control policies and institute measures that help prevent the spread of the parasite. To our knowledge, this is the first molecular diagnosis report, which gives a picture of camel trypanosomiasis covering large geographical areas in Sudan. PMID:21375725

Health sector decentralization and local decision-making: Decision space, institutional capacities and accountability in Pakistan.

PubMed

Bossert, Thomas John; Mitchell, Andrew David

2011-01-01

Health sector decentralization has been widely adopted to improve delivery of health services. While many argue that institutional capacities and mechanisms of accountability required to transform decentralized decision-making into improvements in local health systems are lacking, few empirical studies exist which measure or relate together these concepts. Based on research instruments administered to a sample of 91 health sector decision-makers in 17 districts of Pakistan, this study analyzes relationships between three dimensions of decentralization: decentralized authority (referred to as "decision space"), institutional capacities, and accountability to local officials. Composite quantitative indicators of these three dimensions were constructed within four broad health functions (strategic and operational planning, budgeting, human resources management, and service organization/delivery) and on an overall/cross-function basis. Three main findings emerged. First, district-level respondents report varying degrees of each dimension despite being under a single decentralization regime and facing similar rules across provinces. Second, within dimensions of decentralization-particularly decision space and capacities-synergies exist between levels reported by respondents in one function and those reported in other functions (statistically significant coefficients of correlation ranging from ρ=0.22 to ρ=0.43). Third, synergies exist across dimensions of decentralization, particularly in terms of an overall indicator of institutional capacities (significantly correlated with both overall decision space (ρ=0.39) and accountability (ρ=0.23)). This study demonstrates that decentralization is a varied experience-with some district-level officials making greater use of decision space than others and that those who do so also tend to have more capacity to make decisions and are held more accountable to elected local officials for such choices. These findings suggest that Pakistan's decentralization policy should focus on synergies among dimensions of decentralization to encouraging more use of de jure decision space, work toward more uniform institutional capacity, and encourage greater accountability to local elected officials. Copyright © 2010 Elsevier Ltd. All rights reserved.

History of the U.S. Navy Body Composition program.

PubMed

Peterson, David D

2015-01-01

The Navy currently employs maximum weight-for-height tables and body fat prediction equations based on circumference measurements to assess body composition. However, many Sailors believe the current method fails to accurately predict body fat percentage. As a result, the Naval Health Research Center (NHRC) conducted numerous studies in an attempt to improve the accuracy and reliability of the Navy's Body Composition Analysis program. In 2012, NHRC conducted a study that researched the feasibility of using a single abdominal circumference (AC) measurement in lieu of circumference measurements. The Air Force and National Institutes of Health (NIH) employ a single AC measurement taken at the superior border of the iliac crest to assess body composition and all-cause mortality risk. Although the Air Force and NIH use the iliac crest, NHRC is proposing the Navy use the umbilicus as the AC site since it is less invasive and easier to identify. If implemented, the Navy would use cutoff values of 40 in. and 36 in. for males and females, respectively. The purpose of this article is to provide a brief history of the Navy's Body Composition Analysis program as well as propose the transition from circumference measurements to a single AC measurement. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Significant reduction in red blood cell transfusions in a general hospital after successful implementation of a restrictive transfusion policy supported by prospective computerized order auditing.

PubMed

Yerrabothala, Swaroopa; Desrosiers, Kevin P; Szczepiorkowski, Zbigniew M; Dunbar, Nancy M

2014-10-01

Our hospital transfusion policy was recently revised to recommend single-unit red blood cell transfusion (RBC TXN) for nonbleeding inpatients when the hemoglobin (Hb) level is not more than 7 g/dL. Our computerized provider order entry system was reconfigured to provide real-time decision support using prospective computerized order auditing based on the most recent Hb level and to remove the single-click ordering option for 2-unit RBC TXNs to enhance compliance. This study was undertaken to assess the impact of these changes on hospital transfusion practice. This study analyzed the total number of transfusion events, proportion of single and 2-unit transfusions and the Hb transfusion trigger in the preimplementation period (October 2011-March 2012) compared to the postimplementation period (October 2012-March 2013). In the postimplementation period the total number of RBC units transfused/1000 patient-days decreased from 60.8 to 44.2 (p < 0.0001). The proportion of 2-unit TXNs decreased from 47% to 15% (p < 0.0001). We also observed significant decreases in pretransfusion Hb triggers. Implementation of restrictive transfusion policy supported by prospective computerized order auditing has resulted in significantly decreased RBC utilization at our institution. © 2014 AABB.

76 FR 52328 - Single Source Cooperative Agreement Award for the Gorgas Memorial Institute of Health Studies

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... infectious disease threats including select bio-terrorism agents and novel influenza viruses. The amount of... or actual spread of bio-terrorism agents or a pandemic to the United States, thereby enhancing the...

Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen.

PubMed

Sanz, J; Boluda, J C H; Martín, C; González, M; Ferrá, C; Serrano, D; de Heredia, C D; Barrenetxea, C; Martinez, A M; Solano, C; Sanz, M A; Sanz, G F

2012-10-01

Attempts to optimize outcomes in cord blood transplantation (CBT) by using new conditioning regimens and standardization of cord blood unit selection are warranted. In all, 88 patients (18 children and 70 adults) with hematological malignancy from nine Spanish institutions underwent a single-unit CBT after an i.v. BU-based myeloablative conditioning regimen. All evaluable patients except one engrafted. The overall cumulative incidence (CI) of myeloid engraftment was 94% at a median time of 19 days. In multivariate analysis, nonadvanced disease stage was the only factor with a favorable impact on myeloid engraftment. The CI of acute GVHD grades II-IV and chronic extensive GVHD were 24% each. The CI of nonrelapse mortality at 100 days, 180 days and 5 years was 14, 23 and 44%, respectively. The 5-year CI of relapse was 18%, whereas disease-free survival (DFS) was 46%, 39% and 11% for patients transplanted in early, intermediate and advanced stages of the disease, respectively. Our study shows high rates of engraftment with fast neutrophil recovery in patients undergoing single-unit CBT using a BU-based conditioning regimen. Long-term DFS can be achieved in a substantial number of patients with high-risk hematological malignancies, particularly when transplanted in an early stage of the disease.

Clinical efficacy and safety of surface imaging guided radiosurgery (SIG-RS) in the treatment of benign skull base tumors.

PubMed

Lau, Steven K M; Patel, Kunal; Kim, Teddy; Knipprath, Erik; Kim, Gwe-Ya; Cerviño, Laura I; Lawson, Joshua D; Murphy, Kevin T; Sanghvi, Parag; Carter, Bob S; Chen, Clark C

2017-04-01

Frameless, surface imaging guided radiosurgery (SIG-RS) is a novel platform for stereotactic radiosurgery (SRS) wherein patient positioning is monitored in real-time through infra-red camera tracking of facial topography. Here we describe our initial clinical experience with SIG-RS for the treatment of benign neoplasms of the skull base. We identified 48 patients with benign skull base tumors consecutively treated with SIG-RS at a single institution between 2009 and 2011. Patients were diagnosed with meningioma (n = 22), vestibular schwannoma (n = 20), or nonfunctional pituitary adenoma (n = 6). Local control and treatment-related toxicity were retrospectively assessed. Median follow-up was 65 months (range 61-72 months). Prescription doses were 12-13 Gy in a single fraction (n = 18), 8 Gy × 3 fractions (n = 6), and 5 Gy × 5 fractions (n = 24). Actuarial tumor control rate at 5 years was 98%. No grade ≥3 treatment-related toxicity was observed. Grade ≤2 toxicity was associated with symptomatic lesions (p = 0.049) and single fraction treatment (p = 0.005). SIG-RS for benign skull base tumors produces clinical outcomes comparable to conventional frame-based SRS techniques while enhancing patient comfort.

Long-Term Outcome of Laparoscopic Totally Extraperitoneal Repair of Bilateral Inguinal Hernias with a Large Single Mesh.

PubMed

Issa, Nidal; Ohana, Gil; Bachar, Gil Nissim; Powsner, Eldad

2016-02-01

A totally extraperitoneal (TEP) approach is currently the technique of choice for the laparoscopic repair of bilateral inguinal hernias in our institution. Most other surgeons use two meshes for the TEP repair, one for each side. We prefer a large single mesh when possible since it allows for easier correct placement of the mesh in one stage. We compared our long-term results of both techniques in terms of late complications and recurrence rates. This study retrospectively evaluated the medical records of 108 patients who underwent bilateral laparoscopic TEP repair in our institution between January 2002 and December 2003. Excluded were patients who had a conversion to a transabdominal preperitoneal or open approach. A total of 73 (67 %) patients fulfilled study entrance criteria and were enrolled: 39 had undergone single mesh repair and 34 had undergone double mesh repair. There were no significant group differences in demographics, operating time, postoperative morbidity, or hospital stay. Likewise, after a median follow-up of 102 months (range 94–115 months), there were no significant group differences between the single and double mesh groups in persistent pain (5.8 vs 2.5 %, respectively; p = 0.476) and recurrence (7.6 vs 8.8 %, respectively; p = 0.55). The use of a large single mesh is an effective and safe alternative technique for TEP repair of bilateral inguinal hernias, and is technically easy to perform.

A Phenomenological Study of How Biblical Spiritual Disciplines Influence Women's Character and Leadership Practices in Christian Faith-Based Institutions in Higher Education in North America

ERIC Educational Resources Information Center

Bailey, Kristin Michelle

2017-01-01

As Christian faith-based institutions of higher education strive to uphold Christian values, there is a need to be intentional in identifying and developing future leaders. This study was viewed through the lens that women are underrepresented in senior-level positions in Christian institutions, they have unique leadership attributes to offer, and…

7 CFR 4290.150 - Management and ownership diversity requirement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Associates. A single “acceptable” Institutional Investor may be substituted for two or three of the three investors who are otherwise required. The following Institutional Investors are “acceptable” for this... income taxation; and (6) Other Institutional Investors satisfactory to the Secretary. (d) Voting...

7 CFR 4290.150 - Management and ownership diversity requirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Associates. A single “acceptable” Institutional Investor may be substituted for two or three of the three investors who are otherwise required. The following Institutional Investors are “acceptable” for this... income taxation; and (6) Other Institutional Investors satisfactory to the Secretary. (d) Voting...

7 CFR 4290.150 - Management and ownership diversity requirement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Associates. A single “acceptable” Institutional Investor may be substituted for two or three of the three investors who are otherwise required. The following Institutional Investors are “acceptable” for this... income taxation; and (6) Other Institutional Investors satisfactory to the Secretary. (d) Voting...

7 CFR 4290.150 - Management and ownership diversity requirement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Associates. A single “acceptable” Institutional Investor may be substituted for two or three of the three investors who are otherwise required. The following Institutional Investors are “acceptable” for this... income taxation; and (6) Other Institutional Investors satisfactory to the Secretary. (d) Voting...

7 CFR 4290.150 - Management and ownership diversity requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Associates. A single “acceptable” Institutional Investor may be substituted for two or three of the three investors who are otherwise required. The following Institutional Investors are “acceptable” for this... income taxation; and (6) Other Institutional Investors satisfactory to the Secretary. (d) Voting...

Myeloablative therapy against high risk Ewing's sarcoma: A single institution experience and literature review

PubMed Central

Lopez, Jose Luis; Pérez, Concepcion; Marquez, Catalina; Cabrera, Patricia; Perez, Jose Maria; Ramirez, Gema Lucia; Ordoñez, Rafael; Praena-Fernandez, Juan Manuel; Ortiz, Maria Jose

2011-01-01

Background Attempts to improve survival outcomes of patients with high risk Ewing's sarcoma (ES) have focused on chemotherapy dose intensification strategies. Aim The objective of this study is to retrospectively evaluate clinical characteristics and outcome of pediatric patients with high risk ES treated at a single institution. Materials and methods From 1995 to 2008, seventeen patients (male:female, 14:3) were treated with dose-intensive therapy in our institution. Median age at diagnosis was 10 years (range: 2–15). Seven patients had metastases at diagnosis (lung in 6 cases and bone in one case). Eleven patients presented with unresectable disease. Fifteen (88.2%) received the Spanish Society of Pediatric Oncology protocol which includes six cycles of vincristine, doxorubicin, ifosfamide and etoposide. Two out of the six cases that were resectable received postoperative radiation. In addition, eleven patients received definitive radiation therapy. Finally, twelve (70.5%) out of 17 patients received myeloablative therapy with melphalan/etoposide. The rest of patients (N = 5) received busulfan/melphalan. Results Median follow-up was 78 months (range: 15–155 months). Initial responses were complete in all patients, but 9 of them developed progression disease. Seven patients became long-term event-free survivors. No patient died of toxicity after transplantation. The 2- and 5-year overall survival rates for all patients were 93% and 73%, respectively. Event-free survival rates were 74% and 54% at 2 and 5 years, respectively. Conclusion This single-institution experience suggests that myeloablative therapy against high risk ES is effective and safe. PMID:24376974

Gender and international clinician educators.

PubMed

Stadler, Dora J; Archuleta, Sophia; Ibrahim, Halah; Shah, Nina G; Al-Mohammed, Ahmed Ali; Cofrancesco, Joseph

2017-12-01

To describe gender differences of international clinician educators (CEs) and leaders, and CEs' perceptions by gender of preparation, roles, rewards and factors affecting job satisfaction and retention in emerging international competency-based residency programmes. Cross-sectional surveys of CEs and leadership were conductedJune 2013-June 2014 at institutions that had adopted competency-based graduate medical education and were accredited by the Accreditation Council for Graduate Medical Education-International. 274 (76.3%) of 359 eligible participants responded; 69 (25.2%) were female. Two (18%) of 11 chief executive officers and 1 (9%) of 11 chief medical officers were women. Female CEs were younger, more likely to be single and childless. They were less likely to hold academic appointments, despite no gender differences in length of time at current institution or in current position. A greater proportion of female CEs felt they were 'never' rewarded by academic promotion. Satisfaction rates were similar between the genders. Single female CEs were five times as likely to report being 'extremely likely' to stay in the country. Female CEs with children <21 were less likely to report high likelihood of staying in academia. Marital status and children were not associated with outcomes for male CEs. In the international academic medicine programmes studied, there were fewer female CEs in the pipeline and they perceived a gender gap in appointment and advancement. Stakeholders at international programmes need to develop contextualised strategies to expand entry and decrease attrition of women into CE tracks, and promote gender equity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Definitive airway management after pre-hospital supraglottic airway insertion: Outcomes and a management algorithm for trauma patients.

PubMed

Hernandez, Matthew C; Aho, Johnathon M; Zielinski, Martin D; Zietlow, Scott P; Kim, Brian D; Morris, David S

2018-01-01

Prehospital airway management increasingly involves supraglottic airway insertion and a paucity of data evaluates outcomes in trauma populations. We aim to describe definitive airway management in traumatically injured patients who necessitated prehospital supraglottic airway insertion. We performed a single institution retrospective review of multisystem injured patients (≥15years) that received prehospital supraglottic airway insertion during 2009 to 2016. Baseline demographics, number and type of: supraglottic airway insertion attempts, definitive airway and complications were recorded. Primary outcome was need for tracheostomy. Univariate and multivariable statistics were performed. 56 patients met inclusion criteria and were reviewed, 78% were male. Median age [IQR] was 36 [24-56] years. Injuries comprised blunt (94%), penetrating (4%) and burns (2%). Median ISS was 26 [22-41]. Median number of prehospital endotracheal intubation (PETI) attempts was 2 [1-3]. Definitive airway management included: (n=20, 36%, tracheostomy), (n=10, 18%, direct laryngoscopy), (n=6, 11%, bougie), (n=9, 15%, Glidescope), (n=11, 20%, bronchoscopic assistance). 24-hour mortality was 41%. Increasing number of PETI was associated with increasing facial injury. On regression, increasing cervical and facial injury patterns as well as number of PETI were associated with definitive airway control via surgical tracheostomy. After supraglottic airway insertion, operative or non-operative approaches can be utilized to obtain a definitive airway. Patients with increased craniofacial injuries have an increased risk for airway complications and need for tracheostomy. We used these factors to generate an evidence based algorithm that requires prospective validation. Level IV - Retrospective study. Retrospective single institution study. Copyright © 2017 Elsevier Inc. All rights reserved.

Transformation of Palm Beach Community College to Palm Beach State College: A Case Study

ERIC Educational Resources Information Center

Basiratmand, Mehran

2013-01-01

The purpose of this single-site case study was to examine the organization and leadership change process of Palm Beach State College, a publicly funded institution in Florida, as it embarked on offering bachelor's degree programs. The study examined the organizational change process and the extent to which Palm Beach State College's organization…

Chapter 10: Case studies in ecosystem management: the Mammoth-June ecosystem management project, Inyo National Forest

Treesearch

Constance I. Millar

1996-01-01

To assess the various ways organizations and people come together to manage Sierran ecosystems, SNEP conducted four case studies to examine the efficacy of different institutional arrangements:The Mammoth-June case study examines how a single national forest is attempting to implement the new Forest Service policy for ecosystem analysis...

Undergraduate Engineering--A Comparative Study of First Year Performance in Single Gender Campuses

ERIC Educational Resources Information Center

Dana-Picard, Thierry; Kidron, Ivy; Komar, Meir; Steiner, Joseph

2005-01-01

The Jerusalem College of Technology is an institution for higher education in Israel, where the majority of the students study towards an undergraduate degree in Engineering (Electronics, Applied Optics, Computers, etc.). The studies are held on three different campuses, one campus for men and two for women. We describe the organization of the…

Graft arterial stenosis in kidney en bloc grafts from very small pediatric donors: incidence, timing, and role of ultrasound in screening.

PubMed

Bent, C; Fananapazir, G; Tse, G; Corwin, M T; Vu, C; Santhanakrishnan, C; Perez, R V; Troppmann, C

2015-11-01

In previous studies with different donor selection criteria and noncontemporary surgical techniques, graft arterial stenosis (GAS) has been reported to occur more frequently in adult recipients of pediatric en bloc renal allografts (EBKT) as compared to single adult donor allografts. The purpose of our study was to evaluate the incidence of GAS within our EBKT recipient population and to evaluate clinical and imaging features of those cases with GAS. In a retrospective cohort study, we analyzed 182 EBKT performed at a single institution. We identified cases of suspected GAS based on clinical factors, lab results, and noninvasive imaging. Diagnosis of GAS was confirmed by digital subtraction angiography. Two EBKT recipients (1.1% of 182) had angiographically confirmed GAS at 2.5 and 4.5 months after transplant. In both cases, the stenoses were short segment within the proximal (perianastomotic) donor aorta, color Doppler ultrasound demonstrated peak systolic velocities of >400 cm/s, and poststenotic parvus tardus waveforms were present. Both patients underwent angioplasty and demonstrated postintervention improvement in renal function and blood pressure. Restenosis did not occur during follow up. In conclusion, recipients of EBKT have a low incidence of GAS, similar to the lowest reported for adult single allografts. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Pain in chronic pancreatitis: managing beyond the pancreatic duct.

PubMed

Talukdar, Rupjyoti; Reddy, D Nageshwar

2013-10-14

Chronic pancreatitis (CP) continues to be a clinical challenge. Persistent or recurrent abdominal pain is the most compelling symptom that drives patients to seek medical care. Unfortunately, in spite of using several treatment approaches in the clinical setting, there is no single specific treatment modality that can be earmarked as a cure for this disease. Traditionally, ductal hypertension has been associated with causation of pain in CP; and patients are often subjected to endotherapy and surgery with a goal to decompress the pancreatic duct. Recent studies on humans (clinical and laboratory based) and experimental models have put forward several mechanisms, including neuroimmune alterations, which could be responsible for pain. This might explain the partial or no response to single modality treatment in a significant proportion of patients. The current review discusses the recent concepts of pain generation in CP and evidence based therapeutic approaches (other than ductal decompression) to handle persistent or recurrent pain. We focus primarily on parenchymal and neural components; and discuss the role of antioxidants and the existing controversies, drugs that interfere with neural transmission, pancreatic enzyme supplementation, celiac neurolysis, and pancreatic resection procedures. The review concludes with the treatment approach that we follow at our institute.

Severe neutropenia in children: a single institutional experience.

PubMed

Yilmaz, Deniz; Ritchey, Arthur Kim

2007-08-01

Severe neutropenia (SN) is a rare disorder in childhood. This study aimed to document the approach to diagnosis and treatment of children with SN in a single university-based children's hospital, determine the types of SN seen in a 4-year period, and determine outcomes of the subtypes of SN. Forty-five children with SN were identified between 2000 and 2004. Two patients had autoimmune, 3 congenital, 3 familial, 6 cyclic, and 31 idiopathic SN. The median age of the patients with idiopathic SN was 15 months (3 mo to 17 y). Thirteen patients with idiopathic SN received filgrastim and 18 were observed. The history of severe infection and hospitalization at presentation was significantly more common among the patients who received filgrastim than those observed, but was not different between the 2 groups during the follow-up period. SN resolved in 16 patients and persisted in 14 patients. One patient with idiopathic SN did not respond to filgrastim and died of sepsis while she was still neutropenic. In summary, the majority of patients with SN had idiopathic SN, the infection risk was variable, treatment was based on clinical judgment rather than absolute neutrophil count, and approximately half of the patients had complete recovery.

The Antitumor Effect of Single-domain Antibodies Directed Towards Membrane-associated Catalase and Superoxide Dismutase.

PubMed

Bauer, Georg; Motz, Manfred

2016-11-01

Neutralizing single-domain antibodies directed towards catalase or superoxide dismutase (SOD) caused efficient reactivation of intercellular reactive oxygen species/reactive nitrogen species (ROS/RNS)-dependent apoptosis-inducing signaling specifically in human tumor cells. Single-domain antibodies targeted tumor cell-specific membrane-associated SOD and catalase, but not the corresponding intracellular enzymes. They were shown to be about 200-fold more effective than corresponding classical recombinant antigen-binding fragments and more than four log steps more efficient than monoclonal antibodies. Combined addition of single-domain antibodies against catalase and SOD caused a remarkable synergistic effect. Proof-of-concept experiments in immunocompromised mice using human tumor xenografts and single-domain antibodies directed towards SOD showed an inhibition of tumor growth. Neutralizing single-domain antibodies directed to catalase and SOD also caused a very strong synergistic effect with the established chemotherapeutic agent taxol, indicating an overlap of signaling pathways. This effect might also be useful in order to avoid unwanted side-effects and to drastically lower the costs for taxol-based therapy. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

National Institute on Drug Abuse Training Grants Directory.

ERIC Educational Resources Information Center

Mitchell, Lonnie E.

This catalog lists for individuals, universities and colleges, and Single State Agency directors training grants supported by the National Institute on Drug Abuse. The four different types of grants described are developmental, career teacher, individual fellowship, and institutional research training grants. Each section is divided alphabetically…

All Female Education: Self Image and Academic Success of Fourth through Eighth Grade Girls.

ERIC Educational Resources Information Center

Heffernan, Erin J.

This study examines how young women in single sex institutions perceive their educational experience in four categories: academics, resources, participation, and self-image. When investigating whether there are advantages in all female education, it is important to consider student perceptions within these all female schools. This study was…

Substance Use and Attitudes on Professional Conduct among Medical Students: A Single-Institution Study

ERIC Educational Resources Information Center

Choi, Daisi; Tolova, Vera; Socha, Edward; Samenow, Charles P.

2013-01-01

Objective: This study sought to examine how specific substance-use behavior, including nonmedical prescription stimulant (NPS) use, among U.S. medical students correlates with their attitudes and beliefs toward professionalism. Method: An anonymous survey was distributed to all medical students at a private medical university (46% response rate).…

Studying the Workplace: Considering the Usefulness of Activity Theory

ERIC Educational Resources Information Center

Worthen, Helena

2004-01-01

The field of industrial relations, to which labour studies and labour education are closely linked both historically and institutionally, is an interdisciplinary field and, as such, has never securely claimed a single theoretical foundation. This article draws attention to a theoretical framework that may be useful as a way of promoting discussion…

Incidence and Risk Factors for Perioperative Cardiovascular and Respiratory Adverse Events in Pediatric Patients With Congenital Heart Disease Undergoing Noncardiac Procedures.

PubMed

Lee, Sandra; Reddington, Elise; Koutsogiannaki, Sophia; Hernandez, Michael R; Odegard, Kirsten C; DiNardo, James A; Yuki, Koichi

2018-04-27

While mortality and adverse perioperative events after noncardiac surgery in children with a broad range of congenital cardiac lesions have been investigated using large multiinstitutional databases, to date single-center studies addressing adverse outcomes in children with congenital heart disease (CHD) undergoing noncardiac surgery have only included small numbers of patients with significant heart disease. The primary objective of this study was to determine the incidences of perioperative cardiovascular and respiratory events in a large cohort of patients from a single institution with a broad range of congenital cardiac lesions undergoing noncardiac procedures and to determine risk factors for these events. We identified 3010 CHD patients presenting for noncardiac procedures in our institution over a 5-year period. We collected demographic information, including procedure performed, cardiac diagnosis, ventricular function as assessed by echocardiogram within 6 months of the procedure, and classification of CHD into 3 groups (minor, major, or severe CHD) based on residual lesion burden and cardiovascular functional status. Characteristics related to conduct of anesthesia care were also collected. The primary outcome variables for our analysis were the incidences of intraoperative cardiovascular and respiratory events. Univariable and multivariable logistic regressions were used to determine risk factors for these 2 outcomes. The incidence of cardiovascular events was 11.5% and of respiratory events was 4.7%. Univariate analysis and multivariable analysis demonstrated that American Society of Anesthesiologists (≥3), emergency cases, major and severe CHD, single-ventricle physiology, ventricular dysfunction, orthopedic surgery, general surgery, neurosurgery, and pulmonary procedures were associated with perioperative cardiovascular events. Respiratory events were associated with American Society of Anesthesiologists (≥4) and otolaryngology, gastrointestinal, general surgery, and maxillofacial procedures. Intraoperative cardiovascular events and respiratory events in patients with CHD were relatively common. While cardiovascular events were highly associated with cardiovascular status, respiratory events were not associated with cardiovascular status.

Predictive modeling of outcomes following definitive chemoradiotherapy for oropharyngeal cancer based on FDG-PET image characteristics

NASA Astrophysics Data System (ADS)

Folkert, Michael R.; Setton, Jeremy; Apte, Aditya P.; Grkovski, Milan; Young, Robert J.; Schöder, Heiko; Thorstad, Wade L.; Lee, Nancy Y.; Deasy, Joseph O.; Oh, Jung Hun

2017-07-01

In this study, we investigate the use of imaging feature-based outcomes research (‘radiomics’) combined with machine learning techniques to develop robust predictive models for the risk of all-cause mortality (ACM), local failure (LF), and distant metastasis (DM) following definitive chemoradiation therapy (CRT). One hundred seventy four patients with stage III-IV oropharyngeal cancer (OC) treated at our institution with CRT with retrievable pre- and post-treatment 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scans were identified. From pre-treatment PET scans, 24 representative imaging features of FDG-avid disease regions were extracted. Using machine learning-based feature selection methods, multiparameter logistic regression models were built incorporating clinical factors and imaging features. All model building methods were tested by cross validation to avoid overfitting, and final outcome models were validated on an independent dataset from a collaborating institution. Multiparameter models were statistically significant on 5 fold cross validation with the area under the receiver operating characteristic curve (AUC)  =  0.65 (p  =  0.004), 0.73 (p  =  0.026), and 0.66 (p  =  0.015) for ACM, LF, and DM, respectively. The model for LF retained significance on the independent validation cohort with AUC  =  0.68 (p  =  0.029) whereas the models for ACM and DM did not reach statistical significance, but resulted in comparable predictive power to the 5 fold cross validation with AUC  =  0.60 (p  =  0.092) and 0.65 (p  =  0.062), respectively. In the largest study of its kind to date, predictive features including increasing metabolic tumor volume, increasing image heterogeneity, and increasing tumor surface irregularity significantly correlated to mortality, LF, and DM on 5 fold cross validation in a relatively uniform single-institution cohort. The LF model also retained significance in an independent population.

Benefits for Women and Men of Inquiry-Based Learning in College Mathematics: A Multi-Institution Study

ERIC Educational Resources Information Center

Laursen, Sandra L.; Hassi, Marja-Liisa; Kogan, Marina; Weston, Timothy J.

2014-01-01

Slow faculty uptake of research-based, student-centered teaching and learning approaches limits the advancement of U.S. undergraduate mathematics education. A study of inquiry-based learning (IBL) as implemented in over 100 course sections at 4 universities provides an example of such multicourse, multi-institution uptake. Despite variation in how…

Single step recombinant human growth hormone (rhGH) purification from milk by peptide affinity chromatography.

PubMed

Saavedra, Soledad L; Martínez Ceron, María C; Giudicessi, Silvana L; Forno, Guillermina; Bosco, María Belén; Marani, Mariela M; Erra-Balsells, Rosa; Albericio, Fernando; Cascone, Osvaldo; Camperi, Silvia A

2018-04-25

Recombinant human growth hormone (rhGH) is used for the treatment of several pathologies, most of them related to growth. Although different expression systems can be used for its production, the milk from transgenic cows is one of the most interesting due to the high rhGH level achieved (5 g/L). We have designed and synthesized short peptides (9 or 10 amino acid long) using Fmoc chemistry and studied their ability to purify rhGH from milk once immobilized on an agarose support. Using spiked milk with the hormone as a sample, rhGH was purified with 88% yield and 92% purity in a single step with a fold purification of 4.5. © 2018 American Institute of Chemical Engineers Biotechnol. Prog., 2018. © 2018 American Institute of Chemical Engineers.

Modified irinotecan and infusional 5-fluorouracil (mFOLFIRI) in patients with refractory advanced pancreas cancer (APC): a single-institution experience.

PubMed

Bupathi, M; Ahn, D H; Wu, C; Ciombor, K K; Stephens, J A; Reardon, J; Goldstein, D A; Bekaii-Saab, T

2016-04-01

Pancreatic adenocarcinoma is the fourth leading cause of cancer death. Recently, MM-398 (nanoliposomal irinotecan) was shown to be associated with significant improvement in outcome measures with acceptable toxicities when combined with 5-fluorouracil (5-FU)/leucovorin (LV) compared to 5-FU/LV alone in patients failing one line of gemcitabine-based therapy. There is a paucity of data evaluating the role of irinotecan in combination with 5FU in advanced pancreas cancer (APC). We performed a retrospective analysis of all patients who received mFOLFIRI (minus bolus 5FU and LV). All patients with metastatic disease who had failed at least one line of gemcitabine-based therapy prior to receiving mFOLFIRI were included in this study. Descriptive statistics were used to assess the continuous variables and adverse events (AEs), and Kaplan-Meier methods were used to calculate the median progression-free survival (PFS) and overall survival (OS). Forty patients were included in this analysis. Patients received 1-5 lines of prior therapy (25 % with more than 3 lines of prior therapy). The mean age at diagnosis was 60, and 98 % had ECOG of 1. The mean CA 19-9 at the start of therapy was 33,169 U/ml. The median PFS was 2.59 months [95 % confidence interval (CI) (1.90, 3.54)], and OS was 4.75 months [95 % CI (3.14, 8.98)]. The most common AEs included fatigue (98 %), neuropathy (83 %), anorexia (68 %), nausea (60 %) and constipation (55 %). Grade 3 toxicities included fatigue (13 %) and rash (3 %). There were no observed grade 4 toxicities. In this single-institution retrospective analysis, mFOLFIRI was found to be both tolerable and relatively effective in a heavily pretreated patient population with APC. Future prospective studies should consider evaluating the role of mFOLFIRI in refractory APC.

How IRBs view and make decisions about coercion and undue influence.

PubMed

Klitzman, Robert

2013-04-01

Scholars have debated how to define coercion and undue influence, but how institutional review boards (IRBs) view and make decisions about these issues in actual cases has not been explored. I contacted the leadership of 60 US IRBs (every fourth one in the list of the top 240 institutions by National Institutes of Health funding), and interviewed 39 IRB leaders or administrators from 34 of these institutions (response rate=55%), and 7 members. IRBs wrestled with defining of 'coercion' and 'undue inducement', most notably in deciding about participant compensation. IRBs often use these terms synonymously and define undue inducement in varying ways, often wrestling with these issues, relying on 'gut feelings', and seeking compromises. Ambiguities arose, partly reflecting underlying tensions: whether subjects should 'get paid' versus 'volunteer' (ie, whether subjects should be motivated by compensation vs altruism), and whether subjects should be paid differently based on income, given possible resultant selection bias. Lack of consistent standards emerged between and even on single IRBs. Questions arose concerning certain aspects and types of studies; for example, how to view and weigh providing free care in research, whether and how recruitment flyers should mention compensation, and how to avoid coercion in paediatric, developing world, or students research. These data, the first to probe qualitatively how IRBs view and approach questions about coercion, undue influence and participant compensation, and to examine how IRBs have reviewed actual cases, reveal several critical ambiguities and dilemmas, and have vital implications for future practice, education, policy and research.

Oncology healthcare providers' knowledge, attitudes, and practice behaviors regarding LGBT health.

PubMed

Shetty, Gina; Sanchez, Julian A; Lancaster, Johnathan M; Wilson, Lauren E; Quinn, Gwendolyn P; Schabath, Matthew B

2016-10-01

There are limited data on lesbian, gay, bisexual, and transgender (LGBT) healthcare experiences and interactions with the providers. This study assessed knowledge, attitudes, and practice behaviors of oncology providers regarding LGBT health. A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. 108 providers participated in the survey (28% response rate). <50% answered knowledge questions correctly. 94% stated they were comfortable treating this population. 26% actively inquired about a patient's sexual orientation when taking a history. 36% felt the need for mandatory education on LGBT cultural competency at the institution. Results from the open comments section identified multiple misconceptions. This study revealed knowledge gaps about LGBT health risks. Cultural competency training may aid oncology providers to understand the need to inquire about patients' gender identity and sexual orientation. Health care providers who incorporate the routine collection of gender identity and sexual orientation (SOGI) in their patient history taking may improve patient care by offering tailored education and referrals. While identifying as LGBT does not in itself increase risk for adverse health outcomes, this population tends to have increased risk behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Mobile radio alternative systems study satellite/terrestrial (hybrid) systems concepts

NASA Technical Reports Server (NTRS)

Kiesling, J. D.; Anderson, R. E.

1983-01-01

The use of satellites for mobile radio service in non-urban areas of the United States in the years from 1985 to 2000 was investigated. Several satellite concepts are considered: a system with single-beam coverage of the fifty United States and Puerto Rico, and multi-beam satellites with greater capacity. All of the needed functions and services identified in the market study are provided by the satellite systems, including nationwide radio access to vehicles without knowledge of vehicle location wideband data transmission from remote sites, two way exchange of short data and control messages between vehicles and dispatch or control centers, and automatic vehicle location (surveillance). The costs of providing the services are within acceptable limits, and the desired returns to the system investors are attractive. The criteria by which the Federal Communication judges the competing demands for public radio spectrum are reviewed with comments on how the criteria might apply to the consideration of land mobile satellites. Institutional arrangements for operating a mobile satellite system are based on the present institutional arrangements in which the services are offered to the end users through wireline and radio common carriers, with direct access by large private and government users.

Profile of adults seeking voluntary HIV testing and counseling in rural Central India: results from a hospital-based study.

PubMed

Pai, Nitika Pant; Joshi, Rajnish; Moodie, Erica E M; Taksande, Bharati; Kalantri, S P; Pai, Madhukar; Tulsky, Jacqueline P; Reingold, Arthur

2009-03-01

Rural India has an undetected load of HIV-positive individuals. Few rural adults present for HIV testing and counseling due to stigma, discrimination, and fear of social ostracization. In this rural hospital clinic-based study, we document profiles of rural adults seeking voluntary testing and counseling, and analyze correlates of HIV seropositivity. This cross-sectional study was conducted in 450 participants presenting to the outpatient clinics of Mahatma Gandhi Institute of Medical Sciences, Sevagram, Central India. After informed consent, pre- and post-test counseling, HIV testing, and face-to-face interviews were conducted. Data were collected using a structured questionnaire. The median age of the 450 study participants was 34 years (range 18-88 years); the majority (74%) was married. The overall proportion of HIV seropositivity was 32% [95% CI 28%, 37%]. The proportions of HIV seropositivity in married women, married men, and single men were 41%, 37%, 18%, respectively. No single woman was found seropositive in the study. Very few married women were aware of their husbands' HIV status. In a multivariate analysis, correlates of HIV seropositivity in men were: age 30-39 years, being married, having sex with multiple partners, use of alcohol before sex, and testing positive for HIV in the past. In married women, the only predictor of seropositivity was being married. Although limited by the non-random nature of the sampling method, this pilot study is unique in that it is the first from this rural region of Central India. It provides baseline data on marginalized, largely unstudied populations that may aid in designing probabilistic community-based surveys in this neglected population.

Demographics of Head and Neck Cancer Patients: A Single Institution Experience

PubMed Central

Kitanova, Martina; Dzhenkov, Deyan L; Ghenev, Peter; Sapundzhiev, Nikolay

2017-01-01

Introduction Head and neck cancer (HNC) comprises a diverse group of oncological entities, originating from various tissue types and organ localizations, situated in the topographical regions of the head and neck (H&N). This single institution retrospective study was aimed at establishing the HNC patient demographics and categorizing the individual incidence of H&N malignancies, regarding their organ of origin and main histopathological type. Materials and methods All histologically verified cases of HNC from a single tertiary referral center were reviewed in a descriptive retrospective manner. Data sampling period was 47 months. Results Male to female ratio of the registered HNC cases was 3.24:1. The mean age of diagnosis was 63.84 ± 12.65 years, median 65 years. The most common HNC locations include the larynx 30.37% (n = 188), lips and oral cavity 29.08% (n = 180), pharynx 20.03% (n = 124) and salivary glands 10.94% (n = 68), with other locations such as the external nose, nasal cavity and sinuses and auricle and external ear canal harboring a minority of the cases. The main histopathological groups include squamous cell carcinoma 76.74% (n = 475) and adenocarcinoma 6.14% (n = 38), with other malignant entries such as other epithelial malignancies, primary tonsillar, mucosa-associated lymphoid tissue or parenchymal lymphomas, connective tissue neoplasias, neuroendocrine and vascular malignancies diagnosed in a minority of cases. Conclusion Considered to be relatively rare, HNC represents a diverse group of oncological entities with individual and specific demographic characteristics. The reported single institution results appear representative of the national incidence and characteristics of HNC. PMID:28875091

Growing Research Among Osteopathic Residents and Medical Students: A Consortium-Based Research Education Continuum Model.

PubMed

Brannan, Grace D

2016-05-01

In general, physicians' interest in research continues to be a challenge. The lack of research culture is more pronounced in the osteopathic medical profession, which is historically not research oriented. With increasing focus on evidence-based medicine and with the single accreditation system for graduate medical education in motion, growing research and scholarly activities among osteopathic physicians and students and residents becomes imperative. This article illustrates how an educational consortium, such as an osteopathic postdoctoral training institution, can play a pivotal role in creating a culture of research through broad-based training of medical students and residents.

Great prospects for fiber optics sensors

NASA Technical Reports Server (NTRS)

Hansen, T. E.

1983-01-01

Fiber optic sensors provide noise immunity and galvanic insulation at the measurement point. Interest in such sensors is increasing for these reasons. In the United States sales are expected to increase from 12 million dollars in 1981 to 180 million in 1991. Interferometric sensors based on single modus fibers deliver extremely high sensitivity, while sensors based on multi-modus fibers are more easily manufactured. The fiber optic sensors which are available today are based on point measurements. Development of fiber optic sensors in Norway is being carried out at the Central institute and has resulted in the development of medical manometers which are now undergoing clinical testing.

Research on SOI-based micro-resonator devices

NASA Astrophysics Data System (ADS)

Xiao, Xi; Xu, Haihua; Hu, Yingtao; Zhou, Liang; Xiong, Kang; Li, Zhiyong; Li, Yuntao; Fan, Zhongchao; Han, Weihua; Yu, Yude; Yu, Jinzhong

2010-10-01

SOI (silicon-on-insulator)-based micro-resonator is the key building block of silicon photonics, which is considered as a promising solution to alleviate the bandwidth bottleneck of on-chip interconnects. Silicon-based sub-micron waveguide, microring and microdisk devices are investigated in Institute of Semiconductors, Chinese Academy of Sciences. The main progress in recent years is presented in this talk, such as high Q factor single mode microdisk filters, compact thirdorder microring filters with the through/drop port extinctions to be ~ 30/40 dB, fast microring electro-optical switches with the switch time of < 400 ps and crosstalk < -23 dB, and > 10 Gbit/s high speed microring modulators.

Using a multi-scale approach to identify and quantify oil and gas emissions: a case study for GHG emissions verification

NASA Astrophysics Data System (ADS)

Sweeney, C.; Kort, E. A.; Rella, C.; Conley, S. A.; Karion, A.; Lauvaux, T.; Frankenberg, C.

2015-12-01

Along with a boom in oil and natural gas production in the US, there has been a substantial effort to understand the true environmental impact of these operations on air and water quality, as well asnet radiation balance. This multi-institution effort funded by both governmental and non-governmental agencies has provided a case study for identification and verification of emissions using a multi-scale, top-down approach. This approach leverages a combination of remote sensing to identify areas that need specific focus and airborne in-situ measurements to quantify both regional and large- to mid-size single-point emitters. Ground-based networks of mobile and stationary measurements provide the bottom tier of measurements from which process-level information can be gathered to better understand the specific sources and temporal distribution of the emitters. The motivation for this type of approach is largely driven by recent work in the Barnett Shale region in Texas as well as the San Juan Basin in New Mexico and Colorado; these studies suggest that relatively few single-point emitters dominate the regional emissions of CH4.

Can we share questions? Performance of questions from different question banks in a single medical school.

PubMed

Freeman, Adrian; Nicholls, Anthony; Ricketts, Chris; Coombes, Lee

2010-01-01

To use progress testing, a large bank of questions is required, particularly when planning to deliver tests over a long period of time. The questions need not only to be of good quality but also balanced in subject coverage across the curriculum to allow appropriate sampling. Hence as well as creating its own questions, an institution could share questions. Both methods allow ownership and structuring of the test appropriate to the educational requirements of the institution. Peninsula Medical School (PMS) has developed a mechanism to validate questions written in house. That mechanism can be adapted to utilise questions from an International question bank International Digital Electronic Access Library (IDEAL) and another UK-based question bank Universities Medical Assessment Partnership (UMAP). These questions have been used in our progress tests and analysed for relative performance. Data are presented to show that questions from differing sources can have comparable performance in a progress testing format. There are difficulties in transferring questions from one institution to another. These include problems of curricula and cultural differences. Whilst many of these difficulties exist, our experience suggests that it only requires a relatively small amount of work to adapt questions from external question banks for effective use. The longitudinal aspect of progress testing (albeit summatively) may allow more flexibility in question usage than single high stakes exams.

Hot subdwarf stars in close-up view. II. Rotational properties of single and wide binary subdwarf B stars

NASA Astrophysics Data System (ADS)

Geier, S.; Heber, U.

2012-07-01

Subluminous B stars (sdBs) form the extremely hot end of the horizontal branch and are therefore related to the blue horizontal branch (BHB) stars. While the rotational properties of BHB stars have been investigated extensively, studies of sdB stars have concentrated on close binaries that are influenced by tidal interactions between their components. Here we present a study of 105 sdB stars, which are either single stars or in wide binaries where tidal effects become negligible. The projected rotational velocities have been determined by measuring the broadening of metal lines using high-resolution optical spectra. All stars in our sample are slow rotators (vrotsini < 10 km s-1). Furthermore, the vrotsini-distributions of single sdBs are similar to those of hot subdwarfs in wide binaries with main-sequence companions as well as close binary systems with unseen companions and periods exceeding ≃1.2 d. We show that blue horizontal and extreme horizontal branch stars are also related in terms of surface rotation and angular momentum. Hot BHB stars (Teff > 11 500 K) with diffusion-dominated atmospheres are slow rotators like the hot subdwarf stars located on the extreme horizontal branch, which lost more envelope and therefore angular momentum in the red-giant phase. The uniform rotation distributions of single and wide binary sdBs pose a challenge to our understanding of hot subdwarf formation. Especially the high fraction of helium white dwarf mergers predicted by theory seems to be inconsistent with the results presented here. Based on observations at the Paranal Observatory of the European Southern Observatory for programmes number 165.H-0588(A), 167.D-0407(A), 071.D-0380(A) and 072.D-0487(A). Based on observations at the La Silla Observatory of the European Southern Observatory for programmes number 073.D-0495(A), 074.B-0455(A), 076.D-0355(A), 077.D-0515(A) and 078.D-0098(A). Based on observations collected at the Centro Astronómico Hispano Alemán (CAHA) at Calar Alto, operated jointly by the Max-Planck Institut für Astronomie and the Instituto de Astrofísica de Andalucía (CSIC). Some of the data presented here were obtained at the W. M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California, and the National Aeronautics and Space Administration. The Observatory was made possible by the generous financial support of the W. M. Keck Foundation. Based on data obtained with the Hobby-Eberly Telescope (HET), which is a joint project of the University of Texas at Austin, the Pennsylvania State University, Stanford University, Ludwig-Maximilians-Universität München, and Georg-August-Universität Göttingen.

Application service provider (ASP) financial models for off-site PACS archiving

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Liu, Brent J.; McCoy, J. Michael; Enzmann, Dieter R.

2003-05-01

For the replacement of its legacy Picture Archiving and Communication Systems (approx. annual workload of 300,000 procedures), UCLA Medical Center has evaluated and adopted an off-site data-warehousing solution based on an ASP financial with a one-time single payment per study archived. Different financial models for long-term data archive services were compared to the traditional capital/operational costs of on-site digital archives. Total cost of ownership (TCO), including direct and indirect expenses and savings, were compared for each model. Financial parameters were considered: logistic/operational advantages and disadvantages of ASP models versus traditional archiving systems. Our initial analysis demonstrated that the traditional linear ASP business model for data storage was unsuitable for large institutions. The overall cost markedly exceeds the TCO of an in-house archive infrastructure (when support and maintenance costs are included.) We demonstrated, however, that non-linear ASP pricing models can be cost-effective alternatives for large-scale data storage, particularly if they are based on a scalable off-site data-warehousing service and the prices are adapted to the specific size of a given institution. The added value of ASP is that it does not require iterative data migrations from legacy media to new storage media at regular intervals.

Southern promises: a snapshot of the microbiology research landscape in South America based on bibliometric data.

PubMed

Nai, Corrado

2017-09-01

Scientists have a single currency for productivity and impact: published articles. In an effort to map the global research landscape in microbiology, and to obviate the current lack of bibliometric analysis in the field, FEMS-the Federation of European Microbiological Societies-generated a dataset encompassing an exhaustive, worldwide list of microbiology studies for 2013-14, which further includes information as author affiliation, funding agency and number of citations. The manually curated database is useful in assessing the impact and regional productivity of microbiology research at different levels. Here, the data for microbiology research in South America are presented and discussed in detail. Based on the analysis, it emerged that despite great degrees of variation between number of published articles among the countries, a more levelled research productivity was observed when considering further dimensions like population size or number of research institutes. Normalised productivity and impact increase in countries with a 'central research hub', i.e. an institute or university producing a substantial portion of the national output (15% or more). From these observations, a possible strategy to increase impact and productivity in (microbiology) research for emerging countries is outlined. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Radiation Dose Index of Renal Colic Protocol CT Studies in the United States

PubMed Central

Lukasiewicz, Adam; Bhargavan-Chatfield, Mythreyi; Coombs, Laura; Ghita, Monica; Weinreb, Jeffrey; Gunabushanam, Gowthaman; Moore, Christopher L.

2016-01-01

Purpose To determine radiation dose indexes for computed tomography (CT) performed with renal colic protocols in the United States, including frequency of reduced-dose technique usage and any institutional-level factors associated with high or low dose indexes. Materials and Methods The Dose Imaging Registry (DIR) collects deidentified CT data, including examination type and dose indexes, for CT performed at participating institutions; thus, the DIR portion of the study was exempt from institutional review board approval and was HIPAA compliant. CT dose indexes were examined at the institutional level for CT performed with a renal colic protocol at institutions that contributed at least 10 studies to the registry as of January 2013. Additionally, patients undergoing CT for renal colic at a single institution (with institutional review board approval and informed consent from prospective subjects and waiver of consent from retrospective subjects) were studied to examine individual renal colic CT dose index patterns and explore relationships between patient habitus, demographics, and dose indexes. Descriptive statistics were used to analyze dose indexes, and linear regression and Spearman correlations were used to examine relationships between dose indexes and institutional factors. Results There were 49 903 renal colic protocol CT examinations conducted at 93 institutions between May 2011 and January 2013. Mean age ± standard deviation was 49 years ± 18, and 53.9% of patients were female. Institutions contributed a median of 268 (interquartile range, 77–699) CT studies. Overall mean institutional dose-length product (DLP) was 746 mGy · cm (effective dose, 11.2 mSv), with a range of 307–1497 mGy · cm (effective dose, 4.6–22.5 mSv) for mean DLPs. Only 2% of studies were conducted with a DLP of 200 mGy · cm or lower (a “reduced dose”) (effective dose, 3 mSv), and only 10% of institutions kept DLP at 400 mGy · cm (effective dose, 6 mSv) or less in at least 50% of patients. Conclusion Reduced-dose renal protocol CT is used infrequently in the United States. Mean dose index is higher than reported previously, and institutional variation is substantial. PMID:24484064

Single versus bilateral lung transplantation for idiopathic pulmonary fibrosis: a ten-year institutional experience.

PubMed

Meyers, B F; Lynch, J P; Trulock, E P; Guthrie, T; Cooper, J D; Patterson, G A

2000-07-01

Between July 1988 and July 1998, we performed 433 lung transplants. Forty-five patients had idiopathic pulmonary fibrosis, and operations for these patients included 32 single lung transplants and 13 bilateral sequential lung transplants. This study reviews this experience and compares single lung transplantation and bilateral lung transplantation for pulmonary fibrosis. We performed a retrospective review, including inpatient hospital charts, outpatient clinic records, and telephone contact with patients to verify current health status. Perioperative mortality was 4 (8.9%) patients. One patient underwent redo bilateral lung transplantation for reperfusion injury and graft failure after single lung transplantation. The median hospitalization was 22 days. Actuarial survival at 1 and 5 years was 75.5% and 53.5%, respectively, which was not significantly different from our survival for all recipients (85.5% and 56.4%, respectively). Seventeen (41%) of 41 operative survivors have died. Late causes of death included obliterative bronchiolitis with respiratory failure (9), malignancy (3), and cytomegalovirus pneumonitis (2). Hospital mortality was 3 (9.4%) of 32 after single lung transplantation and 1 (7.7%) of 13 after bilateral lung transplantation. There was no difference between single and bilateral lung transplantation with regard to hospital stay. Four (12.5%) of the 32 patients undergoing single lung transplantation required tracheostomy, whereas 3 (23%) of 13 recipients undergoing bilateral lung transplantation required tracheostomy. Single or bilateral lung transplantations offer viable therapy for patients with pulmonary fibrosis. We demonstrate no benefit of bilateral over single lung transplantation for patients with this diagnosis. Survival after transplantation appears better than that of historic control subjects receiving standard medical care at other institutions.

The Preliminary Investigation of the Factors that Influence the E-Learning Adoption in Higher Education Institutes: Jordan Case Study

ERIC Educational Resources Information Center

Al-hawari, Maen; Al-halabi, Sanaa

2010-01-01

Creativity and high performance in learning processes are the main concerns of educational institutions. E-learning contributes to the creativity and performance of these institutions and reproduces a traditional learning model based primarily on knowledge transfer into more innovative models based on collaborative learning. In this paper, the…

Towards a Strength-Based Juvenile Correctional Facility: Sustainability and Effects of an Institutional Transformation

ERIC Educational Resources Information Center

Barton, William H.; Mackin, Juliette R.

2012-01-01

In 2006, the administration of a state-run, secure juvenile correctional facility initiated an attempt to transform its institutional culture using a strength-based approach to assessment and case planning. This resulted in a rapid improvement in institutional climate. The current study revisits this setting several years later to see if those…

Telomere length and early severe social deprivation: linking early adversity and cellular aging

PubMed Central

Drury, SS; Theall, K; Gleason, MM; Smyke, AT; De Vivo, I; Wong, JYY; Fox, NA; Zeanah, CH; Nelson, CA

2012-01-01

Accelerated telomere length attrition has been associated with psychological stress and early adversity in adults; however, no studies have examined whether telomere length in childhood is associated with early experiences. The Bucharest Early Intervention Project is a unique randomized controlled trial of foster care placement compared with continued care in institutions. As a result of the study design, participants were exposed to a quantified range of time in institutional care, and represented an ideal population in which to examine the association between a specific early adversity, institutional care and telomere length. We examined the association between average relative telomere length, telomere repeat copy number to single gene copy number (T/S) ratio and exposure to institutional care quantified as the percent of time at baseline (mean age 22 months) and at 54 months of age that each child lived in the institution. A significant negative correlation between T/S ratio and percentage of time was observed. Children with greater exposure to institutional care had significantly shorter relative telomere length in middle childhood. Gender modified this main effect. The percentage of time in institutional care at baseline significantly predicted telomere length in females, whereas the percentage of institutional care at 54 months was strongly predictive of telomere length in males. This is the first study to demonstrate an association between telomere length and institutionalization, the first study to find an association between adversity and telomere length in children, and contributes to the growing literature linking telomere length and early adversity. PMID:21577215

Analyte variations in consecutive 24-hour urine collections in children.

PubMed

Ellison, Jonathan S; Hollingsworth, John M; Langman, Craig B; Asplin, John R; Schwaderer, Andrew L; Yan, Phyllis; Bierlein, Maggie; Barraza, Mark A; Defoor, William R; Figueroa, T Ernesto; Jackson, Elizabeth C; Jayanthi, Venkata R; Johnson, Emilie K; Joseph, David B; Shnorhavorian, Margarett

2017-12-01

The metabolic evaluation of children with nephrolithiasis begins with a 24-h urine collection. For adults, the diagnostic yield increases with consecutive collections; however, little is known regarding the variability of multiple 24-h studies in the pediatric population. We sought to evaluate the variability of consecutive 24-h urine collection in children through a multi-institutional study hypothesizing that compared with a single collection, consecutive 24-h urine collections would reveal a greater degree of clinically useful information in the evaluation of children at risk for nephrolithiasis. Including data from six institutions, we identified children less than 18 years of age considered at risk for recurrent nephrolithiasis, undergoing metabolic evaluation. We evaluated a subset of patients performing two collections with urine creatinine varying by 10% or less during a 7-day period. Discordance between repeat collections based on normative urine chemistry values was evaluated. A total of 733 children met inclusion criteria, and in over a third both urine calcium and urine volume differed by 30% or more between samples. Urine oxalate demonstrated greater variation between collections in children <5 years than among older children (p = 0.030) while variation in other parameters did not differ by age. Discordance between repeat samples based on normative values was most common for urine oxalate (22.5%) and the derived relative supersaturation ratios for both calcium phosphate (25.1%) and calcium oxalate (20.5%). The proportion of discordant samples, based on normative thresholds, as well as variability greater ≥30% and 50%, respectively, are shown in the table. Our analysis indicates that stone risk in as many as one in four children may be misclassified if normative values of only a single 24-h urine are used. In light of these findings, repeat 24-h urine collections prior to targeted intervention to modify stone risk are advised to increase diagnostic yield in children at risk for nephrolithiasis. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Nurse teachers' knowledge in curriculum planning and implementation.

PubMed

Thomas, Eiddwen; Davies, Brian

2006-10-01

Nurses are required to base care on research evidence but research findings on nursing practice often suggest that the linkage is poor and ritualistic routines often prevail. The study explored the origin and nature of knowledge utilised by nurse teachers when developing and implementing a curriculum. In a single, ethnographic case study data were collected from two curriculum development and two curriculum implementation groups, using interviews, participant observation and documents. The study drew directly on Bernstein's theory of the pedagogic device and cultural reproduction. Findings suggested that even though nurse education appears to be dominated by policies and guidelines produced by state agencies, it was teachers operating at institutional and classroom levels who determined what was delivered to student nurses as they relied upon their experience of teaching and clinical practice to plan and implement curriculum. Notwithstanding both national and local aspirations to the contrary, teaching and assessment practices were mostly teacher- rather than student-centred, with heavy reliance on propositional knowledge. The practices identified within this study may induce approaches to learning that may be antithetical to delivering research based care within a prevailing climate that advocates evidence-based practice, clinical effectiveness and governance.

Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review

PubMed Central

2016-01-01

Purpose The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. Methods The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Results Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Conclusion Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students’ EBP competence. PMID:27649902

Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review.

PubMed

Kyriakoulis, Konstantinos; Patelarou, Athina; Laliotis, Aggelos; Wan, Andrew C; Matalliotakis, Michail; Tsiou, Chrysoula; Patelarou, Evridiki

2016-01-01

The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students' EBP competence.

Estimation of a Preference-Based Summary Score for the Patient-Reported Outcomes Measurement Information System: The PROMIS®-Preference (PROPr) Scoring System.

PubMed

Dewitt, Barry; Feeny, David; Fischhoff, Baruch; Cella, David; Hays, Ron D; Hess, Rachel; Pilkonis, Paul A; Revicki, Dennis A; Roberts, Mark S; Tsevat, Joel; Yu, Lan; Hanmer, Janel

2018-06-01

Health-related quality of life (HRQL) preference-based scores are used to assess the health of populations and patients and for cost-effectiveness analyses. The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS ® ) consists of patient-reported outcome measures developed using item response theory. PROMIS is in need of a direct preference-based scoring system for assigning values to health states. To produce societal preference-based scores for 7 PROMIS domains: Cognitive Function-Abilities, Depression, Fatigue, Pain Interference, Physical Function, Sleep Disturbance, and Ability to Participate in Social Roles and Activities. Online survey of a US nationally representative sample ( n = 983). Preferences for PROMIS health states were elicited with the standard gamble to obtain both single-attribute scoring functions for each of the 7 PROMIS domains and a multiplicative multiattribute utility (scoring) function. The 7 single-attribute scoring functions were fit using isotonic regression with linear interpolation. The multiplicative multiattribute summary function estimates utilities for PROMIS multiattribute health states on a scale where 0 is the utility of being dead and 1 the utility of "full health." The lowest possible score is -0.022 (for a state viewed as worse than dead), and the highest possible score is 1. The online survey systematically excludes some subgroups, such as the visually impaired and illiterate. A generic societal preference-based scoring system is now available for all studies using these 7 PROMIS health domains.

Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria.

PubMed

Yildiz, Bulent Okan; Bozdag, Gurkan; Yapici, Zuhal; Esinler, Ibrahim; Yarali, Hakan

2012-10-01

What is the prevalence, phenotype and metabolic features of polycystic ovary syndrome (PCOS) in the same population according to three different diagnostic criteria? The prevalence of PCOS under National Institutes of Health (NIH), Rotterdam and Androgen Excess and PCOS (AE-PCOS) Society criteria was 6.1, 19.9 and 15.3%, respectively. PCOS carried a 2-fold increased risk of metabolic syndrome regardless of the diagnostic criteria used. The prevalence rates of PCOS differ depending on the diagnostic criteria used to define the syndrome. The current paper gives the prevalence rates of the component and composite phenotypes of PCOS in the same population and reports similar rates of metabolic syndrome in women with PCOS under contrasting diagnostic criteria. In this cross-sectional study, 392 women between the ages of 18 and 45 years were analyzed. When the prevalence of PCOS according to NIH was set to 8% with a precision of 2.2% and confidence interval of 95%, the sample size required for a prevalence survey was found to be 400 subjects. The study was carried out in the General Directorate of Mineral Research and Exploration, a government-based institute, in which the largest number of female staff (n = 527) are employed within a single institute in Ankara, Turkey. The study was performed between 7 December 2009 and 30 April 2010. All female subjects between the ages of 18 and 45 years were invited to participate. Women older than 45 or younger than 18 years, post-menopausal women, women with a history of hysterectomy or bilateral oopherectomy and pregnant women were excluded. Totally, 392 of the employees were recruited for the final analyses. The prevalence of PCOS under NIH, Rotterdam and AE-PCOS Society criteria were 6.1, 19.9 and 15.3%, respectively. While the prevalence of metabolic syndrome was 6.1% in the whole study group, within the patients diagnosed as PCOS according to NIH, Rotterdam and AE-PCOS Society criteria, it was 12.5, 10.3 and 10.0%, respectively. Even though we have included women working at a single institution with a high response rate for the participation, we cannot exclude potential selection bias due to undetermined differences between our sample and background community. We might have underestimated actual prevalence of metabolic syndrome in PCOS due to lack of oral glucose tolerance test 2 h glucose data. Current results can be generalized to Caucasian populations and may present variations in other populations according to race and ethnicity. This work was, in part, sponsored by Merck Serono. Not applicable.

Using Arden Syntax to Identify Registry-Eligible Very Low Birth Weight Neonates from the Electronic Health Record

PubMed Central

Sarkar, Indra Neil; Chen, Elizabeth S.; Rosenau, Paul T.; Storer, Matthew B.; Anderson, Beth; Horbar, Jeffrey D.

2014-01-01

Condition-specific registries are essential resources for supporting epidemiological, quality improvement, and clinical trial studies. The identification of potentially eligible patients for a given registry often involves a manual process or use of ad hoc software tools. With the increased availability of electronic health data, such as within Electronic Health Record (EHR) systems, there is potential to develop healthcare standards based approaches for interacting with these data. Arden Syntax, which has traditionally been used to represent medical knowledge for clinical decision support, is one such standard that may be adapted for the purpose of registry eligibility determination. In this feasibility study, Arden Syntax was explored for its ability to represent eligibility criteria for a registry of very low birth weight neonates. The promising performance (100% recall; 97% precision) of the Arden Syntax approach at a single institution suggests that a standards-based methodology could be used to robustly identify registry-eligible patients from EHRs. PMID:25954412

Importance of multi-modal approaches to effectively identify cataract cases from electronic health records

PubMed Central

Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

2012-01-01

Objective There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. Materials and methods We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. Results An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. Discussion A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. Conclusion We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries. PMID:22319176

Open versus endovascular repair of ruptured abdominal aortic aneurysms: What have we learned after more than 2 decades of ruptured endovascular aneurysm repair?

PubMed

Robinson, William P

2017-12-01

Ruptured abdominal aortic aneurysm is one of the most difficult clinical problems in surgical practice, with extraordinarily high morbidity and mortality. During the past 23 years, the literature has become replete with reports regarding ruptured endovascular aneurysm repair. A variety of study designs and databases have been utilized to compare ruptured endovascular aneurysm repair and open surgical repair for ruptured abdominal aortic aneurysm and studies of various designs from different databases have yielded vastly different conclusions. It therefore remains controversial whether ruptured endovascular aneurysm repair improves outcomes after ruptured abdominal aortic aneurysm in comparison to open surgical repair. The purpose of this article is to review the best available evidence comparing ruptured endovascular aneurysm repair and open surgical repair of ruptured abdominal aortic aneurysm, including single institution and multi-institutional retrospective observational studies, large national population-based studies, large national registries of prospectively collected data, and randomized controlled clinical trials. This article will analyze the study designs and databases utilized with their attendant strengths and weaknesses to understand the sometimes vastly different conclusions the studies have reached. This article will attempt to integrate the data to distill some of the lessons that have been learned regarding ruptured endovascular aneurysm repair and identify ongoing needs in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

[Nursing as an option: profile of undergraduate of two teaching institutions].

PubMed

Spíndola, Thelma; Martins, Elizabeth Rose da Costa; Francisco, Márcio Tadeu Ribeiro

2008-01-01

This is a descriptive-exploratory study, aiming at comparing socioeconomic profile of students of two teaching institutions of the municipality of Rio de Janeiro and factors that interfere in their option to choose Nursing. The study was composed by 152 students of Institution (A) and 120 of (B) who were admitted to the undergraduate course in 2004 and 2005. The analysis evidenced that the majority belongs to middle and lower middle class and are young adults, single women. An expanding labor market and an opportunity of a better salary are the main factors that attract students of private schools to nursing career. It is important to the profession to be known in society and, especially, among students who search for a professional option, considering the lack of information of students who are admitted to the Nursing undergraduate course.

Classifying Higher Education Institutions in Korea: A Performance-Based Approach

ERIC Educational Resources Information Center

Shin, Jung Cheol

2009-01-01

The purpose of this study was to classify higher education institutions according to institutional performance rather than predetermined benchmarks. Institutional performance was defined as research performance and classified using Hierarchical Cluster Analysis, a statistical method that classifies objects according to specified classification…

Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16-year tertiary single-institution experience.

PubMed

Li, Meng-Ju; Chang, Hsiu-Hao; Yang, Yung-Li; Lu, Meng-Yao; Shao, Pei-Lan; Fu, Chun-Min; Chou, An-Kuo; Liu, Yen-Lin; Lin, Kai-Hsin; Huang, Li-Min; Lin, Dong-Tsamn; Jou, Shiann-Tarng

2017-10-01

Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection. © 2017 Wiley Periodicals, Inc.

The value of fixed rasburicase dosing versus weight-based dosing in the treatment and prevention of tumor lysis syndrome.

PubMed

Boutin, Alyssa; Blackman, Alison; O'Sullivan, David M; Forcello, Nicholas

2018-01-01

Background Rasburicase is a recombinant urate oxidase enzyme used for the treatment and prevention of tumor lysis syndrome. Our objective was to assess the efficacy of indication-based, low-dose rasburicase administration compared to the Food and Drug Administration-approved weight-based dosing. Methods This was a retrospective cohort study utilizing data from a tertiary medical center including patients admitted from 2012 to 2016, who received at least one dose of rasburicase. The primary outcome was achieving a uric acid level less than 7.5 mg/dl after a single dose of rasburicase in the preprotocol (Food and Drug Administration-approved weight-based dosing) and postprotocol (indication-based, low-dose) groups. Secondary outcomes included the change in uric acid levels between the pre- and postprotocol groups, adherence to the new institutional protocol, need for repeat rasburicase doses, and a cost analysis. Results Sixty-four patients received at least one dose of rasburicase between 1 January 2012 and 1 December 2016. Twenty-seven (79.4%) doses in the preprotocol group and 28 (82.4%) doses in the postprotocol group successfully achieved a uric acid level less than 7.5 mg/dl after a single dose of rasburicase (p=1.000). The average total monthly cost of rasburicase was reduced by 59.9% after adoption of the new protocol. Conclusions Indication-based, low-dose rasburicase displayed significantly more value when compared to weight-based dosing as shown by achieving cost savings without compromising clinical efficacy.

[Information from the invoicing sector as support for decision-making: a case study at the University Hospital of the Federal University of Grande Dourados (UFGD)].

PubMed

Cintra, Renato Fabiano; Vieira, Saulo Fabiano Amâncio; Hall, Rosemar José; Fernandes, Cristiano Rodrigues

2013-10-01

The public sector is the main financing agent of hospital admissions and the information generated constitutes the input for the hospital information network of the Unified Health System (SUS). This paper seeks to design a report template to be used for decision-making in both public and university hospitals. The theoretical approach sought inspiration in discussions about the SUS, hospital institutions, hospital information systems and decision-making. The methodological procedures used are characterized as qualitative-descriptive methods and were conducted in a single case study and action research. The primary data analysis was carried out in two stages from January through December 2007 and from January through December 2008. Based on these periods, the findings were described and the elaboration of new reports was presented, with the importance and need for each being duly emphasized. Lastly, a structured report template was created for the case study that includes information discussed in the article. The conclusion reached is that the hospital information system can become a potential support tool, as the necessary adjustments are made and the report is structured to furnish the institution with an objective communication tool for decision-making.

Examining Part-Time Faculty Utilization and Its Impact on Student Retention at a Public Research University

ERIC Educational Resources Information Center

Johnson, Iryna Y.

2006-01-01

The important concern surrounding growing reliance on part-time faculty is its effect on student retention. Existing studies explored the relationship between part-time faculty utilization and retention of entering cohorts. The study herein assesses retention of the entire population of degree-seeking undergraduates at a single institution. The…

Devices, Distractions and Digital Literacy: "Bring Your Own Device" to Polytech

ERIC Educational Resources Information Center

Drew, Leoni; Forbes, Dianne

2017-01-01

The purpose of this study is to investigate the ways polytechnic students use personal mobile devices to support their learning. This study used purposive sampling and mixed methods to generate data about student ownership and use of mobile digital devices within a single institution. Findings reveal patterns of device ownership, insights into how…

Shaping Strategy: An Institutional Analysis of Decision Making in the Middle Tier

ERIC Educational Resources Information Center

Vasquez, Alejandro

2017-01-01

The intent of this single-case study was to explore the effects of a competitive environment on organizational decision making. The study examines the decision making processes that resulted in the adoption of an undergraduate business major at a traditional, middle-tier Liberal Arts College and offers an analysis of academic leaders' perspectives…

Diversity and Collegiate Experiences Affecting Self-Perceived Gains in Critical Thinking: Which Works, and Who Benefits?

ERIC Educational Resources Information Center

Cole, Darnell; Zhou, Ji

2014-01-01

This study is grounded in the theoretical and conceptual frameworks that postulate diversity and collegiate experiences as triggers for the cognitive disequilibrium that fosters critical thinking (CT). With the assumption that CT is both a general and a discipline-specific facility, this longitudinal, single-institution study of 447 students…

Views and Perspectives of Women's Studies: A Survey of Women and Men Students

ERIC Educational Resources Information Center

Marchbank, Jen; Letherby, Gayle

2006-01-01

In this article we draw on data from a completed project entitled Why Do Women?s Studies? involving five English Universities. However, the data reported here focuses on a single institution. The data were collected through questionnaires which combined quantitative and qualitative questions and we have the views of three distinct groups of…

A Collective Locus of Leadership: Exploring Leadership in Higher Education through a Paradigm of Collaborative Effort

ERIC Educational Resources Information Center

Harris, Kendra E.

2010-01-01

This single-case qualitative study examines leadership in an institution of higher education using the Responsible Leadership for Performance (RLP) model (Lynham & Chermack, 2006) as a framework. The study explores how using a paradigm of collective leadership as an alternative to models of individual leadership could inform understanding of…

Acetone-butanol-ethanol competitive sorption simulation from single, binary, and ternary systems in a fixed-bed of KA-I resin.

PubMed

Wu, Jinglan; Zhuang, Wei; Ying, Hanjie; Jiao, Pengfei; Li, Renjie; Wen, Qingshi; Wang, Lili; Zhou, Jingwei; Yang, Pengpeng

2015-01-01

Separation of butanol based on sorption methodology from acetone-butanol-ethanol (ABE) fermentation broth has advantages in terms of biocompatibility and stability, as well as economy, and therefore gains much attention. In this work a chromatographic column model based on the solid film linear driving force approach and the competitive Langmuir isotherm equations was used to predict the competitive sorption behaviors of ABE single, binary, and ternary mixture. It was observed that the outlet concentration of weaker retained components exceeded the inlet concentration, which is an evidence of competitive adsorption. Butanol, the strongest retained component, could replace ethanol almost completely and also most of acetone. In the end of this work, the proposed model was validated by comparison of the experimental and predicted ABE ternary breakthrough curves using the real ABE fermentation broth as a feed solution. © 2014 American Institute of Chemical Engineers.

Evaluation of intratumoral HER-2 heterogeneity by fluorescence in situ hybridization in invasive breast cancer: a single institution study.

PubMed

Lee, Sarah; Jung, Woohee; Hong, Soon-Won; Koo, Ja Seung

2011-08-01

This study aimed to determine the incidence and characteristics of HER-2 gene heterogeneity in invasive breast cancer in a single institution. Included were 971 cases of primary invasive breast cancer diagnosed between 2008 and 2010. Fluorescence in situ hybridization (FISH) image files were retrospectively reviewed and HER-2 gene heterogeneity was defined as more than 5% but less than 50% of analyzed invasive tumor cells with a HER-2/Chr17 ratio higher than 2.2, according to the College of American Pathologists guidelines. HER-2 gene heterogeneity was identified in 24 (2.5%) cases. The mean proportion of invasive tumor cells with a HER-2/chromosome 17 ratio higher than 2.2 was 11.6% (range: 5%-25%). Of 24 cases, HER-2 gene status was not amplified in 8, showed borderline amplification in 2, and amplification in 14. All HER-2 amplification cases were low-grade. In conclusion, HER-2 gene heterogeneity of invasive breast cancer is identified in routine FISH examination. This may affect the results of HER-2 gene amplification status in FISH studies.

Alzheimer Disease and Behavioral Variant Frontotemporal Dementia: Automatic Classification Based on Cortical Atrophy for Single-Subject Diagnosis.

PubMed

Möller, Christiane; Pijnenburg, Yolande A L; van der Flier, Wiesje M; Versteeg, Adriaan; Tijms, Betty; de Munck, Jan C; Hafkemeijer, Anne; Rombouts, Serge A R B; van der Grond, Jeroen; van Swieten, John; Dopper, Elise; Scheltens, Philip; Barkhof, Frederik; Vrenken, Hugo; Wink, Alle Meije

2016-06-01

Purpose To investigate the diagnostic accuracy of an image-based classifier to distinguish between Alzheimer disease (AD) and behavioral variant frontotemporal dementia (bvFTD) in individual patients by using gray matter (GM) density maps computed from standard T1-weighted structural images obtained with multiple imagers and with independent training and prediction data. Materials and Methods The local institutional review board approved the study. Eighty-four patients with AD, 51 patients with bvFTD, and 94 control subjects were divided into independent training (n = 115) and prediction (n = 114) sets with identical diagnosis and imager type distributions. Training of a support vector machine (SVM) classifier used diagnostic status and GM density maps and produced voxelwise discrimination maps. Discriminant function analysis was used to estimate suitability of the extracted weights for single-subject classification in the prediction set. Receiver operating characteristic (ROC) curves and area under the ROC curve (AUC) were calculated for image-based classifiers and neuropsychological z scores. Results Training accuracy of the SVM was 85% for patients with AD versus control subjects, 72% for patients with bvFTD versus control subjects, and 79% for patients with AD versus patients with bvFTD (P ≤ .029). Single-subject diagnosis in the prediction set when using the discrimination maps yielded accuracies of 88% for patients with AD versus control subjects, 85% for patients with bvFTD versus control subjects, and 82% for patients with AD versus patients with bvFTD, with a good to excellent AUC (range, 0.81-0.95; P ≤ .001). Machine learning-based categorization of AD versus bvFTD based on GM density maps outperforms classification based on neuropsychological test results. Conclusion The SVM can be used in single-subject discrimination and can help the clinician arrive at a diagnosis. The SVM can be used to distinguish disease-specific GM patterns in patients with AD and those with bvFTD as compared with normal aging by using common T1-weighted structural MR imaging. (©) RSNA, 2015.

Role Orientation of Certified Athletic Trainers at Institutions of Higher Education

ERIC Educational Resources Information Center

Brumels, Kirk; Beach, Andrea

2008-01-01

Objective: This study examined the role orientation hierarchy among teaching, research, service, and administrative responsibilities of certified athletic trainers (ATCs) employed at the collegiate level. Design and Setting: Four single response role orientation questions regarding their actual, ideal, promoted, and most appropriate role…

The Future of Single- to Multi-band Detector Technologies: Review

NASA Technical Reports Server (NTRS)

Abedin, M. Nurul; Bhat, Ishwara; Gunapala, Sarath D.; Bandara, Sumith V.; Refaat, Tamer F.; Sandford, Stephen P.; Singh, Upendra N.

2006-01-01

Using classical optical components such as filters, prisms and gratings to separate the desired wavelengths before they reach the detectors results in complex optical systems composed of heavy components. A simpler system will result by utilizing a single optical system and a detector that responds separately to each wavelength band. Therefore, a continuous endeavors to develop the capability to reliably fabricate detector arrays that respond to multiple wavelength regions. In this article, we will review the state-of-the-art single and multicolor detector technologies over a wide spectral-range, for use in space-based and airborne remote sensing applications. Discussions will be focused on current and the most recently developed focal plane arrays (FPA) in addition to emphasizing future development in UV-to-Far infrared multicolor FPA detectors for next generation space-based instruments to measure water vapor and greenhouse gases. This novel detector component will make instruments designed for these critical measurements more efficient while reducing complexity and associated electronics and weight. Finally, we will discuss the ongoing multicolor detector technology efforts at NASA Langley Research Center, Jet Propulsion Laboratory, Rensselaer Polytechnic Institute, and others.

The autowave modes of solid phase polymerization of metal-containing monomers in two- and three-dimensional fiberglass-filled matrices.

PubMed

Barelko, V. V.; Pomogailo, A. D.; Dzhardimalieva, G. I.; Evstratova, S. I.; Rozenberg, A. S.; Uflyand, I. E.

1999-06-01

The phenomenon of autowave (frontal) solid phase polymerization of metal-containing monomers based on metal-acrylamide complexes is considered. The comparison of the features of autowave processes realized in both the single-component matrices of the monomer and the matrices filled by the fiberglass materials is performed. The unstable regimes of the polymerization wave as well as the conditions for the stabilization of the flat front in the filled matrices are described. The peculiarities of the frontal regimes in the three- and two-dimensional media are studied. Some possibilities for using of autowave polymerization in the fabrication of the polymer-fiberglass composites and composition prepregs are discussed. (c) 1999 American Institute of Physics.

Scientometric analysis of physics (1979-2008): A quantitative description of scientific impact

NASA Astrophysics Data System (ADS)

Zheng, YanNing; Yuan, JunPeng; Pan, YunTao; Zhao, XiaoYuan

2011-01-01

Citations are a way to show how researchers build on existing research to further evolve research. The citation count is an indication of the influence of specific articles. The importance of citations means that it is valuable to analyze the articles that are cited the most. This research investigates highly-cited articles in physics (1979-2008) using citation data from the ISI Web of Science. In this study, 1544205 articles were examined. The objective of the analysis was to identify and list the highly-productive countries, institutions, authors, and fields in physics. Based on the analysis, it was found that the USA is the world leader in physics, and Japan has maintained the highest growth rate in physics research since 1990. Furthermore, the research focus at Bell Labs and IBM has played important roles in physics. A striking fact is that the five most active authors are all Japanese, but the five most active institutions are all in the USA. In fact, only The University of Tokyo is ranked among the top 11 institutions, and only American authors have single-author articles ranked among the top 19 articles. The highest-impact articles are distributed across 25 subjects categories. Physics, Multidisciplinary has 424 articles, and is ranked at No. 1 in total articles; followed by Physics, Condensed Matter. The study can provide science policy makers with a picture of innovation capability in this field and help them make better decisions. Hopefully, this study will stimulate useful discussion among scientists and research managers about future research directions.

Diagnosis is a team sport - partnering with allied health professionals to reduce diagnostic errors: A case study on the role of a vestibular therapist in diagnosing dizziness.

PubMed

Thomas, Dana B; Newman-Toker, David E

2016-06-01

Diagnostic errors are the most common, most costly, and most catastrophic of medical errors. Interdisciplinary teamwork has been shown to reduce harm from therapeutic errors, but sociocultural barriers may impact the engagement of allied health professionals (AHPs) in the diagnostic process. A qualitative case study of the experience at a single institution around involvement of an AHP in the diagnostic process for acute dizziness and vertigo. We detail five diagnostic error cases in which the input of a physical therapist was central to correct diagnosis. We further describe evolution of the sociocultural milieu at the institution as relates to AHP engagement in diagnosis. Five patients with acute vestibular symptoms were initially misdiagnosed by physicians and then correctly diagnosed based on input from a vestibular physical therapist. These included missed labyrinthine concussion and post-traumatic benign paroxysmal positional vertigo (BPPV); BPPV called gastroenteritis; BPPV called stroke; stroke called BPPV; and multiple sclerosis called BPPV. As a consequence of surfacing these diagnostic errors, initial resistance to physical therapy input to aid medical diagnosis has gradually declined, creating a more collaborative environment for 'team diagnosis' of patients with dizziness and vertigo at the institution. Barriers to AHP engagement in 'team diagnosis' include sociocultural norms that establish medical diagnosis as something reserved only for physicians. Drawing attention to the valuable diagnostic contributions of AHPs may help facilitate cultural change. Future studies should seek to measure diagnostic safety culture and then implement proven strategies to breakdown sociocultural barriers that inhibit effective teamwork and transdisciplinary diagnosis.

Study of the Discipline-Based Education vs. Liberal Education in the Department of Social Sciences, S. P. J. C. [St. Petersburg Junior College, Florida].

ERIC Educational Resources Information Center

McCuskey, E. Scott; Worley, William E.

The heterogeneous nature of community college populations has resulted in an academic dichotomy within two-year institutions. Most institutions offer two types of programs: (1) discipline-based, university parallel programs, oriented toward transferring students to four-year institutions; (2) vocational/technical programs, oriented toward terminal…

Factors Related to the Adoption of IT Emerging Technologies by Research and Non-Research Based Higher Education Institutions

ERIC Educational Resources Information Center

Then, Keri Ann; Amaria, Pesi

2013-01-01

This study examined the adoption of information technology (IT) emerging technology by higher education institutions with a focus on non-research and research based institutions categorized by Carnegie Mellon classifications that are members of EDUCAUSE, a higher education non-profit organization, whose mission is the use of IT in higher…

A centroid molecular dynamics study of liquid para-hydrogen and ortho-deuterium.

PubMed

Hone, Tyler D; Voth, Gregory A

2004-10-01

Centroid molecular dynamics (CMD) is applied to the study of collective and single-particle dynamics in liquid para-hydrogen at two state points and liquid ortho-deuterium at one state point. The CMD results are compared with the results of classical molecular dynamics, quantum mode coupling theory, a maximum entropy analytic continuation approach, pair-product forward- backward semiclassical dynamics, and available experimental results. The self-diffusion constants are in excellent agreement with the experimental measurements for all systems studied. Furthermore, it is shown that the method is able to adequately describe both the single-particle and collective dynamics of quantum liquids. (c) 2004 American Institute of Physics

"It's like Tuskegee in reverse": a case study of ethical tensions in institutional review board review of community-based participatory research.

PubMed

Malone, Ruth E; Yerger, Valerie B; McGruder, Carol; Froelicher, Erika

2006-11-01

Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment.

ExPASy: SIB bioinformatics resource portal.

PubMed

Artimo, Panu; Jonnalagedda, Manohar; Arnold, Konstantin; Baratin, Delphine; Csardi, Gabor; de Castro, Edouard; Duvaud, Séverine; Flegel, Volker; Fortier, Arnaud; Gasteiger, Elisabeth; Grosdidier, Aurélien; Hernandez, Céline; Ioannidis, Vassilios; Kuznetsov, Dmitry; Liechti, Robin; Moretti, Sébastien; Mostaguir, Khaled; Redaschi, Nicole; Rossier, Grégoire; Xenarios, Ioannis; Stockinger, Heinz

2012-07-01

ExPASy (http://www.expasy.org) has worldwide reputation as one of the main bioinformatics resources for proteomics. It has now evolved, becoming an extensible and integrative portal accessing many scientific resources, databases and software tools in different areas of life sciences. Scientists can henceforth access seamlessly a wide range of resources in many different domains, such as proteomics, genomics, phylogeny/evolution, systems biology, population genetics, transcriptomics, etc. The individual resources (databases, web-based and downloadable software tools) are hosted in a 'decentralized' way by different groups of the SIB Swiss Institute of Bioinformatics and partner institutions. Specifically, a single web portal provides a common entry point to a wide range of resources developed and operated by different SIB groups and external institutions. The portal features a search function across 'selected' resources. Additionally, the availability and usage of resources are monitored. The portal is aimed for both expert users and people who are not familiar with a specific domain in life sciences. The new web interface provides, in particular, visual guidance for newcomers to ExPASy.

Cross-National Gender Gaps in Political Knowledge

PubMed Central

Fortin-Rittberger, Jessica

2016-01-01

Although the majority of studies on political knowledge document lingering gender-based differences in advanced industrial democracies, most contributors have drawn such conclusions from a single or a handful of countries, using limited batteries of political information items. Exploiting a pooled data set of the Comparative Study of Electoral Systems encompassing 106 post-election surveys in forty-seven countries between 1996 and 2011, this article demonstrates that survey instrument–related factors, such as question format and content, as well as the overall difficulty of questions, are more consequential in shaping the size of gender gaps in political knowledge than institutional factors, such as electoral rules or opportunity structures. The research design of this article draws from almost three hundred different items measuring factual political knowledge using the broadest country coverage and most comprehensive approach to measurement to date. PMID:27524874

Enhancing High Value Care in Gastroenterology Practice.

PubMed

Camilleri, Michael; Katzka, David A

2016-10-01

The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs. We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing. The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence. These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Learning Environment in Light of Positional, Institutional, and Cultural Interpretations: An Empirically-Based Conceptual Analysis

ERIC Educational Resources Information Center

Kovac, Velibor Bobo; Lund, Ingrid; Omdal, Heidi

2017-01-01

This study explores the possibility that the concept of learning environment (LE) is understood and interpreted differently by various users, depending on their relative positions in the educational system, institutional affiliation, and cultural heritage. The study employs a qualitative approach and is based on 14 semistructured separate…

Variation of Cats under Domestication: Genetic Assignment of Domestic Cats to Breeds and Worldwide Random Bred Populations

PubMed Central

Kurushima, J. D.; Lipinski, M. J.; Gandolfi, B.; Froenicke, L.; Grahn, J. C.; Grahn, R. A.; Lyons, L. A.

2012-01-01

Summary Both cat breeders and the lay public have interests in the origins of their pets, not only in the genetic identity of the purebred individuals, but also the historical origins of common household cats. The cat fancy is a relatively new institution with over 85% of its 40–50 breeds arising only in the past 75 years, primarily through selection on single-gene aesthetic traits. The short, yet intense cat breed history poses a significant challenge to the development of a genetic marker-based breed identification strategy. Using different breed assignment strategies and methods, 477 cats representing 29 fancy breeds were analysed with 38 short tandem repeats, 148 intergenic and five phenotypic single nucleotide polymorphisms. Results suggest the frequentist method of Paetkau (accuracy single nucleotide polymorphisms = 0.78, short tandem repeats = 0.88) surpasses the Bayesian method of Rannala and Mountain (single nucleotide polymorphisms = 0.56, short tandem repeats = 0.83) for accurate assignment of individuals to the correct breed. Additionally, a post-assignment verification step with the five phenotypic single nucleotide polymorphisms accurately identified between 0.31 and 0.58 of the mis-assigned individuals raising the sensitivity of assignment with the frequentist method to 0.89 and 0.92 single nucleotide polymorphisms and short tandem repeats respectively. This study provides a novel multi-step assignment strategy and suggests that, despite their short breed history and breed family groupings, a majority of cats can be assigned to their proper breed or population of origin, i.e. race. PMID:23171373

Electrical coupling of single cardiac rat myocytes to field-effect and bipolar transistors.

PubMed

Kind, Thomas; Issing, Matthias; Arnold, Rüdiger; Müller, Bernt

2002-12-01

A novel bipolar transistor for extracellular recording the electrical activity of biological cells is presented, and the electrical behavior compared with the field-effect transistor (FET). Electrical coupling is examined between single cells separated from the heart of adults rats (cardiac myocytes) and both types of transistors. To initiate a local extracellular voltage, the cells are periodically stimulated by a patch pipette in voltage clamp and current clamp mode. The local extracellular voltage is measured by the planar integrated electronic sensors: the bipolar and the FET. The small signal transistor currents correspond to the local extracellular voltage. The two types of sensor transistors used here were developed and manufactured in the laboratory of our institute. The manufacturing process and the interfaces between myocytes and transistors are described. The recordings are interpreted by way of simulation based on the point-contact model and the single cardiac myocyte model.

A robotics platform for automated batch fabrication of high density, microfluidics-based DNA microarrays, with applications to single cell, multiplex assays of secreted proteins.

PubMed

Ahmad, Habib; Sutherland, Alex; Shin, Young Shik; Hwang, Kiwook; Qin, Lidong; Krom, Russell-John; Heath, James R

2011-09-01

Microfluidics flow-patterning has been utilized for the construction of chip-scale miniaturized DNA and protein barcode arrays. Such arrays have been used for specific clinical and fundamental investigations in which many proteins are assayed from single cells or other small sample sizes. However, flow-patterned arrays are hand-prepared, and so are impractical for broad applications. We describe an integrated robotics/microfluidics platform for the automated preparation of such arrays, and we apply it to the batch fabrication of up to eighteen chips of flow-patterned DNA barcodes. The resulting substrates are comparable in quality with hand-made arrays and exhibit excellent substrate-to-substrate consistency. We demonstrate the utility and reproducibility of robotics-patterned barcodes by utilizing two flow-patterned chips for highly parallel assays of a panel of secreted proteins from single macrophage cells. © 2011 American Institute of Physics

Understanding community-based processes for research ethics review: a national study.

PubMed

Shore, Nancy; Brazauskas, Ruta; Drew, Elaine; Wong, Kristine A; Moy, Lisa; Baden, Andrea Corage; Cyr, Kirsten; Ulevicus, Jocelyn; Seifer, Sarena D

2011-12-01

Institutional review boards (IRBs), designed to protect individual study participants, do not routinely assess community consent, risks, and benefits. Community groups are establishing ethics review processes to determine whether and how research is conducted in their communities. To strengthen the ethics review of community-engaged research, we sought to identify and describe these processes. In 2008 we conducted an online survey of US-based community groups and community-institutional partnerships involved in human-participants research. We identified 109 respondents who met participation criteria and had ethics review processes in place. The respondents' processes mainly functioned through community-institutional partnerships, community-based organizations, community health centers, and tribal organizations. These processes had been created primarily to ensure that the involved communities were engaged in and directly benefited from research and were protected from research harms. The primary process benefits included giving communities a voice in determining which studies were conducted and ensuring that studies were relevant and feasible, and that they built community capacity. The primary process challenges were the time and resources needed to support the process. Community-based processes for ethics review consider community-level ethical issues that institution-based IRBs often do not.

Prognostic Implications of Single-Sample Confirmatory Testing for Undiagnosed Diabetes: A Prospective Cohort Study.

PubMed

Selvin, Elizabeth; Wang, Dan; Matsushita, Kunihiro; Grams, Morgan E; Coresh, Josef

2018-06-19

Current clinical definitions of diabetes require repeated blood work to confirm elevated levels of glucose or hemoglobin A1c (HbA1c) to reduce the possibility of a false-positive diagnosis. Whether 2 different tests from a single blood sample provide adequate confirmation is uncertain. To examine the prognostic performance of a single-sample confirmatory definition of undiagnosed diabetes. Prospective cohort study. The ARIC (Atherosclerosis Risk in Communities) study. 13 346 ARIC participants (12 268 without diagnosed diabetes) with 25 years of follow-up for incident diabetes, cardiovascular outcomes, kidney disease, and mortality. Confirmed undiagnosed diabetes was defined as elevated levels of fasting glucose (≥7.0 mmol/L [≥126 mg/dL]) and HbA1c (≥6.5%) from a single blood sample. Among 12 268 participants without diagnosed diabetes, 978 had elevated levels of fasting glucose or HbA1c at baseline (1990 to 1992). Among these, 39% had both (confirmed undiagnosed diabetes), whereas 61% had only 1 elevated measure (unconfirmed undiagnosed diabetes). The confirmatory definition had moderate sensitivity (54.9%) but high specificity (98.1%) for identification of diabetes cases diagnosed during the first 5 years of follow-up, with specificity increasing to 99.6% by 15 years. The 15-year positive predictive value was 88.7% compared with 71.1% for unconfirmed cases. Confirmed undiagnosed diabetes was significantly associated with cardiovascular and kidney disease and mortality, with stronger associations than unconfirmed diabetes. Lack of repeated measurements of fasting glucose and HbA1c. A single-sample confirmatory definition of diabetes had a high positive predictive value for subsequent diagnosis and was strongly associated with clinical end points. Our results support the clinical utility of using a combination of elevated fasting glucose and HbA1c levels from a single blood sample to identify undiagnosed diabetes in the population. National Institute of Diabetes and Digestive and Kidney Diseases and National Heart, Lung, and Blood Institute.

Hydroxyapatite ceramic implants for cranioplasty in children: a single-center experience.

PubMed

Zaccaria, Laura; Tharakan, Sasha Job; Altermatt, Stefan

2017-02-01

The use of hydroxyapatite ceramic (HAC) implants for the treatment of skull defects in pediatric patients started 2010 at our institution. Ceramic implants facilitate osteoblast migration and therefore optimize osteointegration with the host bone. The purpose of this study is to report a single-center experience with this treatment modality. A retrospective review of all patients from July 2010 through June 2014 undergoing a cranioplasty using hydroxyapatite ceramic implant and managed at a single institution was performed. Indication for cranioplasty, the hospital course, and follow-up were reviewed. Bone density was measured in Hounsfield Units (HU) and osteointegration was calculated using Mimics Software® (Mimics Innovation Suite v17.0 Medical, Materialize, Leuven, Belgium). Over the 4-year period, six patients met criteria for the study. Five patients had an osteointegration of nearly 100%. One patient had an incomplete osteointegration with a total bone-implant contact area of 69%. The mean bone density was 2800 HU (2300-3000 HU). Bone density alone is estimated to have a Hounsfield value between 400 and 2000 HU depending on the body region and bone quality. There were no major complications, and the patients were highly satisfied with the esthetical result. Hydroxyapatite ceramic implants for cranioplasty in pediatric patients are a good choice for different indications. The implants show excellent osteointegration and esthetical results.

Retention Strategies for Reducing Voluntary Turnover in a Higher Education Institution

ERIC Educational Resources Information Center

Walker, Susan K.

2017-01-01

Employees who choose to leave employment cause significant challenges for organizations. Compounded challenges exist when employee retention strategies are not effective, affecting job satisfaction and personnel replacement costs as the organization continues to lose qualified and valuable staff. This single case study, built on a psychological…

Exploring Metaphoric Language Use to Assess Collaboration between Educational Institutions

ERIC Educational Resources Information Center

Newberry, Melissa; Richardson, Michael

2015-01-01

In this single case study of a school and university collaborative project, positioning theory was used to deconstruct the metaphors expressed in descriptions of roles of 23 participants. Present in the metaphors were discrepancies in understandings of collaboration that revealed ways that collaboration was inhibited as participants positioned…

Student Leaders at Women's Postsecondary Institutions: A Global Perspective

ERIC Educational Resources Information Center

Renn, Kristen A.; Lytle, Jesse H.

2010-01-01

The single-sex higher education sector is growing worldwide as more women seek access to postsecondary education. Although positive learning outcomes--including leadership development--of women's colleges are well documented in the United States, less is known internationally. We conducted an exploratory qualitative study of 46 student leaders…

Incidence and Clinical Features of Rare Cutaneous Malignancies in Olmsted County, Minnesota, 2000 to 2010.

PubMed

Tolkachjov, Stanislav N; Schmitt, Adam R; Muzic, John G; Weaver, Amy L; Baum, Christian L

2017-01-01

The incidence of rare cutaneous malignancies is unknown. Current estimates of rare cutaneous malignancy incidences are based on broad epidemiologic data or single institution experiences, not population-based data. To determine the incidence of several rare nonmelanoma skin cancers. The authors conducted a retrospective chart review of a population-based cohort between the years 2000 and 2010. Residents of Olmsted County, Minnesota, who were diagnosed with a biopsy-proven nonmelanoma skin cancer-excluding basal cell carcinoma and squamous cell carcinoma-were included in this study. The primary outcome was tumor incidence. Additionally, the authors extracted patient demographics, tumor characteristics, treatment modalities, and outcomes. The age-adjusted and sex-adjusted incidences per 100,000 persons of multiple rare cutaneous malignancies were: atypical fibroxanthoma (1.8), sebaceous carcinoma (0.8), dermatofibrosarcoma protuberans (0.4), microcystic adnexal carcinoma (0.7), eccrine carcinoma (0.4), eccrine porocarcinoma (0.2), and leiomyosarcoma (0.2). The authors report population-based incidences and clinical characteristics for these rare cutaneous malignancies. The immune status and smoking status of patients and the treatment and outcomes of these tumors are reported. Additional studies in a broader population are needed to further define the epidemiology and outcomes of these malignancies.

Resident versus no resident: a single institutional study on operative complications, mortality, and cost.

PubMed

Hwang, Christine S; Pagano, Christina R; Wichterman, Keith A; Dunnington, Gary L; Alfrey, Edward J

2008-08-01

Previous studies have demonstrated an increase in surgical morbidity, mortality, duration of stay, and costs in teaching hospitals. These studies are confounded by many variables. Controlling for these variables, we studied the effect of surgical residents on these outcomes during rotations with non-academic-based teaching faculty at a teaching hospital. Patients received care at a single teaching hospital from a group of 8 surgeons. Four surgeons did not have resident coverage (group 1) and the other 4 had coverage (group 2). Continuous severity adjusted complications, mortality, length of stay, cost, and hospital margin data were collected and compared. Five common procedures were examined: bowel resection, laparoscopic cholecystectomy, hernia, mastectomy, and appendectomy. Comparing all procedures together, there were no differences in complications between the groups, although there was greater mortality, a greater duration of stay, and higher costs in group 2. When comparing the 5 most common procedures individually, there was no difference in complications or mortality, although a greater length of stay and higher costs in group 2. Comparing the most common procedures performed individually, patients cared for by surgeons with surgical residents at a teaching hospital have an increase in duration of stay and cost, although no difference in complications or mortality compared to surgeons without residents.

Outcomes of Pediatric Low-grade Gliomas Treated With Radiation Therapy: A Single-institution Study

PubMed Central

Raikar, Sunil S.; Halloran, Donna R.; Elliot, Michael; McHugh, Michele; Patel, Shaun; Gauvain, Karen M.

2014-01-01

Summary Radiation therapy is often considered the treatment of choice for low-grade gliomas. However, given the long-term effects of radiation on the developing brain, the appropriate use of radiation therapy in pediatric patients remains controversial. The purpose of this study was to evaluate progression-free survival (PFS) of pediatric low-grade glioma patients treated with radiation therapy. Data were obtained through a retrospective chart review of patients treated between 1991 and 2008 from a single tertiary care center in the midwest. The study population consisted of 17 patients, of whom 8 (47%) had tumor recurrence after radiation therapy. The median follow-up time was 8.2 years, with a range of 2.3 to 17.2 years. The median age at diagnosis was 5.4 years, and the median age at radiation therapy was 9.4 years. The 3- and the 10-year PFS were 69% ± 11.7% and 46% ± 13.3%, respectively. A significant difference in PFS was seen when comparing brainstem tumors with hypothalamic/optic pathway tumors (P = 0.019). Differences in PFS based on the age at diagnosis, the extent of initial surgery, and indication for radiation therapy were not significant. A larger multicenter study is needed to better assess PFS in these patients. PMID:24714505

Navigating Change and Leading an Institution of Higher Education: A Case Study of the Missional Leadership of a University President

ERIC Educational Resources Information Center

Bunn, Christopher Edward

2010-01-01

The purpose of this qualitative, single case study is to explore key leadership principles and strategies related to the "good to great" pattern of growth at Lee University. In order to accomplish this purpose, this study investigates Dr. Paul Conn's thoughts and navigation through times of change, conflict, and the strategic execution of planned…

A Diet Low in Fermentable Oligo-, Di-, and Monosaccharides and Polyols Improves Quality of Life and Reduces Activity Impairment in Patients With Irritable Bowel Syndrome and Diarrhea.

PubMed

Eswaran, Shanti; Chey, William D; Jackson, Kenya; Pillai, Sivaram; Chey, Samuel W; Han-Markey, Theresa

2017-12-01

We investigated the effects of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) vs traditional dietary recommendations on health-related quality of life (QOL), anxiety and depression, work productivity, and sleep quality in patients with irritable bowel syndrome and diarrhea (IBS-D). We conducted a prospective, single-center, single-blind trial of 92 adult patients with IBS-D (65 women; median age, 42.6 years) randomly assigned to groups placed on a diet low in FODMAPs or a modified diet recommended by the National Institute for Health and Care Excellence (mNICE) for 4 weeks. IBS-associated QOL (IBS-QOL), psychosocial distress (based on the Hospital Anxiety and Depression Scale), work productivity (based on the Work Productivity and Activity Impairment), and sleep quality were assessed before and after diet periods. Eighty-four patients completed the study (45 in the low-FODMAP group and 39 in the mNICE group). At 4 weeks, patients on the diet low in FODMAPs had a larger mean increase in IBS-QOL score than did patients on the mNICE diet (15.0 vs 5.0; 95% CI, -17.4 to -4.3). A significantly higher proportion of patients in the low-FODMAP diet group had a meaningful clinical response, based on IBS-QOL score, than in the mNICE group (52% vs 21%; 95% CI, -0.52 to -0.08). Anxiety scores decreased in the low-FODMAP diet group compared with the mNICE group (95% CI, 0.46-2.80). Activity impairment was significantly reduced with the low-FODMAP diet (-22.89) compared with the mNICE diet (-9.44; 95% CI, 2.72-24.20). In a randomized, controlled trial, a diet low in FODMAPs led to significantly greater improvements in health-related QOL, anxiety, and activity impairment compared with a diet based on traditional recommendations for patients with IBS-D. ClinicalTrials.gov, number NCT01624610. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

12 CFR 205.4 - General disclosure requirements; jointly offered services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Signatures in Global and National Commerce Act (E-Sign Act) (15 U.S.C. 7001 et seq.). A financial institution.... A financial institution may combine the required disclosures into a single statement for a consumer... with the requirements that this part imposes on any or all of them. An institution need make only the...

Holography at the Butler Institute of American Art

NASA Astrophysics Data System (ADS)

Cvetkovich, Thomas

2013-02-01

The Butler Institute of American Art is the first museum in the country to focus on American art. Since 2003 there has been a continuious showing of international holographic artists at the Butler Art Institute, perhaps more then any other single museum. This paper will catalog these exhibits with ccommentary from the artists and staff of the Butler.

A Study on Learning Organizations in Indian Higher Educational Institutes

ERIC Educational Resources Information Center

Chawla, Saniya; Lenka, Usha

2015-01-01

Purpose: This paper aims to study the antecedents and consequences of learning organizations (LOs) in Indian higher educational institutes. Design/methodology/approach: The methodology used is survey-based. Primary data were collected from 300 faculty members of Indian higher educational institutes. Findings: It was found that all the variables,…

A Comparative Study of International Student Engagement and Success Based on Race/Ethnicity, Gender, and Institutional Type

ERIC Educational Resources Information Center

Phillips, Gareth Carlington

2013-01-01

The study examined international students' engagement and success using NSSE 2007 data. The sample consisted of 1996 first years and 2,158 seniors. These students were compared by race/ethnicity, gender, and institutional type. The study found that students' engagement differed by race/ethnicity as well as type of institution. The null hypotheses…

Team-Based Learning in US Colleges and Schools of Pharmacy

PubMed Central

Copeland, Jeffrey; Franks, Andrea S.; Karimi, Reza; McCollum, Marianne; Riese, David J.; Lin, Anne Y.F.

2013-01-01

Objective. To characterize the use of team-based learning (TBL) in US colleges and schools of pharmacy, including factors that may affect implementation and perceptions of faculty members regarding the impact of TBL on educational outcomes. Methods. Respondents identified factors that inhibit or enable TBL use and its impact on student learning. Results were stratified by type of institution (public/private), class size, and TBL experience. Results. Sixty-nine of 100 faculty members (69%) representing 43 (86%) institutions responded. Major factors considered to enable TBL implementation included a single campus and student and administration buy-in. Inhibiting factors included distant campuses, faculty resistance, and lack of training. Compared with traditional lectures, TBL is perceived to enhance student engagement, improve students’ preparation for class, and promote achievement of course outcomes. In addition, TBL is perceived to be more effective than lectures at fostering learning in all 6 domains of Bloom’s Taxonomy. Conclusions. Despite potential implementation challenges, faculty members perceive that TBL improves student engagement and learning. PMID:23966718

The Design of Phase II Clinical Trials Testing Cancer Therapeutics: Consensus Recommendations from the Clinical Trial Design Task Force of the National Cancer Institute Investigational Drug Steering Committee

PubMed Central

Seymour, Lesley; Ivy, S. Percy; Sargent, Daniel; Spriggs, David; Baker, Laurence; Rubinstein, Larry; Ratain, Mark J; Le Blanc, Michael; Stewart, David; Crowley, John; Groshen, Susan; Humphrey, Jeffrey S; West, Pamela; Berry, Donald

2010-01-01

The optimal design of phase II studies continues to be the subject of vigorous debate, especially with regards to studies of newer molecularly targeted agents. The observations that many new therapeutics ‘fail’ in definitive phase III studies, coupled with the numbers of new agents to be tested as well as the increasing costs and complexity of clinical trials further emphasizes the critical importance of robust and efficient phase II design. The Clinical Trial Design Task Force(CTD-TF)of the NCI Investigational Drug Steering Committee (IDSC) has published a series of discussion papers on Phase II trial design in Clinical Cancer Research. The IDSC has developed formal recommendations regarding aspects of phase II trial design which are the subject of frequent debate such as endpoints(response vs. progression free survival), randomization(single arm designs vs. randomization), inclusion of biomarkers, biomarker based patient enrichment strategies, and statistical design(e.g. two stage designs vs. multiple-group adaptive designs). While these recommendations in general encourage the use of progression-free survival as the primary endpoint, the use of randomization, the inclusion of biomarkers and the incorporation of newer designs, we acknowledge that objective response as an endpoint, and single arm designs, remain relevant in certain situations. The design of any clinical trial should always be carefully evaluated and justified based on the characteristic specific to the situation. PMID:20215557

Beating the odds: The poisson distribution of all input cells during limiting dilution grossly underestimates whether a cell line is clonally-derived or not.

PubMed

Zhou, Yizhou; Shaw, David; Lam, Cynthia; Tsukuda, Joni; Yim, Mandy; Tang, Danming; Louie, Salina; Laird, Michael W; Snedecor, Brad; Misaghi, Shahram

2017-09-23

Establishing that a cell line was derived from a single cell progenitor and defined as clonally-derived for the production of clinical and commercial therapeutic protein drugs has been the subject of increased emphasis in cell line development (CLD). Several regulatory agencies have expressed that the prospective probability of clonality for CHO cell lines is assumed to follow the Poisson distribution based on the input cell count. The probability of obtaining monoclonal progenitors based on the Poisson distribution of all cells suggests that one round of limiting dilution may not be sufficient to assure the resulting cell lines are clonally-derived. We experimentally analyzed clonal derivatives originating from single cell cloning (SCC) via one round of limiting dilution, following our standard legacy cell line development practice. Two cell populations with stably integrated DNA spacers were mixed and subjected to SCC via limiting dilution. Cells were cultured in the presence of selection agent, screened, and ranked based on product titer. Post-SCC, the growing cell lines were screened by PCR analysis for the presence of identifying spacers. We observed that the percentage of nonclonal populations was below 9%, which is considerably lower than the determined probability based on the Poisson distribution of all cells. These results were further confirmed using fluorescence imaging of clonal derivatives originating from SCC via limiting dilution of mixed cell populations expressing GFP or RFP. Our results demonstrate that in the presence of selection agent, the Poisson distribution of all cells clearly underestimates the probability of obtaining clonally-derived cell lines. © 2017 American Institute of Chemical Engineers Biotechnol. Prog., 2017. © 2017 American Institute of Chemical Engineers.

Ventilator-Associated Pneumonia in Trauma Patients: Different Criteria, Different Rates.

PubMed

Leonard, Kenji L; Borst, Gregory M; Davies, Stephen W; Coogan, Michael; Waibel, Brett H; Poulin, Nathaniel R; Bard, Michael R; Goettler, Claudia E; Rinehart, Shane M; Toschlog, Eric A

2016-06-01

No consensus exists regarding the definition of ventilator-associated pneumonia (VAP). Even within a single institution, inconsistent diagnostic criteria result in conflicting rates of VAP. As a Level 1 trauma center participating in the Trauma Quality Improvement Project (TQIP) and the National Healthcare Safety Network (NHSN), our institution showed inconsistencies in VAP rates depending on which criteria was applied. The purpose of this study was to compare VAP definitions, defined by culture-based criteria, National Trauma Data Bank (NTDB) and NHSN, using incidence in trauma patients. A retrospective chart review of consecutive trauma patients who were diagnosed with VAP and met pre-determined inclusion and exclusion criteria admitted to our rural, 861-bed, Level 1 trauma and tertiary care center between January 2008 and December 2011 was performed. These patients were identified from the National Trauma Registry of the American College of Surgeons (NTRACS) database and an in-house infection control database. Ventilator-associated pneumonia diagnosis criteria defined by the U.S. Center for Disease Control and Prevention (used by the NHSN), the NTDB, and our institutional, culture-based criteria gold standard were compared among patients. Two hundred seventy-nine patients were diagnosed with VAP (25.4% met NHSN criteria, 88.2% met NTDB, and 76.3% met culture-based criteria). Only 58 (20.1%) patients met all three criteria. When NHSN criteria were compared with culture-based criteria, NHSN showed a high specificity (92.5%) and low sensitivity (28.2%). The positive predictive value (PPV) was 84.5%, but the negative predictive value (NPV) was 47.1%. The agreement between the NHSN and the culture-based criteria was poor (κ = 0.18). Conversely, the NTDB showed a lower specificity (57.8%), but greater sensitivity (86.4%) compared with culture-based criteria. The PPV and NPV were both 74% and the two criteria showed fair agreement (κ = 0.41). The lack of standard diagnostic criteria for VAP resulted in variable reporting to different agencies. Emphasis on establishing a consensus VAP definition should be undertaken.

Genomic Insights into Geothermal Spring Community Members using a 16S Agnostic Single-Cell Approach

NASA Astrophysics Data System (ADS)

Bowers, R. M.

2016-12-01

INSTUTIONS (ALL): DOE Joint Genome Institute, Walnut Creek, CA USA. Bigelow Laboratory for Ocean Sciences, East Boothbay, ME USA. Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada. ABSTRACT BODY: With recent advances in DNA sequencing, rapid and affordable screening of single-cell genomes has become a reality. Single-cell sequencing is a multi-step process that takes advantage of any number of single-cell sorting techniques, whole genome amplification (WGA), and 16S rRNA gene based PCR screening to identify the microbes of interest prior to shotgun sequencing. However, the 16S PCR based screening step is costly and may lead to unanticipated losses of microbial diversity, as cells that do not produce a clean 16S amplicon are typically omitted from downstream shotgun sequencing. While many of the sorted cells that fail the 16S PCR step likely originate from poor quality amplified DNA, some of the cells with good WGA kinetics may instead represent bacteria or archaea with 16S genes that fail to amplify due to primer mis-matches or the presence of intervening sequences. Using cell material from Dewar Creek, a hot spring in British Columbia, we sequenced all sorted cells with good WGA kinetics irrespective of their 16S amplification success. We show that this high-throughput approach to single-cell sequencing (i) can reduce the overall cost of single-cell genome production, and (ii). may lead to the discovery of previously unknown branches on the microbial tree of life.

Institutional design and organizational practice for universal coverage in lesser-developed countries: challenges facing the Lao PDR.

PubMed

Ahmed, Shakil; Annear, Peter Leslie; Phonvisay, Bouaphat; Phommavong, Chansaly; Cruz, Valeria de Oliveira; Hammerich, Asmus; Jacobs, Bart

2013-11-01

There is now widespread acceptance of the universal coverage approach, presented in the 2010 World Health Report. There are more and more voices for the benefit of creating a single national risk pool. Now, a body of literature is emerging on institutional design and organizational practice for universal coverage, related to management of the three health-financing functions: collection, pooling and purchasing. While all countries can move towards universal coverage, lower-income countries face particular challenges, including scarce resources and limited capacity. Recently, the Lao PDR has been preparing options for moving to a single national health insurance scheme. The aim is to combine four different social health protection schemes into a national health insurance authority (NHIA) with a single national fund- and risk-pool. This paper investigates the main institutional and organizational challenges related to the creation of the NHIA. The paper uses a qualitative approach, drawing on the World Health Organization's institutional and Organizational Assessment for Improving and Strengthening health financing (OASIS) conceptual framework for data analysis. Data were collected from a review of key health financing policy documents and from 17 semi-structured key informant interviews. Policy makers and advisors are confronting issues related to institutional arrangements, funding sources for the authority and government support for subsidies to the demand-side health financing schemes. Compulsory membership is proposed, but the means for covering the informal sector have not been resolved. While unification of existing schemes may be the basis for creating a single risk pool, challenges related to administrative capacity and cross-subsidies remain. The example of Lao PDR illustrates the need to include consideration of national context, the sequencing of reforms and the time-scale appropriate for achieving universal coverage. Copyright © 2013 Elsevier Ltd. All rights reserved.

Validity of the Medical College Admission Test for Predicting MD-PhD Student Outcomes

ERIC Educational Resources Information Center

Bills, James L.; VanHouten, Jacob; Grundy, Michelle M.; Chalkley, Roger; Dermody, Terence S.

2016-01-01

The Medical College Admission Test (MCAT) is a quantitative metric used by MD and MD-PhD programs to evaluate applicants for admission. This study assessed the validity of the MCAT in predicting training performance measures and career outcomes for MD-PhD students at a single institution. The study population consisted of 153 graduates of the…

Students' Academic Performance in Environmental Studies: An Empirical Study of Different Groups of Secondary School Graduates

ERIC Educational Resources Information Center

Cheung, Lewis Ting On; Fok, Lincoln; Gou, Gloria Rui

2016-01-01

The Hong Kong education system has undergone a dramatic change in its secondary and tertiary level of education. A single public examination for senior secondary education namely Hong Kong Diploma of Secondary Education (HKDSE) was adopted to replace two previously used examinations in 2012. As a result, all higher education institutes in Hong…

Knowledge management in Portuguese healthcare institutions.

PubMed

Cruz, Sofia Gaspar; Ferreira, Maria Manuela Frederico

2016-06-01

Knowledge management imposes itself as a pressing need for the organizations of several sectors of the economy, including healthcare. to evaluate the perception of healthcare institution collaborators in relation to knowledge management in the institution where they operate and analyze the existence of differences in this perception, based on the institution's management model. a study conducted in a sample consisting of 671 collaborators from 10 Portuguese healthcare institutions with different models of management. In order to assess the knowledge management perception, we used a score designed from and based on items from the scores available in the literature. the perception of moderate knowledge management on the healthcare institutions and the statistically significant differences in knowledge management perception were evidenced in each management model. management knowledge takes place in healthcare institutions, and the current management model determines the way staff at these institutions manage their knowledge.

Euro50: Proposal for a 50 m Optical and Infrared Telescope

NASA Astrophysics Data System (ADS)

Ardeberg, Arne; Andersen, Torben; Rodriguez Espinosa, Jose Miguel

Staff from Instituto de Astrofisica de Canarias, Lund Observatory, Physics Department and Larmor Research Institute at Galway, and Tuorla Observatory is collaborating on studies for a 50 m optical and infrared telescope. The telescope concepts are based on the work on extremely large telescopes carried out during 1991-2000 at Lund Observatory, and on the experience from the 10.4 m segmented Grantecan telescope presently under construction. The proposed 50 m telescope is a fully adaptive Nasmyth telescope with a Ritchey Chretien configuration. It will have an aspherical, segmented primary mirror with 2 m large segments and a deformable secondary. Adaptive optics will be implemented in several steps. From the beginning, there will be single-conjugate adaptive optics for the K-band. Next, and within the first year of operation, the telescope will have single-conjugate adaptive optics for visible wavelengths. As a third step, and another year of operation, dual-conjugate adaptive optics will be made available for the K-band. The telescope will be housed in a co-rotating enclosure at the Roque de los Muchachos observatory on La Palma. Further studies are in progress aiming at preparation of a proposal during the first half of 2002.

Congenital megaprepuce: a 12-year experience (52 cases) of this specific form of buried penis.

PubMed

Rod, Julien; Desmonts, Alexis; Petit, Thierry; Ravasse, Philippe

2013-12-01

Congenital megaprepuce is a specific form of buried penis. Children affected by this malformation usually suffer from a subjective difficulty in voiding which is the main indication for early surgical correction. The aim of this study was to report a single center's 12-year experience in the treatment of megaprepuce in children, describing the surgical procedure we used to treat it and the results. We retrospectively reviewed the charts of all children who underwent congenital megaprepuce repair between January 1999 and August 2011 in our institution. Fifty-two children were operated during the study period. Our single surgical technique, not an original one, consists of fixing the penile shaft at the base of the penis, and widely reducing the inner prepuce. Four children (8%) underwent revision surgery but according to our criteria a very good result was observed in only 23 patients, and a less good but still acceptable result in 25 patients. Our 12-year experience in the surgical treatment of congenital megaprepuce demonstrated satisfying results from a safe and simple surgical technique, but to achieve the optimum result remains difficult. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Identifying the institutional decision process to introduce decentralized sanitation in the city of Kunming (China).

PubMed

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

Endogenous change: on cooperation and water availability in two ancient societies

NASA Astrophysics Data System (ADS)

Pande, S.; Ertsen, M.

2014-05-01

We propose and test the theory of endogenous change in societal institutions based on historical reconstructions of two ancient civilizations, the Indus and Hohokam, in two water-scarce basins, the Indus Basin in the Indian subcontinent and the lower Colorado Basin in the southwestern United States. In our reconstructions, institutions are approximated by the scale of "cooperation", be it in the form of the extent of trade, sophisticated irrigation networks, a central state or a loosely held state with a common cultural identity. We study changes in institutions brought about by changes in factors like rainfall, population density, and land-use-induced water resource availability, in a proximate manner. These factors either change naturally or are changed by humans; in either case we contend that the changes affect the stability of cooperative structures over time. We relate the quantitative dimensions of water access by ancient populations to the co-evolution of water access and the socioeconomic and sociopolitical organizations. In doing so, we do not claim that water manipulation was the single most significant factor in stimulating social development and complexity - this would be highly reductionist. Nonetheless, we provide a discussion with the aim to enhance our understanding of the complexity of coupled human-hydrological systems. We find that scarcity triggered more complex cooperative arrangements in both Indus and Hohokam societies.

Identifying the Institutional Decision Process to Introduce Decentralized Sanitation in the City of Kunming (China)

NASA Astrophysics Data System (ADS)

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A.

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

Dehydration of Older Patients in Institutional Care and the Home Environment.

PubMed

Lešnik, Amadeus; Piko, Nejc; Železnik, Danica; Bevc, Sebastjan

2017-11-01

Dehydration in older adults is an important clinical problem associated with more comorbidities, longer hospital stays, and higher mortality rates. However, in daily clinical practice, no single gold standard marker of hydration status in older adults is available. The aim of the current study was to define the fluid balance status in older adults residing in institutional care or the home. Four hundred ten patients (192 from institutional care and 218 from home care) 65 and older from the region of lower Styria (Slovenia) were included in the study. Serum osmolality, electrolytes, and blood urea nitrogen to creatinine (BUN:Cr) ratio were used to identify dehydration. Statistically significant differences were found between groups in serum osmolality and BUN:Cr ratio. Moreover, dehydration (defined as increased serum osmolality) was significantly more common in patients in institutional care than home care (51% versus 41.3%, respectively). The results confirm that dehydration is a common clinical problem in older adults, especially in those from institutional care. Although many methods of determining hydration status in older adults have been proposed, no gold standard exists, making hydration evaluation difficult in this population. [Res Gerontol Nurs. 2017; 10(6):260-266.]. Copyright 2017, SLACK Incorporated.

Women at VMI and the Citadel: History Reenacted.

ERIC Educational Resources Information Center

Goree, Cathryn T.

1997-01-01

Presents a historical process model for the full integration of women into a male institution based on historical studies of several institutions. Draws analogies to current decisions at Virginia Military Institute and the Citadel, including predictions about ways in which the presence of women will affect the student life of these institutions.…

Managing Multilingualism on State Websites: How Institutional Employees Explain Language Choice

ERIC Educational Resources Information Center

Berezkina, Maimu

2018-01-01

The purpose of this study is to understand how institutional language managers make and legitimize decisions about language choice on state websites. The focus lies on state institutions in two technologically advanced European nation-states: Estonia and Norway. The analysis is empirically based on interviews with employees at the institutions who…

Exploring the Relationship between Institutional and Professional Autonomy: A Comparative Study between Portugal and Finland

ERIC Educational Resources Information Center

Carvalho, Teresa; Diogo, Sara

2018-01-01

By comparing two distinct settings--Portugal and Finland--and based on previous studies revealing similar trends in both countries, this article analyses the relationship between institutional and academic autonomy in the higher education sector. Based on crosschecking of the literature review and 47 interviews with key actors in both the…

Rural Governance, Community Empowerment and the New Institutionalism: A Case Study of the Isle of Wight

ERIC Educational Resources Information Center

Clark, David; Southern, Rebekah; Beer, Julian

2007-01-01

This article compares two different institutional models--state-sponsored rural partnerships and community-based development trusts--for engaging and empowering local communities in area-based regeneration, using the Isle of Wight as a case study. Following a critical review of the literature on community governance, we evaluate the effectiveness…

Factors associated with utilization of maternal serum screening for Down syndrome in mainland China: a cross-sectional study.

PubMed

Li, Chuanlin; Shi, Leiyu; Huang, Jiayan; Qian, Xu; Chen, Yingyao

2016-01-14

Knowledge of the factors that influence maternal serum screening (MSS) service utilization can be used to develop health policies to promote equitable access to MSS and further diagnostic tests. The purpose of this study was to find the factors associated with utilization of MSS as well as the current status of service utilization in mainland China. This was a hospital-based cross-sectional study with respondents interviewed with a questionnaire designed based on Andersen's behavioral model. Descriptive statistics, univariate analysis, and multilevel logistic regression analysis were used to identify the factors associated with MSS utilization, and to explore potential methods to improve screening uptake. A total of 8110 women who had given birth within the previous 7 days in one of 111 participating institutions from six provinces in mainland China were interviewed. Approximately 36% of the participants had used MSS. Women between 20 and 35 years, who resided in urban areas, were educated, were in a stable occupation, who had health knowledge, who attended maternal preparation classes, who had received eight or more prenatal checkups, who were from a region of higher social economic status, and who delivered in a tertiary healthcare institution were significantly more likely to use MSS than their counterparts. As compared with other factors, insufficient education is the single most important demographic factor for service underutilization. Efforts should not only be made to target the population that underuses MSS, but the overall organization of MSS service delivery should be assessed during policy development to make access to MSS equitable to the entire population of mainland China.

Assessment of the current D-dimer cutoff point in pulmonary embolism workup at a single institution: Retrospective study.

PubMed

Alhassan, S; Bihler, E; Patel, K; Lavudi, S; Young, M; Balaan, M

2018-06-06

The currently used D-dimer (DD) cutoff point is associated with a large number of negative CT-pulmonary angiographies (CTPA). We hypothesized presence of deficiency in the current cutoff and a need to look for a better DD threshold. We conducted a retrospective medical records analysis of all patients who had a CTPA as part of pulmonary embolism (PE) workup over a 1-year period. All emergency room (ER) patients who had DD assay checked prior to CTPA were included in the analysis. We assessed our institutional cutoff point and tried to test other presumptive DD thresholds retrospectively. At our institution 1591 CTPA were performed in 2014, with 1220 scans (77%) performed in the ER. DD test was ordered prior to CTPA imaging in 238 ER patients (19.5%) as part of the PE workup. PE was diagnosed in 14 cases (6%). The sensitivity and specificity of the currently used DD cutoff (0.5 mcg/mL) were found to be 100% and 13%, respectively. Shifting the cutoff value from 0.5 to 0.85 mcg/mL would result in a significant increase in the specificity from 13% to 51% while maintaining the same sensitivity of 100%. This would make theoretically 84 CTPA scans, corresponding to 35% of CTPA imaging, unnecessary because DD would be considered negative based on this presumptive threshold. Our results suggest a significant deficiency in the institutional DD cutoff point with the need to find a better threshold through a large multicenter prospective trial to minimize unnecessary CTPA scans and to improve patient safety.

Challenges of intra-institutional transfer of care from paediatric to adult congenital cardiology: the need for retention as well as transition.

PubMed

Bohun, Claudine M; Woods, Patricia; Winter, Christiane; Mitchell, Julie; McLarry, Joel; Weiss, Joseph; Broberg, Craig S

2016-02-01

Transferring patients with CHD from paediatric to adult care has been challenging, especially across institutions. Within a single institution, some issues such as provider interaction, information exchange, or administrative directives should not play a significant role, and should favour successful transfer. We studied patients who were eligible for transfer to the adult congenital heart disease service within our institution in order to identify factors associated with successful transfer to adult care providers versus failure to transfer. Patients above18 years of age with CHD who were seen by paediatric cardiologists before January, 2008 were identified through a patient-care database. Records were reviewed to determine follow-up between 2008 and 2011 and to determine whether the patient was seen in the adult congenital cardiology clinic, paediatric cardiology clinic, or had no follow-up, and statistical comparisons were made between groups. After reviewing 916 records, 229 patients were considered eligible for transition to adult congenital cardiology. Of these, 77 (34%) were transferred successfully to adult congenital cardiology, 47 (21%) continued to be seen by paediatric cardiologists, and 105 (46%) were lost to follow-up. Those who transferred successfully differed with regard to complexity of diagnosis, insurance, and whether a formal referral was made by a paediatric care provider. Only a small fraction of the patients who were lost to follow-up could be contacted. Within a single institution, with shared information systems, administrations, and care providers, successful transfer from paediatric to adult congenital cardiology was still poor. Efforts for successful retention are just as vital as those for transfer.

Clickers don't always help: Classroom context and goals can mitigate clicker effects on student learning

NASA Astrophysics Data System (ADS)

Shapiro, Amy; O'Rielly, Grant; Sims-Knight, Judith

2014-03-01

Clickers are commonly used in large-enrollment introductory courses in order to encourage attendance, increase student engagement and improve learning. We report the results from a highly controlled study of factual and conceptual clicker questions in calculus-based introductory physics courses, on students' performance on the factual and conceptual exam questions they targeted. We found that clicker questions did not enhance student performance on either type of exam question. The use of factual clicker questions actually decreased student performance on conceptual exam questions, however. Directing students' attention to surface features of the course content may distract them from the important underlying concepts. The conceptual clicker questions were likely ineffective because the practice students got on homework questions had a stronger effect than the single question posed in class. Interestingly, the same studies in general education biology and psychology courses show a strong, positive effect of clickers on student learning. This study suggest that the usefulness of clickers should be weighed in the context of other course activities and goals. Secondary analyses will explore the effect of students' GPA, motivation and study strategies on the results. This work was supported by the Institute of Education Sciences, US Dept. of Education, through Grant R305A100625 to UMass Dartmouth. The opinions expressed are those of the authors and do not represent views of the Institute or the US Dept. of Education.

Cancer's Big Data Problem

DOE PAGES

Breaux, Justin H. S.

2017-03-15

The US Department of Energy (DOE) has partnered with the National Cancer Institute (NCI) to use DOE supercomputers to aid in the fight against cancer by building sophisticated models based on data available at the population, patient, and molecular levels. Here, through a three-year pilot project called the Joint Design of Advanced Computing Solutions for Cancer (JDACSC), four participating national laboratories--Argonne, Lawrence Livermore, Los Alamos, and Oak Ridge--will focus on three problems singled out by the NCI as the biggest bottlenecks to advancing cancer research.

Cancer's Big Data Problem

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

Breaux, Justin H. S.

The US Department of Energy (DOE) has partnered with the National Cancer Institute (NCI) to use DOE supercomputers to aid in the fight against cancer by building sophisticated models based on data available at the population, patient, and molecular levels. Here, through a three-year pilot project called the Joint Design of Advanced Computing Solutions for Cancer (JDACSC), four participating national laboratories--Argonne, Lawrence Livermore, Los Alamos, and Oak Ridge--will focus on three problems singled out by the NCI as the biggest bottlenecks to advancing cancer research.

A Blind Segmentation Approach to Acoustic Event Detection Based on I Vector

DTIC Science & Technology

2013-08-25

Hui Lee1 1 School of ECE, Georgia Institute of Technology , Atlanta, GA. 30332-0250, USA 2 School of Computing, University of Eastern Finland, Finland...recordings obtained at low signal-to-noise-ratio (SNR) enviroments with highly-mixed events in a single acous- tic segment. Research in AED [1] is...2532–2535. [28] C.-C. Chang and C.-J. Lin, “LIBSVM: A library for support vector machines,” ACM Transactions on Intelligent Systems and Technology

Knowledge-driven institutional change: an empirical study on combating desertification in northern China from 1949 to 2004.

PubMed

Yang, Lihua; Wu, Jianguo

2012-11-15

Understanding institutional changes is crucial for environmental management. Here we investigated how institutional changes influenced the process and result of desertification control in northern China between 1949 and 2004. Our analysis was based on a case study of 21 field sites and a meta-analysis of additional 29 sites reported in the literature. Our results show that imposed knowledge-driven institutional change was often perceived as a more progressive, scientific, and rational type of institutional change by entrepreneurs, scholars, experts, and technicians, while voluntary, knowledge-driven institutional change based on indigenous knowledge and experiences of local populations was discouraged. Our findings also demonstrate that eight working rules of imposed knowledge-driven institutional change can be applied to control desertification effectively. These rules address the issues of perception of potential gains, entrepreneurs' appeals and support, coordination of multiple goals, collaboration among multiple organizations, interest distribution and conflict resolution, incremental institutional change, external intervention, and coordination among the myriad institutions involved. Imposed knowledge-driven institutional change tended to be more successful when these rules were thoroughly implemented. These findings provide an outline for implementing future institutional changes and policy making to combat desertification and other types of ecological and environmental management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education

PubMed Central

Thayer, Erin K.; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C.; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A.

2016-01-01

Issue Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. Approach IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Implications Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data. PMID:27443407

Approach to Non-Neutropenic Fever in Pediatric Oncology Patients-A Single Institution Study.

PubMed

Ali, Bilal Abou; Hirmas, Nader; Tamim, Hani; Merabi, Zeina; Hanna-Wakim, Rima; Muwakkit, Samar; Abboud, Miguel; Solh, Hassan El; Saab, Raya

2015-12-01

Pediatric oncology patients with fever, even when not neutropenic, are known to be at an increased risk of bloodstream infections. However, there are no standard guidelines for management of fever in non-neutropenic patients, resulting in variability in practice across institutions. We retrospectively analyzed the clinical characteristics, management, and outcome of all febrile non-neutropenic episodes in pediatric oncology patients at a single institution over the two-year period 2011-2012, to identify predictors of bloodstream infections. We assessed the efficacy of a uniform approach to outpatient management of a defined subset of patients at low risk of invasive infections. A total of 254 episodes in 83 patients were identified. All patients had implanted central venous catheters (port). Sixty-two episodes (24%) were triaged as high-risk and admitted for inpatient management; five (8%) had positive blood cultures. The remaining 192 episodes were triaged as low risk and managed with once daily outpatient intravenous ceftriaxone; three (1.6%) were associated with bacteremia, and 10% required eventual inpatient management. Of all the factors analyzed, only signs of sepsis (lethargy, chills, hypotension) were associated with positive bloodstream infection. Treatment of a defined subset of patients with outpatient intravenous ceftriaxone was safe and effective. Signs of sepsis were the only factor significantly associated with bloodstream infection. This study provides a baseline for future prospective studies assessing the safety of withholding antibiotics in this subset of patients. © 2015 Wiley Periodicals, Inc.

Teaching Web 2.0 beyond the library: adventures in social media, the class.

PubMed

Farrell, Ann M; Mayer, Susan H; Rethlefsen, Melissa L

2011-01-01

Librarians at the Mayo Clinic developed customized Web 2.0 courses for library staff, health science faculty, and nurse educators. As demand for this type of training spread across the institution, a single, self-paced class was developed for all employees. The content covered the typical Web 2.0 and social media tools (e.g., blogs, really simple syndication [RSS], wikis, social networking tools) emphasizing the organization's social media guidelines. The team consulted with the public affairs department to develop the class and coordinate marketing and advertising. The eight-module, blog-based course was introduced to all employees in 2010. Employees completing each module and passing a brief assessment receive credit on their employee transcript. Libraries staff provided support to participants throughout the duration of the course through chat widgets, e-mail, and blog comments. The results show that even though a high number of learners accessed the course, the completion percentage was low since there was no requirement to complete the course. Deploying a single, self-paced course for a large institution is an enormous undertaking, requiring the support of high level administration, managers, and employees.

E-Portfolio Assessment: A Mixed Methods Study of an Instructional Leadership Program's Assessment System

ERIC Educational Resources Information Center

Hardin, James; Wright, Vivian H.

2017-01-01

Institutions of higher education face demands to provide evidence of institutional and student achievement. Many institutions utilize standards-based e-portfolio assessment practices to meet these demands. The assessment data derived from the studied program's e-portfolio process were not originally intended to serve as a data source for…

Febuxostat for management of tumor lysis syndrome including its effects on levels of purine metabolites in patients with hematological malignancies - a single institution's, pharmacokinetic and pilot prospective study.

PubMed

Takai, Mihoko; Yamauchi, Takahiro; Ookura, Miyuki; Matsuda, Yasufumi; Tai, Katsunori; Kishi, Shinji; Yoshida, Akira; Iwasaki, Hiromichi; Nakamura, Toru; Ueda, Takanori

2014-12-01

Tumor lysis syndrome (TLS) is a life-threatening oncological emergency, and control of serum uric acid level (S-UA) is most important. In this single-institution, short-term and pilot prospective study, the efficacy of a new xanthine oxidase inhibitor, febuxostat, as an alternative to conventional allopurinol, including its effects on hypoxanthine and xanthine, was evaluated in 10 consecutive patients with hematological malignancies at intermediate risk for TLS. Febuxostat at 40 mg (n=7) or 60 mg (n=3) daily was administered according to renal function, and induction chemotherapy was started within 24 h. The primary end-point was the reduction of S-UA to ≤ 7.5 mg/dl by day 5. The median S-UA at base-line was 8.0 mg/dl (range=3.2-10.6 mg/dl). The median S-UA on day 5 after chemotherapy was 3.3 mg/dl (range=1.1-5.8 mg/dl) (p<0.0001, by paired t-test), indicating successful control of S-UA during chemotherapy. All patients achieved S-UA ≤ 7.5 mg/dl. A simultaneous decrease in serum creatinine and increase in estimated glomerular filtration rate were seen. Serum hypoxanthine and xanthine levels (as the consequence of inhibition of xanthine oxidase) were elevated along with the decrease in S-UA. Xanthine level was elevated higher compared to hypoxanthine level and reached the level reported to cause xanthine nephropathy, but no advance of renal impairment was observed. Serum febuxostat concentrations at 2 h after administration were 891.8 ± 285.0 ng/ml (mean ± SE) for the 40-mg dose and 770.6 ± 242.7 ng/ml for the 60-mg dose (p=0.80, unpaired t-test), showing no accumulation in patients with renal impairment. No febuxostat-related adverse reactions were noted. No patients experienced progressive TLS. Febuxostat is promising for the management of TLS of an intermediate-risk patient and further observation and reevaluation regarding xanthine nephropathy should be performed. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Is Routine Pathologic Evaluation of Sebaceous Cysts Necessary?: A 15-Year Retrospective Review of a Single Institution.

PubMed

Gargya, Vipul; Lucas, Heather D; Wendel Spiczka, Amy J; Mahabir, Raman Chaos

2017-02-01

A question arose in our practice of whether all cysts considered sebaceous should be sent for pathologic evaluation. To address this controversial topic, we performed a retrospective study of our single institution's histopathology database. A natural language search of the CoPath database across the institution was undertaken using the diagnosis of sebaceous cyst, epidermal cyst, epidermoid cyst, epithelial cyst, infundibular cyst, pilar cyst, trichilemmal cyst, and steatocystoma. A surgical pathologic review of all specimens with one of these preexcision diagnoses was included in the 15-year retrospective study of 1998 to 2013. All slides were confirmed to have undergone histopathologic review, and the preexcision diagnoses were compared with the postexcision diagnoses. Chart review was undertaken in instances of a diagnosis of malignancy. A total of 13,746 samples were identified. Forty-eight specimens had histopathologic diagnosis of malignancy, for an incidence of 0.3% and with the most common malignancy being squamous cell carcinoma. Chart review showed that for all cases, the surgeons reported uncertainty with regard to the diagnosis because of history or physical characteristics, or both. In addition, a comprehensive literature review showed results consistent with our data and illustrated 19 cases during the past 10 years in which most of the findings were squamous cell carcinoma. We propose the recommendation that routine pathologic evaluation of sebaceous cysts is necessary only when clinical suspicion exists.

Pasteur Institute of Iran--an evaluation model.

PubMed

Dejman, Masoumeh; Habibi, Elham; Baradarn Eftekhari, Monir; Falahat, Katayoun; Malekafzali, Hossein

2014-07-01

Pasteur Institute of Iran was established in 1919 with the aim to produce vaccines and prevent communicable diseases in Iran. Over time, their activities extended into areas of research, education and services. Naturally, such a vast development begs establishment of a comprehensive management and monitoring system. With this outlook, the present study was carried out with the aim to design a performance assessment model for Pasteur Institute of Iran that, in addition to determining evaluation indicators, it could prepare the necessary grounds for providing a unified assessment model for the global network of the Pasteur Institutes. This study was designed and performed in 4 stages: first; design of indicators and determining their scores. Second; editing indicators according to the outcome of discussions and debates held with members of Research Council of Pasteur Institute of Iran. Third; implementation of a pilot model based on the Institute's activities in 2011. Fourth; providing the pilot model feedback to the stakeholders and finalizing the model according to an opinion survey. Based on the results obtained, the developed indicators for Pasteur Institute of Iran evaluation were designed in 10 axes and 18 sub-axes, which included 101 major and 58 minor indicators. The axes included governance and leadership, resources and facilities, capacity building, knowledge production and collaborations, reference services, economic value of products and services, participation in industrial exhibitions, status of the institute, satisfaction and institute's role in health promotion. The indicators presented in this article have been prepared based on the balance in the Institute's four missions, to provide the basis for assessment of the Institute's activities in consecutive years, and possibility of comparison with other institutes worldwide.

Predicting In-State Workforce Retention After Graduate Medical Education Training.

PubMed

Koehler, Tracy J; Goodfellow, Jaclyn; Davis, Alan T; Spybrook, Jessaca; vanSchagen, John E; Schuh, Lori

2017-02-01

There is a paucity of literature when it comes to identifying predictors of in-state retention of graduate medical education (GME) graduates, such as the demographic and educational characteristics of these physicians. The purpose was to use demographic and educational predictors to identify graduates from a single Michigan GME sponsoring institution, who are also likely to practice medicine in Michigan post-GME training. We included all residents and fellows who graduated between 2000 and 2014 from 1 of 18 GME programs at a Michigan-based sponsoring institution. Predictor variables identified by logistic regression with cross-validation were used to create a scoring tool to determine the likelihood of a GME graduate to practice medicine in the same state post-GME training. A 6-variable model, which included 714 observations, was identified. The predictor variables were birth state, program type (primary care versus non-primary care), undergraduate degree location, medical school location, state in which GME training was completed, and marital status. The positive likelihood ratio (+LR) for the scoring tool was 5.31, while the negative likelihood ratio (-LR) was 0.46, with an accuracy of 74%. The +LR indicates that the scoring tool was useful in predicting whether graduates who trained in a Michigan-based GME sponsoring institution were likely to practice medicine in Michigan following training. Other institutions could use these techniques to identify key information that could help pinpoint matriculating residents/fellows likely to practice medicine within the state in which they completed their training.

Differentiation of Recurrent Glioblastoma from Delayed Radiation Necrosis by Using Voxel-based Multiparametric Analysis of MR Imaging Data.

PubMed

Yoon, Ra Gyoung; Kim, Ho Sung; Koh, Myeong Ju; Shim, Woo Hyun; Jung, Seung Chai; Kim, Sang Joon; Kim, Jeong Hoon

2017-10-01

Purpose To assess a volume-weighted voxel-based multiparametric (MP) clustering method as an imaging biomarker to differentiate recurrent glioblastoma from delayed radiation necrosis. Materials and Methods The institutional review board approved this retrospective study and waived the informed consent requirement. Seventy-five patients with pathologic analysis-confirmed recurrent glioblastoma (n = 42) or radiation necrosis (n = 33) who presented with enlarged contrast material-enhanced lesions at magnetic resonance (MR) imaging after they completed concurrent chemotherapy and radiation therapy were enrolled. The diagnostic performance of the total MP cluster score was determined by using the area under the receiver operating characteristic curve (AUC) with cross-validation and compared with those of single parameter measurements (10% histogram cutoffs of apparent diffusion coefficient [ADC10] or 90% histogram cutoffs of normalized cerebral blood volume and initial time-signal intensity AUC). Results Receiver operating characteristic curve analysis showed that an AUC for differentiating recurrent glioblastoma from delayed radiation necrosis was highest in the total MP cluster score and lowest for ADC10 for both readers. The total MP cluster score had significantly better diagnostic accuracy than any single parameter (corrected P = .001-.039 for reader 1; corrected P = .005-.041 for reader 2). The total MP cluster score was the best predictor of recurrent glioblastoma (cross-validated AUCs, 0.942-0.946 for both readers), with a sensitivity of 95.2% for reader 1 and 97.6% for reader 2. Conclusion Quantitative analysis with volume-weighted voxel-based MP clustering appears to be superior to the use of single imaging parameters to differentiate recurrent glioblastoma from delayed radiation necrosis. © RSNA, 2017 Online supplemental material is available for this article.

A newly identified calculation discrepancy of the Sunset semi-continuous carbon analyzer

NASA Astrophysics Data System (ADS)

Zheng, G. J.; Cheng, Y.; He, K. B.; Duan, F. K.; Ma, Y. L.

2014-07-01

The Sunset semi-continuous carbon analyzer (SCCA) is an instrument widely used for carbonaceous aerosol measurement. Despite previous validation work, in this study we identified a new type of SCCA calculation discrepancy caused by the default multipoint baseline correction method. When exceeding a certain threshold carbon load, multipoint correction could cause significant total carbon (TC) underestimation. This calculation discrepancy was characterized for both sucrose and ambient samples, with two protocols based on IMPROVE (Interagency Monitoring of PROtected Visual Environments) (i.e., IMPshort and IMPlong) and one NIOSH (National Institute for Occupational Safety and Health)-like protocol (rtNIOSH). For ambient samples, the IMPshort, IMPlong and rtNIOSH protocol underestimated 22, 36 and 12% of TC, respectively, with the corresponding threshold being ~ 0, 20 and 25 μgC. For sucrose, however, such discrepancy was observed only with the IMPshort protocol, indicating the need of more refractory SCCA calibration substance. Although the calculation discrepancy could be largely reduced by the single-point baseline correction method, the instrumental blanks of single-point method were higher. The correction method proposed was to use multipoint-corrected data when below the determined threshold, and use single-point results when beyond that threshold. The effectiveness of this correction method was supported by correlation with optical data.

Investigation of air transportation technology at Princeton University, 1988-1989

NASA Technical Reports Server (NTRS)

Stengel, Robert F.

1990-01-01

The Air Transportation Technology Program at Princeton University, a program emphasizing graduate and undergraduate student research, proceeded along several avenues during the past year. A study of optimal trajectories for penetration of microbursts when encounter is unavoidable was conducted. The emphasis of current wind shear research is on developing an expert system for wind shear avoidance. A knowledge-based reconfigurable flight control system that is implemented with the Pascal programming language using parallel microprocessors was developed. This expert system could be considered a prototype for a failure-tolerant control system that can be constructed using existing hardware. Development of a real-time cockpit simulator continued during the year. The simulator provides a single-person crew station with both conventional and advanced control devices; it currently is programmed to simulate the Navion single-engine general aviation airplane. Alternatives for the air traffic control system giving particular attention to the institutional structure of the FAA are analyzed. A simple numerical procedure for estimating the stochastic robustness of control systems is being investigated. The revitalization of the general aviation industry is also discussed.

Indexing and retrieving DICOM data in disperse and unstructured archives.

PubMed

Costa, Carlos; Freitas, Filipe; Pereira, Marco; Silva, Augusto; Oliveira, José L

2009-01-01

This paper proposes an indexing and retrieval solution to gather information from distributed DICOM documents by allowing searches and access to the virtual data repository using a Google-like process. The medical imaging modalities are becoming more powerful and less expensive. The result is the proliferation of equipment acquisition by imaging centers, including the small ones. With this dispersion of data, it is not easy to take advantage of all the information that can be retrieved from these studies. Furthermore, many of these small centers do not have large enough requirements to justify the acquisition of a traditional PACS. A peer-to-peer PACS platform to index and query DICOM files over a set of distributed repositories that are logically viewed as a single federated unit. The solution is based on a public domain document-indexing engine and extends traditional PACS query and retrieval mechanisms. This proposal deals well with complex searching requirements, from a single desktop environment to distributed scenarios. The solution performance and robustness were demonstrated in trials. The characteristics of presented PACS platform make it particularly important for small institutions, including educational and research groups.

Feminisms at the Door: Gender and Sex at a Women's College

ERIC Educational Resources Information Center

Overton, Susan Chappell

2013-01-01

This dissertation is a qualitative study of early 21st century American female college students' experiences of their gender, sexuality, and racial identities, and of institutional politics as their single-sex college transitioned to co-education. It is an ethnography that utilizes feminist theorizing to understand tensions between feminists…

Identities, Education and Reentry (Part One of Two): Identities and Performative Spaces

ERIC Educational Resources Information Center

Wright, Randall

2014-01-01

This is part one of a two-part interdisciplinary paper that examines the various forces (discourses and institutional processes) that shape prisoner-student identities. Discourses of officers from a correctional website serve as a limited, single case study of discourses that ascribe dehumanized, stigmatized identities to "the prisoner."…

Do Diversity Experiences Help College Students Become More Civically Minded? Applying Banks' Multicultural Education Framework

ERIC Educational Resources Information Center

Cole, Darnell; Zhou, Ji

2014-01-01

In this longitudinal, single institution study, we utilized Banks' five dimensions of multicultural education framework to examine whether and to what extent involvement in various diversity experiences helped students become more civically minded. The findings suggested that greater involvement in service learning, multicultural courses,…

Development of Independence among Future Primary School Teachers by Applying Interactive Learning Methods

ERIC Educational Resources Information Center

Rotova, Natalia Alexandrovna

2018-01-01

The necessity to develop independence among future primary school teachers during the process of studying in higher education institutions is substantiated. The essentials of independence notion are disclosed as efforts of students aimed at reaching the goals single-handedly. The results of the ascertaining experiment on defining the level of…

Sustainability: Perspectives of Students as Stakeholders in the Curriculum

ERIC Educational Resources Information Center

Hiser, Krista Karyn

2012-01-01

Institutions of higher education are increasingly engaged in sustainability efforts, both in classrooms and on the campus. Yet, little is known about what students really know and believe about sustainability issues. Using Lattuca and Stark's (2009) curricular frame and a single case study approach, this research explored student and non-student…

Redefining Roles and Responsibilities: Implementing a Triage Reference Model at a Single Service Point

ERIC Educational Resources Information Center

LaMagna, Michael; Hartman-Caverly, Sarah; Marchetti, Lori

2016-01-01

As academic institutions continue to renovate and remodel existing libraries to include colocated services, it is important to understand how this new environment requires the redefining of traditional library roles and responsibilities. This case study examines how Delaware County Community College redefined reference and research service by…

Female Students and Denominational Affiliation: Sources of Success and Variation among Nineteenth-Century Academies.

ERIC Educational Resources Information Center

Beadie, Nancy

1999-01-01

Studies the institutional characteristics and strategic choices of successful academies operating under the New York Regents system from 1838 to 1850. Identifies single-sex education and denominational affiliation as important for success. Suggests frameworks for investigating variations among the 19th-century academies and discusses implications…

Language of Evaluation: How PLA Evaluators Write about Student Learning

ERIC Educational Resources Information Center

Travers, Nan L.; Smith, Bernard; Ellis, Leslie; Brady, Tom; Feldman, Liza; Hakim, Kameyla; Onta, Bhuwan; Panayotou, Maria; Seamans, Laurie; Treadwell, Amanda

2011-01-01

Very few studies (e.g., Arnold, 1998; Joosten-ten Brinke, et al., 2009) have examined the ways in which evaluators assess students' prior learning. This investigation explored the ways that evaluators described students' prior learning in final assessment reports at a single, multiple-location institution. Results found four themes; audience,…

A Survey of Speech Programs in Community Colleges.

ERIC Educational Resources Information Center

Meyer, Arthur C.

The rapid growth of community colleges in the last decade resulted in large numbers of students enrolled in programs previously unavailable to them in a single comprehensive institution. The purpose of this study was to gather and analyze data to provide information about the speech programs that community colleges created or expanded as a result…

The Impact of Culture on Filipino American Students' Sense of Belonging

ERIC Educational Resources Information Center

Museus, Samuel D.; Maramba, Dina C.

2011-01-01

The purpose of this study was to examine the influence of cultural factors on Filipino American students' sense of belonging in college. The authors utilized structural equation modeling techniques to analyze a single-institution sample of 143 Filipino American undergraduates and estimate the impact of pressure to commit "cultural…

Are Cancer Survivors/Patients Knowledgeable about Osteoporosis? Results from a Survey of 285 Chemotherapy-Treated Cancer Patients and Their Companions

ERIC Educational Resources Information Center

McKean, Heidi; Looker, Sherry; Hartmann, Lynn C.; Hayman, Suzanne R.; Kaur, Judith S.; McWilliams, Robert R.; Peethambaram, Prema P.; Stahl, Jean F.; Jatoi, Aminah

2008-01-01

Objective: This study assessed osteoporosis knowledge deficits among cancer patients and their spouses/partners. Design: Single-institution survey (modified version of the Osteoporosis Knowledge Assessment Tool). Setting: The Mayo Clinic in Rochester, Minnesota. Participants: Consecutive chemotherapy-treated cancer patients (n = 285) with their…

Foregrounding Women in the Doctoral Classroom: Mainstreaming and Single-Sex Approaches to Graduate Education

ERIC Educational Resources Information Center

Dzubinski, Leanne

2018-01-01

An increasing number of published studies have drawn attention to gender disparities in various dimensions of Christian higher education. Although the majority of students on the campuses of member institutions of the Council for Christian Colleges & Universities (CCCU) are women, and the percentage of women holding faculty and administrative…

Dysplastic nevi with severe atypia: Long-term outcomes in patients with and without re-excision.

PubMed

Engeln, Kathleen; Peters, Kaitlin; Ho, Jonhan; Jedrych, Jaroslaw; Winger, Daniel; Ferris, Laura Korb; Patton, Timothy

2017-02-01

Dysplastic nevi with severe atypia (severely dysplastic nevi [SDN]) are frequently re-excised because of the concern that these lesions may in fact represent early melanoma. Data on long-term follow-up of these patients are limited. We sought to determine the rate of subsequent melanoma development in patients with SDN who underwent re-excision versus those who did not and to determine factors associated with decision to re-excise. A retrospective single institutional study was conducted with 451 adult patients (mean age 41.3 years) with SDN biopsied between November 1994 and November 2004, with clinical follow-up of at least 5 years. In 451 patients with SDN, re-excision was performed on 36.6%. Two melanomas were diagnosed in the re-excision specimens. Subsequent metastatic melanoma developed in 7 patients, all of whom had a history of melanoma. Margin comments influenced decision to re-excise. This was a retrospective study at a single institution. Re-excision of all SDN may not be necessary. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Handwashing compliance.

PubMed

Antoniak, Jeannie

2004-09-01

Undeniably, handwashing remains the single most effective and cost-efficient method for preventing and reducing the transmission of nosocomial infections. Yet the rates and outbreaks of nosocomial infections in Canadian and international healthcare institutions continue to increase. Shaikh Khalifa Medical Center developed and implemented a multidisciplinary approach to address the challenges of handwashing compliance among nurses and healthcare workers in its workplace setting. Supported by evidence-based research, the approach consisted of three components: collaboration, implementation and evaluation. The use of the alcohol-based hand rub sanitizer or "solution" was integral to the multidisciplinary approach. Ongoing education, communication and a committed leadership were essential to promote and sustain handwashing compliance.

Developing Mentoring Competency: Does a One Session Training Workshop Have Impact?

PubMed

Lau, Chloe; Ford, Jennifer; Van Lieshout, Ryan J; Saperson, Karen; McConnell, Meghan; McCabe, Randi

2016-06-01

Mentorship remains vital to the career development, research productivity, and professional advancement of healthcare professionals in all disciplines of academic medicine. Recent studies describe mentor training initiatives aimed at increasing mentoring competency through multisession training curricula. Although the published results of these programs are promising, they require the following: (1) substantial financial resources from the institution, and (2) continuous participation and time commitment from faculty, which may reduce participation and effectiveness. A single, half-day of evidence-based mentor training would represent a more cost-effective and accessible option for educating mentors. The present study investigates the impact of a half-day interactive mentor training workshop on mentoring competency in faculty, staff, and trainees of the Department of Psychiatry and Behavioural Neurosciences at McMaster University. Overall, participants' self-reported mentoring competency mean scores were significantly higher post-workshop compared to pre-workshop ratings [mean = 4.48 vs. 5.02 pre- and post-workshop, respectively; F(1, 31) = 18.386, P < 0.001, η p2 = 0.37]. Survey respondents gave positive feedback and reported greater understanding of mentorship and specific mentoring changes they planned to apply after attending the workshop. Academic and healthcare institutions may use this framework to guide the development of a half-day mentoring workshop into their education programs.

Noncredit Activities in Institutions of Higher Education, 1967-68, Institutional Distribution.

ERIC Educational Resources Information Center

Kemp, Florence B.

Of 2336 institutions of higher education queried on the distribution of noncredit activities in 1967-68, 1102 responded affirmatively. The bulk of this study is comprised of tables and charts based upon information received from these institutions. Highlights are summarized. A questionnaire, which is appended, was used to gather data. Some of the…

Array-based comparative genomic hybridization in 190 Korean patients with developmental delay and/or intellectual disability: a single tertiary care university center study.

PubMed

Lee, Cha Gon; Park, Sang-Jin; Yun, Jun-No; Ko, Jung Min; Kim, Hyon-Ju; Yim, Shin-Young; Sohn, Young Bae

2013-11-01

This study analyzed and evaluated the demographic, clinical, and cytogenetic data [G-banded karyotyping and array-based comparative genomic hybridization (array CGH)] of patients with unexplained developmental delay or intellectual disability at a single Korean institution. We collected clinical and cytogenetic data based on retrospective charts at Ajou University Medical Center, Suwon, Korea from April 2008 to March 2012. A total of 190 patients were identified. Mean age was 5.1±1.87 years. Array CGH yielded abnormal results in 26 of 190 patients (13.7%). Copy number losses were about two-fold more frequent than gains. A total of 61.5% of all patients had copy number losses. The most common deletion disorders included 22q11.2 deletion syndrome, 15q11.2q12 deletion and 18q deletion syndrome. Copy number gains were identified in 34.6% of patients, and common diseases among these included Potocki-Lupski syndrome, 15q11-13 duplication syndrome and duplication 22q. Abnormal karyotype with normal array CGH results was exhibited in 2.6% of patients; theses included balanced translocation (n=2), inversion (n=2) and low-level mosaicism (n=1). Facial abnormalities (p<0.001) and failure to thrive were (p<0.001) also more frequent in the group of patients with abnormal CGH findings. Array CGH is a useful diagnostic tool in clinical settings in patients with developmental delay or intellectual disability combined with facial abnormalities or failure to thrive.

Combined Utility/Transportation Tunnel Systems - Economic, Technical and Institutional Feasibility

DOT National Transportation Integrated Search

1976-07-01

Although utility tunnels are common in Europe and Asia, United States use is largely confined to institutions where all utilities are under single ownership. Cut-and-cover transportation projects appear to display nearly ideal conditions for the use ...

Effectiveness of a Model Bundle Payment Initiative for Femur Fracture Patients.

PubMed

Lott, Ariana; Belayneh, Rebekah; Haglin, Jack; Konda, Sanjit; Egol, Kenneth A

2018-05-28

Analyze the effectiveness of a BPCI (Bundle Payments for Care Improvement) initiative for patients who would be included in a future potential Surgical Hip and Femur Fracture Treatment (SHFFT) bundle. Retrospective cohort SETTING:: Single Academic Institution PATIENTS/PARTICIPANTS:: Patients discharged with operative fixation of a hip or femur fracture (DRG codes 480-482) between 1/2015-10/2016 were included. A BPCI initiative based upon an established program for BPCI Total Joint Arthroplasty (TJA) was initiated for patients with hip and femur fractures in January 2016. Patients were divided into non-bundle (care before initiative) and bundle (care with initiative) cohorts. Application of BPCI principles MAIN OUTCOME MEASURES:: Length of stay, location of discharge, readmissions RESULTS:: 116 patients participated in the "institutional bundle," and 126 received care prior to the initiative. There was a trend towards decreased mean length of stay, (7.3 ± 6.3 days vs. 6.8 ± 4.0 days, p=0.457) and decreased readmission within 90 days (22.2% vs. 18.1%, p=0.426). The number of patients discharged home doubled (30.2% vs. 14.3%, p=0.008). There was no difference in readmission rates in bundle vs. non-bundle patients based on discharged home status; however, bundle patients discharged to SNF trended towards less readmissions than non-bundle patients discharged to SNF (37.3% vs. 50.6%, p=0.402). Mean episode cost reduction due to initiative was estimated to be $6,450 using Medicare reimbursement data. This study demonstrates the potential success of a BPCI initiative at one institution in decreasing post-acute care facility utilization and cost of care when used for a hip and femur fracture population. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Empowering Students through Project-Based Learning: Perceptions of Instructors and Students in Vocational Education Institutes in Thailand

ERIC Educational Resources Information Center

Tongsakul, Anuvat; Jitgarun, Kalayanee; Chaokumnerd, Weerachai

2011-01-01

The purpose of this study was to identify and compare instructors' and students' perceptions of factors that contribute to the effective use of Project-Based Learning (PBL) in Thailand. The sample for the study consisted of 247 electrical technology instructors from Thai vocational education institutes and 161 students who were electrical power…

Effects of an Incentive Based Budgeting System on Institutional Performance Indicators: An Exploratory Longitudinal Case Study of a Public University

ERIC Educational Resources Information Center

Willett, Michael S.

2013-01-01

The purpose of this exploratory longitudinal case study was to examine how the implementation of an Incentive Based Budgeting (IBB) system (i.e., Responsibility-Centered Management [RCM]) affected selected institutional performance indicators at the campus level and two comparable schools at a large Mid-Western public University. The value of…

Child violence experiences in institutionalised/orphanage care.

PubMed

Sherr, Lorraine; Roberts, Kathryn J; Gandhi, Natasha

2017-03-01

Institutions are not necessarily good environments for children. In the face of challenges such as HIV, Ebola, poverty, conflict and disaster the numbers have grown rather than reduced. Some countries have closed institutions down -driven by findings that cognitive developmental delay is associated with institutional care. Yet insight into abuse and violence within institutionalised settings is neglected. Maltreatment -violence and abuse -may be an issue. This systematic review series addresses violence and abuse experiences in institutionalised care, exploring firstly the frequency of abuse/violence in institutions, secondly any interventions to reduce such violence or abuse and thirdly the perpetrators of such violence or abuse. The final systematic review updates the findings on cognitive delay associated with institutionalised care. With a violence lens, cognitive delay may well be considered under the umbrella of neglect. Maltreatment and abuse may be a driver of cognitive delay. The keyword search covered several electronic databases and studies were included for data abstraction if they met adequacy criteria. Eight studies were identified on the prevalence of abuse in institutions and a further three studies reported on interventions. Only one study was identified documenting peer on peer violence in institutions. Sixty-six studies were identified examining cognitive development for institutionalised children. All but two of these record cognitive deficits associated with institutionalisation. Only two asked about violence or abuse which was found to be higher in institutionalised children. Overall the abuse experiences of children in institutions are poorly recorded, and in one study violence was associated with high suicidal attempts. The major intervention pathway for ameliorating cognitive challenge seems to be placement out of the institutions which shows benefits and redresses some cognitive outcomes - yet not a total panacea. The single study providing training and monitoring of harsh punishment and maltreatment showed immediate and decided reductions. This data suggest, despite the paucity of studies, violence and abuse, by commission or omission is prevalent in institutions, has an effect on child well-being and is amenable to intervention. Simple training or more complex structures to place children within conducive alternative environments (or to avoid institutionalised placements in the first place) seem to be the main pathway of intervention.

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

Wu, C

Purpose: To implement a novel, automatic, institutional customizable DVH quantities evaluation and PDF report tool on Philips Pinnacle treatment planning system (TPS) Methods: An add-on program (P3DVHStats) is developed by us to enable automatic DVH quantities evaluation (including both volume and dose based quantities, such as V98, V100, D2), and automatic PDF format report generation, for EMR convenience. The implementation is based on a combination of Philips Pinnacle scripting tool and Java language pre-installed on each Pinnacle Sun Solaris workstation. A single Pinnacle script provide user a convenient access to the program when needed. The activated script will first exportmore » DVH data for user selected ROIs from current Pinnacle plan trial; a Java program then provides a simple GUI interface, utilizes the data to compute any user requested DVH quantities, compare with preset institutional DVH planning goals; if accepted by users, the program will also generate a PDF report of the results and export it from Pinnacle to EMR import folder via FTP. Results: The program was tested thoroughly and has been released for clinical use at our institution (Pinnacle Enterprise server with both thin clients and P3PC access), for all dosimetry and physics staff, with excellent feedback. It used to take a few minutes to use MS-Excel worksheet to calculate these DVH quantities for IMRT/VMAT plans, and manually save them as PDF report; with the new program, it literally takes a few mouse clicks in less than 30 seconds to complete the same tasks. Conclusion: A Pinnacle scripting and Java language based program is successfully implemented, customized to our institutional needs. It is shown to dramatically reduce time and effort needed for DVH quantities computing and EMR reporting.« less

Risk-Based Immunization Policies and Tuberculosis Screening Practices for Animal Care and Research Workers in the United States: Survey Results and Recommendations

PubMed Central

Weigler, Benjamin J; Cooper, Donna R; Hankenson, F Claire

2012-01-01

A national survey was conducted to assess immunization practices and tuberculosis screening methods for animal care and research workers in biomedical settings throughout the United States. Veterinarians (n = 953) were surveyed via a web-based mechanism; completed surveys (n = 308) were analyzed. Results showed that occupational health and safety programs were well-developed, enrolling veterinary, husbandry, and research staff at rates exceeding 90% and involving multiple modalities of health assessments and risk communication for vaccine-preventable diseases. Most (72.7%) institutions did not store serum samples from animal research personnel. More than half of the institutions housed nonhuman primates and maintained tuberculosis screening programs, although screening methods varied. Immunization protocols included various recommended or required vaccines that differed depending on job duties, type of institution, and nature of scientific programs. A single case of an identified vaccine–preventable illness in a laboratory worker was noted. Tetanus toxoid was the predominant vaccine administered (91.7%) to animal care and research workers, followed by hepatitis B (54.8%), influenza (39.9%), and rabies (38.3%). For some immunization protocols, an inconsistent rationale for administration was evident. Indications that animal care and research workers are unprotected from work-related etiologic agents did not emerge from this survey; rather, existing guidelines from the Advisory Committee on Immunization Practices and available biologics seem sufficient to address most needs of the laboratory animal research community. Institutions should commit to performance-based standards in parallel with context-specific risk assessment methods to maintain occupational health and safety programs and practices appropriate to their needs. PMID:23312084

A Review of Propulsion Industrial Base Studies and an Introduction to the National Institute of Rocket Propulsion Systems

NASA Technical Reports Server (NTRS)

Doreswamy, Rajiv; Fry, Emma K.

2012-01-01

Over the past decade there have been over 40 studies that have examined the state of the industrial base and infrastructure that supports propulsion systems development in the United States. This paper offers a comprehensive, systematic review of these studies and develops conclusions and recommendations in the areas of budget, policy, sustainment, infrastructure, workforce retention and development and mission/vision and policy. The National Institute for Rocket Propulsion System (NIRPS) is a coordinated, national organization that is responding to the key issues highlighted in these studies. The paper outlines the case for NIRPS and the specific actions that the Institute is taking to address these issues.

34 CFR 425.3 - What activities may the Secretary fund?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Vocational students at postsecondary institutions; (4) Individuals enrolled in adult programs; or (5) Single parents, displaced homemakers, and single pregnant women. (Authority: 20 U.S.C. 2420(a), (b)(3) and (4)) ...

Inter-rater Agreement of End-of-shift Evaluations Based on a Single Encounter

PubMed Central

Warrington, Steven; Beeson, Michael; Bradford, Amber

2017-01-01

Introduction End-of-shift evaluation (ESE) forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms. Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation. Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM) educators. Methods Following institutional review board exemption, we created a scripted video simulating an encounter between an intern and a patient with an ankle injury. That video was shown during a lecture at the Council of EM Residency Director’s Academic Assembly with attendees asked to evaluate the “resident” using one of eight possible ESE forms randomly distributed. Descriptive statistics were used to analyze the results with Fleiss’ kappa to evaluate inter-rater agreement. Results Most of the 324 respondents were leadership in residency programs (66%), with a range of 29–47 responses per evaluation form. Few individuals (5%) felt they were experts in assessing residents based on EM milestones. Fleiss’ kappa ranged from 0.157 – 0.308 and did not perform much better in two post-hoc subgroup analyses. Conclusion The kappa ranges found show only slight to fair inter-rater agreement and raise concerns about the use of ESE forms in assessment of EM residents. Despite limitations present in this study, these results and a lack of other studies on inter-rater agreement of encounter cards should prompt further studies of such methods of assessment. Additionally, EM educators should focus research on methods to improve inter-rater agreement of ESE forms or other evaluating other methods of assessment of EM residents. PMID:28435505

Does ASA classification impact success rates of endovascular aneurysm repairs?

PubMed

Conners, Michael S; Tonnessen, Britt H; Sternbergh, W Charles; Carter, Glen; Yoselevitz, Moises; Money, Samuel R

2002-09-01

The purpose of this study was to evaluate the technical success, clinical success, postoperative complication rate, need for a secondary procedure, and mortality rate with endovascular aneurysm repair (EAR), based on the physical status classification scheme advocated by the American Society of Anesthesiologists (ASA). At a single institution 167 patients underwent attempted EAR. Query of a prospectively maintained database supplemented with a retrospective review of medical records was used to gather statistics pertaining to patient demographics and outcome. In patients selected for EAR on the basis of acceptable anatomy, technical and clinical success rates were not significantly different among the different ASA classifications. Importantly, postoperative complication and 30-day mortality rates do not appear to significantly differ among the different ASA classifications in this patient population.

Respiratory health and disease in a UK population-based cohort of 85 year olds: The Newcastle 85+ Study

PubMed Central

Fisher, Andrew J; Yadegarfar, Mohammad E; Collerton, Joanna; Small, Therese; Kirkwood, Thomas B L; Davies, Karen; Jagger, Carol; Corris, Paul A

2016-01-01

Background People aged 85 years and older are the fastest growing age group worldwide. This study assessed respiratory health, prevalence of respiratory disease and use of spirometry in respiratory diagnosis in a population-based cohort of 85 year olds to better understand respiratory health and disease in this sector of society. Methods A single year birth-cohort of 85 year olds participated in a respiratory assessment at their home or residential institution including self-reporting of symptoms and measurement of spirometry. General practice medical records were reviewed for respiratory diagnoses and treatments. Findings In the 845 participants, a substantial burden of respiratory disease was seen with a prevalence of COPD in medical records of 16.6% (n=140). A large proportion of the cohort had environmental exposures through past or current smoking (64.2%, n=539) and occupational risk factors (33.6%, n=269). Spirometry meeting reliability criteria was performed in 87% (n=737) of participants. In the subgroup with a diagnosis of COPD (n=123), only 75.6% (n=93) satisfied Global Initiative in Obstructive Lung Disease (GOLD) criteria for airflow obstruction, and in a healthy subgroup without respiratory symptoms or diagnoses (n=151), 44.4% (n=67) reached GOLD criteria for airflow obstruction and 43.3% (n=29) National Institute of Health and Care Excellence criteria for at least moderate COPD. Interpretation Spirometry can be successfully performed in the very old, aged 85 years, and may help identify respiratory diseases such as COPD. However interpretation in this age group using current definitions of COPD based on spirometry indices may be difficult and lead to overdiagnosis in a healthy group with transient symptoms. PMID:26732736

Pertuzumab for the Neoadjuvant Treatment of Early-Stage HER2-Positive Breast Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

PubMed

Squires, Hazel; Pandor, Abdullah; Thokala, Praveen; Stevens, John W; Kaltenthaler, Eva; Clowes, Mark; Coleman, Robert; Wyld, Lynda

2018-01-01

As part of its single technology appraisal process, the National Institute for Health and Care Excellence invited the manufacturer of pertuzumab (Perjeta ® ; Roche Products Limited) to submit evidence of its clinical and cost- effectiveness for the neoadjuvant treatment of women with high-risk, early-stage, HER2-positive breast cancer when used in combination with trastuzumab and chemotherapy. High-risk women included those with locally advanced (including inflammatory) breast cancer and women with high-risk early-stage breast cancer (classified as T2/3 or N1). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group. This article presents the critical review of the company's submission by the Evidence Review Group and the outcome of the National Institute for Health and Care Excellence guidance. The clinical data were mainly taken from a phase II, randomised, open-label, active controlled study (NeoSphere), which reported a significant advantage in terms of pathological complete response rates of pertuzumab in combination with trastuzumab and chemotherapy, compared with trastuzumab alone with chemotherapy (45.8 vs. 29.0%, p = 0.0141). The company did not make any indirect comparisons. A meta-analysis of 12 neoadjuvant studies investigating the relationship between pathological complete response and event-free survival was used to extrapolate the outcomes reported in the NeoSphere study. A cardiac safety study (TRYPHAENA) demonstrated the safety of pertuzumab. The company undertook a model-based economic evaluation of neoadjuvant pertuzumab plus trastuzumab and docetaxel compared with neoadjuvant trastuzumab and docetaxel over a lifetime horizon from the National Health Service and Personal Social Services perspective. The probabilistic incremental cost-effectiveness ratio was estimated to be £20,104 per quality-adjusted life-year gained for pertuzumab alongside trastuzumab and docetaxel compared with trastuzumab and docetaxel, which was revised to £21,869 per quality-adjusted life-year gained following the clarification process. The Evidence Review Group corrected an error in the digitisation of the survivor functions and modified the clinically inappropriate assumption that recurrence is zero after 7 years. The Evidence Review Group's probabilistic base case was £23,962 per quality-adjusted life-year gained. During the appraisal, to mitigate the uncertainties associated with the evidence, the company offered a patient access scheme, which led to the National Institute for Health and Care Excellence Appraisal Committee recommending pertuzumab in this patient group, subject to the company providing the agreed discount in the patient access scheme.

Diagnosis is a team sport - partnering with allied health professionals to reduce diagnostic errors.

PubMed

Thomas, Dana B; Newman-Toker, David E

2016-06-01

Diagnostic errors are the most common, most costly, and most catastrophic of medical errors. Interdisciplinary teamwork has been shown to reduce harm from therapeutic errors, but sociocultural barriers may impact the engagement of allied health professionals (AHPs) in the diagnostic process. A qualitative case study of the experience at a single institution around involvement of an AHP in the diagnostic process for acute dizziness and vertigo. We detail five diagnostic error cases in which the input of a physical therapist was central to correct diagnosis. We further describe evolution of the sociocultural milieu at the institution as relates to AHP engagement in diagnosis. Five patients with acute vestibular symptoms were initially misdiagnosed by physicians and then correctly diagnosed based on input from a vestibular physical therapist. These included missed labyrinthine concussion and post-traumatic benign paroxysmal positional vertigo (BPPV); BPPV called gastroenteritis; BPPV called stroke; stroke called BPPV; and multiple sclerosis called BPPV. As a consequence of surfacing these diagnostic errors, initial resistance to physical therapy input to aid medical diagnosis has gradually declined, creating a more collaborative environment for 'team diagnosis' of patients with dizziness and vertigo at the institution. Barriers to AHP engagement in 'team diagnosis' include sociocultural norms that establish medical diagnosis as something reserved only for physicians. Drawing attention to the valuable diagnostic contributions of AHPs may help facilitate cultural change. Future studies should seek to measure diagnostic safety culture and then implement proven strategies to breakdown sociocultural barriers that inhibit effective teamwork and transdisciplinary diagnosis.

How Residents Develop Trust in Interns: A Multi-Institutional Mixed-Methods Study.

PubMed

Sheu, Leslie; O'Sullivan, Patricia S; Aagaard, Eva M; Tad-Y, Darlene; Harrell, Heather E; Kogan, Jennifer R; Nixon, James; Hollander, Harry; Hauer, Karen E

2016-10-01

Although residents trust interns to provide patient care, little is known about how trust forms. Using a multi-institutional mixed-methods study design, the authors interviewed (March-September 2014) internal medicine (IM) residents in their second or third postgraduate year at a single institution to address how they develop trust in interns. Transcript analysis using grounded theory yielded a model for resident trust. Authors tested (January-March 2015) the model with residents from five IM programs using a two-section quantitative survey (38 items; 31 rated 0 = not at all to 100 = very much; 7 rated 0 = strongly disagree to 100 = strongly agree) to identify influences on how residents form trust. Qualitative analysis of 29 interviews yielded 14 themes within five previously identified factors of trust (resident, intern, relationship, task, and context). Of 478 residents, 376 (78.7%) completed the survey. Factor analysis yielded 11 factors that influence trust. Respondents rated interns' characteristics (reliability, competence, and propensity to make errors) highest when indicating importance to trust (respective means 86.3 [standard deviation = 9.7], 76.4 [12.9], and 75.8 [20.0]). They also rated contextual factors highly as influencing trust (access to an electronic medical record, duty hours, and patient characteristics; respective means 79.8 [15.3], 73.1 [14.4], and 71.9 [20.0]). Residents form trust based on primarily intern- and context-specific factors. Residents appear to consider trust in a way that prioritizes interns' execution of essential patient care tasks safely within the complexities and constraints of the hospital environment.

A Retrospective Analysis Comparing the New Standardized Letter of Recommendation in Dermatology with the Classic Narrative Letter of Recommendation

PubMed Central

Mosser, Joy; Lee, Grace; Pootrakul, Llana; Harfmann, Katya; Fabbro, Stephanie; Faith, Esteban Fernandez; Carr, David; Plotner, Alisha; Zirwas, Matthew; Kaffenberger, Benjamin H.

2016-01-01

Background: In an effort to avoid numerous problems associated with narrative letters of recommendation, a dermatology standardized letter of recommendation was utilized in the 2014–2015 resident application cycle. Objective: A comparison of the standardized letter of recommendation and narrative letters of recommendation from a single institution and application cycle to determine if the standardized letter of recommendation met its original goals of efficiency, applicant stratification, and validity. Methods: Eight dermatologists assessed all standardized letters of recommendation/narrative letters of recommendation pairs received during the 2014–2015 application cycle. Five readers repeated the analysis two months later. Each letter of recommendation was evaluated based on a seven question survey. Letter analysis and survey completion for each letter was timed. Results: Compared to the narrative letters of recommendation, the standardized letter of recommendation is easier to interpret (p<0.0001), has less exaggeration of applicants’ positive traits (p<0.001), and has higher inter-rater and intrarater reliability for determining applicant traits including personality, reliability, work-ethic, and global score. Standardized letters of recommendation are also faster to interpret (p<0.0001) and provide more information about the writer’s background or writer-applicant relationship than narrative letters of recommendation (p<0.001). Limitations: This study was completed at a single institution. Conclusions: The standardized letter of recommendation appears to be meeting its initial goals of 1) efficiency, 2) applicant stratification, and 3) validity. (J Clin Aesthet Dermatol. 2016;9(9):36–2.) PMID:27878060

Dexamethasone exerts profound immunologic interference on treatment efficacy for recurrent glioblastoma

PubMed Central

Wong, E T; Lok, E; Gautam, S; Swanson, K D

2015-01-01

Background: Patients with recurrent glioblastoma have a poor outcome. Data from the phase III registration trial comparing tumour-treating alternating electric fields (TTFields) vs chemotherapy provided a unique opportunity to study dexamethasone effects on patient outcome unencumbered by the confounding immune and myeloablative side effects of chemotherapy. Methods: Using an unsupervised binary partitioning algorithm, we segregated both cohorts of the trial based on the dexamethasone dose that yielded the greatest statistical difference in overall survival (OS). The results were validated in a separate cohort treated in a single institution with TTFields and their T lymphocytes were correlated with OS. Results: Patients who used dexamethasone doses >4.1 mg per day had a significant reduction in OS when compared with those who used ⩽4.1 mg per day, 4.8 vs 11.0 months respectively (χ2=34.6, P<0.0001) in the TTField-treated cohort and 6.0 vs 8.9 months respectively (χ2=10.0, P<0.0015) in the chemotherapy-treated cohort. In a single institution validation cohort treated with TTFields, the median OS of patients who used dexamethasone >4.1 mg per day was 3.2 months compared with those who used ⩽4.1 mg per day was 8.7 months (χ2=11.1, P=0.0009). There was a significant correlation between OS and T-lymphocyte counts. Conclusions: Dexamethasone exerted profound effects on both TTFields and chemotherapy efficacy resulting in lower patient OS. Therefore, global immunosuppression by dexamethasone likely interferes with immune functions that are necessary for the treatment of glioblastoma. PMID:26125449

Institutional and Individual Autonomy: Investigating Predictors of Attitudes toward Institutional Care in China

ERIC Educational Resources Information Center

Guan, Xinping; Zhan, Heying Jenny; Liu, Guangya

2007-01-01

This study examines the institutional and attitudinal changes in elder care homes in Tianjin, China. Based on a survey conducted in 2001 with 61 elder home managers and 265 elder residents, this study examines 1) factors that influence elder home managers' views about elder home development and 2) elders' evaluation of elder home quality and their…

Bioelectrical impedance methods in clinical research: a follow-up to the NIH Technology Assessment Conference.

PubMed

Ellis, K J; Bell, S J; Chertow, G M; Chumlea, W C; Knox, T A; Kotler, D P; Lukaski, H C; Schoeller, D A

1999-01-01

In 1994, the National Institutes of Health (NIH) convened a Technology Assessment Conference "to provide physicians with a responsible assessment of bioelectrical impedance analysis (BIA) technology for body composition measurement." In 1997, Serono Symposia USA, Inc., organized an invited panel of scientists and clinicians, with extensive research and clinical experience with BIA, to provide an update. Panel members presented reviews based on their own work and published studies for the intervening years. Updates were provided on the single and multifrequency BIA methods and models; continued clinical research experiences; efforts toward establishing population reference norms; and the feasibility of establishing guidelines for potential diagnostic use of BIA in a clinical setting. This report provides a summary of the panel's findings including a consensus on several technical and clinical issues related to the research use of BIA, and those areas that are still in need of additional study.

A Phase I/II adaptive design for heterogeneous groups with application to a stereotactic body radiation therapy trial.

PubMed

Wages, Nolan A; Read, Paul W; Petroni, Gina R

2015-01-01

Dose-finding studies that aim to evaluate the safety of single agents are becoming less common, and advances in clinical research have complicated the paradigm of dose finding in oncology. A class of more complex problems, such as targeted agents, combination therapies and stratification of patients by clinical or genetic characteristics, has created the need to adapt early-phase trial design to the specific type of drug being investigated and the corresponding endpoints. In this article, we describe the implementation of an adaptive design based on a continual reassessment method for heterogeneous groups, modified to coincide with the objectives of a Phase I/II trial of stereotactic body radiation therapy in patients with painful osseous metastatic disease. Operating characteristics of the Institutional Review Board approved design are demonstrated under various possible true scenarios via simulation studies. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of Intratumoral HER-2 Heterogeneity by Fluorescence In Situ Hybridization in Invasive Breast Cancer: A Single Institution Study

PubMed Central

Lee, Sarah; Jung, Woohee; Hong, Soon-Won

2011-01-01

This study aimed to determine the incidence and characteristics of HER-2 gene heterogeneity in invasive breast cancer in a single institution. Included were 971 cases of primary invasive breast cancer diagnosed between 2008 and 2010. Fluorescence in situ hybridization (FISH) image files were retrospectively reviewed and HER-2 gene heterogeneity was defined as more than 5% but less than 50% of analyzed invasive tumor cells with a HER-2/Chr17 ratio higher than 2.2, according to the College of American Pathologists guidelines. HER-2 gene heterogeneity was identified in 24 (2.5%) cases. The mean proportion of invasive tumor cells with a HER-2/chromosome 17 ratio higher than 2.2 was 11.6% (range: 5%-25%). Of 24 cases, HER-2 gene status was not amplified in 8, showed borderline amplification in 2, and amplification in 14. All HER-2 amplification cases were low-grade. In conclusion, HER-2 gene heterogeneity of invasive breast cancer is identified in routine FISH examination. This may affect the results of HER-2 gene amplification status in FISH studies. PMID:21860549

High-resolution Spectroscopic Observations of Single Red Giants in Three Open Clusters: NGC 2360, NGC 3680, and NGC 5822

NASA Astrophysics Data System (ADS)

Peña Suárez, V. J.; Sales Silva, J. V.; Katime Santrich, O. J.; Drake, N. A.; Pereira, C. B.

2018-02-01

Single stars in open clusters with known distances are important targets in constraining the nucleosynthesis process since their ages and luminosities are also known. In this work, we analyze a sample of 29 single red giants of the open clusters NGC 2360, NGC 3680, and NGC 5822 using high-resolution spectroscopy. We obtained atmospheric parameters, abundances of the elements C, N, O, Na, Mg, Al, Ca, Si, Ti, Ni, Cr, Y, Zr, La, Ce, and Nd, as well as radial and rotational velocities. We employed the local thermodynamic equilibrium atmospheric models of Kurucz and the spectral analysis code MOOG. Rotational velocities and light-element abundances were derived using spectral synthesis. Based on our analysis of the single red giants in these three open clusters, we could compare, for the first time, their abundance pattern with that of the binary stars of the same clusters previously studied. Our results show that the abundances of both single and binary stars of the open clusters NGC 2360, NGC 3680, and NGC 5822 do not have significant differences. For the elements created by the s-process, we observed that the open clusters NGC 2360, NGC 3680, and NGC 5822 also follow the trend already raised in the literature that young clusters have higher s-process element abundances than older clusters. Finally, we observed that the three clusters of our sample exhibit a trend in the [Y/Mg]-age relation, which may indicate the ability of the [Y/Mg] ratio to be used as a clock for the giants. Based on the observations made with the 2.2 m telescope at the European Southern Observatory (La Silla, Chile) under an agreement with Observatório Nacional and under an agreement between Observatório Nacional and Max-Planck Institute für Astronomie.

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

Hoppe, Bradford S., E-mail: bhoppe@floridaproton.org; Henderson, Randal; Pham, Dat

Purpose: Proton therapy has been shown to reduce radiation dose to organs at risk (OAR) and could be used to safely escalate the radiation dose. We analyzed outcomes in a group of phase 2 study patients treated with dose-escalated proton therapy with concurrent chemotherapy for stage 3 non-small cell lung cancer (NSCLC). Methods and Materials: From 2009 through 2013, LU02, a phase 2 trial of proton therapy delivering 74 to 80 Gy at 2 Gy/fraction with concurrent chemotherapy for stage 3 NSCLC, was opened to accrual at our institution. Due to slow accrual and competing trials, the study was closed after justmore » 14 patients (stage IIIA, 9 patients; stage IIIB, 5 patients) were accrued over 4 years. During that same time period, 55 additional stage III patients were treated with high-dose proton therapy, including 7 in multi-institutional proton clinical trials, 4 not enrolled due to physician preference, and 44 who were ineligible based on strict entry criteria. An unknown number of patients were ineligible for enrollment due to insurance coverage issues and thus were treated with photon radiation. Median follow-up of surviving patients was 52 months. Results: Two-year overall survival and progression-free survival rates were 57% and 25%, respectively. Median lengths of overall survival and progression-free survival were 33 months and 14 months, respectively. There were no acute grade 3 toxicities related to proton therapy. Late grade 3 gastrointestinal toxicity and pulmonary toxicity each occurred in 1 patient. Conclusions: Dose-escalated proton therapy with concurrent chemotherapy was well tolerated with encouraging results among a small cohort of patients. Unfortunately, single-institution proton studies may be difficult to accrue and consideration for pragmatic and/or multicenter trial design should be considered when developing future proton clinical trials.« less

Estimating the Cost of a Bachelor's Degree: An Institutional Cost Analysis.

ERIC Educational Resources Information Center

To, Duc-Le

The cost of a bachelor's degree was estimated and compared for different types of institutions. The objective was to develop a single index to show how much each type of institution spends on producing a bachelor's degree graduate, and to use trend data to show how these costs will change over time. The basic concept associated with the cost of a…

Older adults' home- and community-based care service use and residential transitions: a longitudinal study.

PubMed

Chen, Ya-Mei; Berkowitz, Bobbie

2012-08-10

As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults' use of home- and community-based services and their residential transitions. The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults' residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Older adults' use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults' use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal services, were associated with different directions in residential transition, such as CIC and CII respectively. Older adults' differing HCBS use patterns may be the key to explaining older adults' transitions. Attention to older adults' HCBS use patterns is recommended for future practice. However, this was an exploratory study and the analyses cannot establish causal relationships.

Older adults’ home- and community-based care service use and residential transitions: a longitudinal study

PubMed Central

2012-01-01

Background As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults’ use of home- and community-based services and their residential transitions. Methods The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults’ residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Results Older adults’ use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults’ use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal services, were associated with different directions in residential transition, such as CIC and CII respectively. Conclusions Older adults’ differing HCBS use patterns may be the key to explaining older adults’ transitions. Attention to older adults’ HCBS use patterns is recommended for future practice. However, this was an exploratory study and the analyses cannot establish causal relationships. PMID:22877416

The Evaluation of Teaching and Learning.

ERIC Educational Resources Information Center

Potocki-Malicet, Danielle; Holmesland, Icara; Estrela, Maria-Teresa; Veiga-Simao, Ana-Margarida

1999-01-01

Three different approaches to the evaluation of higher education in European and Scandinavian countries are examined: evaluation of a single discipline across institutions (Finland, Norway, Portugal, Spain, United Kingdom, northern Germany); evaluation of several disciplines within certain institutions (France, Germany); and internal evaluation of…

The effects of Global Fund financing on health governance in Brazil.

PubMed

Gómez, Eduardo J; Atun, Rifat

2012-07-16

The impact of donors, such as national government (bi-lateral), private sector, and individual financial (philanthropic) contributions, on domestic health policies of developing nations has been the subject of scholarly discourse. Little is known, however, about the impact of global financial initiatives, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, on policies and health governance of countries receiving funding from such initiatives. This study employs a qualitative methodological design based on a single case study: Brazil. Analysis at national, inter-governmental and community levels is based on in-depth interviews with the Global Fund and the Brazilian Ministry of Health and civil societal activists. Primary research is complemented with information from printed media, reports, journal articles, and books, which were used to deepen our analysis while providing supporting evidence. Our analysis suggests that in Brazil, Global Fund financing has helped to positively transform health governance at three tiers of analysis: the national-level, inter-governmental-level, and community-level. At the national-level, Global Fund financing has helped to increased political attention and commitment to relatively neglected diseases, such as tuberculosis, while harmonizing intra-bureaucratic relationships; at the inter-governmental-level, Global Fund financing has motivated the National Tuberculosis Programme to strengthen its ties with state and municipal health departments, and non-governmental organisations (NGOs); while at the community-level, the Global Fund's financing of civil societal institutions has encouraged the emergence of new civic movements, participation, and the creation of new municipal participatory institutions designed to monitor the disbursement of funds for Global Fund grants. Global Fund financing can help deepen health governance at multiple levels. Future work will need to explore how the financing of civil society by the Global Fund and other donors influence policy agenda-setting and institutional innovations for increased civic participation in health governance and accountability to citizens.

The effects of Global Fund financing on health governance in Brazil

PubMed Central

2012-01-01

Objectives The impact of donors, such as national government (bi-lateral), private sector, and individual financial (philanthropic) contributions, on domestic health policies of developing nations has been the subject of scholarly discourse. Little is known, however, about the impact of global financial initiatives, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, on policies and health governance of countries receiving funding from such initiatives. Methods This study employs a qualitative methodological design based on a single case study: Brazil. Analysis at national, inter-governmental and community levels is based on in-depth interviews with the Global Fund and the Brazilian Ministry of Health and civil societal activists. Primary research is complemented with information from printed media, reports, journal articles, and books, which were used to deepen our analysis while providing supporting evidence. Results Our analysis suggests that in Brazil, Global Fund financing has helped to positively transform health governance at three tiers of analysis: the national-level, inter-governmental-level, and community-level. At the national-level, Global Fund financing has helped to increased political attention and commitment to relatively neglected diseases, such as tuberculosis, while harmonizing intra-bureaucratic relationships; at the inter-governmental-level, Global Fund financing has motivated the National Tuberculosis Programme to strengthen its ties with state and municipal health departments, and non-governmental organisations (NGOs); while at the community-level, the Global Fund’s financing of civil societal institutions has encouraged the emergence of new civic movements, participation, and the creation of new municipal participatory institutions designed to monitor the disbursement of funds for Global Fund grants. Conclusions Global Fund financing can help deepen health governance at multiple levels. Future work will need to explore how the financing of civil society by the Global Fund and other donors influence policy agenda-setting and institutional innovations for increased civic participation in health governance and accountability to citizens. PMID:22799635

Value of trainees in a radiology department. A retrospective semi-quantitative analysis.

PubMed

Vardhanabhuti, V; Bhatnagar, G; Brown, S; James, J; Shuen, V; Sidhu, H; Thomas, R; Fox, B

2011-07-01

To examine the productivity (both economic and otherwise) of trainees within a radiology department at our institution. Productivity was measured in three ways: (1) independent workload contribution, (2) impact on on-call services, and (3) impact on day-to-day practice as perceived by consultant radiologists. Data were collected using retrospective searches on computerized radiology information system (CRIS), analysis of trainees and consultant rotas, and a questionnaire to consultants and trainees. Where possible, productivity was quantified in terms of number of programmed activities (PAs). The contribution of independent work by trainees in a single week was 52.75 PAs (or 1.45 PAs per trainee per week). In addition, the on-call contribution was 23.1 PAs per week (or 0.93 PAs per trainee per week). When both trainees and consultants report independently, productivity in a single list in most cases increased and can be as much as 197%. On calculating the economic impact, this amounts to significant savings of around £1.2million per year at our institution. Based upon objectively measurable areas of service provision, the employment of trainees yields considerable economic benefit. Furthermore, based upon qualitative methods we have shown that trainees contribute positively in those areas, which are much harder to quantifiably evaluate. These are benefits in addition to fundamental requirement to train future competent radiologists. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Robotic Enrichment Processing of Roche 454 Titanium Emlusion PCR at the DOE Joint Genome Institute

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

Hamilton, Matthew; Wilson, Steven; Bauer, Diane

2010-05-28

Enrichment of emulsion PCR product is the most laborious and pipette-intensive step in the 454 Titanium process, posing the biggest obstacle for production-oriented scale up. The Joint Genome Institute has developed a pair of custom-made robots based on the Microlab Star liquid handling deck manufactured by Hamilton to mediate the complexity and ergonomic demands of the 454 enrichment process. The robot includes a custom built centrifuge, magnetic deck positions, as well as heating and cooling elements. At present processing eight emulsion cup samples in a single 2.5 hour run, these robots are capable of processing up to 24 emulsion cupmore » samples. Sample emulsions are broken using the standard 454 breaking process and transferred from a pair of 50ml conical tubes to a single 2ml tube and loaded on the robot. The robot performs the enrichment protocol and produces beads in 2ml tubes ready for counting. The robot follows the Roche 454 enrichment protocol with slight exceptions to the manner in which it resuspends beads via pipette mixing rather than vortexing and a set number of null bead removal washes. The robotic process is broken down in similar discrete steps: First Melt and Neutralization, Enrichment Primer Annealing, Enrichment Bead Incubation, Null Bead Removal, Second Melt and Neutralization and Sequencing Primer Annealing. Data indicating our improvements in enrichment efficiency and total number of bases per run will also be shown.« less

Institutional design and utilization of evaluation: a contribution to a theory of evaluation influence based on Swiss experience.

PubMed

Balthasar, Andreas

2009-06-01

Growing interest in the institutionalization of evaluation in the public administration raises the question as to which institutional arrangement offers optimal conditions for the utilization of evaluations. Institutional arrangement denotes the formal organization of processes and competencies, together with procedural rules, that are applicable independently of individual evaluation projects. It reflects the evaluation practice of an institution and defines the distance between evaluators and evaluees. This article outlines the results of a broad-based study of all 300 or so evaluations that the Swiss Federal Administration completed from 1999 to 2002. On this basis, it derives a theory of the influence of institutional factors on the utilization of evaluations.

Performance of CT examinations in children with suspected acute appendicitis in the community setting: a need for more education.

PubMed

Kim, Michael E; Orth, Robert C; Fallon, Sara C; Lopez, Monica E; Brandt, Mary L; Zhang, Wei; Bisset, George S

2015-04-01

Despite a recent focus on the preferential use of ultrasound over CT for pediatric appendicitis, most children transferred from community hospitals still undergo diagnostic CT scans. The purpose of this study was to evaluate CT techniques performed for children with acute appendicitis at nonpediatric treatment centers. All patients treated for acute appendicitis at our tertiary-care pediatric hospital from July 1, 2011, through June 30, 2012, were identified. Patient demographics, imaging modality used to diagnoses appendicitis (CT or ultrasound), location (home or referral institution), and CT technique parameters were collected. The estimated mean organ radiation dose, number of imaging phases, and use of contrast media were evaluated at home and referral institutions. During the study period, 1215 patients underwent appendectomies after imaging, with 442 (36.4%) imaged at referral facilities. Most referral patients received a diagnosis by CT (n=384, 87%), compared with 73 of 773 (9.4%) who received a diagnosis by CT at the home institution. The estimated mean (±SD) organ radiation dose was not statistically significantly different between home and referral institutions (13.5±7.3 vs 12.9±6.4 mGy; p=0.58) for single-phase examinations. Of 384 referral patients, 344 had images available for review. In total, 40% (138/344) of patients from referral centers were imaged with suboptimal CT techniques: 50 delayed phase only, 52 dual phase (eight of which were imaged twice in delayed phase), eight triple phase, and 36 without IV contrast agent. CT parameters and radiation doses from single-phase examinations in children with appendicitis were similar at nonpediatric treatment centers and a tertiary care children's hospital. Future educational outreach should focus on optimizing other technical parameters.

A differential spectral responsivity measurement system constructed for determining of the spectral responsivity of a single- and triple-junction photovoltaic cells

NASA Astrophysics Data System (ADS)

Sametoglu, Ferhat; Celikel, Oguz; Witt, Florian

2017-10-01

A differential spectral responsivity (DSR) measurement system has been designed and constructed at National Metrology Institute of Turkey (TUBITAK UME) to determine the spectral responsivity (SR) of a single- or a multi-junction photovoltaic device (solar cell). The DSR setup contains a broad band light bias source composed of a constructed Solar Simulator based on a 1000 W Xe-arc lamp owning a AM-1.5 filter and 250 W quartz-tungsten-halogen lamp, a designed and constructed LED-based Bias Light Sources, a DC voltage bias circuit, and a probe beam optical power tracking and correction circuit controlled with an ADuC847 microcontroller card together with an embedded C based software, designed and constructed in TUBITAK UME under this project. By using the constructed DSR measurement system, the SR calibration of solar cells, the monolitic triple-junction solar cell GaInP/GaInAs/Ge and its corresponding component cells have been performed within the EURAMET Joint Research Project SolCell.

Surgeon-Specific Reports in General Surgery: Establishing Benchmarks for Peer Comparison Within a Single Hospital.

PubMed

Hatfield, Mark D; Ashton, Carol M; Bass, Barbara L; Shirkey, Beverly A

2016-02-01

Methods to assess a surgeon's individual performance based on clinically meaningful outcomes have not been fully developed, due to small numbers of adverse outcomes and wide variation in case volumes. The Achievable Benchmark of Care (ABC) method addresses these issues by identifying benchmark-setting surgeons with high levels of performance and greater case volumes. This method was used to help surgeons compare their surgical practice to that of their peers by using merged National Surgical Quality Improvement Program (NSQIP) and Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data to generate surgeon-specific reports. A retrospective cohort study at a single institution's department of surgery was conducted involving 107 surgeons (8,660 cases) over 5.5 years. Stratification of more than 32,000 CPT codes into 16 CPT clusters served as the risk adjustment. Thirty-day outcomes of interest included surgical site infection (SSI), acute kidney injury (AKI), and mortality. Performance characteristics of the ABC method were explored by examining how many surgeons were identified as benchmark-setters in view of volume and outcome rates within CPT clusters. For the data captured, most surgeons performed cases spanning a median of 5 CPT clusters (range 1 to 15 clusters), with a median of 26 cases (range 1 to 776 cases) and a median of 2.8 years (range 0 to 5.5 years). The highest volume surgeon for that CPT cluster set the benchmark for 6 of 16 CPT clusters for SSIs, 8 of 16 CPT clusters for AKIs, and 9 of 16 CPT clusters for mortality. The ABC method appears to be a sound and useful approach to identifying benchmark-setting surgeons within a single institution. Such surgeons may be able to help their peers improve their performance. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Cryotherapy for primary treatment of prostate cancer: intermediate term results of a prospective study from a single institution.

PubMed

Rodríguez, S Alvarez; Arias Fúnez, F; Bueno Bravo, C; Rodríguez-Patrón Rodríguez, R; Sanz Mayayo, E; Palacios, V Hevia; Burgos Revilla, F J

2014-01-01

Purpose. Published data about cryotherapy for prostate cancer (PC) treatment are based on case series with a lack of clinical trials and the inexistence of a validated definition of biochemical failure. A prospective study with standardized followup protocol was conducted in our institution. Material and Methods. Prospective study of a series of cases including 108 patients diagnosed with localized PC at clinical stage T1c-T2c treated by primary cryoablation and median followup of 61 months. Criteria of biochemical recurrence were unified according to the American Society for Therapeutic Radiology and Oncology (ASTRO). End points were biochemical progression-free survival (BPFS), cancer-specific survival, and overall survival. Rate of complications was reported. Results. The BPFS for low-, medium-, and high-risk patients was 96.4%, 91.2%, and 62.2%, respectively. Cancer-specific survival was 98.1%. Overall survival reached 94.4%. Complications included incontinence in 5.6%, urinary tract obstruction in 1.9%, urethral sloughing in 5.6%, haematuria in 1.9%, perineal pain in 11.1%, and prostatorectal fistula in 0.9%. Erectile disfunction was found in 98.1%. Conclusions. Cryotherapy is an effective and minimally invasive treatment for primary PC in well-selected cases, with low surgical risk and good results in terms of BPFS, cancer-specific survival, and overall survival.

Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution

PubMed Central

Rodríguez, S. Alvarez; Arias Fúnez, F.; Bueno Bravo, C.; Rodríguez-Patrón Rodríguez, R.; Sanz Mayayo, E.; Palacios, V. Hevia; Burgos Revilla, F. J.

2014-01-01

Purpose. Published data about cryotherapy for prostate cancer (PC) treatment are based on case series with a lack of clinical trials and the inexistence of a validated definition of biochemical failure. A prospective study with standardized followup protocol was conducted in our institution. Material and Methods. Prospective study of a series of cases including 108 patients diagnosed with localized PC at clinical stage T1c-T2c treated by primary cryoablation and median followup of 61 months. Criteria of biochemical recurrence were unified according to the American Society for Therapeutic Radiology and Oncology (ASTRO). End points were biochemical progression-free survival (BPFS), cancer-specific survival, and overall survival. Rate of complications was reported. Results. The BPFS for low-, medium-, and high-risk patients was 96.4%, 91.2%, and 62.2%, respectively. Cancer-specific survival was 98.1%. Overall survival reached 94.4%. Complications included incontinence in 5.6%, urinary tract obstruction in 1.9%, urethral sloughing in 5.6%, haematuria in 1.9%, perineal pain in 11.1%, and prostatorectal fistula in 0.9%. Erectile disfunction was found in 98.1%. Conclusions. Cryotherapy is an effective and minimally invasive treatment for primary PC in well-selected cases, with low surgical risk and good results in terms of BPFS, cancer-specific survival, and overall survival. PMID:24693437

Distinguishing institutional identification from academic goal pursuit: interactive effects of ethnic identification and race-based rejection sensitivity.

PubMed

Mendoza-Denton, Rodolfo; Pietrzak, Janina; Downey, Geraldine

2008-08-01

We examined the interactive effects of ethnic identification (EI) and race-based rejection sensitivity (RS-race) on institutional outcomes among African American college students. We distinguished between effects on institutional identification on the one hand and academic goal pursuit (e.g., staying in school, grade point average [GPA]) on the other. Supporting the utility of this distinction, we found that EI and RS-race interacted to predict these outcomes differently. Higher EI in combination with higher RS-race predicted reduced identification with the institution (Studies 1, 2, and 3a). This combination, however, did not lead to decreases in GPA over time. Moreover, EI was positively related to intentions to stay in school as well as to GPA increases among those lower in RS-race (Studies 1 and 3b). Implications for understanding identity negotiation vis-à-vis performance in institutional settings are discussed. (c) 2008 APA, all rights reserved

Measuring co-authorship and networking-adjusted scientific impact.

PubMed

Ioannidis, John P A

2008-07-23

Appraisal of the scientific impact of researchers, teams and institutions with productivity and citation metrics has major repercussions. Funding and promotion of individuals and survival of teams and institutions depend on publications and citations. In this competitive environment, the number of authors per paper is increasing and apparently some co-authors don't satisfy authorship criteria. Listing of individual contributions is still sporadic and also open to manipulation. Metrics are needed to measure the networking intensity for a single scientist or group of scientists accounting for patterns of co-authorship. Here, I define I(1) for a single scientist as the number of authors who appear in at least I(1) papers of the specific scientist. For a group of scientists or institution, I(n) is defined as the number of authors who appear in at least I(n) papers that bear the affiliation of the group or institution. I(1) depends on the number of papers authored N(p). The power exponent R of the relationship between I(1) and N(p) categorizes scientists as solitary (R>2.5), nuclear (R = 2.25-2.5), networked (R = 2-2.25), extensively networked (R = 1.75-2) or collaborators (R<1.75). R may be used to adjust for co-authorship networking the citation impact of a scientist. I(n) similarly provides a simple measure of the effective networking size to adjust the citation impact of groups or institutions. Empirical data are provided for single scientists and institutions for the proposed metrics. Cautious adoption of adjustments for co-authorship and networking in scientific appraisals may offer incentives for more accountable co-authorship behaviour in published articles.

Cyberinfrastructure for Open Science at the Montreal Neurological Institute

PubMed Central

Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S.; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M.; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D. Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A.; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C.

2017-01-01

Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing the vision of Open Science at the Montreal Neurological Institute will be a concerted undertaking that seeks to facilitate data sharing for the global research community. Our goal is to utilize the years of experience in multi-site collaborative research infrastructure to implement the technical requirements to achieve this level of public data sharing in a practical yet robust manner, in support of accelerating scientific discovery. PMID:28111547

Cyberinfrastructure for Open Science at the Montreal Neurological Institute.

PubMed

Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C

2016-01-01

Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing the vision of Open Science at the Montreal Neurological Institute will be a concerted undertaking that seeks to facilitate data sharing for the global research community. Our goal is to utilize the years of experience in multi-site collaborative research infrastructure to implement the technical requirements to achieve this level of public data sharing in a practical yet robust manner, in support of accelerating scientific discovery.

Distribution of late Pleistocene ice-rich syngenetic permafrost of the Yedoma Suite in east and central Siberia, Russia

USGS Publications Warehouse

Grosse, Guido; Robinson, Joel E.; Bryant, Robin; Taylor, Maxwell D.; Harper, William; DeMasi, Amy; Kyker-Snowman, Emily; Veremeeva, Alexandra; Schirrmeister, Lutz; Harden, Jennifer

2013-01-01

This digital database is the product of collaboration between the U.S. Geological Survey, the Geophysical Institute at the University of Alaska, Fairbanks; the Los Altos Hills Foothill College GeoSpatial Technology Certificate Program; the Alfred Wegener Institute for Polar and Marine Research, Potsdam, Germany; and the Institute of Physical Chemical and Biological Problems in Soil Science of the Russian Academy of Sciences. The primary goal for creating this digital database is to enhance current estimates of soil organic carbon stored in deep permafrost, in particular the late Pleistocene syngenetic ice-rich permafrost deposits of the Yedoma Suite. Previous studies estimated that Yedoma deposits cover about 1 million square kilometers of a large region in central and eastern Siberia, but these estimates generally are based on maps with scales smaller than 1:10,000,000. Taking into account this large area, it was estimated that Yedoma may store as much as 500 petagrams of soil organic carbon, a large part of which is vulnerable to thaw and mobilization from thermokarst and erosion. To refine assessments of the spatial distribution of Yedoma deposits, we digitized 11 Russian Quaternary geologic maps. Our study focused on extracting geologic units interpreted by us as late Pleistocene ice-rich syngenetic Yedoma deposits based on lithology, ground ice conditions, stratigraphy, and geomorphological and spatial association. These Yedoma units then were merged into a single data layer across map tiles. The spatial database provides a useful update of the spatial distribution of this deposit for an approximately 2.32 million square kilometers land area in Siberia that will (1) serve as a core database for future refinements of Yedoma distribution in additional regions, and (2) provide a starting point to revise the size of deep but thaw-vulnerable permafrost carbon pools in the Arctic based on surface geology and the distribution of cryolithofacies types at high spatial resolution. However, we recognize that the extent of Yedoma deposits presented in this database is not complete for a global assessment, because Yedoma deposits also occur in the Taymyr lowlands and Chukotka, and in parts of Alaska and northwestern Canada.

Exploration of risk factors predicting outcomes for primary T1 high-grade bladder cancer and validation of the Spanish Urological Club for Oncological Treatment scoring model: Long-term follow-up experience at a single institute.

PubMed

Miyake, Makito; Gotoh, Daisuke; Shimada, Keiji; Tatsumi, Yoshihiro; Nakai, Yasushi; Anai, Satoshi; Torimoto, Kazumasa; Aoki, Katsuya; Tanaka, Nobumichi; Konishi, Noboru; Fujimoto, Kiyohide

2015-06-01

To determine the prognostic factors of primary T1 high-grade bladder cancer and to validate the Spanish Urological Club for Oncological Treatment model in Japanese patients with T1 high-grade bladder cancer treated at a single institution. Records of 106 patients with T1 high-grade bladder cancer treated from 1998 to 2013 were retrospectively reviewed. Variables included various clinicopathological parameters, including lymphovascular invasion and tumor growth pattern at the invasion front. Recurrence-free survival and progression-free survival were analyzed. Multivariate Cox proportional regression analysis was used to verify the prognostic significance of the variables. Scores for recurrence and progression were calculated using the Spanish Urological Club for Oncological Treatment model. Of 106 patients, 44 (42%) had recurrence and 16 (15%) developed progression after a median (interquartile range) follow-up period of 54 months (range 32-81 months). Non-papillary shape was the only independent predictor for recurrence, while broad-based tumor stalk and infiltrative tumor growth pattern at the invasion front were determined to be independent predictors for progression. Stratification of patients according to the number of progression risk factors yielded hazard ratios of 10.1 and 13.1 in patients having one and two risks, respectively, compared with those without any risks. The Spanish Urological Club for Oncological Treatment model successfully stratified our patients with a trend toward different probabilities of recurrence and progression. The results of the present study might be helpful for counseling certain patients towards intensive treatment, such as radical cystectomy and/or platinum-based systemic chemotherapy. In addition, the Spanish Urological Club for Oncological Treatment model might be applicable to Japanese patients with T1 high-grade bladder cancer. © 2015 The Japanese Urological Association.

A statistical method for predicting seizure onset zones from human single-neuron recordings

NASA Astrophysics Data System (ADS)

Valdez, André B.; Hickman, Erin N.; Treiman, David M.; Smith, Kris A.; Steinmetz, Peter N.

2013-02-01

Objective. Clinicians often use depth-electrode recordings to localize human epileptogenic foci. To advance the diagnostic value of these recordings, we applied logistic regression models to single-neuron recordings from depth-electrode microwires to predict seizure onset zones (SOZs). Approach. We collected data from 17 epilepsy patients at the Barrow Neurological Institute and developed logistic regression models to calculate the odds of observing SOZs in the hippocampus, amygdala and ventromedial prefrontal cortex, based on statistics such as the burst interspike interval (ISI). Main results. Analysis of these models showed that, for a single-unit increase in burst ISI ratio, the left hippocampus was approximately 12 times more likely to contain a SOZ; and the right amygdala, 14.5 times more likely. Our models were most accurate for the hippocampus bilaterally (at 85% average sensitivity), and performance was comparable with current diagnostics such as electroencephalography. Significance. Logistic regression models can be combined with single-neuron recording to predict likely SOZs in epilepsy patients being evaluated for resective surgery, providing an automated source of clinically useful information.

Does interactive instruction in introductory physics impact long-term outcomes for students?

NASA Astrophysics Data System (ADS)

Gordon, Vernita

Early college classroom experiences contribute greatly to students leaving STEM majors. Peer instruction is a research-based pedagogy in which students, in small groups in the classroom, discuss concepts and work short problems. A single study at Harvard found that taking peer-instruction introductory physics also increases persistence in science majors. To what degree, if at all, peer instruction helps retention and performance for STEM majors at large public institutions (like University of Texas, Austin) is not known. Here I describe the results of a retrospective pilot study comparing outcomes for students who took different sections of the same calculus-based introductory mechanics course in Fall 2012 and Fall 2014. Compared with traditional lecture sections, peer-instruction sections had a 50% lower drop rate, a 40% / 55% higher rate of enrollment in the 2nd/ 3rd courses in the sequence, and, for the Fall 2012 cohort, a 74% / 165% higher rate of graduating from UT Austin / the UT Austin College of Natural Sciences by Fall 2015. I will discuss weaknesses of this retrospective pilot study and present plans for an intentionally-designed study to be implemented beginning Fall 2017.

Institute for High Heat Flux Removal (IHHFR). Phases I, II, and III

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

Boyd, Ronald D.

2014-08-31

The IHHFR focused on interdisciplinary applications as it relates to high heat flux engineering issues and problems which arise due to engineering systems being miniaturized, optimized, or requiring increased high heat flux performance. The work in the IHHFR focused on water as a coolant and includes: (1) the development, design, and construction of the high heat flux flow loop and facility; (2) test section development, design, and fabrication; and, (3) single-side heat flux experiments to produce 2-D boiling curves and 3-D conjugate heat transfer measurements for single-side heated test sections. This work provides data for comparisons with previously developed andmore » new single-side heated correlations and approaches that address the single-side heated effect on heat transfer. In addition, this work includes the addition of single-side heated circular TS and a monoblock test section with a helical wire insert. Finally, the present work includes: (1) data base expansion for the monoblock with a helical wire insert (only for the latter geometry), (2) prediction and verification using finite element, (3) monoblock model and methodology development analyses, and (4) an alternate model development for a hypervapotron and related conjugate heat transfer controlling parameters.« less

Defibrotide, a polydisperse mixture of single-stranded phosphodiester oligonucleotides with lifesaving activity in severe hepatic veno-occlusive disease: clinical outcomes and potential mechanisms of action.

PubMed

Kornblum, Noah; Ayyanar, Kanyalakshmi; Benimetskaya, Luba; Richardson, Paul; Iacobelli, Massimo; Stein, C A

2006-01-01

Veno-occlusive disease of the liver (VOD) remains a troubling and potentially fatal complication of high-dose chemotherapy and hematopoietic stem cell transplantation conditioning regimens. No effective therapy has been available for these patients to date, and the best supportive care measures remain woefully inadequate. Defibrotide (DF) (Gentium, S.p.A., Como, Italy), a polydisperse mixture of all the single-stranded phosphodiester oligodeoxyribonucleotides that can be obtained from the controlled depolymerization of porcine intestinal mucosal genomic DNA, seems to offer a safe and effective treatment for some patients suffering from severe VOD, a condition for which no accepted standard therapy currently exists. Early clinical studies evaluating the efficacy of DF for the treatment of severe VOD in patients undergoing hematopoietic stem cell transplantation have been very encouraging. Approximately 45% of the patients treated in multiple initial phase II clinical trials achieved a complete response at day +100, demonstrating normalization of serum bilirubin and resolution of the clinical syndrome. However, although multi-institutional, these represented single arm studies. A large, FDA-approved, pivotal, prospective, multi-institutional, global phase III trial of DF vs. historical controls (best available therapy) commenced in the first quarter of 2006 and should provide further validation of DF's efficacy. The drug seems to have few significant side effects, and almost all test subjects who have received this treatment have tolerated it well. Although the mechanism of action remains unclear, the drug exerts minimal systemic anticoagulant effects yet appears to induce numerous antithrombotic and profibrinolytic effects both in vitro and in vivo. It may function as an adenosine receptor agonist and causes increased concentrations of endogenous prostaglandins, which modulate thrombomodulin, platelets, and fibrinolysis. It also appears to block lipopolysaccharide (LPS)-induced tissue factor (TF) expression. However, despite the fact the DF is composed of oligonucleotides, its mechanism of action, which at the present time is unclear, is not related to Watson-Crick base pair-dependent downregulation of gene expression but is rather likely a result of its polyanionic nature.

Award-Winning Faculty at a Faith-Based Institution

ERIC Educational Resources Information Center

Livingston, Jennifer; Jun, Alexander

2011-01-01

Exploring the development of excellent teachers could contribute to the revision of current practices in faculty recruitment, evaluation, workload expectations, and reward systems. This grounded theory study examined the professional careers of nine award-winning faculty members of a faith-based institution of higher education. The data, collected…

Performance-Based Funding: State Policy Influences on Small Rural Community Colleges

ERIC Educational Resources Information Center

Thornton, Zoë Mercedes; Friedel, Janice Nahra

2016-01-01

Performance-based funding (PBF) models intend to increase efficiency and productivity of the institution, thereby influencing organizational change. This change may be structural, programmatic, or procedural, and it may affect institutional practice and/or policy. The purpose of this qualitative case study was to understand the organizational…

Collaborative Research in Childhood Cancer Survivorship: The Current Landscape

PubMed Central

Bhatia, Smita; Armenian, Saro H.; Armstrong, Gregory T.; van Dulmen-den Broeder, Eline; Hawkins, Michael M.; Kremer, Leontien C.M.; Kuehni, Claudia E.; Olsen, Jørgen H.; Robison, Leslie L.; Hudson, Melissa M.

2015-01-01

Survivors of childhood cancer carry a substantial burden of morbidity and are at increased risk for premature death. Furthermore, clear associations exist between specific therapeutic exposures and the risk for a variety of long-term complications. The entire landscape of health issues encountered for decades after successful completion of treatment is currently being explored in various collaborative research settings. These settings include large population-based or multi-institutional cohorts and single-institution studies. The ascertainment of outcomes has depended on self-reporting, linkage to registries, or clinical assessments. Survivorship research in the cooperative group setting, such as the Children's Oncology Group, has leveraged the clinical trials infrastructure to explore the molecular underpinnings of treatment-related adverse events, and to understand specific complications in the setting of randomized risk-reduction strategies. This review highlights the salient findings from these large collaborative initiatives, emphasizing the need for life-long follow-up of survivors of childhood cancer, and describing the development of several guidelines and efforts toward harmonization. Finally, the review reinforces the need to identify populations at highest risk, facilitating the development of risk prediction models that would allow for targeted interventions across the entire trajectory of survivorship. PMID:26304891

How Well Do Undergraduate Research Programs Promote Engagement and Success of Students?

PubMed Central

Fechheimer, Marcus; Webber, Karen; Kleiber, Pamela B.

2011-01-01

Assessment of undergraduate research (UR) programs using participant surveys has produced a wealth of information about design, implementation, and perceived benefits of UR programs. However, measurement of student participation university wide, and the potential contribution of research experience to student success, also require the study of extrinsic measures. In this essay, institutional data on student credit-hour generation and grade point average (GPA) from the University of Georgia are used to approach these questions. Institutional data provide a measure of annual enrollment in UR classes in diverse disciplines. This operational definition allows accurate and retrospective analysis, but does not measure all modes of engagement in UR. Cumulative GPA is proposed as a quantitative extrinsic measure of student success. Initial results show that extended participation in research for more than a single semester is correlated with an increase in GPA, even after using SAT to control for the initial ability level of the students. While the authors acknowledge that correlation does not prove causality, continued efforts to measure the impact of UR programs on student outcomes using GPA or an alternate extrinsic measure is needed for development of evidence-based programmatic recommendations. PMID:21633064

Institutions and national development in Latin America: a comparative study

PubMed Central

Portes, Alejandro; Smith, Lori D.

2013-01-01

We review the theoretical and empirical literatures on the role of institutions on national development as a prelude to present a more rigorous and measurable definition of the concept and a methodology to study this relationship at the national and subnational levels. The existing research literature features conflicting definitions of the concept of “institutions” and empirical tests based mostly on reputational indices, with countries as units of analysis. The present study’s methodology is based on a set of five strategic organizations studied comparatively in five Latin American countries. These include key federal agencies, public administrative organizations, and stock exchanges. Systematic analysis of results show a pattern of differences between economically-oriented institutions and those entrusted with providing basic services to the general population. Consistent differences in institutional quality also emerge across countries, despite similar levels of economic development. Using the algebraic methods developed by Ragin, we test six hypotheses about factors determining the developmental character of particular institutions. Implications of results for theory and for methodological practices of future studies in this field are discussed. PMID:26543407

Recruitment of ethnic minorities for public health research: An interpretive synthesis of experiences from six interlinked Danish studies.

PubMed

Nielsen, Annemette Ljungdalh; Jervelund, Signe Smith; Villadsen, Sarah Fredsted; Vitus, Kathrine; Ditlevsen, Kia; TØrslev, Mette Kirstine; Kristiansen, Maria

2017-03-01

This paper examines the importance of recruitment site in relation to the recruitment of ethnic minorities into health research. It presents a synthesis of experiences drawn from six interlinked Danish studies which applied different methods and used healthcare facilities and educational settings as sites for recruitment. Inspired by interpretive reviewing, data on recruitment methods from the different studies were synthesized with a focus on the various levels of recruitment success achieved. This involved an iterative process of comparison, analysis and discussion of experiences among the researchers involved. Success in recruitment seemed to depend partly on recruitment site. Using healthcare facilities as the recruitment site and healthcare professionals as gatekeepers was less efficient than using schools and employees from educational institutions. Successful study designs also depended on the possibility of singling out specific locations with a high proportion of the relevant ethnic minority target population. The findings, though based on a small number of cases, indicate that health professionals and healthcare institutions, despite their interest in high-quality health research into all population groups, fail to facilitate research access to some of the most disadvantaged groups, who need to be included in order to understand the mechanisms behind health disparities. This happens despite the genuine wish of many healthcare professionals to help facilitate such research. In this way, the findings indirectly emphasize the specific challenge of accessing more vulnerable and sick groups in research studies.

Feasibility and Associated Limitations of Office-Based Laryngeal Surgery Using Carbon Dioxide Lasers.

PubMed

Hu, Hao-Chun; Lin, Shu-Yi; Hung, Yi-Ting; Chang, Shyue-Yih

2017-05-01

There are few reports evaluating awake, office-based carbon dioxide (CO2) laser surgery for laryngeal lesions. To date, this study was the largest reported case series of office-based laryngeal surgery by fiber delivery CO2 laser. Office-based laryngeal surgical procedures have become increasingly popular. Technical problems and treatment outcomes associated with the use of a CO2 laser for office-based laryngeal surgery have yet to be fully addressed. To discuss a single institution's clinical experience with office-based CO2 laser laryngeal surgery and the feasibility and limitations associated with this procedure. This retrospective study evaluated 49 laryngeal surgical procedures performed using a CO2 laser in 40 consecutive adult patients at a single institution in Taiwan from July 1, 2014, through September 30, 2015. Laryngeal lesions treated included vocal fold leukoplakia (n = 13), benign vocal fold lesions (n = 10), Reinke edema (n = 4), recurrent respiratory papillomatosis (n = 6), and lesions outside the vocal folds (n = 7). Office-based laryngeal surgery performed using a CO2 laser under topical anesthesia. Videolaryngoscopy was performed on all patients at each follow-up point. Among patients with benign vocal lesions and Reinke edema, videolaryngostroboscopy, voice laboratory measurements, perceptual measurements of vocal quality, and subjective evaluations were conducted before and after surgery. Among the 40 patients included in this study (28 men [70%] and 12 women [30%]; median [range] age, 56 [29-83] years), median follow-up time was 6.5 months (range, 1-21 months). Among the 49 procedures, 2 (4%) could not be tolerated by patients owing to severe gag reflex and laryngeal hypersensitivity, 6 (12%) could not completely evaporate lesions owing to an inadequate surgical field or laryngeal instability, and 1 (2%) led to a complication (ie, mild vocal fold wound stiffness). In addition, 2 patients with premalignant vocal fold leukoplakia showed lesion recurrence in the subglottic area. Among patients with benign vocal lesions and Reinke edema, postoperative phonatory function showed large improvements in jitter (effect size, 0.61; median difference, -0.98%; 95% CI, -1.57% to -0.11%), noise to harmonic ratio (effect size, 0.63; median difference, -0.02; 95% CI, -0.07 to -0.01), maximal phonation time (effect size, 0.61; median difference, 3.6 seconds; 95% CI, 1.9 to 8.8 seconds), and Voice Handicap Index-10 score (effect size, 0.60; median difference, -7; 95% CI, -12 to -2). Office-based laryngeal surgery performed using a CO2 laser was shown to be a feasible treatment option for various types of vocal lesions. However, patients should not undergo this procedure if they have multiple bulky lesions or lesions involving the subglottic area, the laryngeal ventricle, or (in cases of inadequate laryngeal stability) the free edge of a vocal fold.

TEMP, TEXAS EDUCATIONAL MICROWAVE PROJECT. FINAL REPORT.

ERIC Educational Resources Information Center

SCHENKKAN, R.F.; AND OTHERS

A PILOT EFFORT TO LINK 11 INSTITUTIONS OF HIGHER LEARNING BY MICROWAVE TRANSMITTERS FOR INSTRUCTIONAL PURPOSES WAS DEMONSTRATED. THIS MICROWAVE LINKAGE PROVIDED A SINGLE CLOSED-CIRCUIT TELEVISION SYSTEM THROUGHOUT THE PARTICIPATING INSTITUTIONS. THROUGH THE FORMATION OF THE "ELECTRONIC CAMPUS," THE FACULTY RESOURCES OF ALL 11 SCHOOLS…

13 CFR 107.150 - Management-ownership diversity requirement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... with any of your Associates. A single “acceptable” Institutional Investor may be substituted for two or... if exempt from Federal income taxation; and (vi) Other Institutional Investors satisfactory to SBA... requirement. 107.150 Section 107.150 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL...

13 CFR 107.150 - Management-ownership diversity requirement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... with any of your Associates. A single “acceptable” Institutional Investor may be substituted for two or... if exempt from Federal income taxation; and (vi) Other Institutional Investors satisfactory to SBA... requirement. 107.150 Section 107.150 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL...

13 CFR 107.150 - Management-ownership diversity requirement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... with any of your Associates. A single “acceptable” Institutional Investor may be substituted for two or... if exempt from Federal income taxation; and (vi) Other Institutional Investors satisfactory to SBA... requirement. 107.150 Section 107.150 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL...

A Tale of Transformation

ERIC Educational Resources Information Center

Gohn, David; Moore, John

2007-01-01

Underperforming institutions frequently face financial and enrollment challenges, and/or lack a sense of direction and momentum. There is no single or easy approach to turning things around and putting the institution on track to positive development. In 1983, Drury University in Springfield, Missouri, faced declining enrollments, a growing…

Characterization of Sodium Mobility and Binding by 23 Na NMR Spectroscopy in a Model Lipoproteic Emulsion Gel for Sodium Reduction.

PubMed

Okada, Kyle S; Lee, Youngsoo

2017-07-01

The effects of formulation and processing parameters on sodium availability in a model lipid/protein-based emulsion gel were studied for purposes of sodium reduction. Heat-set model gels were prepared with varying levels of protein, lipid, and NaCl contents and high pressure homogenization treatments. Single quantum and double quantum-filtered 23 Na NMR spectroscopy experiments were used to characterize sodium mobility, structural order around "bound" (restricted mobility) sodium, and sodium binding, which have been correlated to saltiness perception in food systems previously. Total sodium mobility was lower in gels with higher protein or fat content, and was not affected by changes in homogenization pressure. The gels with increased protein, fat, or homogenization pressure had increased structure surrounding "bound" sodium and more relative "bound" sodium due to increased interfacial protein interactions. The data obtained in this study provide information on factors affecting sodium availability, which can be applied towards sodium reduction in lipid/protein-based foods. © 2017 Institute of Food Technologists®.

[Comparison of antiemesis effects of granisetron, aprepitant and dexamethasone to palonosetron, aprepitant and dexamethasone in treatment of high-emetic risk chemotherapy-induced nausea and vomiting - a retrospective study for efficacy and safety in a single institute].

PubMed

Osawa, Hiroshi; Goto, Hiroaki; Myojo, Tomohiro

2013-05-01

Nausea and vomiting are among the most problematic symptoms experienced by patients with cancer who are receiving chemotherapy. 5-hydroxytryptamine 3(5-HT3)-receptor antagonists, NK1 receptor antagonists(aprepitant)and dexamethasone are now the standard therapies for preventing chemotherapy-induced nausea and vomiting(CINV)that follow highly emetogenic chemotherapy, such as cisplatin and anthracycline. However, since it is not cleared which 5-HT3-recepter antagonist is a proper treatment for combined use with aprepitant and dexamethasone, we conducted a questionnaire survey, which used the numerical rating scale(NRS), for comparing palonosetron with granisetron in the same patient. Palonosetron showed a significant improvement of nausea for both acute(within 24 hours)and delayed phase(24-120 hours later), regardless of the type of chemotherapy(cisplatin or anthracycline-based regimen). Furthermore, palonosetron had a tolerable safety profile. Our study suggests that palonosetron-based antiemetic treatment will be a preferred choice for preventing CINV following highly emetogenic chemotherapy.

Ethics in clinical drug trial research in private practice.

PubMed

Beran, R G; Beran, M E

2006-09-01

Private clinics and clinicians have been involved in clinical drug trials for approximately two decades. This paper reviews the ethical consideration inherent in this process. Involvement of a single community based, private, Australian neurological clinic in the conduct of trials was audited. Changes in ethical considerations were analysed. The clinic previously audited its clinical trial involvement, starting with pharmaceutical company orchestrated trials. These were vetted by hospital based ethics committees (ECs) which then refused to review private research. A private EC accommodating NH & MRC standards was formed to assess private research. Indemnity concerns forced return to institutional ECs with government guaranteed indemnification. Trials evolved to investigator initiated, company sponsored studies thence a company asking the clinic to devise, sponsor and manage a trial. The latter relegated trial co-ordination to the clinic which would control publication thereby creating new ethical standards. Private practice trial involvement evolved from reluctant inclusion to a pivotal role in privately sponsored studies. Access to ECs is government endorsed and publication is independent for investigator-sponsored trials. There has been modification of standard operating procedures and enhanced ethical standards.

Methodological standards in single-case experimental design: Raising the bar.

PubMed

Ganz, Jennifer B; Ayres, Kevin M

2018-04-12

Single-case experimental designs (SCEDs), or small-n experimental research, are frequently implemented to assess approaches to improving outcomes for people with disabilities, particularly those with low-incidence disabilities, such as some developmental disabilities. SCED has become increasingly accepted as a research design. As this literature base is needed to determine what interventions are evidence-based practices, the acceptance of SCED has resulted in increased critiques with regard to methodological quality. Recent trends include recommendations from a number of expert scholars and institutions. The purpose of this article is to summarize the recent history of methodological quality considerations, synthesize the recommendations found in the SCED literature, and provide recommendations to researchers designing SCEDs with regard to essential and aspirational standards for methodological quality. Conclusions include imploring SCED to increase the quality of their experiments, with particular consideration regarding the applied nature of SCED research to be published in Research in Developmental Disabilities and beyond. Copyright © 2018 Elsevier Ltd. All rights reserved.

Value-based assessment of robotic pancreas and liver surgery

PubMed Central

Patti, James C.; Ore, Ana Sofia; Barrows, Courtney; Velanovich, Vic

2017-01-01

Current healthcare economic evaluations are based only on the perspective of a single stakeholder to the healthcare delivery process. A true value-based decision incorporates all of the outcomes that could be impacted by a single episode of surgical care. We define the value proposition for robotic surgery using a stakeholder model incorporating the interests of all groups participating in the provision of healthcare services: patients, surgeons, hospitals and payers. One of the developing and expanding fields that could benefit the most from a complete value-based analysis is robotic hepatopancreaticobiliary (HPB) surgery. While initial robot purchasing costs are high, the benefits over laparoscopic surgery are considerable. Performing a literature search we found a total of 18 economic evaluations for robotic HPB surgery. We found a lack of evaluations that were carried out from a perspective that incorporates all of the impacts of a single episode of surgical care and that included a comprehensive hospital cost assessment. For distal pancreatectomies, the two most thorough examinations came to conflicting results regarding total cost savings compared to laparoscopic approaches. The most thorough pancreaticoduodenectomy evaluation found non-significant savings for total hospital costs. Robotic hepatectomies showed no cost savings over laparoscopic and only modest savings over open techniques. Lastly, robotic cholecystectomies were found to be more expensive than the gold-standard laparoscopic approach. Existing cost accounting data associated with robotic HPB surgery is incomplete and unlikely to reflect the state of this field in the future. Current data combines the learning curves for new surgical procedures being undertaken by HPB surgeons with costs derived from a market dominated by a single supplier of robotic instruments. As a result, the value proposition for stakeholders in this process cannot be defined. In order to solve this problem, future studies must incorporate (I) quality of life, survival, and return to independent function alongside data such as (II) intent-to-treat analysis of minimally-invasive surgery accounting for conversions to open, (III) surgeon and institution experience and operative time as surrogates for the learning curve; and (IV) amortization and maintenance costs as well as direct costs of disposables and instruments. PMID:28848747

Value-based assessment of robotic pancreas and liver surgery.

PubMed

Patti, James C; Ore, Ana Sofia; Barrows, Courtney; Velanovich, Vic; Moser, A James

2017-08-01

Current healthcare economic evaluations are based only on the perspective of a single stakeholder to the healthcare delivery process. A true value-based decision incorporates all of the outcomes that could be impacted by a single episode of surgical care. We define the value proposition for robotic surgery using a stakeholder model incorporating the interests of all groups participating in the provision of healthcare services: patients, surgeons, hospitals and payers. One of the developing and expanding fields that could benefit the most from a complete value-based analysis is robotic hepatopancreaticobiliary (HPB) surgery. While initial robot purchasing costs are high, the benefits over laparoscopic surgery are considerable. Performing a literature search we found a total of 18 economic evaluations for robotic HPB surgery. We found a lack of evaluations that were carried out from a perspective that incorporates all of the impacts of a single episode of surgical care and that included a comprehensive hospital cost assessment. For distal pancreatectomies, the two most thorough examinations came to conflicting results regarding total cost savings compared to laparoscopic approaches. The most thorough pancreaticoduodenectomy evaluation found non-significant savings for total hospital costs. Robotic hepatectomies showed no cost savings over laparoscopic and only modest savings over open techniques. Lastly, robotic cholecystectomies were found to be more expensive than the gold-standard laparoscopic approach. Existing cost accounting data associated with robotic HPB surgery is incomplete and unlikely to reflect the state of this field in the future. Current data combines the learning curves for new surgical procedures being undertaken by HPB surgeons with costs derived from a market dominated by a single supplier of robotic instruments. As a result, the value proposition for stakeholders in this process cannot be defined. In order to solve this problem, future studies must incorporate (I) quality of life, survival, and return to independent function alongside data such as (II) intent-to-treat analysis of minimally-invasive surgery accounting for conversions to open, (III) surgeon and institution experience and operative time as surrogates for the learning curve; and (IV) amortization and maintenance costs as well as direct costs of disposables and instruments.

Highly cited articles in health care sciences and services field in Science Citation Index Expanded. A bibliometric analysis for 1958 - 2012.

PubMed

Hsu, Y-H E; Ho, Y-S

2014-01-01

This study aimed to identify and analyze characteristics of highly cited articles published in the Web of Science category of health care sciences and services from 1958 to 2012. Articles that have been cited at least 100 times were assessed regarding publication outputs, distribution of outputs in journals, publications of authors, institutions, countries as well as citation life cycles of the articles with the highest total citations since its publication up to 2012 and the highest citations in 2012. Six bibliometric indicators were used to evaluate source countries, institutions, and authors. Total citations from the time the articles were first published to the end of 2012 and citations in 2012 only were applied. Additionally, Y-index was applied to evaluate publication characteristics of authors. A high percentage of authors had the same numbers of first author and corresponding author status of highly cited articles in health care sciences and services field. RESULTS showed that 890 of the most highly referenced articles, published between 1977 and 2009, had been cited at least 100 times. Medical Care and Journal of General Internal Medicine published the most highly cited articles. The United States produced 76% of highly cited articles and also published the most number of independent, internationally collaborative, first authored, corresponding authored, and single author highly cited articles. The Harvard University was the most productive institute and was number one for the total highly cited articles, inter-institutionally collaborative articles, single institution articles, first author articles, and corresponding author articles. The application of quantitative techniques in the analysis of highly cited articles can improve the researchers' understanding of the directions in health care sciences and services field. Y-index is useful for the evaluation of contributing authors.

Half-Work, Half-Study: Schools in Communist China. Recent Experiments with Self-Supporting Educational Institutions. Bulletin, 1964, No. 24. OE-14100

ERIC Educational Resources Information Center

Barendsen, Robert D.

1964-01-01

This study of experiments with a new type of educational institution in Communist China is based upon an analysis of materials from Chinese Communist newspapers and periodicals. Reliance upon a discriminating use of such materials is necessitated by the lack of impartial first hand evaluations of these new institutions by qualified outside…

Laundry pack exposures in children 0-5 years evaluated at a single pediatric institution.

PubMed

Yin, Shan; Behrman, Alysha; Colvin, Jonathan

2015-05-01

Case reports and poison center series have highlighted increased safety concerns with laundry packs, especially when compared to traditional laundry detergents. The purpose of this study was to examine the clinical experience with laundry pack exposures at a single institution. A retrospective chart review was performed for exposures to laundry packs seen at a single tertiary care children's hospital medical center. Cases were identified by searching the poison center database for exposures to laundry products from March 2012 to October 2013 in children <5 years old. Medical records were reviewed for all identified cases. Data collected included demographics, treatments, laboratory and radiology data, disposition, and length of stay in the emergency department (ED). Forty cases were included. Thirty-two were ingestions and eight were ocular exposures. Nine children were admitted, two of which were admitted to a critical care unit. Seven other children were discharged after 1-night admissions; none received any treatments after initial ED treatment. Of these, four children were admitted for the possibility of central nervous system (CNS) depression, but none showed any progression. Twenty-nine children with ingestions were discharged directly from the ED. No children had progression of CNS symptoms. Children discharged from the ED were observed a mean of 189 min. Cases of laundry pack exposures seen at our institution were similar to cases described by US poison centers. No child had progression of CNS depression suggesting that prolonged observation is not necessary if the child does not have CNS depression at presentation. Copyright © 2015 Elsevier Inc. All rights reserved.

Laparoscopic esophagomyotomy for achalasia in children: A review

PubMed Central

Pandian, T Kumar; Naik, Nimesh D; Fahy, Aodhnait S; Arghami, Arman; Farley, David R; Ishitani, Michael B; Moir, Christopher R

2016-01-01

Esophageal achalasia in children is rare but ultimately requires endoscopic or surgical treatment. Historically, Heller esophagomyotomy has been recommended as the treatment of choice. The refinement of minimally invasive techniques has shifted the trend of treatment toward laparoscopic Heller myotomy (LHM) in adults and children with achalasia. A review of the available literature on LHM performed in patients < 18 years of age was conducted. The pediatric LHM experience is limited to one multi-institutional and several single-institutional retrospective studies. Available data suggest that LHM is safe and effective. There is a paucity of evidence on the need for and superiority of concurrent antireflux procedures. In addition, a more complete portrayal of complications and long-term (> 5 years) outcomes is needed. Due to the infrequency of achalasia in children, these characteristics are unlikely to be defined without collaboration between multiple pediatric surgery centers. The introduction of peroral endoscopic myotomy and single-incision techniques, continue the trend of innovative approaches that may eventually become the standard of care. PMID:26839646

Can hydro-economic river basin models simulate water shadow prices under asymmetric access?

PubMed

Kuhn, A; Britz, W

2012-01-01

Hydro-economic river basin models (HERBM) based on mathematical programming are conventionally formulated as explicit 'aggregate optimization' problems with a single, aggregate objective function. Often unintended, this format implicitly assumes that decisions on water allocation are made via central planning or functioning markets such as to maximize social welfare. In the absence of perfect water markets, however, individually optimal decisions by water users will differ from the social optimum. Classical aggregate HERBMs cannot simulate that situation and thus might be unable to describe existing institutions governing access to water and might produce biased results for alternative ones. We propose a new solution format for HERBMs, based on the format of the mixed complementarity problem (MCP), where modified shadow price relations express spatial externalities resulting from asymmetric access to water use. This new problem format, as opposed to commonly used linear (LP) or non-linear programming (NLP) approaches, enables the simultaneous simulation of numerous 'independent optimization' decisions by multiple water users while maintaining physical interdependences based on water use and flow in the river basin. We show that the alternative problem format allows the formulation HERBMs that yield more realistic results when comparing different water management institutions.

Correlates of Self-Concept of Elderly Women Residing in Institutions.

ERIC Educational Resources Information Center

Gfeller-Varga, Dorlinda A.; Long, Barbara H.

Ninety-five females (aged 61-100, mean=80.88) were interviewed in a study to determine correlates of self-regard, as measured by the Philadelphia Geriatric Morale Scale (PGMS) and the Rosenberg Self-Esteem Scale (RSE). The PGMS correlated with the RSE, implying that the two reflect a single construct. Both scales correlated with self-reported…

Students' Experiences with Supports Offered in Educational Opportunity Programs That Lead to Their Persistence in Postsecondary Education

ERIC Educational Resources Information Center

Beauchemin, Amy J.

2017-01-01

The purpose of this single case study was to gain a deeper understanding of the supports provided by postsecondary education institutions to students in Educational Opportunity Programs (EOPs). EOPs provide typically low-income, first generation, academically underprepared, and underserved students, who are often overlooked but show potential,…

"It's Really Making a Difference": How Small-Scale Research Projects Can Enhance Teaching and Learning

ERIC Educational Resources Information Center

Dexter, Barbara; Seden, Roy

2012-01-01

Following an internal evaluation exercise, using Action Research, this paper identifies the positive impact of small-scale research projects on teaching and learning at a single case study UK University. Clear evidence is given of how the projects benefited students and staff, and enhanced institutional culture. Barriers to better practice are…

The Rapid Detection of Single Bacterial Cells by Deep UV Micro Raman Spectroscopy.

DTIC Science & Technology

1992-04-01

Saltzman and C.T. Gregg, Appl. Environ. Microbiol. 44, 1081 (1982). 14. D.’. Mc Greggor, W.K. Grace and G.C. Salzman, in "Rapid Methods and...was used by Dr. Marcus Peter of the Dana -Farber Cancer Institute. During that period he came to our laboratories weekly to study GTP- binding

The Relationship between Reports of Psychological Capital and Reports of Job Satisfaction among Administrative Personnel at a Private Institution of Higher Education

ERIC Educational Resources Information Center

Mello, James A.

2012-01-01

The purpose of this single-site case study was to investigate the relationship between administrative personnel's reports of psychological capital (Luthans, Youssef, & Avolio, 2007) and their reports of job satisfaction (Hackman & Oldham, 1980). Specifically, two surveys, the Psychological Capital Questionnaire (Luthans, Youssef, &…

Exploring Higher Education's Response to the Early Childhood Education Teacher Shortage

ERIC Educational Resources Information Center

Matczak, Melissa L.

2017-01-01

This qualitative single case study attempt is to explore how one institution of higher education can be responsive in meeting the needs of a teacher shortage in early childhood education and the factors impacting (hindering and helping) the collaborative partner process of designing an Applied Bachelor's in Science Degree in Elementary Education…

Single-pilot workload management in entry-level jets.

DOT National Transportation Integrated Search

2013-09-01

Researchers from the NASA Ames Flight Cognition Lab and the FAAs Flight Deck Human Factors Research Laboratory at the Civil Aerospace Medical Institute (CAMI) examined task and workload management by single pilots in Very Light Jets (VLJs), also c...

The National Institutes of Health's Biomedical Translational Research Information System (BTRIS): Design, Contents, Functionality and Experience to Date

PubMed Central

Cimino, James J.; Ayres, Elaine J.; Remennik, Lyubov; Rath, Sachi; Freedman, Robert; Beri, Andrea; Chen, Yang; Huser, Vojtech

2013-01-01

The US National Institutes of Health (NIH) has developed the Biomedical Translational Research Information System (BTRIS) to support researchers’ access to translational and clinical data. BTRIS includes a data repository, a set of programs for loading data from NIH electronic health records and research data management systems, an ontology for coding the disparate data with a single terminology, and a set of user interface tools that provide access to identified data from individual research studies and data across all studies from which individually identifiable data have been removed. This paper reports on unique design elements of the system, progress to date and user experience after five years of development and operation. PMID:24262893

DECADE Web Portal: Integrating MaGa, EarthChem and GVP Will Further Our Knowledge on Earth Degassing

NASA Astrophysics Data System (ADS)

Cardellini, C.; Frigeri, A.; Lehnert, K. A.; Ash, J.; McCormick, B.; Chiodini, G.; Fischer, T. P.; Cottrell, E.

2014-12-01

The release of gases from the Earth's interior to the exosphere takes place in both volcanic and non-volcanic areas of the planet. Fully understanding this complex process requires the integration of geochemical, petrological and volcanological data. At present, major online data repositories relevant to studies of degassing are not linked and interoperable. We are developing interoperability between three of those, which will support more powerful synoptic studies of degassing. The three data systems that will make their data accessible via the DECADE portal are: (1) the Smithsonian Institution's Global Volcanism Program database (GVP) of volcanic activity data, (2) EarthChem databases for geochemical and geochronological data of rocks and melt inclusions, and (3) the MaGa database (Mapping Gas emissions) which contains compositional and flux data of gases released at volcanic and non-volcanic degassing sites. These databases are developed and maintained by institutions or groups of experts in a specific field, and data are archived in formats specific to these databases. In the framework of the Deep Earth Carbon Degassing (DECADE) initiative of the Deep Carbon Observatory (DCO), we are developing a web portal that will create a powerful search engine of these databases from a single entry point. The portal will return comprehensive multi-component datasets, based on the search criteria selected by the user. For example, a single geographic or temporal search will return data relating to compositions of emitted gases and erupted products, the age of the erupted products, and coincident activity at the volcano. The development of this level of capability for the DECADE Portal requires complete synergy between these databases, including availability of standard-based web services (WMS, WFS) at all data systems. Data and metadata can thus be extracted from each system without interfering with each database's local schema or being replicated to achieve integration at the DECADE web portal. The DECADE portal will enable new synoptic perspectives on the Earth degassing process. Other data systems can be easily plugged in using the existing framework. Our vision is to explore Earth degassing related datasets over previously unexplored spatial or temporal ranges.

Clinical outcomes in patients with brain metastases from breast cancer treated with single-session radiosurgery or whole brain radiotherapy.

PubMed

Mix, Michael; Elmarzouky, Rania; O'Connor, Tracey; Plunkett, Robert; Prasad, Dheerendra

2016-12-01

OBJECTIVE Gamma Knife radiosurgery (GKRS) is used to treat brain metastases from breast cancer (BMB) as the sole treatment or in conjunction with tumor resection and/or whole brain radiotherapy (WBRT). This study evaluates outcomes in BMB based on treatment techniques and tumor biological features. METHODS The authors reviewed all patients treated with BMB between 2004 and 2014. Patients were identified from a prospectively collected radiosurgery database and institutional tumor registry; 214 patients were identified. Data were collected from aforementioned sources and supplemented with chart review where needed. Independent radiological review was performed for all available brain imaging in those treated with GKRS. Survival analyses are reported using Kaplan-Meier estimates. RESULTS During the 10-year study period, 214 patients with BMB were treated; 23% underwent GKRS alone, 46% underwent a combination of GKRS and WBRT, and 31% underwent WBRT alone. Median survival after diagnosis of BMB in those treated with GKRS alone was 21 months, and in those who received WBRT alone it was 3 months. In those treated with GKRS plus WBRT, no significant difference in median survival was observed between those receiving WBRT upfront or in a salvage setting following GKRS (19 months vs 14 months, p = 0.63). The median survival of patients with total metastatic tumor volume of ≤ 7 cm 3 versus > 7 cm 3 was 20 months vs 7 months (p < 0.001). Human epidermal growth factor receptor-2 (Her-2) positively impacted survival after diagnosis of BMB (19 months vs 12 months, p = 0.03). Estrogen receptor status did not influence survival after diagnosis of BMB. No difference was observed in survival after diagnosis of BMB based on receptor status in those who received WBRT alone. CONCLUSIONS In this single-institution series of BMB, the addition of WBRT to GKRS did not significantly influence survival, nor did the number of lesions treated with GKRS. Survival after the diagnosis of BMB was most strongly affected by Her-2 positivity and total metastatic tumor volume.

Genetic variation and population structure of maize inbred lines adapted to the mid-altitude sub-humid maize agro-ecology of Ethiopia using single nucleotide polymorphic (SNP) markers.

PubMed

Ertiro, Berhanu Tadesse; Semagn, Kassa; Das, Biswanath; Olsen, Michael; Labuschagne, Maryke; Worku, Mosisa; Wegary, Dagne; Azmach, Girum; Ogugo, Veronica; Keno, Tolera; Abebe, Beyene; Chibsa, Temesgen; Menkir, Abebe

2017-10-12

Molecular characterization is important for efficient utilization of germplasm and development of improved varieties. In the present study, we investigated the genetic purity, relatedness and population structure of 265 maize inbred lines from the Ethiopian Institute of Agricultural Research (EIAR), the International Maize and Wheat Improvement Centre (CIMMYT) and the International Institute of Tropical Agriculture (IITA) using 220,878 single nucleotide polymorphic (SNP) markers obtained using genotyping by sequencing (GBS). Only 22% of the inbred lines were considered pure with <5% heterogeneity, while the remaining 78% of the inbred lines had a heterogeneity ranging from 5.1 to 31.5%. Pairwise genetic distances among the 265 inbred lines varied from 0.011 to 0.345, with 89% of the pairs falling between 0.301 and 0.345. Only <1% of the pairs had a genetic distance lower than 0.200, which included 14 pairs of sister lines that were nearly identical. Relative kinship analysis showed that the kinship coefficients for 59% of the pairs of lines was close to zero, which agrees with the genetic distance estimates. Principal coordinate analysis, discriminant analysis of principal components (DAPC) and the model-based population structure analysis consistently suggested the presence of three groups, which generally agreed with pedigree information (genetic background). Although not distinct enough, the SNP markers showed some level of separation between the two CIMMYT heterotic groups A and B established based on pedigree and combining ability information. The high level of heterogeneity detected in most of the inbred lines suggested the requirement for purification or further inbreeding except those deliberately maintained at early inbreeding level. The genetic distance and relative kinship analysis clearly indicated the uniqueness of most of the inbred lines in the maize germplasm available for breeders in the mid-altitude maize breeding program of Ethiopia. Results from the present study facilitate the maize breeding work in Ethiopia and germplasm exchange among breeding programs in Africa. We suggest the incorporation of high density molecular marker information in future heterotic group assignments.

A proposed method to minimize waste from institutional radiation safety surveillance programs through the application of expected value statistics.

PubMed

Emery, R J

1997-03-01

Institutional radiation safety programs routinely use wipe test sampling and liquid scintillation counting analysis to indicate the presence of removable radioactive contamination. Significant volumes of liquid waste can be generated by such surveillance activities, and the subsequent disposal of these materials can sometimes be difficult and costly. In settings where large numbers of negative results are regularly obtained, the limited grouping of samples for analysis based on expected value statistical techniques is possible. To demonstrate the plausibility of the approach, single wipe samples exposed to varying amounts of contamination were analyzed concurrently with nine non-contaminated samples. Although the sample grouping inevitably leads to increased quenching with liquid scintillation counting systems, the effect did not impact the ability to detect removable contamination in amounts well below recommended action levels. Opportunities to further improve this cost effective semi-quantitative screening procedure are described, including improvements in sample collection procedures, enhancing sample-counting media contact through mixing and extending elution periods, increasing sample counting times, and adjusting institutional action levels.

A proxy of DICOM services

NASA Astrophysics Data System (ADS)

Ribeiro, Luís S.; Costa, Carlos; Oliveira, José Luís

2010-03-01

Diagnostic tools supported by digital medical images have increasingly become an essential aid to medical decisions. However, despite its growing importance, Picture Archiving and Communication Systems (PACS) are typically oriented to support a single healthcare institution, and the sharing of medical data across institutions is still a difficult process. This paper describes a proposal to publish and control Digital Imaging Communications in Medicine (DICOM) services in a wide domain composed of several healthcare institutions. The system creates virtual bridges between intranets enabling the exchange, search and store of the medical data within the wide domain. The service provider publishes the DICOM services following a token-based strategy. The token advertisements are public and known by all system users. However, access to the DICOM service is controlled through a role association between an access key and the service. Furthermore, in medical diagnoses, time is a crucial factor. Therefore, our system is a turnkey solution, capable of exchanging medical data across firewalls and Network Address Translation (NAT), avoiding bureaucratic issues with local network security. Security is also an important concern - in any transmission across different domains, data is encrypted by Transport Layer Security (TLS).

A national-scale authentication infrastructure.

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

Butler, R.; Engert, D.; Foster, I.

2000-12-01

Today, individuals and institutions in science and industry are increasingly forming virtual organizations to pool resources and tackle a common goal. Participants in virtual organizations commonly need to share resources such as data archives, computer cycles, and networks - resources usually available only with restrictions based on the requested resource's nature and the user's identity. Thus, any sharing mechanism must have the ability to authenticate the user's identity and determine if the user is authorized to request the resource. Virtual organizations tend to be fluid, however, so authentication mechanisms must be flexible and lightweight, allowing administrators to quickly establish andmore » change resource-sharing arrangements. However, because virtual organizations complement rather than replace existing institutions, sharing mechanisms cannot change local policies and must allow individual institutions to maintain control over their own resources. Our group has created and deployed an authentication and authorization infrastructure that meets these requirements: the Grid Security Infrastructure. GSI offers secure single sign-ons and preserves site control over access policies and local security. It provides its own versions of common applications, such as FTP and remote login, and a programming interface for creating secure applications.« less

Cross-Species Virus-Host Protein-Protein Interactions Inhibiting Innate Immunity

DTIC Science & Technology

2016-07-01

HDTRA1-13-1-0017 Timothy C. Umland Prepared by: Hauptman-Woodward Medical Research Institute DESTRUCTION NOTICE: Destroy this report when it is no...Wayne Schultz (departed project Feb. 2015) and Timothy C. Umland Organization/Institution: Hauptman-Woodward Medical Research Institute Project Title...Figure 1. Zoonotic infectious diseases are a global problem. This project focused upon members of three negative-sense single- stranded RNA (ssRNA

Institutional Repositories as Infrastructures for Long-Term Preservation

ERIC Educational Resources Information Center

Francke, Helena; Gamalielsson, Jonas; Lundell, Björn

2017-01-01

Introduction: The study describes the conditions for long-term preservation of the content of the institutional repositories of Swedish higher education institutions based on an investigation of how deposited files are managed with regards to file format and how representatives of the repositories describe the functions of the repositories.…

Strategies to Promote Sustainability in Higher Education Institutions

ERIC Educational Resources Information Center

Berchin, Issa Ibrahim; Grando, Vanessa dos Santos; Marcon, Gabriela Almeida; Corseuil, Louise; Guerra, José Baltazar Salgueirinho Osório de Andrade

2017-01-01

Purpose: This paper aims to analyze strategies that promote sustainability in higher education institutions (HEIs), focusing on the case study of a federal institute of higher education in Brazil. Design/methodology/approach: The research was based on a scientific literature review on sustainability in HEIs, to identify the recurrent actions for…

How Is Science Being Taught? Measuring Evidence-Based Teaching Practices across Undergraduate Science Departments

PubMed Central

Drinkwater, Michael J.; Matthews, Kelly E.; Seiler, Jacob

2017-01-01

While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy. PMID:28232589

Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution

PubMed Central

Al-Thani, Hassan; Jabbour, Gaby; El-Menyar, Ayman; Abdelrahman, Husham; Peralta, Ruben; Zarour, Ahmad

2018-01-01

Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center. Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included all the patients who presented with TDIs during the study period. Data included demographics, mechanism of injury, associated injuries, initial vitals, emergency department disposition, length of ICU and hospital stay, ventilator days, management, and outcomes. The variables were analyzed and compared for patients with left (LTDI) and right (RTDI). Results: A total of 52 TDI cases (79% LTDI and 21% RTDI) were identified with a mean age of 31±11. LTDI patients were more likely to have higher Injury severity scores (p=0.50) and greater AAST organ injury scoring (p=0.661 for all) than RTDI patients. Surgical repair was performed for 85% LTDI vs. 73% RTDI (p=0.342). Recurrent DIs was reported only in LTDI (5.1% vs. 0.0%; p=0.911). Twelve patients died (9 LTDI and 3 RTDI), of them 5 had associated head injury. Conclusion: This single-institution study confirms that LTDI are more commonly diagnosed than RTDI. Exploratory laparotomy is the most frequent procedure considered for the management of diaphragmatic injuries in the emergency settings. To improve outcomes in patients presenting with TDI, large prospective multicenter studies are needed to standardize the TDI management protocols including the diagnostic workup, timing of surgical intervention, and the most appropriate approach of treatment.  PMID:29379805

Single-mode fiber, velocity interferometry.

PubMed

Krauter, K G; Jacobson, G F; Patterson, J R; Nguyen, J H; Ambrose, W P

2011-04-01

In this paper, we describe a velocity interferometer system based entirely on single-mode fiber optics. This paper includes a description of principles used in developing the single-mode velocity interferometry system (SMV). The SMV design is based on polarization-insensitive components. Polarization adjusters are included to eliminate the effects of residual birefringence and polarization dependent losses in the interferometers. Characterization measurements and calibration methods needed for data analysis and a method of data analysis are described. Calibration is performed directly using tunable lasers. During development, we demonstrated its operation using exploding-foil bridge-wire fliers up to 200 m/s. In a final test, we demonstrated the SMV in a gas gun experiment up to 1.2 km/sec. As a basis for comparison in the gas gun experiment, we used another velocimetry technique that is also based on single-mode fiber optics: photonic Doppler velocimetry (PDV). For the gas gun experiment, we split the light returned from a single target spot and performed a direct comparison of the homodyne (SMV) and heterodyne (PDV) techniques concurrently. The two techniques had a negligible mean difference and a 1.5% standard deviation in the one-dimensional shock zone. Within one interferometer delay time after a sudden Doppler shift, a SMV unencumbered by multimode-fiber dispersion exhibits two color beats. These beats have the same period as PDV beats-this interference occurs between the "recently" shifted and "formerly unshifted" paths within the interferometer. We believe that recognizing this identity between homodyne and heterodyne beats is novel in the shock-physics field. SMV includes the conveniences of optical fiber, while removing the time resolution limitations associated with the multimode delivery fiber. © 2011 American Institute of Physics

Posthemorrhagic hydrocephalus in preterm neonates: socioeconomic characteristics in a single-institution experience.

PubMed

Pendleton, Courtney; Cristofalo, Elizabeth A; Biondo, Gabriella N; Jallo, George I; Quiñones-Hinojosa, Alfredo; Ahn, Edward S

2012-01-01

Patients with posthemorrhagic hydrocephalus (PHH) from germinal matrix hemorrhage of prematurity often require numerous early interventions, as well as long-term follow-up care from pediatric neurosurgeons, which continues to place high demands on the existing workforce and pediatric health care system. There are established correlations between premature birth and low socioeconomic status. The aim of this study is to characterize the demographic profile and follow-up patterns in this subpopulation of surgically treated infants with PHH from prematurity. A retrospective analysis of the electronic patient records for a single institution, from 2007 to 2010, was performed. All patients who underwent neurosurgical intervention for the treatment of PHH were selected for further analysis. Data elements available within the records included patient demographic features, inpatient treatments and procedures, inpatient mortality rates, length of stay, and postoperative follow-up at the institution. Socioeconomic status was assessed using the median household income for the patient's zip code, as reported in the United States Census for the year 2000. A total of 40 patients who underwent neurosurgical intervention for PHH at a single institution were identified. More patients were female (52.5%); the majority of patients were Black (57.5%). No patients were uninsured; most patients had public insurance (62.5%), and 65% were below the Maryland State median household income (USD 52,868). There were trends toward more frequent emergency room visits among those covered by public insurance and those below the state and national median house income, although differences were not statistically significant. Our data indicate that the majority of patients fall within lower household income brackets, are born into households earning less than the statewide median household income, and are covered by public insurance. In light of the socioeconomic profile of the patient population reported here, these data may prove to be useful in preventative strategies aimed toward prematurity, PHH, and the ongoing treatment of hydrocephalus by pediatric neurosurgeons and other pediatric subspecialists. Copyright © 2012 S. Karger AG, Basel.

Method for Estimating Evaporative Potential (IM/CLO) from ASTM Standard Single Wind Velocity Measures

DTIC Science & Technology

2016-08-10

IM/CLO) FROM ASTM STANDARD SINGLE WIND VELOCITY MEASURES DISCLAIMER The opinions or assertions contained herein are the private views of the...USARIEM TECHNICAL REPORT T16-14 METHOD FOR ESTIMATING EVAPORATIVE POTENTIAL (IM/CLO) FROM ASTM STANDARD SINGLE WIND VELOCITY...ASTM STANDARD SINGLE WIND VELOCITY MEASURES Adam W. Potter Biophysics and Biomedical Modeling Division U.S. Army Research Institute of Environmental

Part-Time Community-College Faculty and the Desire for Full-Time Tenure-Track Positions: Results of a Single Institution Case Study

ERIC Educational Resources Information Center

Jacoby, Dan

2005-01-01

According to data derived from a community-college survey in the state of Washington, the majority of part-time faculty prefer full-time work. Using a logit regression analysis, the study reported in this paper suggests that typical part-timers enter their part-time teaching situations with the intent of becoming full-time, but gradually become…

Juvenile nasopharyngeal angiofibroma: a single institution study.

PubMed

Mistry, Rajesh C; Qureshi, Sajid S; Gupta, Shaikat; Gupta, Sameer

2005-01-01

Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumor of adolescent males and there is a paucity of Indian studies on this subject. To present the experience of management of JNA at a single institution. This is a retrospective observational study of patients with JNA who presented at the Tata Memorial Hospital between May 1988 and August 2001. Thirty-two patients with JNA were treated in the study period. Since the time period was prolonged and diagnostic and therapeutic protocols had undergone many changes, the patients were divided into two groups, namely 1988-1996 and 1997-2001. The age distribution, disease patterns, management approaches and treatment outcomes of patients in the two groups were recorded. Statistical analyses were done using students 't' test and test for proportion. The mean age at presentation was 16 years and more than 90% of the patients had Stage III or IV disease. Preoperative embolization was carried out in 19 patients. The surgical approaches used were median maxillectomy, infratemporal fossa, transpalatal, maxillary swing and craniofacial approach. The recurrence rate, complete resection rate and cure rates were 12.5%, 41% and 63% respectively. Surgery is the mainstay of treatment of JNA. Preoperative embolization and newer surgical approaches result in less blood loss and complete resection. Aggressive re-resection should be done for resectable recurrences reserving radiotherapy for unresectable, recurrent/ residual disease.

Systemic effects of low-dose dopamine during administration of cytarabine.

PubMed

Connelly, James; Benani, Dina J; Newman, Matthew; Burton, Bradley; Crow, Jessica; Levis, Mark

2017-09-01

Purpose Low-dose dopamine has been utilized to improve renal blood flow, urine output, and reduce drug-induced nephrotoxicity. The purpose of this study was to assess changes in renal function, cardiovascular adverse events, and neurologic toxicity in patients receiving cytarabine with or without low-dose dopamine. Methods A retrospective, single-center, cohort study of patients receiving cytarabine at 667 mg/m 2 /dose or greater, with or without dopamine at ≤5 mcg/kg/min. Cohorts were based upon initiation or absence of low-dose dopamine; cytarabine only, cytarabine + pre- and day of low-dose dopamine, and cytarabine + post-low-dose dopamine. Renal outcomes (urine output, serum creatinine, and creatinine clearance) were compared with baseline and between cohorts. Safety endpoints (arrhythmias, tachycardia, and neurotoxicity) were compared between cohorts based on low-dose dopamine exposure. Results There was no difference in urine output from baseline in all cohorts. Comparing cytarabine only and pre- and day of low-dose dopamine cohorts, there was no difference in urine output. In those receiving low-dose dopamine, there was no difference in serum creatinine and creatinine clearance from baseline. No arrhythmias were documented during the study period, and there was no difference in the incidence of tachycardia between groups (P = 0.66). Neurotoxicity was reported in three patients who were on low-dose dopamine. Conclusion Though variation existed in individual patients administered low-dose dopamine, the use of low-dose dopamine did not significantly impact renal function in this small sample at a single institution. In addition, low-dose dopamine did not negatively impact cardiovascular function.

SU-C-BRB-03: Cross-Institutional Validation of An Ultrafast Automatic Planning Platform for Breast Irradiation

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

Li, T; Lockamy, V; Anne, P

2016-06-15

Purpose: Recently an ultrafast automatic planning system for breast irradiation using tangential beams was developed by modeling relationships between patient anatomy and achieved dose distribution. This study evaluates the performance of this system when applied to a different patient population and dose calculation algorithm. Methods: The system and its anatomy-to-dose models was developed at institution A based on 20 cases, which were planned using manual fluence painting technique and calculated WITH heterogeneity correction. Institution B uses field-in-field planning technique and dose calculation WITHOUT heterogeneity correction. 11 breast cases treated at Institution B were randomly selected for retrospective study, including leftmore » and right sides, and different breast size (irradiated volumes defined by Jaw/MLC opening range from 875cc to 3516cc). Comparisons between plans generated automatically (Auto-Plans) and those used for treatment (Clinical-Plans) included: energy choice (single/mixed), volumes receiving 95%/100%/105%/110% Rx dose (V95%/V100%/V105%/V100%) relative to irradiated volume, D1cc, and LungV20Gy. Results: In 9 out of 11 cases single/mixed energy choice made by the software agreed with Clinical-Plans. For the remaining 2 cases software recommended using mixed energy and dosimetric improvements were observed. V100% were similar (p=0.223, Wilcoxon Signed-Rank test) between Auto-Plans and Clinical-Plans (57.6±8.9% vs. 54.8±9.5%). V95% is 2.3±3.0% higher for Auto-Plans (p=0.027), indicating reduced cold areas. Hot spot volume V105% were significantly reduced in Auto-Plan by 14.4±7.2% (p=0.004). Absolute V105% was reduced from 395.6±359.9cc for Clinical-Plans to 108.7±163cc for Auto-Plans. D1cc was 107.4±2.8% for Auto-Plans, and 109.2±2.4% for Clinical-Plans (p=0.056). LungV20Gy were 13.6±4.0% for Auto-Plan vs. 14.0±4.1% for Clinical-Plans (p=0.043). All optimizations were finished within 1.5min. Conclusion: The performance of this breast auto-planning system remained stable and satisfactory when applied to a different patient population and dose calculation algorithm. The auto-planning system was able to produce clinically similar Rx dose coverage with significantly improved homogeneity inside breast tissue, in less than 1.5min.« less

Qualitative evaluation of just-in-time simulation-based learning: the learners' perspective.

PubMed

Kamdar, Gunjan; Kessler, David O; Tilt, Lindsey; Srivastava, Geetanjali; Khanna, Kajal; Chang, Todd P; Balmer, Dorene; Auerbach, Marc

2013-02-01

Just-in-time training (JITT) is an educational strategy where training occurs in close temporal proximity to a clinical encounter. A multicenter study evaluated the impact of simulation-based JITT on interns' infant lumbar puncture (LP) success rates. Concurrent with this multicenter study, we conducted a qualitative evaluation to describe learner perceptions of this modality of skills training. Eleven interns from a single institution participated in a face-to-face semistructured interview exploring their JITT experience. Interviews were audio-recorded and transcribed. Two investigators reviewed the transcripts, assigned codes to the data, and categorized the codes. Categories were modified by 4 emergency physicians. As a means of data triangulation, we performed focus groups at a second institution. Benefits of JITT included review of anatomic landmarks, procedural rehearsal, and an opportunity to ask questions. These perceived benefits improved confidence with infant LP. Deficits of the training included lack of mannequin fidelity and unrealistic context when compared with an actual LP. An unexpected category, which emerged from our analysis, was that of barriers to JITT performance. Barriers included lack of time in a busy clinical setting and various instructor factors. The focus group findings confirmed and elaborated the benefits and deficits of JITT and the barriers to JITT performance. Just-in-time training improved procedural confidence with infant LP, but work place busyness and instructor lack of support or unawareness were barriers to JITT performance. Optimal LP JITT would occur with improved contextual fidelity. More research is needed to determine optimal training strategies that are effective for the learner and maximize clinical outcomes for the patient.

BioSMACK: a linux live CD for genome-wide association analyses.

PubMed

Hong, Chang Bum; Kim, Young Jin; Moon, Sanghoon; Shin, Young-Ah; Go, Min Jin; Kim, Dong-Joon; Lee, Jong-Young; Cho, Yoon Shin

2012-01-01

Recent advances in high-throughput genotyping technologies have enabled us to conduct a genome-wide association study (GWAS) on a large cohort. However, analyzing millions of single nucleotide polymorphisms (SNPs) is still a difficult task for researchers conducting a GWAS. Several difficulties such as compatibilities and dependencies are often encountered by researchers using analytical tools, during the installation of software. This is a huge obstacle to any research institute without computing facilities and specialists. Therefore, a proper research environment is an urgent need for researchers working on GWAS. We developed BioSMACK to provide a research environment for GWAS that requires no configuration and is easy to use. BioSMACK is based on the Ubuntu Live CD that offers a complete Linux-based operating system environment without installation. Moreover, we provide users with a GWAS manual consisting of a series of guidelines for GWAS and useful examples. BioSMACK is freely available at http://ksnp.cdc. go.kr/biosmack.

Overview of registered studies in orthodontics: Evaluation of the ClinicalTrials.gov registry.

PubMed

Allareddy, Veerasathpurush; Rampa, Sankeerth; Masoud, Mohamed I; Lee, Min Kyeong; Nalliah, Romesh; Allareddy, Veerajalandhar

2014-11-01

The Food and Drug Administration Modernization Act of 1997 made it mandatory for all phase II through IV trials regulated by this Act to be registered. After this, the National Institutes of Health created ClinicalTrials.gov, which is a registry of publicly and privately supported clinical studies of human participants. The objective of this study was to examine the characteristics of registered studies in orthodontics. The ClinicalTrials.gov Web site was used to query all registered orthodontic studies. The search term used was "orthodontics." No limitations were placed for the time period. All registered studies regardless of their recruitment status, study results, and study type were selected for analysis. A total of 64 orthodontic studies were registered as of January 1, 2014. Of these, 52 were interventional, and 12 were observational. Close to 60% of the interventional studies and 66.7% of the observational studies had sample sizes of 50 or fewer subjects. About 21.2% of the interventional studies and 16.7% of the observational studies had sample sizes greater than 100. Only 1 study was funded by the National Institutes of Health, and the rest were funded by "other" or "industry" sources. Close to 87.7% of the interventional studies were randomized. Interventional model assignments included factorial assignment (3.9%), parallel assignments (74.5%), crossover assignment (7.8%), and single-group assignment (13.7%). Most studies were treatment oriented (80.4%). The types of masking used by the interventional studies included open label (28.9%), single blind (44.2%), and double blind (26.9%). Outcome assessors were blinded in only 6 studies. Orthodontic studies registered in ClinicalTrials.gov are dominated by small single-center studies. There are wide variations with regard to treatment allocation approaches and randomization methods in the studies. These results also indicate the need for multicenter clinical studies in orthodontics. Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

75 FR 11993 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... before April 12, 2010 to be assured of consideration. Community Development Financial Institutions (CDFI... related to Community Development Entity (CDE)/New Markets Tax Credit material events, as well as Community Development Financial Institutions (CDFI) material events in a single form. The form will provide a more...

Association of single nucleotide polymorphism in CD28(C/T-I3 + 17) and CD40 (C/T-1) genes with the Graves' disease.

PubMed

Mustafa, Saima; Fatima, Hira; Fatima, Sadia; Khosa, Tafheem; Akbar, Atif; Shaikh, Rehan Sadiq; Iqbal, Furhan

2018-01-01

To find out a correlation between the single nucleotide polymorphisms in cluster of differentiation 28 and cluster of differentiation 40 genes with Graves' disease, if any. This case-control study was conducted at the Multan Institute of Nuclear Medicine and Radiotherapy, Multan, Pakistan, and comprised blood samples of Graves' disease patients and controls. Various risk factors were also correlated either with the genotype at each single-nucleotide polymorphism or with various combinations of genotypes studied during present investigation. Of the 160 samples, there were 80(50%) each from patients and controls. Risk factor analysis revealed that gender (p=0.008), marital status (p<0.001), education (p<0.001), smoking (p<0.001), tri-iodothyronine (P <0.001), thyroxin (p<0.001) and thyroid-stimulating hormone (p<0.000) levels in blood were associated with Graves' disease. Both single-nucleotide polymorphisms in both genes were not associated with Graves' disease, either individually or in any combined form.

Assessment of Intracorporeal Suturing in Single-Port Surgery Using an Experimental Suturing Model.

PubMed

Ishiyama, Yasuhiro; Inaki, Noriyuki; Bando, Hiroyuki; Yamada, Tetsuji

2017-04-01

The aim of this study is to assess the difficulty of intracorporeal suturing in single-port surgery, using experimental suturing model in dry box. Subjects were divided for three groups: seven experienced laparoscopic surgeons, seven surgical residents, and seven interns. An experimental suturing model is developed, and working angle was set from 0° to 90°. The completion rate in 0° was significantly lower than that in the other angles. Completion rate of group A was higher than that of the other groups. Precision of task in group A was significantly higher than that of group B and group C in 0° and 60°. Stress score in 0° were significantly higher than that in the other angles. Our study demonstrated that intracorporeal suturing in single-port surgery seems to be more difficult than conventional laparoscopic surgery. Our data should be taken the institution under consideration for introduction of single-port surgery.

Automated pancreatic cyst screening using natural language processing: a new tool in the early detection of pancreatic cancer

PubMed Central

Roch, Alexandra M; Mehrabi, Saeed; Krishnan, Anand; Schmidt, Heidi E; Kesterson, Joseph; Beesley, Chris; Dexter, Paul R; Palakal, Mathew; Schmidt, C Max

2015-01-01

Introduction As many as 3% of computed tomography (CT) scans detect pancreatic cysts. Because pancreatic cysts are incidental, ubiquitous and poorly understood, follow-up is often not performed. Pancreatic cysts may have a significant malignant potential and their identification represents a ‘window of opportunity’ for the early detection of pancreatic cancer. The purpose of this study was to implement an automated Natural Language Processing (NLP)-based pancreatic cyst identification system. Method A multidisciplinary team was assembled. NLP-based identification algorithms were developed based on key words commonly used by physicians to describe pancreatic cysts and programmed for automated search of electronic medical records. A pilot study was conducted prospectively in a single institution. Results From March to September 2013, 566 233 reports belonging to 50 669 patients were analysed. The mean number of patients reported with a pancreatic cyst was 88/month (range 78–98). The mean sensitivity and specificity were 99.9% and 98.8%, respectively. Conclusion NLP is an effective tool to automatically identify patients with pancreatic cysts based on electronic medical records (EMR). This highly accurate system can help capture patients ‘at-risk’ of pancreatic cancer in a registry. PMID:25537257

Computer-Based Learning in Open and Distance Learning Institutions in Nigeria: Cautions on Use of Internet for Counseling

ERIC Educational Resources Information Center

Okopi, Fidel Onjefu; Odeyemi, Olajumoke Janet; Adesina, Adewale

2015-01-01

The study has identified the areas of strengths and weaknesses in the current use of Computer Based Learning (CBL) tools in Open and Distance Learning (ODL) institutions in Nigeria. To achieve these objectives, the following research questions were proposed: (i) What are the computer-based learning tools (soft and hard ware) that are actually in…

Variability of writing disorders in Wernicke's aphasia underperforming different writing tasks: A single-case study.

PubMed

Kozintseva, Elena; Skvortsov, Anatoliy

2016-03-01

The aim of our study was to evolve views on writing disorders in Wernicke's agraphia by comparing group data and analysis of a single patient. We showed how a single-case study can be useful in obtaining essential results that can be hidden by averaging group data. Analysis of a single patient proved to be important for resolving contradictions of the "holistic" and "elementaristic" paradigms of psychology and for the development of theoretical knowledge with the example of a writing disorder. The implementation of a holistic approach was undertaken by presenting the tasks differing in functions in which writing had been performed since its appearance in human culture (communicative, mnestic, and regulatory). In spite of the identical composition of involved psychological components, these differences were identified when certain types of errors were analyzed in the single subject. The results are discussed in terms of used writing strategy, resulting in a way of operation of involved components that lead to qualitative and quantitative changes of writing errors within the syndrome of Wernicke's agraphia. © 2016 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Recent health policy initiatives in Nordic countries

PubMed Central

Saltman, Richard B.

1992-01-01

Health care systems in Sweden, Finland, and Denmark are in the midst of substantial organizational reconfiguration. Although retaining their tax-based single source financing arrangements, they have begun experiments that introduce a limited measure of competitive behavior in the delivery of health services. The emphasis has been on restructuring public operated hospitals and health centers into various forms of public firms, rather than on the privatization of ownership of institutions. If successful, the reforms will enable these Nordic countries to combine their existing macroeconomic controls with enhanced microeconomic efficiency, effectiveness, and responsiveness to patients. PMID:10122003

Student Athlete Persistence Patterns: An Analysis of Retention Factors at a Small, Faith-Based Institution

ERIC Educational Resources Information Center

Couch, Charlie D.

2011-01-01

The persistence patterns of student athletes continues to gain interest among the higher education community, particularly among private, faith-based institutions belonging to the NAIA who continue to rely on student athlete recruitment to optimize overall enrollment patterns. Unfortunately, few studies exist in the literature surrounding student…

Engaged Institutions: Impacting the Lives of Vulnerable Youth through Place-Based Learning.

ERIC Educational Resources Information Center

Rural School and Community Trust, Washington, DC.

Six case studies examine the connections between higher education institutions and schools that have chosen place-based education as a framework for student learning and community growth. Through such partnerships, Lubec (Maine) high school has established a vocational aquaculture program in an effort to revitalize the struggling local fishing…

The Impact of Merit-Based Financial Aid on College Enrollment: A Field Experiment

ERIC Educational Resources Information Center

Monks, James

2009-01-01

Merit-based financial aid awards have become increasingly prevalent in the pricing policies of higher education institutions. This study utilizes an experiment to estimate the efficacy of merit-aid awards in achieving the institutional objective of attracting the most academically desirable applicants. I find that merit aid has a statistically…

A Case of Problem Based Learning for Cross-Institutional Collaboration

ERIC Educational Resources Information Center

Nerantzi, Chrissi

2012-01-01

The idea of moving away from battery-type Academic Development Activities and silo modules and programmes towards open cross-institutional approaches in line with OEP are explored within this paper based on a recent small-scale, fully-online study. This brought together academics and other professionals who support learning, from different…

The Impact of Intercollegiate Athletics on Undergraduate Enrollment at a Small, Private, Southern, Faith-Based Institution

ERIC Educational Resources Information Center

Brunet, Matthew J.

2010-01-01

Based on previous research, it is apparent that many National Collegiate Athletic Association (NCAA) Division I institutions benefit from the existence of and success in intercollegiate athletics. However, there are few, if any, studies that have researched the impact of intercollegiate athletics at National Association of Intercollegiate…

Single-pilot workload management in entry-level jets : appendices.

DOT National Transportation Integrated Search

2013-09-01

Researchers from the NASA Ames Flight Cognition Lab and the FAAs Flight Deck Human Factors Research Laboratory at the Civil Aerospace Medical Institute (CAMI) examined task and workload management by single pilots in Very Light Jets (VLJs), also c...

Climate change adaptation among Tibetan pastoralists: challenges in enhancing local adaptation through policy support.

PubMed

Fu, Yao; Grumbine, R Edward; Wilkes, Andreas; Wang, Yun; Xu, Jian-Chu; Yang, Yong-Ping

2012-10-01

While researchers are aware that a mix of Local Ecological Knowledge (LEK), community-based resource management institutions, and higher-level institutions and policies can facilitate pastoralists' adaptation to climate change, policy makers have been slow to understand these linkages. Two critical issues are to what extent these factors play a role, and how to enhance local adaptation through government support. We investigated these issues through a case study of two pastoral communities on the Tibetan Plateau in China employing an analytical framework to understand local climate adaptation processes. We concluded that LEK and community-based institutions improve adaptation outcomes for Tibetan pastoralists through shaping and mobilizing resource availability to reduce risks. Higher-level institutions and policies contribute by providing resources from outside communities. There are dynamic interrelationships among these factors that can lead to support, conflict, and fragmentation. Government policy could enhance local adaptation through improvement of supportive relationships among these factors. While central government policies allow only limited room for overt integration of local knowledge/institutions, local governments often have some flexibility to buffer conflicts. In addition, government policies to support market-based economic development have greatly benefited adaptation outcomes for pastoralists. Overall, in China, there are still questions over how to create innovative institutions that blend LEK and community-based institutions with government policy making.

Measuring Diversity and Inclusion in Academic Medicine: The Diversity Engagement Survey (DES)

PubMed Central

Person, Sharina D.; Jordan, C. Greer; Allison, Jeroan J.; Fink Ogawa, Lisa M.; Castillo-Page, Laura; Conrad, Sarah; Nivet, Marc A.; Plummer, Deborah L.

2018-01-01

Purpose To produce a physician and scientific workforce capable of delivering high quality, culturally competent health care and research, academic medical centers must assess their capacity for diversity and inclusion and respond to identified opportunities. Thus, the Diversity Engagement Survey (DES) is presented as a diagnostic and benchmarking tool. Method The 22-item DES connects workforce engagement theory with inclusion and diversity constructs. Face and content validity were established based on decades of previous work to promote institutional diversity. The survey was pilot tested at a single academic medical center and subsequently administered at 13 additional academic medical centers. Cronbach alphas assessed internal consistency and Confirmatory Factor Analysis (CFA) established construct validity. Criterion validity was assessed by observed separation in scores for groups traditionally recognized to have less workforce engagement. Results The sample consisted of 13,694 individuals at 14 medical schools from across the U.S. who responded to the survey administered between 2011– 2012. The Cronbach alphas for inclusion and engagement factors (range: 0.68 to 0.85), CFA fit indices, and item correlations with latent constructs, indicated an acceptable model fit and that questions measured the intended concepts. DES scores clearly distinguished higher and lower performing institutions. The DES detected important disparities for black, women, and those who did not have heterosexual orientation. Conclusions This study demonstrated that the DES is a reliable and valid instrument for internal assessment and evaluation or external benchmarking of institutional progress in building inclusion and engagement. PMID:26466376

Tackling the "so what" problem in scientific research: a systems-based approach to resource and publication tracking.

PubMed

Harris, Paul A; Kirby, Jacqueline; Swafford, Jonathan A; Edwards, Terri L; Zhang, Minhua; Yarbrough, Tonya R; Lane, Lynda D; Helmer, Tara; Bernard, Gordon R; Pulley, Jill M

2015-08-01

Peer-reviewed publications are one measure of scientific productivity. From a project, program, or institutional perspective, publication tracking provides the quantitative data necessary to guide the prudent stewardship of federal, foundation, and institutional investments by identifying the scientific return for the types of support provided. In this article, the authors describe the Vanderbilt Institute for Clinical and Translational Research's (VICTR's) development and implementation of a semiautomated process through which publications are automatically detected in PubMed and adjudicated using a "just-in-time" workflow by a known pool of researchers (from Vanderbilt University School of Medicine and Meharry Medical College) who receive support from Vanderbilt's Clinical and Translational Science Award. Since implementation, the authors have (1) seen a marked increase in the number of publications citing VICTR support, (2) captured at a more granular level the relationship between specific resources/services and scientific output, (3) increased awareness of VICTR's scientific portfolio, and (4) increased efficiency in complying with annual National Institutes of Health progress reports. They present the methodological framework and workflow, measures of impact for the first 30 months, and a set of practical lessons learned to inform others considering a systems-based approach for resource and publication tracking. They learned that contacting multiple authors from a single publication can increase the accuracy of the resource attribution process in the case of multidisciplinary scientific projects. They also found that combining positive (e.g., congratulatory e-mails) and negative (e.g., not allowing future resource requests until adjudication is complete) triggers can increase compliance with publication attribution requests.

Evolution of the “Drivers” of Translational Cancer Epidemiology: Analysis of Funded Grants and the Literature

PubMed Central

Lam, Tram Kim; Chang, Christine Q.; Rogers, Scott D.; Khoury, Muin J.; Schully, Sheri D.

2015-01-01

Concurrently with a workshop sponsored by the National Cancer Institute, we identified key “drivers” for accelerating cancer epidemiology across the translational research continuum in the 21st century: emerging technologies, a multilevel approach, knowledge integration, and team science. To map the evolution of these “drivers” and translational phases (T0–T4) in the past decade, we analyzed cancer epidemiology grants funded by the National Cancer Institute and published literature for 2000, 2005, and 2010. For each year, we evaluated the aims of all new/competing grants and abstracts of randomly selected PubMed articles. Compared with grants based on a single institution, consortium-based grants were more likely to incorporate contemporary technologies (P = 0.012), engage in multilevel analyses (P = 0.010), and incorporate elements of knowledge integration (P = 0.036). Approximately 74% of analyzed grants and publications involved discovery (T0) or characterization (T1) research, suggesting a need for more translational (T2–T4) research. Our evaluation indicated limited research in 1) a multilevel approach that incorporates molecular, individual, social, and environmental determinants and 2) knowledge integration that evaluates the robustness of scientific evidence. Cancer epidemiology is at the cusp of a paradigm shift, and the field will need to accelerate the pace of translating scientific discoveries in order to impart population health benefits. While multi-institutional and technology-driven collaboration is happening, concerted efforts to incorporate other key elements are warranted for the discipline to meet future challenges. PMID:25767265

Hydrocephalus: an underrated long-term complication of microvascular decompression for trigeminal neuralgia. A single institute experience.

PubMed

Muratorio, Francesco; Tringali, G; Levi, V; Ligarotti, G K I; Nazzi, V; Franzini, A A

2016-11-01

Hydrocephalus is a common complication of posterior fossa surgery, but its real incidence after microvascular decompression (MVD) for idiopathic trigeminal neuralgia (TN) still remains unclear. The aim of this study was to focus on the potential association between MVD and hydrocephalus as a surgery-related complication. All patients who underwent MVD procedure for idiopathic TN at our institute between 2009 and 2014 were reviewed to search for early or late postoperative hydrocephalus. There were 259 consecutive patients affected by idiopathic TN who underwent MVD procedure at our institution between 2009 and 2014 (113 men, 146 women; mean age 59 years, range 30-87 years; mean follow-up 40.92 months, range 8-48 months). Nine patients (3.47 %) developed communicating hydrocephalus after hospital discharge and underwent standard ventriculo-peritoneal shunt. No cases of acute hydrocephalus were noticed. Our study suggests that late communicating hydrocephalus may be an underrated potential long-term complication of MVD surgery.

People don't talk in institutional statements: A methodological case study of the Institutional Analysis and Development Framework

Treesearch

Cristy Watkins; Lynne M. Westphal

2015-01-01

In this paper, we describe our application of Ostrom et al.'s ADICO syntax, a grammatical tool based in the Institutional Analysis and Development framework, to a study of ecological restoration decision making in the Chicago Wilderness region. As this method has only been used to look at written policy and/or extractive natural resource management systems, our...

Social, Organizational, and Contextual Characteristics of Clinical Decision Support Systems for Intensive Insulin Therapy: A Literature Review and Case Study

PubMed Central

Campion, Thomas R.; Waitman, Lemuel R.; May, Addison K.; Ozdas, Asli; Lorenzi, Nancy M.; Gadd, Cynthia S.

2009-01-01

Introduction: Evaluations of computerized clinical decision support systems (CDSS) typically focus on clinical performance changes and do not include social, organizational, and contextual characteristics explaining use and effectiveness. Studies of CDSS for intensive insulin therapy (IIT) are no exception, and the literature lacks an understanding of effective computer-based IIT implementation and operation. Results: This paper presents (1) a literature review of computer-based IIT evaluations through the lens of institutional theory, a discipline from sociology and organization studies, to demonstrate the inconsistent reporting of workflow and care process execution and (2) a single-site case study to illustrate how computer-based IIT requires substantial organizational change and creates additional complexity with unintended consequences including error. Discussion: Computer-based IIT requires organizational commitment and attention to site-specific technology, workflow, and care processes to achieve intensive insulin therapy goals. The complex interaction between clinicians, blood glucose testing devices, and CDSS may contribute to workflow inefficiency and error. Evaluations rarely focus on the perspective of nurses, the primary users of computer-based IIT whose knowledge can potentially lead to process and care improvements. Conclusion: This paper addresses a gap in the literature concerning the social, organizational, and contextual characteristics of CDSS in general and for intensive insulin therapy specifically. Additionally, this paper identifies areas for future research to define optimal computer-based IIT process execution: the frequency and effect of manual data entry error of blood glucose values, the frequency and effect of nurse overrides of CDSS insulin dosing recommendations, and comprehensive ethnographic study of CDSS for IIT. PMID:19815452

Community Structure in Online Collegiate Social Networks

NASA Astrophysics Data System (ADS)

Traud, Amanda; Kelsic, Eric; Mucha, Peter; Porter, Mason

2009-03-01

Online social networking sites have become increasingly popular with college students. The networks we studied are defined through ``friendships'' indicated by Facebook users from UNC, Oklahoma, Caltech, Georgetown, and Princeton. We apply the tools of network science to study the Facebook networks from these five different universities at a single point in time. We investigate each single-institution network's community structure, which we obtain through partitioning the graph using an eigenvector method. We use both graphical and quantitative tools, including pair-counting methods, which we interpret through statistical analysis and permutation tests to measure the correlations between the network communities and a set of characteristics given by each user (residence, class year, major, and high school). We also analyze the single gender subsets of these networks, and the impact of missing demographical data. Our study allows us to compare the online social networks for the five schools as well as infer differences in offline social interactions. At the schools studied, we were able to define which characteristics of the Facebook users correlate best with friendships.

Third-Line Chemotherapy for Metastatic Urothelial Cancer: A Retrospective Observational Study

PubMed Central

Di Lorenzo, Giuseppe; Buonerba, Carlo; Bellelli, Teresa; Romano, Concetta; Montanaro, Vittorino; Ferro, Matteo; Benincasa, Alfonso; Ribera, Dario; Lucarelli, Giuseppe; De Cobelli, Ottavio; Sonpavde, Guru; De Placido, Sabino

2015-01-01

Abstract The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting. We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma. Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73%) received second-line salvage treatment. Fifty-two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10–17) and 31 (28–36) weeks. Single-agent cyclophosphamide was associated with a PFS of 18 (13–22) and an OS of 38 (33–41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR) = 0.42; 95% CI: 0.20–0.89; P = 0.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95% CI = 1.95–9.77; P < 0.01). We observed a significantly longer overall survival in patients receiving single-agent cyclophosphamide, with few grade 3 to 4 toxicities. Further studies should assess the efficacy of metronomic single-agent cyclophosphamide in advanced lines of treatment, as it may yield a survival benefit with low costs and no detrimental effects on quality of life. PMID:26705213