Atmospheric Entry Studies for Venus Missions: 45 Sphere-Cone Rigid Aeroshells and Ballistic Entries

NASA Technical Reports Server (NTRS)

Prabhu, Dinesh K.; Spilker, Thomas R.; Allen, Gary A., Jr.; Hwang, Helen H.; Cappuccio, Gelsomina; Moses, Robert W.

2013-01-01

The present study considers direct ballistic entries into the atmosphere of Venus using a 45deg sphere-cone rigid aeroshell, a legacy shape that has been used successfully in the past in the Pioneer Venus Multiprobe Mission. For a number of entry mass and heatshield diameter combinations (i.e., various ballistic coefficients) and entry velocities, the trajectory space in terms of entry flight path angles between skip out and -30deg is explored with a 3DoF trajectory code, TRAJ. From these trajectories, the viable entry flight path angle space is determined through the use of mechanical and thermal performance limits on the thermal protection material and science payload; the thermal protection material of choice is entry-grade carbon phenolic, for which a material thermal response model is available. For mechanical performance, a 200 g limit is placed on the peak deceleration load experienced by the science instruments, and 10 bar is assumed as the pressure limit for entry-grade carbon-phenolic material. For thermal performance, inflection points in the total heat load distribution are used as cut off criteria. Analysis of the results shows the existence of a range of critical ballistic coefficients beyond which the steepest possible entries are determined by the pressure limit of the material rather than the deceleration load limit.

A multicenter study of outcome in systemic lupus erythematosus. I. Entry variables as predictors of prognosis.

PubMed

Ginzler, E M; Diamond, H S; Weiner, M; Schlesinger, M; Fries, J F; Wasner, C; Medsger, T A; Ziegler, G; Klippel, J H; Hadler, N M; Albert, D A; Hess, E V; Spencer-Green, G; Grayzel, A; Worth, D; Hahn, B H; Barnett, E V

1982-06-01

A retrospective study of factors influencing survival in 1,103 patients with systemic lupus erythematosus (SLE) was carried out at 9 university centers diverse in geographic, socioeconomic, and racial characteristics. The mortality and disease characteristics of the patients at study entry varied widely among centers. The survival rates from the time patients with a diagnosis of SLE were first evaluated at the participating center was 90% at 1 year, 77% at 5 years, and 71% at 10 years. Patients with a serum creatinine greater than 3 mg/dl at study entry had the lowest survival rates: 48%, 29%, and 12% at 1, 5, and 10 years, respectively. Survival rate also correlated independently with the entry hematocrit, degree of proteinuria, number of preliminary American Rheumatism Association criteria for SLE satisfied, and source of funding of medical care. When data were corrected for socioeconomic status, race/ethnic origin did not significantly influence survival. Survival rates varied widely at different participating institutions, generally due to differences in disease severity. Place of treatment was independently associated with survival only in the second year after study entry. Disease duration before study entry did not account for the differences in disease severity.

Etiquette for medical students' email communication with faculty members: a single-institution study.

PubMed

Kim, Do-Hwan; Yoon, Hyun Bae; Yoo, Dong-Mi; Lee, Sang-Min; Jung, Hee-Yeon; Kim, Seog Ju; Shin, Jwa-Seop; Lee, Seunghee; Yim, Jae-Joon

2016-04-27

Email is widely used as a means of communication between faculty members and students in medical education because of its practical and educational advantages. However, because of the distinctive nature of medical education, students' inappropriate email etiquette may adversely affect their learning as well as faculty members' perception of them. Little data on medical students' competency in professional email writing is available; therefore, this study explored the strengths and weaknesses of medical students' email etiquette and factors that contribute to professional email writing. A total of 210 emails from four faculty members at Seoul National University College of Medicine were collected. An evaluation criteria and a scoring rubric were developed based on the various email-writing guidelines. The rubric comprised 10 items, including nine items for evaluation related to the email components and one item for the assessment of global impression of politeness. Three evaluators independently assessed all emails according to the criteria. Students were identified as being 61.0% male and 52.8% were in the undergraduate-entry program. The sum of each component score was 62.21 out of 100 and the mean value for global impression was 2.6 out of 4. The results demonstrated that students' email etiquettes remained low-to-mediocre for most criteria, except for readability and honorifics. Three criteria, salutation (r=0.668), closing (r=0.653), and sign-off (r=0.646), showed a strong positive correlation with the global impression of politeness. Whether a student entered a graduate-entry program or an undergraduate-entry program significantly contributed to professional email writing after other variables were controlled. Although students in the graduate-entry program demonstrated a relatively superior level of email etiquette, the majority of medical students did not write emails professionally. Educating all medical students in email etiquette may well contribute to the improvement of student-faculty relationships as well as their email writing.

Effects of a change in entry-to-practice criteria for cardiovascular perfusion in Canada: results of a national survey.

PubMed

Belway, Dean; Tran, Diem T T; Rubens, Fraser D

2017-05-01

Years of experience and level of education are two important determinants of a clinician's expertise. While entry-to-practice criteria for admission to perfusion training in Canada changed from clinical experience-based criteria to education-based criteria in 2006, the effects of these changes have not been studied. To determine the academic and clinical backgrounds of perfusionists in Canada, ascertain perceptions about the adequacy of training and evaluate the effects of the changes on the composition of the perfusion community of Canada. An electronic questionnaire was distributed to all practicing perfusionists in Canada, addressing details regarding clinical experience, academic education and perceptions about the adequacy of training. Two hundred and twenty-eight questionnaires were completed, representing a 72% response rate. Perfusionists admitted under academic-based criteria have significantly higher levels of education (100% degree holders vs 69.1%, p<0.001), but less antecedent clinical training and experience (median, IQR: 0, 0 - 4.5 years vs 2, 2 - 8 years, p<0.0001), are younger (median age range 31-35 years vs 51-55 years, p<0.0001), more likely to be female (58.7% vs 41.3%, p=0.006) and are significantly more likely to enter perfusion because of attraction to the type of work (p=0.045). Many perfusionists (70, 32%) in Canada believe themselves inadequately trained for their clinical assignments outside the OR. In addition, 19% of perfusionists plan to retire over the next 10 years. The introduction of education-based entry criteria has changed the academic and clinical experience levels of perfusionists in Canada. Strategies designed to better prepare perfusionists for their clinical assignments outside the OR are merited.

Moral Waivers and Suitability for High Security Military Jobs

DTIC Science & Technology

1988-12-01

Score 9 High School Diploma 10 Service Entry Variables 11 Months in the Delayed Entry Program (DEP) 11 DoD Primary Occupation Code ( DPOC ) 14...services 6 4. DoD Primary Occupational ( DPOC ) Areas 14 5. Cumulative percentage of personnel who received Bis during first six months of...Entry Variables - Months in the Delayed Entry Program (DEP) - DoD Primary Occupation Code ( DPOC ) Clearance Criteria - Issue case - Clearance status

ClinicalTrials.gov as a data source for semi-automated point-of-care trial eligibility screening.

PubMed

Pfiffner, Pascal B; Oh, JiWon; Miller, Timothy A; Mandl, Kenneth D

2014-01-01

Implementing semi-automated processes to efficiently match patients to clinical trials at the point of care requires both detailed patient data and authoritative information about open studies. To evaluate the utility of the ClinicalTrials.gov registry as a data source for semi-automated trial eligibility screening. Eligibility criteria and metadata for 437 trials open for recruitment in four different clinical domains were identified in ClinicalTrials.gov. Trials were evaluated for up to date recruitment status and eligibility criteria were evaluated for obstacles to automated interpretation. Finally, phone or email outreach to coordinators at a subset of the trials was made to assess the accuracy of contact details and recruitment status. 24% (104 of 437) of trials declaring on open recruitment status list a study completion date in the past, indicating out of date records. Substantial barriers to automated eligibility interpretation in free form text are present in 81% to up to 94% of all trials. We were unable to contact coordinators at 31% (45 of 146) of the trials in the subset, either by phone or by email. Only 53% (74 of 146) would confirm that they were still recruiting patients. Because ClinicalTrials.gov has entries on most US and many international trials, the registry could be repurposed as a comprehensive trial matching data source. Semi-automated point of care recruitment would be facilitated by matching the registry's eligibility criteria against clinical data from electronic health records. But the current entries fall short. Ultimately, improved techniques in natural language processing will facilitate semi-automated complex matching. As immediate next steps, we recommend augmenting ClinicalTrials.gov data entry forms to capture key eligibility criteria in a simple, structured format.

Evaluating soil contamination

USGS Publications Warehouse

Beyer, W.N.

1990-01-01

This compilation was designed to help U.S. Fish and Wildlife Service contaminant specialists evaluate the degree of contamination of a soil, based on chemical analyses. Included are regulatory criteria, opinions, brief descriptions of scientific articles, and miscellaneous information that might be useful in making risk assessments. The intent was to make hard-to-obtain material readily available to contaminant specialists, but not to critique the material or develop new criteria. The compilation is to be used with its index, which includes about 200 contaminants. There are several entries for a few of the most thoroughly studied contaminants, but for most of them the information available is meager. Entries include soil contaminant criteria from other countries, contaminant guidelines for applying sewage sludge to soil, guidelines for evaluating sediments, background soil concentrations for various elements, citations to scientific articles that may help estimate the potential movement of soil contaminants into wildlife food chains, and a few odds and ends. Articles on earthworms were emphasized because they are a natural bridge between soil and many species of wildlife.

Orion Capsule Handling Qualities for Atmospheric Entry

NASA Technical Reports Server (NTRS)

Tigges, Michael A.; Bihari, Brian D.; Stephens, John-Paul; Vos, Gordon A.; Bilimoria, Karl D.; Mueller, Eric R.; Law, Howard G.; Johnson, Wyatt; Bailey, Randall E.; Jackson, Bruce

2011-01-01

Two piloted simulations were conducted at NASA's Johnson Space Center using the Cooper-Harper scale to study the handling qualities of the Orion Command Module capsule during atmospheric entry flight. The simulations were conducted using high fidelity 6-DOF simulators for Lunar Return Skip Entry and International Space Station Return Direct Entry flight using bank angle steering commands generated by either the Primary (PredGuid) or Backup (PLM) guidance algorithms. For both evaluations, manual control of bank angle began after descending through Entry Interface into the atmosphere until drogue chutes deployment. Pilots were able to use defined bank management and reversal criteria to accurately track the bank angle commands, and stay within flight performance metrics of landing accuracy, g-loads, and propellant consumption, suggesting that the pilotability of Orion under manual control is both achievable and provides adequate trajectory performance with acceptable levels of pilot effort. Another significant result of these analyses is the applicability of flying a complex entry task under high speed entry flight conditions relevant to the next generation Multi Purpose Crew Vehicle return from Mars and Near Earth Objects.

A Comparison of Two Skip Entry Guidance Algorithms

NASA Technical Reports Server (NTRS)

Rea, Jeremy R.; Putnam, Zachary R.

2007-01-01

The Orion capsule vehicle will have a Lift-to-Drag ratio (L/D) of 0.3-0.35. For an Apollo-like direct entry into the Earth's atmosphere from a lunar return trajectory, this L/D will give the vehicle a maximum range of about 2500 nm and a maximum crossrange of 216 nm. In order to y longer ranges, the vehicle lift must be used to loft the trajectory such that the aerodynamic forces are decreased. A Skip-Trajectory results if the vehicle leaves the sensible atmosphere and a second entry occurs downrange of the atmospheric exit point. The Orion capsule is required to have landing site access (either on land or in water) inside the Continental United States (CONUS) for lunar returns anytime during the lunar month. This requirement means the vehicle must be capable of flying ranges of at least 5500 nm. For the L/D of the vehicle, this is only possible with the use of a guided Skip-Trajectory. A skip entry guidance algorithm is necessary to achieve this requirement. Two skip entry guidance algorithms have been developed: the Numerical Skip Entry Guidance (NSEG) algorithm was developed at NASA/JSC and PredGuid was developed at Draper Laboratory. A comparison of these two algorithms will be presented in this paper. Each algorithm has been implemented in a high-fidelity, 6 degree-of-freedom simulation called the Advanced NASA Technology Architecture for Exploration Studies (ANTARES). NASA and Draper engineers have completed several monte carlo analyses in order to compare the performance of each algorithm in various stress states. Each algorithm has been tested for entry-to-target ranges to include direct entries and skip entries of varying length. Dispersions have been included on the initial entry interface state, vehicle mass properties, vehicle aerodynamics, atmosphere, and Reaction Control System (RCS). Performance criteria include miss distance to the target, RCS fuel usage, maximum g-loads and heat rates for the first and second entry, total heat load, and control system saturation. The comparison of the performance criteria has led to a down select and guidance merger that will take the best ideas from each algorithm to create one skip entry guidance algorithm for the Orion vehicle.

Reevaluation of Ramp Design Speed Criteria

DOT National Transportation Integrated Search

1999-12-01

Current freeway entry ramp design speed criteria were evaluated through observations of twenty ramps in four Texas cities. Field observations of ramp and freeway traffic speed-distance relationships were made using videotaping methods. Traffic operat...

77 FR 48527 - National Customs Automation Program (NCAP) Test Concerning Automated Commercial Environment (ACE...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-14

... Program (NCAP) Test Concerning Automated Commercial Environment (ACE) Simplified Entry: Modification of... Automated Commercial Environment (ACE). The test's participant selection criteria are modified to reflect... (NCAP) test concerning Automated Commercial Environment (ACE) Simplified Entry functionality (Simplified...

Allowable Trajectory Variations for Space Shuttle Orbiter Entry-Aeroheating CFD

NASA Technical Reports Server (NTRS)

Wood, William A.; Alter, Stephen J.

2008-01-01

Reynolds-number criteria are developed for acceptable variations in Space Shuttle Orbiter entry trajectories for use in computational aeroheating analyses. The criteria determine if an existing computational fluid dynamics solution for a particular trajectory can be extrapolated to a different trajectory. The criteria development begins by estimating uncertainties for seventeen types of computational aeroheating data, such as boundary layer thickness, at exact trajectory conditions. For each type of datum, the allowable uncertainty contribution due to trajectory variation is set to be half of the value of the estimated exact-trajectory uncertainty. Then, for the twelve highest-priority datum types, Reynolds-number relations between trajectory variation and output uncertainty are determined. From these relations the criteria are established for the maximum allowable trajectory variations. The most restrictive criterion allows a 25% variation in Reynolds number at constant Mach number between trajectories.

Correlation of patient entry rates and physician documentation errors in dictated and handwritten emergency treatment records.

PubMed

Dawdy, M R; Munter, D W; Gilmore, R A

1997-03-01

This study was designed to examine the relationship between patient entry rates (a measure of physician work load) and documentation errors/omissions in both handwritten and dictated emergency treatment records. The study was carried out in two phases. Phase I examined handwritten records and Phase II examined dictated and transcribed records. A total of 838 charts for three common chief complaints (chest pain, abdominal pain, asthma/chronic obstructive pulmonary disease) were retrospectively reviewed and scored for the presence or absence of 11 predetermined criteria. Patient entry rates were determined by reviewing the emergency department patient registration logs. The data were analyzed using simple correlation and linear regression analysis. A positive correlation was found between patient entry rates and documentation errors in handwritten charts. No such correlation was found in the dictated charts. We conclude that work load may negatively affect documentation accuracy when charts are handwritten. However, the use of dictation services may minimize or eliminate this effect.

10 CFR 73.45 - Performance capabilities for fixed site physical protection systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... authorization schedules and entry criteria before permitting entry and to initiate response measures to deny... movement of strategic special nuclear material within material access areas. To achieve this capability the physical protection system shall: (1) Detect unauthorized placement and movement of strategic special...

30 CFR 75.222 - Roof control plan-approval criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... systems. (1) Systematic supplemental support should be installed throughout— (i) The tailgate entry of the first longwall panel prior to any mining; and (ii) In the proposed tailgate entry of each subsequent... should address— (i) Notification of miners that the travelway is blocked; (ii) Re-instruction of miners...

30 CFR 75.222 - Roof control plan-approval criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... systems. (1) Systematic supplemental support should be installed throughout— (i) The tailgate entry of the first longwall panel prior to any mining; and (ii) In the proposed tailgate entry of each subsequent... should address— (i) Notification of miners that the travelway is blocked; (ii) Re-instruction of miners...

30 CFR 75.222 - Roof control plan-approval criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... systems. (1) Systematic supplemental support should be installed throughout— (i) The tailgate entry of the first longwall panel prior to any mining; and (ii) In the proposed tailgate entry of each subsequent... should address— (i) Notification of miners that the travelway is blocked; (ii) Re-instruction of miners...

How the Admission Criteria to a Competitive-Entry Undergraduate Programme Could Be Improved

ERIC Educational Resources Information Center

Shulruf, Boaz; Shaw, John

2015-01-01

The introduction of a new standards-based secondary school assessment system, the National Certificate of Educational Achievement (NCEA), necessitated significant changes to the admissions processes for New Zealand universities, particularly for competitive-entry programmes such as medicine, engineering and pharmacy. Selection to such programmes…

40 CFR 141.100 - Criteria and procedures for public water systems using point-of-entry devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... water systems using point-of-entry devices. 141.100 Section 141.100 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER... meet all national primary drinking water regulations and would be of acceptable quality similar to...

Is clarithromycin a potential treatment for cachexia in people with lung cancer? A feasibility study.

PubMed

Awan, Sarah; Crosby, Vincent; Potter, Vanessa; Hennig, Ivo; Baldwin, David; Ndlovu, Mehluli; Paradine, Sharon; Wilcock, Andrew

2017-02-01

Clarithromycin may improve cachexia and survival in non-small cell lung cancer (NSCLC), but adequately controlled data are lacking. This study was undertaken primarily to inform the feasibility and scale of a phase III trial. Eligible consenting patients with stage IV NSCLC and cachexia were to be randomized to receive either clarithromycin 250mg twice daily or placebo for eight weeks. Aspects of trial feasibility recorded included numbers eligible, approached and recruited, together with adherence and completion of treatment and assessments. Over 6 months, none of 125 patients identified fulfilled the entry criteria. The commonest reasons for ineligibility were the use of an excluded concurrent drug (45, 36%), brain metastases (22, 18%), poor performance status (21, 17%) and current chemotherapy (15, 12%). A phase III trial of clarithromycin using these entry criteria is not feasible in this setting. Other macrolides that have a lower risk of a drug-drug interaction may be more practical to pursue. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Measurement and Analysis Infrastructure Diagnostic (MAID) Evaluation Criteria, Version 1.0

DTIC Science & Technology

2010-02-01

information) 13 These criteria do not address data collection for special cases such as inferential statistical studies which would imply the need for...2009-TR-022 3.2 When a dataset is examined 3.2.1 a data value is not missing from a data cell unless entry has been specified as optional 3.2.2 data... dataset distribution is examined to expose data outliers (if they exist) and to ensure that departures from underlying assumptions associated with the

A theoretical study of the initiation, maintenance and termination of gastric slow wave re-entry.

PubMed

Du, Peng; Paskaranandavadivel, Niranchan; O'Grady, Greg; Tang, Shou-Jiang; Cheng, Leo K

2015-12-01

Gastric slow wave dysrhythmias are associated with motility disorders. Periods of tachygastria associated with slow wave re-entry were recently recognized as one important dysrhythmia mechanism, but factors promoting and sustaining gastric re-entry are currently unknown. This study reports two experimental forms of gastric re-entry and presents a series of multi-scale models that define criteria for slow wave re-entry initiation, maintenance and termination. High-resolution electrical mapping was conducted in porcine and canine models and two spatiotemporal patterns of re-entrant activities were captured: single-loop rotor and double-loop figure-of-eight. Two separate multi-scale mathematical models were developed to reproduce the velocity and entrainment frequency of these experimental recordings. A single-pulse stimulus was used to invoke a rotor re-entry in the porcine model and a figure-of-eight re-entry in the canine model. In both cases, the simulated re-entrant activities were found to be perpetuated by tachygastria that was accompanied by a reduction in the propagation velocity in the re-entrant pathways. The simulated re-entrant activities were terminated by a single-pulse stimulus targeted at the tip of re-entrant wave, after which normal antegrade propagation was restored by the underlying intrinsic frequency gradient. (i) the stability of re-entry is regulated by stimulus timing, intrinsic frequency gradient and conductivity; (ii) tachygastria due to re-entry increases the frequency gradient while showing decreased propagation velocity; (iii) re-entry may be effectively terminated by a targeted stimulus at the core, allowing the intrinsic slow wave conduction system to re-establish itself. © The authors 2014. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.

A theoretical study of the initiation, maintenance and termination of gastric slow wave re-entry

PubMed Central

Du, Peng; Paskaranandavadivel, Niranchan; O’Grady, Greg; Tang, Shou-Jiang; Cheng, Leo K.

2015-01-01

Gastric slow wave dysrhythmias are associated with motility disorders. Periods of tachygastria associated with slow wave re-entry were recently recognized as one important dysrhythmia mechanism, but factors promoting and sustaining gastric re-entry are currently unknown. This study reports two experimental forms of gastric re-entry and presents a series of multi-scale models that define criteria for slow wave re-entry initiation, maintenance and termination. High-resolution electrical mapping was conducted in porcine and canine models and two spatiotemporal patterns of re-entrant activities were captured: single-loop rotor and double-loop figure-of-eight. Two separate multi-scale mathematical models were developed to reproduce the velocity and entrainment frequency of these experimental recordings. A single-pulse stimulus was used to invoke a rotor re-entry in the porcine model and a figure-of-eight re-entry in the canine model. In both cases, the simulated re-entrant activities were found to be perpetuated by tachygastria that was accompanied by a reduction in the propagation velocity in the re-entrant pathways. The simulated re-entrant activities were terminated by a single-pulse stimulus targeted at the tip of re-entrant wave, after which normal antegrade propagation was restored by the underlying intrinsic frequency gradient. Main findings: (i) the stability of re-entry is regulated by stimulus timing, intrinsic frequency gradient and conductivity; (ii) tachygastria due to re-entry increases the frequency gradient while showing decreased propagation velocity; (iii) re-entry may be effectively terminated by a targeted stimulus at the core, allowing the intrinsic slow wave conduction system to re-establish itself. PMID:25552487

Characteristics of Competency. Measurement Criteria for Entry-Level Electronics Technician Skills..

ERIC Educational Resources Information Center

Electronic Industries Foundation, Washington, DC.

This supplement to "Raising the Standard" details the knowledge and skills required to successfully achieve competence in each of the tasks identified in the standards manual. It is divided into five sections that correspond to the five skill categories for entry-level electronics technician: additional skills, desirable behavior and work habits,…

The frequency of U-shaped dose responses in the toxicological literature.

PubMed

Calabrese, E J; Baldwin, L A

2001-08-01

Hormesis has been defined as a dose-response relationship in which there is a stimulatory response at low doses, but an inhibitory response at high doses, resulting in a U- or inverted U-shaped dose response. To assess the proportion of studies satisfying criteria for evidence of hormesis, a database was created from published toxicological literature using rigorous a priori entry and evaluative criteria. One percent (195 out of 20,285) of the published articles contained 668 dose-response relationships that met the entry criteria. Subsequent application of evaluative criteria revealed that 245 (37% of 668) dose-response relationships from 86 articles (0.4% of 20,285) satisfied requirements for evidence of hormesis. Quantitative evaluation of false-positive and false-negative responses indicated that the data were not very susceptible to such influences. A complementary analysis of all dose responses assessed by hypothesis testing or distributional analyses, where the units of comparison were treatment doses below the NOAEL, revealed that of 1089 doses below the NOAEL, 213 (19.5%) satisfied statistical significance or distributional data evaluative criteria for hormesis, 869 (80%) did not differ from the control, and 7 (0.6%) displayed evidence of false-positive values. The 32.5-fold (19.5% vs 0.6%) greater occurrence of hormetic responses than a response of similar magnitude in the opposite (negative) direction strongly supports the nonrandom nature of hormetic responses. This study, which provides the first documentation of a data-derived frequency of hormetic responses in the toxicologically oriented literature, indicates that when the study design satisfies a priori criteria (i.e., a well-defined NOAEL, > or = 2 doses below the NOAEL, and the end point measured has the capacity to display either stimulatory or inhibitory responses), hormesis is frequently encountered and is broadly represented according to agent, model, and end point. These findings have broad-based implications for study design, risk assessment methods, and the establishment of optimal drug doses and suggest important evolutionarily adaptive strategies for dose-response relationships.

Solar power satellite system definition study. Part 2, volume 8: SPS launch vehicle ascent and entry sonic overpressure and noise effects

NASA Technical Reports Server (NTRS)

1977-01-01

Recoverable launch vehicle concepts for the Solar Power Satellite program were identified. These large launch vehicles are powered by proposed engines in the F-1 thrust level class. A description of the candidate launch vehicles and their operating mode was provided. Predictions of the sonic over pressures during ascent and entry for both types of vehicles, and prediction of launch noise levels in the vicinity of the launch site were included. An overall assessment and criteria for sonic overpressure and noise levels was examined.

An audit of inpatient case records and suggestions for improvements.

PubMed

Arshad, A R; Ganesananthan, S; Ajik, S

2000-09-01

A study was carried out in Kuala Lumpur Hospital to review the adequacy of documentation of bio-data and clinical data including clinical examination, progress review, discharge process and doctor's identification in ten of our clinical departments. Twenty criteria were assessed in a retrospective manner to scrutinize the contents of medical notes and subsequently two prospective evaluations were conducted to see improvement in case notes documentation. Deficiencies were revealed in all the criteria selected. However there was a statistically significant improvement in the eleven clinical data criteria in the subsequent two evaluations. Illegibility of case note entries and an excessive usage of abbreviations were noted during this audit. All clinical departments and hospitals should carry out detailed studies into the contents of their medical notes.

7 CFR 1530.107 - Bond or letter of credit requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE..., which meets the criteria set forth in this section. (b) The bond or letter of credit may cover entries made either during the period of time specified in the bond (a term bond) or for a specified entry (a...

7 CFR 1530.107 - Bond or letter of credit requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE..., which meets the criteria set forth in this section. (b) The bond or letter of credit may cover entries made either during the period of time specified in the bond (a term bond) or for a specified entry (a...

7 CFR 1530.107 - Bond or letter of credit requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE..., which meets the criteria set forth in this section. (b) The bond or letter of credit may cover entries made either during the period of time specified in the bond (a term bond) or for a specified entry (a...

7 CFR 1530.107 - Bond or letter of credit requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE..., which meets the criteria set forth in this section. (b) The bond or letter of credit may cover entries made either during the period of time specified in the bond (a term bond) or for a specified entry (a...

Curriculum Differentiation and Social Inequality in Higher Education Entry in Scotland and Ireland

ERIC Educational Resources Information Center

Iannelli, Cristina; Smyth, Emer; Klein, Markus

2016-01-01

This paper examines the relative importance of upper secondary subject choice and attainment in explaining social inequalities in access to higher education (HE) in Scotland and Ireland. These two countries differ in the extent of curriculum differentiation, in the degree of standardisation in school examination and in HE entry criteria. In…

34 CFR 421.21 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2010 CFR

2010-07-01

... VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION BUSINESS AND EDUCATION STANDARDS PROGRAM How Does the... those needs, including the need of business for competent entry-level workers in the occupations to be studied; and (4) The benefits to business, labor, and education that will result from meeting those needs...

Medical student satisfaction, coping and burnout in direct-entry versus graduate-entry programmes.

PubMed

DeWitt, Dawn; Canny, Benedict J; Nitzberg, Michael; Choudri, Jennifer; Porter, Sarah

2016-06-01

There is ongoing debate regarding the optimal length of medical training, with concern about the cost of prolonged training. Two simultaneous tracks currently exist in Australia: direct entry from high school and graduate entry for students with a bachelor degree. Medical schools are switching to graduate entry based on maturity, academic preparedness and career-choice surety. We tested the assumption that graduate entry is better by exploring student preferences, coping, burnout, empathy and alcohol use. From a potential pool of 2188 participants, enrolled at five Australian medical schools, a convenience sample of 688 (31%) first and second year students completed a survey in the middle of the academic year. Participants answered questions about demographics, satisfaction and coping and completed three validated instruments. Over 90% of students preferred their own entry-type, though more graduate-entry students were satisfied with their programme (82.4% versus 65.3%, p < 0.001). There was no difference between graduate-entry and direct-entry students in self-reported coping or in the proportion of students meeting criteria for burnout (50.7% versus 51.2%). Direct-entry students rated significantly higher for empathy (concern, p = 0.022; personal distress, p = 0.031). Graduate-entry students reported significantly more alcohol use and hazardous drinking (30.0% versus 22.8%; p = 0.017). Our multi-institution data confirm that students are generally satisfied with their choice of entry pathway and do not confirm significant psychosocial benefits of graduate entry. Overall, our data suggest that direct-entry students cope with the workload and psychosocial challenges of medical school, in the first 2 years, as well as graduate-entry students. Burnout and alcohol use should be addressed in both pathways. Despite studies showing similar academic outcomes, and higher total costs, more programmes in Australia are becoming graduate entry. Further research on non-cognitive issues and outcomes is needed so that universities, government funders and the medical profession can decide whether graduate entry, direct entry, or a mix, is ideal. © 2016 John Wiley & Sons Ltd.

Student retention practices in associate degree, entry-level dental hygiene programs.

PubMed

Holt, Marianne P

2005-01-01

The main purpose of this study was to investigate student retention strategies and practices implemented in associate degree, entry-level dental hygiene programs. Included are student attrition issues, academic standards, re-entry policies, and clinical remediation strategies. A survey consisting of forced choice and open-ended questions was mailed to 31 randomly selected associate degree, entry-level dental hygiene programs. Surveys were analyzed using descriptive statistics and frequency distributions. Open-ended questions were analyzed using the constant comparative qualitative method to identify recurring themes. There was an 80% (n=25) return response to the survey. The findings of this study determined that dental hygiene programs are graduating, on average, a higher percentage (83%) of students when compared to two-year, associate degree programs in general (46%). The primary reasons reported by respondents for student attrition included: academic difficulties (88%), dissatisfaction with career choice (76%), family/personal responsibilities (72%), and clinical skill difficulties (56%). A wide variety of retention strategies were reported. Those most often cited were academic remediation (92%), clinical skill development/remediation (84%), academic advising (84%), financial aid assistance (84%), and tutoring (80%). Participating programs also reported setting high academic and ethical standards. Specific criteria for student re-entry were discussed. The findings of this study suggest that associate degree, entry-level dental hygiene programs are committed to student retention and make considerable efforts to help students succeed. Student retention efforts could be enhanced for those student groups identified as possibly being at high risk for attrition. The findings and recommendations in this investigation may assist associate degree, entry-level dental hygiene programs in their efforts to retain a higher percentage of students.

Duration of untreated psychosis: a proposition regarding treatment definition.

PubMed

Polari, Andrea; Lavoie, Suzie; Sarrasin, Pascale; Pellanda, Veronica; Cotton, Sue; Conus, Philippe

2011-11-01

Duration of untreated psychosis (DUP) refers to the time elapsing between psychosis onset and treatment initiation. Despite a certain degree of consensus regarding the definition of psychosis onset, the definition of treatment commencement varies greatly between studies and DUP may be underestimated due to lack of agreement. In the present study, three sets of criteria to define the end of the untreated period were applied in a first-episode psychosis cohort to assess the impact of the choice of definition on DUP estimation. The DUP of 117 patients admitted in the Treatment and Early Intervention in Psychosis Program Psychosis in Lausanne was measured using the following sets of criteria to define treatment onset: (i) initiation of antipsychotic medication; (ii) entry into a specialized programme; and (iii) entry into a specialized programme and adequate medication with a good compliance. DUP varied greatly according to definitions, the most restrictive criteria leading to the longest DUP (median DUP1=2.2 months, DUP2=7.4 months and DUP3=13.6 months). A percentage of 19.7 of the patients who did not meet these restrictive criteria had poorer premorbid functioning and were more likely to use cannabis. Longer DUP3 was associated with poorer premorbid functioning and with younger age at onset of psychosis. These results underline the need for a unique and standardized definition of the end of DUP. We suggest that the most restrictive definition of treatment should be used when using the DUP concept in future research. © 2011 Blackwell Publishing Asia Pty Ltd.

An investigation into the validity of specifying 5 "O' levels in the General Certificate of Education as an entry requirement for the education and training of district nurses.

PubMed

Jarvis, P; Gibson, S J

1981-11-01

District nursing, like many other professionalizing occupations, has stipulated that possession of five ordinary level GCE passes might constitute one criterion of entry. This paper reports a longitudinal study over four intakes of district nurse students in one teaching centre and examines the relationship between selection criteria, in particular educational achievement prior to entry to the course, and the students' achievement during this. The research explored the relationship between educational achievement prior to commencing their course of study and the level of academic and practical performance during it. Additionally other factors, including the results of aptitude and personality tests, were examined to see if they would provide indication of the level of the students; grades during training. No factors were discovered that might provide an adequate basis for selection, which raises questions about trying to specify any pre-requisite for selection other than state registration and appropriate professional experience until further research has been undertaken.

Refugee Status Required for Resettlement in the United States

DTIC Science & Technology

2017-06-09

predominant topic in the United States (US) today . There are more refugees in need of humanitarian assistance than at any other time in history. The US...the criteria from the Cuban- Haitian migration that is applicable or no longer applicable today , with criteria applicable today for the approval of...status today . US refugee laws mandate the procedures for Customs and Immigrations on the criteria for refugee status and entry into the US

Mobility assessment: Sensitivity and specificity of measurement sets in older adults

PubMed Central

Panzer, Victoria P.; Wakefield, Dorothy B.; Hall, Charles B.; Wolfson, Leslie I.

2011-01-01

Objective To identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall-risk and predict future falls. Design Observational study with 1-year weekly falls follow-up Setting Mobility laboratory Participants Community-dwelling volunteers (n=74; 65–94 years old) categorized at entry as 27 ‘Non-fallers’ or 47 ‘Fallers’ by Medicare criteria (1 injury fall or >1 non-injury falls in the previous year). Interventions None Outcome Measures Test-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (Falls-status), Tinetti Performance Oriented Mobility Assessment (POMA), Computerized Dynamic Posturography Sensory Organization Test (SOT) and subsequent falls reported weekly. Results Measurement variables were selected that met reliability (ICC > 0.6) and/or discrimination (p<.01) criteria (Clinical variables- Turn- steps, time, Gait- velocity, Step-in-tub-time, and Downstairs- time; Force plate variables- Quiet standing Romberg ratio sway-area, Maximal lean- anterior-posterior excursion, Sit-to-stand medial-lateral excursion and sway-area). Sets were created (3 clinical, 2 force plate) utilizing combinations of variables appropriate for older adults with different functional activity levels and composite scores were calculated. Scores identified entry Falls-status and concurred with POMA and SOT. The Full clinical set (5 measurement variables) produced sensitivity/specificity (.80/.74) to Falls-status. Composite scores were sensitive and specific in predicting subsequent injury falls and multiple falls compared to Falls-status, POMA or SOT. Conclusions Sets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls using tasks that should be appropriate to diverse participants. PMID:21621667

Optometrists Association Australia Universal (entry-level) and Therapeutic Competency Standards for Optometry 2008.

PubMed

Kiely, Patricia M

2009-07-01

Competency standards for entry-level to the profession of optometry in Australia were first developed in 1993, revised in 1997 and expanded in 2000 to include therapeutic competency standards. The entry-level standards cover the competencies required by a person entering the profession without therapeutic endorsement of their registration. The therapeutic competency standards address the additional competencies required for therapeutic endorsement of registration. This paper presents a revised version of the universal (entry-level) and therapeutic competency standards for the profession of optometry in Australia in 2008. Expert members of the profession and representatives from schools of optometry, registration boards in Australia, state divisions of Optometrists Association Australia and the New Zealand Association of Optometrists were consulted in the process of updating the standards. Three new elements of competency have been added to the standards. Twenty-three new performance criteria with associated indicators have been added. Some performance criteria from the earlier document have been combined. Substantial alterations were made to the presentation of indicators throughout the document. The updated entry-level (universal) and therapeutic competency standards were adopted on behalf of the profession by the National Council of Optometrists Association Australia in November 2008. Competency standards are used by Australian and New Zealand registration authorities for the purposes of registration and therapeutic endorsement of registration via the Optometry Council of Australia and New Zealand accreditation and assessment processes. They have also been used as the basis of the World Council of Optometry Global Competency-Based Model.

Canal switch and re-entry phenomenon in benign paroxysmal positional vertigo: difference between immediate and delayed occurrence.

PubMed

Dispenza, F; DE Stefano, A; Costantino, C; Rando, D; Giglione, M; Stagno, R; Bennici, E

2015-04-01

This prospective study was designed to evaluate the differences between immediate and delayed canal re-entry of otoliths after therapeutic manoeuvres in patients with benign paroxysmal positional vertigo (BPPV). A total of 196 patients with BPPV were visited and 127 matched our inclusion criteria. The mean age was 54.74 years. The horizontal semicircular canal (HSC) was involved in 30 cases and the posterior semicircular canal (PSC) in 97 patients. Patients with hearing loss in the ear affected by BPPV have a more recurrent form, compared to those with normal hearing. An immediate canal re-entry was recorded in 3 patients with HSC BPPV, all with geotropic nystagmus. In 7 patients with PSC BPPV, the immediate canal re-entry was detected and the delayed form was noted in 5 patients. The patients with the delayed canal re-entry underwent more than 2 previous manoeuvres. The canal re-entry was not related to the manoeuvre performed. The timing of the Dix-Hallpike test to verify the resolution of the BPPV had a significant role in immediate canal re-entry. A recurrence in the follow-up at least one month after treatment was recorded in 20 patients and was more frequent in patients that had canal re-entry. The canal re-entry or canal switch is a clinical entity that should be kept in mind of the neurotologist when approaching BPPV patients. It is important to distinguish it from recurrence when delayed and from manoeuvre failure when immediate. The timing of manoeuvre performing, in particular the final verification test after therapeutic sessions, is important to prevent the immediate reflux of particles into canals.

Comparison of study designs for acute otitis media trials.

PubMed

Pichichero, Michael E; Casey, Janet R

2008-06-01

A framework for evaluating the efficacy of antibiotics in development as well as those currently approved for acute otitis media (AOM) is needed. Review strengths and limitations of various antibiotic trial designs and their outcome measures. A review of 157 published trials involving 36,710 subjects for the treatment of AOM. AOM trials have three designs: (1) clinical, clinical diagnosis and assessment of outcomes; (2) single tympanocentesis, microbiologic diagnosis (by middle ear fluid culture) and clinical assessment of outcomes; and (3) double tympanocentesis, microbiologic diagnosis and microbiologic outcome assessment. Identifiable strengths and limitations of each design are reviewed. Case definitions for entry of children in trials of AOM vary widely. The lack of stringent diagnostic criteria in a clinical design allows for inclusion of a significant proportion of children with a non-bacterial etiology (i.e., viral AOM or otitis media with effusion). Tympanocentesis increases diagnostic accuracy at study entry; however, the procedure is confounding because of its potentially therapeutic benefit and the procedure is not performed in a uniform manner. A second tympanocentesis allows a high sensitivity to detect microbiologic eradication, but it does not correlate with clinical outcomes in half of the cases. The timing of outcome assessment also varies widely among trials. Improved clinical diagnosis criteria for AOM are needed to enhance specificity; emphasis on a bulging tympanic membrane has the best evidence base. Tympanocentesis within study designs has merits. At study entry it assures diagnostic accuracy but may alter outcomes and it is useful to document microbiologic outcomes but lacks specificity for clinical outcomes. For all designs, test of cure assessment 2-7 days after completion of therapy seems most appropriate.

Psychiatric symptoms and antiretroviral nonadherence in US youth with perinatal HIV: a longitudinal study.

PubMed

Kacanek, Deborah; Angelidou, Konstantia; Williams, Paige L; Chernoff, Miriam; Gadow, Kenneth D; Nachman, Sharon

2015-06-19

The relationship of specific psychiatric conditions to adherence has not been examined in longitudinal studies of youth with perinatal HIV infection (PHIV). We examined associations between psychiatric conditions and antiretroviral nonadherence over 2 years. Longitudinal study in 294 PHIV youth, 6-17 years old, in the United States and Puerto Rico. We annually assessed three nonadherence outcomes: missed above 5% of doses in the past 3 days, missed a dose within the past month, and unsuppressed viral load (>400 copies/ml). We fit multivariable logistic models for nonadherence using Generalized Estimating Equations, and evaluated associations of psychiatric conditions (attention deficit hyperactivity disorder, disruptive behavior, depression, anxiety) at entry with incident nonadherence using multivariable logistic regression. Nonadherence prevalence at study entry was 14% (3-day recall), 32% (past month nonadherence), and 38% (unsuppressed viral load), remaining similar over time. At entry, 38% met symptom cut-off criteria for at least one psychiatric condition. Greater odds of 3-day recall nonadherence were observed at week 96 for those with depression [adjusted odds ratio (aOR) 4.14, 95% confidence interval (CI) 1.11-15.42] or disruptive behavior (aOR 3.36, 95% CI 1.02-11.10], but not at entry. Those with vs. without attention deficit hyperactivity disorder had elevated odds of unsuppressed viral load at weeks 48 (aOR 2.46, 95% CI 1.27-4.78) and 96 (aOR 2.35, 95% CI 1.01-5.45), but not at entry. Among 232 youth adherent at entry, 16% reported incident 3-day recall nonadherence. Disruptive behavior conditions at entry were associated with incident 3-day recall nonadherence (aOR 3.01, 95% CI 1.24-7.31). In PHIV youth, comprehensive adherence interventions that address psychiatric conditions throughout the transition to adult care are needed.

Item generation and pilot testing of the Comprehensive Professional Behaviours Development Log.

PubMed

Bartlett, Doreen J; Lucy, S Deborah; Bisbee, Leslie

2006-01-01

The purpose of this project was to generate and refine criteria for professional behaviors previously identified to be important for physical therapy practice and to develop and pilot test a new instrument, which we have called the Comprehensive Professional Behaviours Development Log (CPBDL). Items were generated from our previous work, the work of Warren May and his colleagues, a competency profile for entry-level physical therapists, our regulatory code of ethics, and an evaluation of clinical performance. A group of eight people, including recent graduates, clinical instructors and professional practice leaders, and faculty members, refined the items in two iterations using the Delphi process. The CPBDL contains nine key professional behaviors with a range of nine to 23 specific behavioral criteria for individuals to reflect on and to indicate the consistency of performance from a selection of "not at all," "sometimes," and "always" response options. Pilot testing with a group of 42 students in the final year of our entry-to-practice curriculum indicated that the criteria were clear, the measure was feasible to complete in a reasonable time frame, and there were no ceiling or floor effects. We believe that others, including health care educators and practicing professionals, might be interested in adapting the CPBDL in their own settings to enhance the professional behaviors of either students in preparation for entry to practice or clinicians wishing to demonstrate continuing competency to professional regulatory bodies.

Asthma and eligibility for the Australian Defence Force.

PubMed

Bailey, Jodi; Williams, Felicity

2009-11-01

Entry to the Australian Defence Force (ADF) for candidates with asthma has recently changed. This article summarises the ADF entry standards for candidates with asthma. It also explains the role of general practitioners in the safe and smooth transition to the military training environment for patients with asthma. Candidates with mild asthma may be considered for entry to the ADF subject to certain criteria which includes normal spirometry and negative bronchial provocation testing. If a candidate with asthma is assessed as fit to enter the ADF, they will need to present to their GP before entry to ensure they are prepared. Assistance from the GP in providing the patient with appropriate Asthma Action Plans, prescriptions, and medications is required to ensure continuity of care during what is often a challenging transition to military life.

Tomorrow's Teachers--Selecting the Best: An Exploration of the Quality Rationale behind Academic and Experiential Selection Criteria for Initial Teacher Education Programmes

ERIC Educational Resources Information Center

Heinz, Manuela

2013-01-01

Using Ireland as an example, this paper explores the rationale behind various selection criteria currently used to select suitable candidates for initial teacher education courses. It investigates and discusses patterns of association between second-level student teachers' background characteristics on entry to their teacher education programme…

Diagnostic inaccuracy and subject exclusions render placebo and observational studies of acute otitis media inconclusive.

PubMed

Pichichero, Michael E; Casey, Janet R

2008-11-01

Diagnostic accuracy and appropriate inclusion/exclusion criteria representative of children at greatest risk is of paramount importance in trials to evaluate placebo or observation as an option for acute otitis media (AOM) management. Twelve observational studies spanning the time frame 1958-2005 and 13 natural history studies spanning the time frame 1968-2006 were evaluated for the diagnostic criteria, inclusion criteria, and exclusion criteria applied within the study design. Although a bulging or full tympanic membrane (TM) with effusion is the best indication of a diagnosis of bacterial AOM based on tympanocentesis findings, few observational and natural history studies required a bulging TM. Examination of subject inclusion criteria showed that many subjects did not have AOM but rather had no middle ear disease at all or they had otitis media with effusion. Exclusion criteria of subjects were also remarkable. Frequently children <2 years old were excluded; mean age among the studies reflected an older age group, unlike the true epidemiology of AOM. Otitis prone children, those with severe disease, with a bulging TM, with fever, with a definite need for antibiotics, with recent antibiotic treatment, with recent AOM, or with perforation of the TM were often excluded. Guidelines and some authorities have overlooked or discounted the importance of the issues of inaccurate diagnosis on study entry, broad inclusion criteria, and the creation of bias in exclusion criteria among placebo/natural history trials in AOM. The current data favoring observation of children with AOM should be reconsidered until better studies are conducted.

19 CFR 10.301 - Scope and applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... suspend operation of the Agreement with effect from January 1, 1994, to coincide with the entry into force..., or country of origin marking, other criteria for determining origin may be applicable pursuant to...

17 CFR Appendix A to Part 38 - Guidance on Compliance With Designation Criteria

Code of Federal Regulations, 2011 CFR

2011-04-01

...-matching algorithm and order entry procedures. An application involving a trade-matching algorithm that is... algorithm. (b) A designated contract market's specifications on initial and periodic objective testing and...

17 CFR Appendix A to Part 38 - Guidance on Compliance With Designation Criteria

Code of Federal Regulations, 2012 CFR

2012-04-01

...-matching algorithm and order entry procedures. An application involving a trade-matching algorithm that is... algorithm. (b) A designated contract market's specifications on initial and periodic objective testing and...

Implementation of home-based medication order entry at a community hospital.

PubMed

Thorne, Alicia; Williamson, Sarah; Jellison, Tara; Jellison, Chris

2009-11-01

The implementation of a home-based order-entry program at a community hospital is described. Parkview Hospital is a 600-bed, community-based facility located in Fort Wayne, Indiana, that provides 24-hour pharmacy services. The main purpose for establishing a home-based order-entry program was to provide extra pharmacist coverage during the event of a spontaneous order surge in an effort to maintain excellent customer service. A virtual private network (VPN) was created to ensure the security and confidentiality of patients' health care information. The names of volunteer pharmacists who met specific criteria and who were capable of performing home-based order entry were collected. These pharmacists were trained and tested in the home-based order-entry process. When home-based order-entry is needed, the lead pharmacist contacts the pharmacists on the list by telephone. If available, the pharmacists (maximum of three) are notified to log into the Internet, access the VPN, and perform order entry with the same vigilance, confidentiality, and care as they would onsite. Home-based order entry is discontinued when off-trigger points are met. Pharmacists entering orders from home are paid by the time spent conducting order entry. Pharmacists reported that the program was easy to contact home-based order-entry volunteers, there were no problems with logging into the VPNs, and turnaround time was close to our target of 25 minutes. A community-based hospital successfully implemented a home-based medication order-entry program. The program alleviated the shortage of pharmacists during spontaneous surges of medication orders.

Learning analytics: Dataset for empirical evaluation of entry requirements into engineering undergraduate programs in a Nigerian university.

PubMed

Odukoya, Jonathan A; Popoola, Segun I; Atayero, Aderemi A; Omole, David O; Badejo, Joke A; John, Temitope M; Olowo, Olalekan O

2018-04-01

In Nigerian universities, enrolment into any engineering undergraduate program requires that the minimum entry criteria established by the National Universities Commission (NUC) must be satisfied. Candidates seeking admission to study engineering discipline must have reached a predetermined entry age and met the cut-off marks set for Senior School Certificate Examination (SSCE), Unified Tertiary Matriculation Examination (UTME), and the post-UTME screening. However, limited effort has been made to show that these entry requirements eventually guarantee successful academic performance in engineering programs because the data required for such validation are not readily available. In this data article, a comprehensive dataset for empirical evaluation of entry requirements into engineering undergraduate programs in a Nigerian university is presented and carefully analyzed. A total sample of 1445 undergraduates that were admitted between 2005 and 2009 to study Chemical Engineering (CHE), Civil Engineering (CVE), Computer Engineering (CEN), Electrical and Electronics Engineering (EEE), Information and Communication Engineering (ICE), Mechanical Engineering (MEE), and Petroleum Engineering (PET) at Covenant University, Nigeria were randomly selected. Entry age, SSCE aggregate, UTME score, Covenant University Scholastic Aptitude Screening (CUSAS) score, and the Cumulative Grade Point Average (CGPA) of the undergraduates were obtained from the Student Records and Academic Affairs unit. In order to facilitate evidence-based evaluation, the robust dataset is made publicly available in a Microsoft Excel spreadsheet file. On yearly basis, first-order descriptive statistics of the dataset are presented in tables. Box plot representations, frequency distribution plots, and scatter plots of the dataset are provided to enrich its value. Furthermore, correlation and linear regression analyses are performed to understand the relationship between the entry requirements and the corresponding academic performance in engineering programs. The data provided in this article will help Nigerian universities, the NUC, engineering regulatory bodies, and relevant stakeholders to objectively evaluate and subsequently improve the quality of engineering education in the country.

Return to play criteria after hamstring muscle injury in professional football: a Delphi consensus study.

PubMed

Zambaldi, Mattia; Beasley, Ian; Rushton, Alison

2017-08-01

Hamstring muscle injury (HMI) is the most common injury in professional football and has a high re-injury rate. Despite this, there are no validated criteria to support return to play (RTP) decisions. To use the Delphi method to reach expert consensus on RTP criteria after HMI in professional football. All professional football clubs in England (n=92) were invited to participate in a 3-round Delphi study. Round 1 requested a list of criteria used for RTP decisions after HMI. Responses were independently collated by 2 researchers under univocal definitions of RTP criteria. In round 2 participants rated their agreement for each RTP criterion on a 1-5 Likert Scale. In round 3 participants re-rated the criteria that had reached consensus in round 2. Descriptive statistics and Kendall's coefficient of concordance enabled interpretation of consensus. Participation rate was limited at 21.7% (n=20), while retention rate was high throughout the 3 rounds (90.0%, 85.0%, 90.0%). Round 1 identified 108 entries with varying definitions that were collated into a list of 14 RTP criteria. Rounds 2 and 3 identified 13 and 12 criteria reaching consensus, respectively. Five domains of RTP assessment were identified: functional performance, strength, flexibility, pain and player's confidence. The highest-rated criteria were in the functional performance domain, with particular importance given to sprint ability. This study defined a list of consensually agreed RTP criteria for HMI in professional football. Further work is now required to determine the validity of the identified criteria. © 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.

The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature.

PubMed

Georgiou, Andrew; Prgomet, Mirela; Paoloni, Richard; Creswick, Nerida; Hordern, Antonia; Walter, Scott; Westbrook, Johanna

2013-06-01

We undertake a systematic review of the quantitative literature related to the effect of computerized provider order entry systems in the emergency department (ED). We searched MEDLINE, EMBASE, Inspec, CINAHL, and CPOE.org for English-language studies published between January 1990 and May 2011. We identified 1,063 articles, of which 22 met our inclusion criteria. Sixteen used a pre/post design; 2 were randomized controlled trials. Twelve studies reported outcomes related to patient flow/clinical work, 7 examined decision support systems, and 6 reported effects on patient safety. There were no studies that measured decision support systems and its effect on patient flow/clinical work. Computerized provider order entry was associated with an increase in time spent on computers (up to 16.2% for nurses and 11.3% for physicians), with no significant change in time spent on patient care. Computerized provider order entry with decision support systems was related to significant decreases in prescribing errors (ranging from 17 to 201 errors per 100 orders), potential adverse drug events (0.9 per 100 orders), and prescribing of excessive dosages (31% decrease for a targeted set of renal disease medications). There are tangible benefits associated with computerized provider order entry/decision support systems in the ED environment. Nevertheless, when considered as part of a framework of technical, clinical, and organizational components of the ED, the evidence base is neither consistent nor comprehensive. Multimethod research approaches (including qualitative research) can contribute to understanding of the multiple dimensions of ED care delivery, not as separate entities but as essential components of a highly integrated system of care. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Guidelines for Improving Entry Into and Retention in Care and Antiretroviral Adherence for Persons With HIV: Evidence-Based Recommendations From an International Association of Physicians in AIDS Care Panel

PubMed Central

Thompson, Melanie A.; Mugavero, Michael J.; Amico, K. Rivet; Cargill, Victoria A.; Chang, Larry W.; Gross, Robert; Orrell, Catherine; Altice, Frederick L.; Bangsberg, David R.; Bartlett, John G.; Beckwith, Curt G.; Dowshen, Nadia; Gordon, Christopher M.; Horn, Tim; Kumar, Princy; Scott, James D.; Stirratt, Michael J.; Remien, Robert H.; Simoni, Jane M.; Nachega, Jean B.

2014-01-01

Description After HIV diagnosis, timely entry into HIV medical care and retention in that care are essential to the provision of effective antiretroviral therapy (ART). ART adherence is among the key determinants of successful HIV treatment outcome and is essential to minimize the emergence of drug resistance. The International Association of Physicians in AIDS Care convened a panel to develop evidence-based recommendations to optimize entry into and retention in care and ART adherence for people with HIV. Methods A systematic literature search was conducted to produce an evidence base restricted to randomized, controlled trials and observational studies with comparators that had at least 1 measured biological or behavioral end point. A total of 325 studies met the criteria. Two reviewers independently extracted and coded data from each study using a standardized data extraction form. Panel members drafted recommendations based on the body of evidence for each method or intervention and then graded the overall quality of the body of evidence and the strength for each recommendation. Recommendations Recommendations are provided for monitoring of entry into and retention in care, interventions to improve entry and retention, and monitoring of and interventions to improve ART adherence. Recommendations cover ART strategies, adherence tools, education and counseling, and health system and service delivery interventions. In addition, they cover specific issues pertaining to pregnant women, incarcerated individuals, homeless and marginally housed individuals, and children and adolescents, as well as substance use and mental health disorders. Recommendations for future research in all areas are also provided. PMID:22393036

High-speed rail turnout literature review : final report.

DOT National Transportation Integrated Search

2016-08-01

High-speed rail (HSR) turnout design criteria generally address unbalanced lateral acceleration or cant deficiency (CD), cant deficiency change rate (CDCR), and entry and exit jerk. Various countries have adopted different design values for their HSR...

Predictors of long-term recovery in anorexia nervosa and bulimia nervosa: Data from a 22-year longitudinal study.

PubMed

Franko, Debra L; Tabri, Nassim; Keshaviah, Aparna; Murray, Helen B; Herzog, David B; Thomas, Jennifer J; Coniglio, Kathryn; Keel, Pamela K; Eddy, Kamryn T

2018-01-01

The objective of this study was to investigate predictors of long-term recovery from eating disorders 22 years after entry into a longitudinal study. One hundred and seventy-six of the 228 surviving participants (77.2%) were re-interviewed 20-25 years after study entry using the Longitudinal Interval Follow-up Evaluation to assess ED recovery. The sample consisted of 100 women diagnosed with anorexia nervosa (AN) and 76 with bulimia nervosa (BN) at study entry. A comorbid diagnosis of major depression at the start of the study strongly predicted having a diagnosis of AN-Restricting type at the 22-year assessment. A higher body mass index (BMI) at study intake decreased the odds of being diagnosed with AN-Binge Purge type, relative to being recovered, 22 years later. The only predictor that increased the likelihood of having a diagnosis of BN at the 22-year assessment was the length of time during the study when the diagnostic criteria for BN were met. Together, these results indicate that the presence and persistence of binge eating and purging behaviors were poor prognostic indicators and that comorbidity with depression is particularly pernicious in AN. Treatment providers might pay particular attention to these issues in an effort to positively influence recovery over the long-term. Copyright © 2017 Elsevier Ltd. All rights reserved.

Administrative Process and Criteria Ranking for Drug Entering Health Insurance List in Iran-TOPSIS-Based Consensus Model.

PubMed

Viyanchi, Amir; Rajabzadeh Ghatari, Ali; Rasekh, Hamid Reza; SafiKhani, HamidReza

2016-01-01

The purposes of our study were to identify a drug entry process, collect, and prioritize criteria for selecting drugs for the list of basic health insurance commitments to prepare an "evidence based reimbursement eligibility plan" in Iran. The 128 noticeable criteria were found when studying the health insurance systems of developed countries. Four parts (involving criteria) formed the first questionnaire: evaluation of evidences quality, clinical evaluation, economic evaluation, and managerial appraisal. The 85 experts (purposed sampling) were asked to mark the importance of each criterion from 1 to 100 as 1 representing the least and 100 the most important criterion and 45 out of them replied completely. Then, in the next questionnaire, we evaluated the 48 remainder criteria by the same45 participants under four sub-criteria (Cost calculation simplicity, Interpretability, Precision, and Updating capability of a criterion). After collecting the replies, the remainder criteria were ranked by TOPSIS method. Softwares "SPSS" 17 and Excel 2007 were used. The ranks of the five most important criteria which were found for drug approval based on TOPSIS are as follows: 1-domestic production (0.556), 2-duration of using (0.399), 3-independence of the assessment group (0.363) 4-impact budgeting (0.362) 5-decisions of other countries about the same drug (0.358). The numbers in parenthesis are relative closeness alternatives in relation to the ideal solution. This model gave a scientific model for judging fairly on the acceptance of novelty medicines.

Accuracy comparison of guided surgery for dental implants according to the tissue of support: a systematic review and meta-analysis.

PubMed

Raico Gallardo, Yolanda Natali; da Silva-Olivio, Isabela Rodrigues Teixeira; Mukai, Eduardo; Morimoto, Susana; Sesma, Newton; Cordaro, Luca

2017-05-01

To systematically assess the current dental literature comparing the accuracy of computer-aided implant surgery when using different supporting tissues (tooth, mucosa, or bone). Two reviewers searched PubMed (1972 to January 2015) and the Cochrane Central Register of Controlled Trials (Central) (2002 to January 2015). For the assessment of accuracy, studies were included with the following outcome measures: (i) angle deviation, (ii) deviation at the entry point, and (iii) deviation at the apex. Eight clinical studies from the 1602 articles initially identified met the inclusion criteria for the qualitative analysis. Four studies (n = 599 implants) were evaluated using meta-analysis. The bone-supported guides showed a statistically significant greater deviation in angle (P < 0.001), entry point (P = 0.01), and the apex (P = 0.001) when compared to the tooth-supported guides. Conversely, when only retrospective studies were analyzed, not significant differences are revealed in the deviation of the entry point and apex. The mucosa-supported guides indicated a statistically significant greater reduction in angle deviation (P = 0.02), deviation at the entry point (P = 0.002), and deviation at the apex (P = 0.04) when compared to the bone-supported guides. Between the mucosa- and tooth-supported guides, there were no statistically significant differences for any of the outcome measures. It can be concluded that the tissue of the guide support influences the accuracy of computer-aided implant surgery. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Project Flagship.

ERIC Educational Resources Information Center

State Univ. of New York, Buffalo. Coll. at Buffalo.

Project Flagship, the 1974 Distinguished Achievement Awards entry from State University College at Buffalo, New York, is a competency-based teacher education model using laboratory instruction. The special features of this model include a) stated objectives and criteria for evaluation, b) individualized instruction, c) individualized learning…

Trochanteric entry femoral nails yield better femoral version and lower revision rates-A large cohort multivariate regression analysis.

PubMed

Yoon, Richard S; Gage, Mark J; Galos, David K; Donegan, Derek J; Liporace, Frank A

2017-06-01

Intramedullary nailing (IMN) has become the standard of care for the treatment of most femoral shaft fractures. Different IMN options include trochanteric and piriformis entry as well as retrograde nails, which may result in varying degrees of femoral rotation. The objective of this study was to analyze postoperative femoral version between three types of nails and to delineate any significant differences in femoral version (DFV) and revision rates. Over a 10-year period, 417 patients underwent IMN of a diaphyseal femur fracture (AO/OTA 32A-C). Of these patients, 316 met inclusion criteria and obtained postoperative computed tomography (CT) scanograms to calculate femoral version and were thus included in the study. In this study, our main outcome measure was the difference in femoral version (DFV) between the uninjured limb and the injured limb. The effect of the following variables on DFV and revision rates were determined via univariate, multivariate, and ordinal regression analyses: gender, age, BMI, ethnicity, mechanism of injury, operative side, open fracture, and table type/position. Statistical significance was set at p<0.05. A total of 316 patients were included. Piriformis entry nails made up the majority (n=141), followed by retrograde (n=108), then trochanteric entry nails (n=67). Univariate regression analysis revealed that a lower BMI was significantly associated with a lower DFV (p=0.006). Controlling for possible covariables, multivariate analysis yielded a significantly lower DFV for trochanteric entry nails than piriformis or retrograde nails (7.9±6.10 vs. 9.5±7.4 vs. 9.4±7.8°, p<0.05). Using revision as an endpoint, trochanteric entry nails also had a significantly lower revision rate, even when controlling for all other variables (p<0.05). Comparative, objective comparisons between DFV between different nails based on entry point revealed that trochanteric nails had a significantly lower DFV and a lower revision rate, even after regression analysis. However, this is not to state that the other nail types exhibited abnormal DFV. Translation to the clinical impact of a few degrees of DFV is also unknown. Future studies to more in-depth study the intricacies of femoral version may lead to improved technology in addition to potentially improved clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prognostic value of Child-Turcotte criteria in medically treated cirrhosis.

PubMed

Christensen, E; Schlichting, P; Fauerholdt, L; Gluud, C; Andersen, P K; Juhl, E; Poulsen, H; Tygstrup, N

1984-01-01

The Child- Turcotte criteria (CTC) (based on serum bilirubin and albumin, ascites, neurological disorder and nutrition) are established prognostic factors in patients with cirrhosis having portacaval shunt surgery. The objective of this study was to evaluate the prognostic value of CTC in conservatively treated cirrhosis. Patients (n = 245) with histologically verified cirrhosis from a control group of a controlled clinical trial were studied. Data at entry into the trial were used to classify patients according to CTC. Survival curves for up to 16 years were made, and survival rates were compared using the log-rank test. Survival decreased significantly with increasing degree of abnormality (A----B----C) of albumin (p less than 0.001), ascites (p less than 0.001), bilirubin (p = 0.02) and nutritional status (p = 0.03). Survival was insignificantly influenced by neurological status (p = 0.11) probably because none of the patients had hepatic coma at entry into the trial. The five variables in CTC were combined to a score. With increasing score, the median survival time decreased from 6.4 years (score 5) to 2 months (scores 12 or more). Furthermore, the mortality from hepatic failure, gastrointestinal bleeding or hepatocellular carcinoma increased significantly with increasing score. CTC provide valuable and easily obtainable prognostic information in cirrhosis. However, CTC are inferior to a prognostic index based on multivariate analysis of prognostic factors.

How Does Sex Trafficking Increase the Risk of HIV Infection? An Observational Study From Southern India

PubMed Central

Wirth, Kathleen E.; Tchetgen Tchetgen, Eric J.; Silverman, Jay G.; Murray, Megan B.

2013-01-01

Studies have documented the substantial risk of human immunodeficiency virus (HIV) infection endured by sex-trafficked women, but it remains unclear how exposure to trafficking puts its victims at risk. We assessed whether the association between sex trafficking and HIV could be explained by self-reported forced prostitution or young age at entry into prostitution using cross-sectional data collected from 1,814 adult female sex workers in Karnataka, India, between August 2005 and August 2006. Marginal structural logistic regression was used to estimate adjusted odds ratios for HIV infection. Overall, 372 (21%) women met 1 or both criteria used to define sex trafficking: 278 (16%) began sex work before age 18 years, and 107 (5%) reported being forcibly prostituted. Thirteen (0.7%) met both criteria. Forcibly prostituted women were more likely to be HIV-infected than were women who joined the industry voluntarily, independent of age at entering prostitution (odds ratio = 2.30, 95% confidence interval: 1.08, 4.90). Conversely, after adjustment for forced prostitution and other confounders, no association between age at entry into prostitution and HIV was observed. The association between forced prostitution and HIV infection became stronger in the presence of sexual violence (odds ratio = 11.13, 95% confidence interval: 2.41, 51.40). These findings indicate that forced prostitution coupled with sexual violence probably explains the association between sex trafficking and HIV. PMID:23324332

77 FR 21777 - Expanded Charge for Peer Review of the NIOSH document Titled: “Criteria for a Recommended...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

....html for Docket number NIOSH-245. After consultation with the Occupational Safety and Health... consideration which are posted here: http://www.cdc.gov/niosh/review/peer/HISA/diacetyl-pr.html . This entry...

77 FR 8326 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... 2010, FRA formed an Engineering Task Force (ETF) to develop crashworthiness criteria for an... system with other compliant Tier 1 equipments. The waiver petition includes documentation on the... Integrity Colliding Equipment Override Fluid Entry Inhibition End Structure Integrity of Cab End End...

29 CFR 1902.3 - Specific criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... procedures for the development or adoption of standards against which the Assistant Secretary will measure... authority, through appropriate legal process, to compel such entry and inspection. (f) Prohibition against... assurances through the use of budget, organizational description, and any other appropriate means that the...

Posttraumatic stress disorder in patients with traumatic brain injury and amnesia for the event?

PubMed

Warden, D L; Labbate, L A; Salazar, A M; Nelson, R; Sheley, E; Staudenmeier, J; Martin, E

1997-01-01

Frequency of DSM-III-R posttraumatic stress disorder (PTSD) was studied in 47 active-duty service members (46 male, 1 female; mean age 27 = 7) with moderate traumatic brain injury and neurogenic amnesia for the event. Patients had attained "oriented and cooperative" recovery level. When evaluated with a modified Present State Examination and other questions at various points from study entry to 24-month follow-up, no patients met full criteria for PTSD or met criterion B (reexperience); 6 (13%) met both C (avoidance) and D (arousal) criteria. Five of these 6 also had organic mood disorder, depressed type, and/or organic anxiety disorder. Posttraumatic amnesia following moderate head injury may protect against recurring memories and the development of PTSD. Some patients with neurogenic amnesia may develop a form of PTSD without the reexperiencing symptoms.

Self-Perception of HIV Risk and Candidacy for Pre-Exposure Prophylaxis Among Men Who Have Sex with Men Testing for HIV at Commercial Sex Venues in New York City.

PubMed

Gallagher, Timothy; Link, Lauren; Ramos, Michael; Bottger, Edward; Aberg, Judith; Daskalakis, Demetre

2014-09-01

The purpose of this study was to evaluate the ability of men who have sex with men (MSM) testing for HIV at commercial sex venues to assess the following: their candidacy for pre-exposure chemoprophylaxis (PrEP) as defined by meeting entry criteria for the iPrEx (Iniciativa Profilaxis Pre-Exposición) phase III clinical trial of PrEP, and their perception of their own HIV risk and candidacy for PrEP. Interviewers surveyed 629 MSM at three NYC commercial sex venues from June 2011 through June 2012. Questions focused on demographics, sexual activity, and drug use in the three months prior to testing, as well as perceived risk of HIV acquisition and perceived candidacy for PrEP use. Data were analyzed by Chi square and Fisher's exact test. Results show that a majority of clients (80.3%) met entry criteria for the iPrEX. Most of these men (78.0%), however, did not perceive their risk to be significant enough to warrant PrEP use (P=.000). Factors were identified which associated with a risk perception that correlated with eligibility for iPrEX.

Evaluation in a competency-based educational system.

PubMed

May, B J

1977-01-01

Competency-based curricula have been implemented at the Medical College of Georgia to prepare students to meet entry level competencies as physical therapists and physical therapist assistants. Criteria-referenced evaluations are used to determine if students have achieved the desired competencies. Performance is measured against the criteria and not other students. The process of developing the system currently in use at the Medical College of Georgia is delineated in some detail and some of the advantages of the system for physical therapy education are discussed.

Prognostic Value of Exercise Treadmill Testing in Asymptomatic Chronic Nonischemic Mitral Regurgitation

PubMed Central

Supino, Phyllis G.; Borer, Jeffrey S.; Schuleri, Karlheinz; Gupta, Anuj; Hochreiter, Clare; Kligfield, Paul; Herrold, Edmund McM.; Preibisz, Jacek J.

2007-01-01

In many heart diseases, exercise treadmill testing(ETT) has useful functional correlates and/or prognostic value. However, its predictive value in mitral regurgitation(MR) is undefined. To determine whether ETT descriptors predict death or indications for mitral valve surgery among patients with MR, we prospectively followed, for 7±3 endpoint-free years, a cohort of 38 patients with chronic severe nonischemic MR who underwent modified Bruce ETT; all lacked surgical indications at study entry. Their baseline exercise descriptors also were compared with those from 46 patients with severe MR who, at entry, already had reached surgical indications. Endpoints during follow-up among the cohort included sudden death(n=1), heart failure symptoms(n=2), atrial fibrillation(n=4), LVEF<60%(n=2), LV systolic dimensions(IDs)≥45 mm(n=12) and LVIDs>40mm(n=11), LVEF<60%+LVIDs 45 mm(n=3), and heart failure+LVIDs 45mm+LVEF<60%(n=1). In univariate analysis, exercise duration(p=.004), chronotropic response(p=.007), percent predicted peak heart rate(p=.01) and heart rate recovery(p<.02) predicted events; in multivariate analysis, only exercise duration was predictive(p<.02). Average annual event risk was 5-fold lower(4.62%) with exercise duration≥15 minutes vs. <15 minutes(average annual risk=23.48%, p=.004). Relative risks among patients with and without exercise-inducible ST segment depression were comparable(≤1.3[NS]) whether defined at entry and/or during follow-up. Exercise duration, but not prevalence of exercise-inducible ST segment depression, was lower(p<.001) among patients with surgical indications at entry vs. initially endpoint-free patients. In conclusion, among asymptomatic patients with chronic severe nonischemic MR and no objective criteria for operation, progression to surgical indications generally is rapid. However, those with excellent exercise tolerance have a relatively benign course. Exercise-inducible ST segment depression has no prognostic value in this population. We followed, for 7±3 endpoint-free years, 38 patients with chronic severe nonischemic mitral regurgitation (MR) who underwent modified Bruce exercise treadmill testing (ETT) to determine whether ETT descriptors predict death or indications for mitral valve surgery. At study entry, all lacked surgical indications. Exercise duration independently predicted subsequent events; event risks among patients with and without exercise-inducible ST segment depression were comparable. We conclude that among asymptomatic patients with chronic severe nonischemic MR and no objective criteria for operation, those with excellent exercise tolerance have a relatively benign course. Exercise-inducible ST segment depression has no prognostic value in this population. PMID:17920370

Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study.

PubMed

Crosby, Vincent; D'Souza, Catherine; Bristow, Carina; Proffitt, Amy; Hussain, Asmah; Potter, Vanessa; Hennig, Ivo; O'Connor, Richard; Baracos, Vickie; Wilcock, Andrew

2017-04-01

Current methods of dosing platinum-based chemotherapy are suboptimal. Potentially, taking lean body mass into account may help. To inform the design of a future study, we first examined the feasibility and acceptability of such an approach using dual-energy X-ray absorptiometry (DEXA) and explored aspects suggestive of over- and under-dosing. Patients with lung cancer offered platinum-based chemotherapy over 1 year were identified and, if eligible, invited to take part in a prospective feasibility study. Questionnaires examined acceptability of the DEXA scan and of a future study that randomized between traditional dosing and one adjusted according to body composition. Dose-limiting toxicity (DLT) and a lack of neutropenia explored potential over- and under-dosing, respectively. Of the 173 patients offered chemotherapy, 123 (71%) were ineligible, mostly because of failing entry criteria (84, 49%). Of the 50 approached, 18 (36%) participated, most receiving carboplatin, with 17 providing data. All found a DEXA scan acceptable; other assessments were fully completed, except nadir and pre-chemotherapy blood counts. Most (94%) were prepared to take part in a future study, although the additional hospital visits for a nadir blood count were unpopular with some. Five (29%) patients experienced six episodes of DLT which resulted in discontinuation (3), dose reduction (2) or change to a less toxic regimen (1). Nine (60%) patients experienced either no (2) or inconsistent (7) neutropenia. A randomized trial appears acceptable and feasible in patients receiving carboplatin. Adjustment of our entry criteria and avoiding a hospital visit for a nadir blood count should aid recruitment.

47 CFR 90.713 - Entry criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., commercial use to non-Government, Phase I applicants. Applicants for these nationwide channel blocks must... four years of the license term; i.e., that the applicant has net current assets sufficient to cover... application showing net current assets sufficient to meet estimated construction and operating costs. An...

Georgia Mediagraphy. Second Supplement.

ERIC Educational Resources Information Center

Georgia State Dept. of Education, Atlanta. Office of Instructional Services.

This document is a guide to print and nonprint materials about Georgia and Georgians. Entries are arranged under the subject headings used in "Essential Skills for Georgia Schools." Criteria for inclusion were appropriateness for K-12 students and commercial availability of the item. Six books containing pictorial and photographic…

29 CFR 1956.10 - Specific criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... develop or adopt such standards. Indices of the effectiveness of standards and procedures for the... agencies shall have the authority through appropriate legal process to compel such entry. (f) Prohibition... plan. Subject to the results of evaluations, conformity with the Standards for a Merit System of...

Fortresses and Icebergs: The Evolution of the Transatlantic Defense Market and the Implications for U.S. National Security Policy. Volume 2: Country Studies

DTIC Science & Technology

2009-01-01

CHILE ECUADOR PARAGUAY URUGUAY FALKLAND ISLANDS SOUTH GEORGIA ISLAND KENYA ETHIOPIA ERITREA SUDAN EGYPT NIGER MAURITANIA MALI NIGERIA SOMALIA NAMIBIA...painful economic reforms also began to bear fruit. The currency stabilized and budget deficits were brought under control as the country moved toward...the criteria of the Maastricht Treaty to adopt the single European currency in place of the zloty, but entry into the Euro- zone is scheduled for 2012

Simulated Patients in Physical Therapy Education: Systematic Review and Meta-Analysis.

PubMed

Pritchard, Shane A; Blackstock, Felicity C; Nestel, Debra; Keating, Jenny L

2016-09-01

Traditional models of physical therapy clinical education are experiencing unprecedented pressures. Simulation-based education with simulated (standardized) patients (SPs) is one alternative that has significant potential value, and implementation is increasing globally. However, no review evaluating the effects of SPs on professional (entry-level) physical therapy education is available. The purpose of this study was to synthesize and critically appraise the findings of empirical studies evaluating the contribution of SPs to entry-level physical therapy education, compared with no SP interaction or an alternative education strategy, on any outcome relevant to learning. A systematic search was conducted of Ovid MEDLINE, PubMed, AMED, ERIC, and CINAHL Plus databases and reference lists of included articles, relevant reviews, and gray literature up to May 2015. Articles reporting quantitative or qualitative data evaluating the contribution of SPs to entry-level physical therapy education were included. Two reviewers independently extracted study characteristics, intervention details, and quantitative and qualitative evaluation data from the 14 articles that met the eligibility criteria. Pooled random-effects meta-analysis indicated that replacing up to 25% of authentic patient-based physical therapist practice with SP-based education results in comparable competency (mean difference=1.55/100; 95% confidence interval=-1.08, 4.18; P=.25). Thematic analysis of qualitative data indicated that students value learning with SPs. Assumptions were made to enable pooling of data, and the search strategy was limited to English. Simulated patients appear to have an effect comparable to that of alternative educational strategies on development of physical therapy clinical practice competencies and serve a valuable role in entry-level physical therapy education. However, available research lacks the rigor required for confidence in findings. Given the potential advantages for students, high-quality studies that include an economic analysis should be conducted. © 2016 American Physical Therapy Association.

Longwall gate road stability in a steeply pitching thick coal seam with a weak roof. Report of investigations/1995

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

Barron, L.R.; DeMarco, M.J.

1995-12-31

The U.S. Bureau of Mines conducted a ground pressure analysis of a wide abutment-type chain pillar in a two-entry gate road of a Western U.S. coal mine with an extremely weak immediate roof. This report discusses gate road layout and performance and secondary support effectiveness. The results of the pillar pressure study are compared to pillar loading predicted by a widely used pillar design method and to similar studies in other mines. A stability evaluation of the most recent longwall headgate, using the USBM Analysis of Longwall Pillar Stability (ALPS) indicates marginal stability in first-panel mining and instability in second-panelmore » mining. ALPS and the USBM Coal Mine Roof Rating (CMRR) system are used to evaluate tailgate-mining stability of the previous gate roads and to determine pillar and entry width and top coal thickness criteria for tailgate stability in future panels.« less

Development of Thermal Protection Materials for Future Mars Entry, Descent and Landing Systems

NASA Technical Reports Server (NTRS)

Cassell, Alan M.; Beck, Robin A. S.; Arnold, James O.; Hwang, Helen; Wright, Michael J.; Szalai, Christine E.; Blosser, Max; Poteet, Carl C.

2010-01-01

Entry Systems will play a crucial role as NASA develops the technologies required for Human Mars Exploration. The Exploration Technology Development Program Office established the Entry, Descent and Landing (EDL) Technology Development Project to develop Thermal Protection System (TPS) materials for insertion into future Mars Entry Systems. An assessment of current entry system technologies identified significant opportunity to improve the current state of the art in thermal protection materials in order to enable landing of heavy mass (40 mT) payloads. To accomplish this goal, the EDL Project has outlined a framework to define, develop and model the thermal protection system material concepts required to allow for the human exploration of Mars via aerocapture followed by entry. Two primary classes of ablative materials are being developed: rigid and flexible. The rigid ablatives will be applied to the acreage of a 10x30 m rigid mid L/D Aeroshell to endure the dual pulse heating (peak approx.500 W/sq cm). Likewise, flexible ablative materials are being developed for 20-30 m diameter deployable aerodynamic decelerator entry systems that could endure dual pulse heating (peak aprrox.120 W/sq cm). A technology Roadmap is presented that will be used for facilitating the maturation of both the rigid and flexible ablative materials through application of decision metrics (requirements, key performance parameters, TRL definitions, and evaluation criteria) used to assess and advance the various candidate TPS material technologies.

50 CFR 665.816 - American Samoa longline limited entry program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... persons only: (i) A western Pacific community located in American Samoa that meets the criteria set forth...) A family member of the permit holder, (ii) A western Pacific community located in American Samoa... socioeconomic objectives, concerning gear conflict, overfishing, enforceability, compliance, and other issues. ...

50 CFR 665.816 - American Samoa longline limited entry program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... persons only: (i) A western Pacific community located in American Samoa that meets the criteria set forth...) A family member of the permit holder, (ii) A western Pacific community located in American Samoa... socioeconomic objectives, concerning gear conflict, overfishing, enforceability, compliance, and other issues. ...

50 CFR 665.816 - American Samoa longline limited entry program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... persons only: (i) A western Pacific community located in American Samoa that meets the criteria set forth...) A family member of the permit holder, (ii) A western Pacific community located in American Samoa... socioeconomic objectives, concerning gear conflict, overfishing, enforceability, compliance, and other issues. ...

50 CFR 665.816 - American Samoa longline limited entry program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... persons only: (i) A western Pacific community located in American Samoa that meets the criteria set forth...) A family member of the permit holder, (ii) A western Pacific community located in American Samoa... socioeconomic objectives, concerning gear conflict, overfishing, enforceability, compliance, and other issues. ...

50 CFR 660.160 - Catcher/processor (C/P) Coop Program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Coop Program, or the Shorebased IFQ Program. As determined necessary by the Regional Administrator... combination. [Reserved] (4) Appeals. [Reserved] (5) Fees. The Regional Administrator is authorized to charge... entry permit owner in the NMFS permit database. (ii) Qualifying criteria for C/P endorsement. In order...

Validation and extraction of molecular-geometry information from small-molecule databases.

PubMed

Long, Fei; Nicholls, Robert A; Emsley, Paul; Graǽulis, Saulius; Merkys, Andrius; Vaitkus, Antanas; Murshudov, Garib N

2017-02-01

A freely available small-molecule structure database, the Crystallography Open Database (COD), is used for the extraction of molecular-geometry information on small-molecule compounds. The results are used for the generation of new ligand descriptions, which are subsequently used by macromolecular model-building and structure-refinement software. To increase the reliability of the derived data, and therefore the new ligand descriptions, the entries from this database were subjected to very strict validation. The selection criteria made sure that the crystal structures used to derive atom types, bond and angle classes are of sufficiently high quality. Any suspicious entries at a crystal or molecular level were removed from further consideration. The selection criteria included (i) the resolution of the data used for refinement (entries solved at 0.84 Å resolution or higher) and (ii) the structure-solution method (structures must be from a single-crystal experiment and all atoms of generated molecules must have full occupancies), as well as basic sanity checks such as (iii) consistency between the valences and the number of connections between atoms, (iv) acceptable bond-length deviations from the expected values and (v) detection of atomic collisions. The derived atom types and bond classes were then validated using high-order moment-based statistical techniques. The results of the statistical analyses were fed back to fine-tune the atom typing. The developed procedure was repeated four times, resulting in fine-grained atom typing, bond and angle classes. The procedure will be repeated in the future as and when new entries are deposited in the COD. The whole procedure can also be applied to any source of small-molecule structures, including the Cambridge Structural Database and the ZINC database.

What proportion of patients with chronic heart failure are eligible for sacubitril-valsartan?

PubMed

Pellicori, Pierpaolo; Urbinati, Alessia; Shah, Parin; MacNamara, Alexandra; Kazmi, Syed; Dierckx, Riet; Zhang, Jufen; Cleland, John G F; Clark, Andrew L

2017-06-01

The PARADIGM-HF trial showed that sacubitril-valsartan, an ARB-neprilysin inhibitor, is more effective than enalapril for some patients with heart failure (HF). It is uncertain what proportion of patients with HF would be eligible for sacubitril-valsartan in clinical practice. Between 2001 and 2014, 6131 patients consecutively referred to a community HF clinic with suspected HF were assessed. The criteria required to enter the randomized phase of PARADIGM-HF, including symptoms, NT-proBNP, and current treatment with or without target doses of ACE inhibitors or ARBs, were applied to identify the proportion of patients eligible for sacubitril-valsartan. Recognizing the diversity of clinical opinion and guideline recommendations concerning this issue, entry criteria were applied singly and in combination. Of 1396 patients with reduced left ventricular ejection fraction (≤40%, HFrEF) and contemporary measurement of NT-proBNP, 379 were on target doses of an ACE inhibitor or ARB at their initial visit and, of these, 172 (45%) fulfilled the key entry criteria for the PARADIGM-HF trial. Lack of symptoms (32%) and NT-proBNP <600 ng/L (49%) were common reasons for failure to fulfil criteria. A further 122 patients became eligible during follow-up (n = 294, 21%). However, if background medication and doses were ignored, then 701 (50%) were eligible initially and a further 137 became eligible during follow-up. Of patients with HFrEF referred to a clinic such as ours, only 21% fulfilled the PARADIGM-HF randomization criteria, on which the ESC Guidelines are based; this proportion rises to 60% if background medication is ignored. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

Directory of Facilities for Mentally Ill Children in the United States.

ERIC Educational Resources Information Center

National Association for Mental Health, New York, NY.

Facilities for mentally ill children are listed by states in this directory for parents and professional people. Each entry includes information on diagnostic considerations, capacity, admission criteria, whether the facility is residential or day care, geographic eligibility, and fees. Separate indexes list residential and day care facilities and…

Resources for Improving Principal Effectiveness. Annotated Bibliography of Packaged Training Programs.

ERIC Educational Resources Information Center

Gaddy, C. Stephen

This annotated bibliography of commercially prepared training materials for management and leadership development programs offers 10 topical sections of references applicable to school principal training. Entries were selected by using the following criteria: (1) programs dealing too specifically with management in sales, manufacturing, finance,…

47 CFR 90.713 - Entry criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MOBILE RADIO SERVICES Regulations Governing Licensing and Use of Frequencies in the 220-222 MHz Band § 90... channels in the emergency medical category may not have any interest in another pending application in the same geographic area for channels in the emergency medical category. [62 FR 15994, Apr. 3, 1997, as...

47 CFR 1.1705 - Forms; electronic and manual filing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... with the basic signal leakage performance criteria. (2) FCC Form 321, Aeronautical Frequency... time the data entry is made. (2) Attachments to applications must be uploaded along with the...) Forms 320, 321, 322, 324, 325, and 327 may be filed manually. (2) Manual filings must be submitted to...

47 CFR 1.1705 - Forms; electronic and manual filing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... with the basic signal leakage performance criteria. (2) FCC Form 321, Aeronautical Frequency... time the data entry is made. (2) Attachments to applications must be uploaded along with the...) Forms 320, 321, 322, 324, 325, and 327 may be filed manually. (2) Manual filings must be submitted to...

32 CFR 761.7 - Basic controls.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Basic controls. 761.7 Section 761.7 National... OF THE PACIFIC ISLANDS Criteria and Basic Controls § 761.7 Basic controls. (a) General. Except for such persons, ship, or aircraft as are issued an authorization to enter by an Entry Control Commander...

32 CFR 761.7 - Basic controls.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Basic controls. 761.7 Section 761.7 National... OF THE PACIFIC ISLANDS Criteria and Basic Controls § 761.7 Basic controls. (a) General. Except for such persons, ship, or aircraft as are issued an authorization to enter by an Entry Control Commander...

32 CFR 761.7 - Basic controls.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Basic controls. 761.7 Section 761.7 National... OF THE PACIFIC ISLANDS Criteria and Basic Controls § 761.7 Basic controls. (a) General. Except for such persons, ship, or aircraft as are issued an authorization to enter by an Entry Control Commander...

ENTRI HOME PAGE

Science.gov Websites

TREATY LOCATOR Treaty Locator Icon Select treaties based on search criteria. Browse results or construct updated August 2012 Metadata and suggested citations Collaborators and sponsors FAQs Search Treaty Texts Enter Keyword or Phrase: Search advanced search Search Conference of Party Decisions Search a complete

PROJECT NOTIFY--NEEDED OCCUPATIONAL TELEVISION INSTRUCTION FOR YOUTH.

ERIC Educational Resources Information Center

BANCROFT, JOHN; LAWSON, WILLIAM H.

AN EVALUATION WAS MADE OF THE EFFECTIVENESS OF VIDEO TAPES AS A MEANS OF DISSEMINATING OCCUPATIONAL INFORMATION TO HIGH SCHOOL STUDENTS. AFTER CRITERIA FOR SELECTION WERE DETERMINED, SEVEN OCCUPATIONAL AREAS WERE CHOSEN FOR PRESENTATION BY VIDEO TAPE. THE TELEVISION PROGRAMS WERE DESIGNED TO IDENTIFY ENTRY LEVEL JOBS IN THE OCCUPATIONAL AREAS…

Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen.

PubMed

Bamford, J; Fortnum, H; Bristow, K; Smith, J; Vamvakas, G; Davies, L; Taylor, R; Watkin, P; Fonseca, S; Davis, A; Hind, S

2007-08-01

To describe and analyse in detail current practice of school entry hearing screening (SES) in the UK. Main electronic databases were searched up to May 2005. A national postal questionnaire survey was addressed to all leads for SES in the UK, considering current practice in terms of implementation, protocols, target population and performance data. Primary data from cohort studies in one area of London were examined. A systematic review of alternative SES tests, test performance and impact on outcomes was carried out. Finally, a review of published studies on costs, plus economic modelling of current and alternative programmes was prepared. The survey suggested that SES is used in most of England, Wales and Scotland; just over 10% of respondents have abandoned the screen; others are awaiting national guidance. Coverage of SES is variable, but is often over 90% for children in state schools. Referral rates are variable, with a median of about 8%. The test used for the screen is the pure tone sweep test but with wide variation in implementation, with differing frequencies, pass criteria and retest protocols; written examples of protocols were often poor and ambiguous. There is no national approach to data collection, audit and quality assurance, and there are variable approaches at local level. The screen is performed in less than ideal test conditions and resources are often limited, which has an impact on the quality of the screen. The primary cohort studies show that the prevalence of permanent childhood hearing loss continues to increase through infancy. Of the 3.47 in 1000 children with a permanent hearing loss at school screen age, 1.89 in 1000 required identification after the newborn screen. Newborn hearing screening is likely to reduce significantly the yield of SES for permanent bilateral and unilateral hearing impairments; yield had fallen from about 1.11 in 1000 before newborn screening to about 0.34 in 1000 for cohorts that had had newborn screening, of which only 0.07 in 1000 were unilateral impairments. Just under 20% of permanent moderate or greater bilateral, mild bilateral and unilateral impairments, known to services as 6-year-olds or older, remained to be identified around the time of school entry. No good-quality published comparative trials of alternative screens or tests for SES were identified and studies concerned with the relative accuracy of alternative tests are difficult to compare and often flawed by differing referral criteria and case definitions; with full pure tone audiometry as the reference test, the pure tone sweep test appears to have high sensitivity and high specificity for minimal, mild and greater hearing impairments, better than alternative tests for which evidence was identified. There is insufficient evidence regarding possible harm of the screen. There were no published studies identified that examined the possible effects of SES on longer term outcomes. No good-quality published economic evaluations of SES were identified and a universal SES based on pure tone sweep tests was associated with higher costs and slightly higher quality-adjusted life-years (QALYs) compared with no screen and other screen alternatives; the incremental cost-effectiveness ratio for such a screen is around 2500 pounds per QALY gained; the range of expected costs, QALYs and net benefits was broad, indicating a considerable degree of uncertainty. Targeted screening could be more cost-effective than universal school entry screening; however, the lack of primary data and the wide limits for variables in the modelling mean that any conclusions must be considered indicative and exploratory only. A national screening programme for permanent hearing impairment at school entry meets all but three of the criteria for a screening programme, but at least six criteria are not met for screening for temporary hearing impairment. The lack of good-quality evidence in this area remains a serious problem. Services should improve quality and audit screen performance for identification of previously unknown permanent hearing impairment, pending evidence-based policy decisions based on the research recommendations. Further research is needed into a number of important areas including the evaluation of an agreed national protocol for services delivering SES to make future studies and audits of screen performance more directly comparable.

Risk Management in EVA

NASA Technical Reports Server (NTRS)

Hall, Jonathan; Lutomski, M.

2006-01-01

This viewgraph presentation reviews the use of risk management in Extravehicular Activities (EVA). The contents include: 1) EVA Office at NASA - JSC; 2) EVA Project Risk Management: Why and When; 3) EVA Office Risk Management: How; 4) Criteria for Closing a Risk; 5) Criteria for Accepting a Risk; 6) ISS IRMA Reference Card Data Entry Requirement s; 7) XA/ EVA Office Risk Activity Summary; 8) EVA Significant Change Summary; 9) Integrated Risk Management Application (XA) Matrix, March 31, 2004; 10) ISS Watch Item: 50XX Summary Report; and 11) EVA Project RM Usefulness

A phase 2 autologous cellular therapy trial in patients with acute, complete spinal cord injury: pragmatics, recruitment, and demographics.

PubMed

Jones, L A T; Lammertse, D P; Charlifue, S B; Kirshblum, S C; Apple, D F; Ragnarsson, K T; Poonian, D; Betz, R R; Knoller, N; Heary, R F; Choudhri, T F; Jenkins, A L; Falci, S P; Snyder, D A

2010-11-01

Post hoc analysis from a randomized controlled cellular therapy trial in acute, complete spinal cord injury (SCI). Description and quantitative review of study logistics, referral patterns, current practice patterns and subject demographics. Subjects were recruited to one of six international study centers. Data are presented from 1816 patients pre-screened, 75 participants screened and 50 randomized. Of the 1816 patients pre-screened, 53.7% did not meet initial study criteria, primarily due to an injury outside the time window (14 days) or failure to meet neurological criteria (complete SCI between C5 motor/C4 sensory and T11). MRIs were obtained on 339 patients; 51.0% were ineligible based on imaging criteria. Of the 75 participants enrolled, 25 failed screening (SF), leaving 50 randomized. The primary reason for SF was based on the neurological exam (51.9%), followed by failure to meet MRI criteria (22.2%). Of the 50 randomized subjects, there were no significant differences in demographics in the active versus control arms. In those participants for whom data was available, 93.8% (45 of 48) of randomized participants received steroids before study entry, whereas 94.0% (47 of 50) had spine surgery before study enrollment. The 'funnel effect' (large numbers of potentially eligible participants with a small number enrolled) impacts all trials, but was particularly challenging in this trial due to eligibility criteria and logistics. Data collected may provide information on current practice patterns and the issues encountered and addressed may facilitate design of future trials.

Study to determine potential flight applications and human factors design guidelines for voice recognition and synthesis systems

NASA Astrophysics Data System (ADS)

White, R. W.; Parks, D. L.

1985-07-01

A study was conducted to determine potential commercial aircraft flight deck applications and implementation guidelines for voice recognition and synthesis. At first, a survey of voice recognition and synthesis technology was undertaken to develop a working knowledge base. Then, numerous potential aircraft and simulator flight deck voice applications were identified and each proposed application was rated on a number of criteria in order to achieve an overall payoff rating. The potential voice recognition applications fell into five general categories: programming, interrogation, data entry, switch and mode selection, and continuous/time-critical action control. The ratings of the first three categories showed the most promise of being beneficial to flight deck operations. Possible applications of voice synthesis systems were categorized as automatic or pilot selectable and many were rated as being potentially beneficial. In addition, voice system implementation guidelines and pertinent performance criteria are proposed. Finally, the findings of this study are compared with those made in a recent NASA study of a 1995 transport concept.

Study to determine potential flight applications and human factors design guidelines for voice recognition and synthesis systems

NASA Technical Reports Server (NTRS)

White, R. W.; Parks, D. L.

1985-01-01

A study was conducted to determine potential commercial aircraft flight deck applications and implementation guidelines for voice recognition and synthesis. At first, a survey of voice recognition and synthesis technology was undertaken to develop a working knowledge base. Then, numerous potential aircraft and simulator flight deck voice applications were identified and each proposed application was rated on a number of criteria in order to achieve an overall payoff rating. The potential voice recognition applications fell into five general categories: programming, interrogation, data entry, switch and mode selection, and continuous/time-critical action control. The ratings of the first three categories showed the most promise of being beneficial to flight deck operations. Possible applications of voice synthesis systems were categorized as automatic or pilot selectable and many were rated as being potentially beneficial. In addition, voice system implementation guidelines and pertinent performance criteria are proposed. Finally, the findings of this study are compared with those made in a recent NASA study of a 1995 transport concept.

Characterization of patients with diabetic foot disease presenting to an Irish Podiatry Centre: profiling suitability for entry to a clinical trial of advanced wound therapeutics.

PubMed

Mahon, A M; MacGilchrist, C; McIntosh, C; O'Brien, T

2017-08-01

Diabetes mellitus, coined the 'Black Death of the Twenty-First Century', is associated with complications, including foot ulceration with potential loss of limb. There is a need for development of new wound therapies through completion of robust clinical trials. To profile demographics and wound characteristics of an Irish cohort with diabetes, forecast eligibility for entry to a clinical trial of advanced wound therapeutics, and adjust criteria to optimize eligibility for enrolment. A cross-sectional study of out-patients attending a Podiatry centre over 12 weeks was conducted. Information was collected through clinical assessment, including Neuropathy Disability Score and Ankle-Brachial Pressure Index. Ulcers were characterised as 'healing' or 'non-healing'; a 'healing' wound decreased by 30 % over the previous month, accomplished by retrospective analysis of files. Statistics, including binomial logistic regression and column analysis for eligibility assessment, were conducted. Seventy-four participants were identified with a mean age of 67 (± 8.79) years. Non-healing DFU status correlated significantly with larger wound area (P = 0.013), infection (P = 0.009), and greater degrees of ischaemia (P = 0.015). The eligibility criteria were modelled after those proposed by the EU consortium project REDDSTAR. In this Irish population, these criteria limit eligibility to 1.4 %. This research found an eligibility criterion of wound area 2-10 cm 2 for enrolment in a clinical trial of mesenchymal stromal cell therapy too restrictive. Extension of wound area to 1-10 cm 2 and the inclusion of neuro-ischaemic ulcers increased eligibility for enrolment from 1.4 to 20 %.

A theoretical analysis of anatomical and functional intestinal slow wave re-entry.

PubMed

Du, Peng; O'Grady, Gregory; Cheng, Leo K

2017-07-21

Intestinal bioelectrical slow waves are a key regulator of intestinal motility. Peripheral pacemakers, ectopic initiations and sustained periods of re-entrant activities have all been experimentally observed to be important factors in setting the frequency of intestinal slow waves, but the tissue-level mechanisms underpinning these activities are unclear. This theoretical analysis aimed to define the initiation, maintenance, and termination criteria of two classes of intestinal re-entrant activities: anatomical re-entry and functional re-entry. Anatomical re-entry was modeled in a three-dimensional (3D) cylindrical model, and functional rotor was modeled in a 2D rectangle model. A single-pulse stimulus was used to invoke an anatomical re-entry and a prolonged refractory block was used to invoke the rotor. In both cases, the simulated re-entrant activities operated at frequencies above the baseline entrainment frequency. The anatomical re-entry simulation results demonstrated that a temporary functional refractory block would be required to initiate the re-entrant activity in a single direction around the cylindrical model. The rotor could be terminated by a single-pulse stimulus delivered around the core of the rotor. In conclusion, the simulation results provide the following new insights into the mechanisms of intestinal re-entry: (i) anatomical re-entry is only maintained within a specific range of velocities, outside of which the re-entrant activities become either an ectopic activity or simultaneous activations of the intestinal wall; (ii) a maintained rotor entrained slow waves faster in the antegrade direction than in the retrograde direction. Simulations are shown to be a valuable tool for achieving novel insights into the mechanisms of intestinal slow wave dysrhythmia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Heterogeneity in Recent Onset Type 1 Diabetes – A Clinical Trial Perspective

PubMed Central

Bollyky, Jennifer B.; Xu, Ping; Butte, Atul J.; Wilson, Darrell M.; Beam, Craig A.; Greenbaum, Carla J.

2015-01-01

Background Type 1 Diabetes TrialNet is an NIH-sponsored clinical trial network aimed at altering the disease course of type 1 diabetes. The purpose of this study is to evaluate age-dependent heterogeneity in clinical, metabolic, and immunologic characteristics of individuals with recent-onset type 1 diabetes (T1D), to identify cohorts of interest and to aid in planning of future studies. Methods 883 individuals with recent onset T1D involved in five TrialNet studies were categorized by age as: ≥ 18, age 12-17, ages 8-12, and age <8. Data was compared with healthy age-matched subjects in the National Health and Nutrition Examination Survey. Results While only 2.0 % of individuals overall were excluded due to insufficient C-peptide values (<0.2 pmol/ml), 9.0% of those < age 8 did not meet this entry criteria. Leukopenia was present in 21.2% of individuals and lymphopenia in 11.6%; these frequencies were markedly different than age-matched healthy population. 24.5% of the cohort was overweight or obese. 31.1% of adults and 21.1% of children had neither HLA DR3 nor DR4. Conclusions The ability of recent onset T1D patients to meet key entry criteria for TrialNet studies, including C-peptide >0.2 pmol/ml, varies by age. Lower C-peptide level requirements for younger participants should be considered in the design of future trials. These data also highlight subgroups of type 1 diabetes patients, such as those with abnormal WBC or who are overweight, which allow for targeted studies of etiopathology and interventions. PMID:25689602

The health systems' priority setting criteria for selecting health technologies: A systematic review of the current evidence.

PubMed

Mobinizadeh, Mohammadreza; Raeissi, Pouran; Nasiripour, Amir Ashkan; Olyaeemanesh, Alireza; Tabibi, Seyed Jamaleddin

2016-01-01

In the recent years, using health technologies to diagnose and treat diseases has had a considerable and accelerated growth. The proper use of these technologies may considerably help in the diagnosis and treatment of different diseases. On the other hand, unlimited and unrestricted entry of these technologies may result in induced demand by service providers. The aim of this study was to determine the appropriate criteria used in health technologies priority-setting models in the world. Using MESH and free text, we sought and retrieved the relevant articles from the most appropriate medical databases (the Cochrane Library, PubMed and Scopus) through three separate search strategies up to March 2015. The inclusion criteria were as follows: 1) Studies with specific criteria; 2) Articles written in English; 3) Those articles conducted in compliance with priority setting of health technologies. Data were analyzed qualitatively using a thematic synthesis technique. After screening the retrieved papers via PRISMA framework, from the 7,012 papers, 40 studies were included in the final phase. Criteria for selecting health technologies (in pre assessment and in the assessment phase) were categorized into six main themes: 1) Health outcomes; 2) Disease and target population; 3) Technology alternatives; 4) Economic aspects; 5) Evidence; 6) and other factors. "Health effects/benefits" had the maximum frequency in health outcomes (8 studies); "disease severity" had the maximum frequency in disease and target population (12 studies); "the number of alternatives" had the maximum frequency in alternatives (2 studies); "cost-effectiveness" had the maximum frequency in economic aspects (15 studies); "quality of evidence" had the maximum frequency in evidence (4 studies); and "issues concerning the health system" had the maximum frequency in other factors (10 studies). The results revealed an increase in the number of studies on health technologies priority setting around the world, and emphasized the necessity of application of a multi- criteria approach for appropriate decision making about healthcare technologies in the health systems.

A strategical re-thinking on National Blood Donor Pool: Anti-HBc positivity related re-entry mechanisms.

PubMed

Yilmaz, Soner; Unlu, Aytekin; Cetinkaya, Riza Aytac; Yapar, Mehmet; Avci, Ismail Yasar; Yilmaz, Sebahattin; Eyigun, Can Polat

2016-04-01

Screening of blood donations for antibodies against hepatitis B core antigen (anti-HBc) is used to prevent transfusion transmitted hepatitis B virus (HBV) infection. In this study, we studied the magnitude of blood donor gain by using a re-entry mechanism in our Blood Bank of Gulhane Military Academy of Medicine. Between January and May 2013, 5148 voluntary blood donors were screened by ELISA method for HBsAg, anti-HBc total and other screening markers, prospectively. Samples with repeated reactivity for the presence of anti-HBc were further tested with four supplemental assays. We detected 515 (10%) anti-HBc positive and 4612 (90%) anti-HBc negative cases in 5127 HBsAg negative serum samples. A total of 461 (89.5%) blood units were reactive for at least one additional serologic parameter and 54 were (10.5%) negative. Isolated anti-HBc positivity rate was 1.3% (69/5127). In the isolated anti-HBc positive samples, 54 were also anti-HBe and HBeAg negative. HBV DNA was not detected in any of the samples. Applying the EDQM criteria would decrease our blood donor loss from 10% to 5.4%. As alternative re-entry mechanisms have already been presented in the literature, institution of a new policy is needed to enhance the limited blood donor pool in our system. Copyright © 2016. Published by Elsevier Ltd.

Private Actors and the Right to Education

ERIC Educational Resources Information Center

Balsera, Maria Ron; Dorsi, Delphine; Termes, Andreu; Bonal, Xavier; Verger, Antoni; Gonzalez Diaz, Javier

2016-01-01

Privatisation of education is on the rise, being offered as the best alternative to achieve universal education and improve its quality and cost-efficiency. However, the benefits of the entry of private providers in education are highly controversial and tend to be judged in terms of market criteria such as choice and efficiency, neglecting the…

17 CFR Appendix A to Part 37 - Guidance on Compliance With Registration Criteria

Code of Federal Regulations, 2011 CFR

2011-04-01

... facility should include the system's trade-matching algorithm and order entry procedures. A submission involving a trade-matching algorithm that is based on order priority factors other than on a best price/earliest time basis should include a brief explanation of the alternative algorithm. (b) A board of trade's...

17 CFR Appendix A to Part 37 - Guidance on Compliance With Registration Criteria

Code of Federal Regulations, 2012 CFR

2012-04-01

... facility should include the system's trade-matching algorithm and order entry procedures. A submission involving a trade-matching algorithm that is based on order priority factors other than on a best price/earliest time basis should include a brief explanation of the alternative algorithm. (b) A board of trade's...

44 CFR 60.3 - Flood plain management criteria for flood-prone areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... improvements, that fully enclosed areas below the lowest floor that are usable solely for parking of vehicles... that they permit the automatic entry and exit of floodwaters. (6) Require that manufactured homes that... building standards. Such enclosed space shall be useable solely for parking of vehicles, building access...

44 CFR 60.3 - Flood plain management criteria for flood-prone areas.

Code of Federal Regulations, 2011 CFR

2011-10-01

... improvements, that fully enclosed areas below the lowest floor that are usable solely for parking of vehicles... that they permit the automatic entry and exit of floodwaters. (6) Require that manufactured homes that... building standards. Such enclosed space shall be useable solely for parking of vehicles, building access...

Teaching Complaint and Adjustment Letters--And Tact (My Favorite Assignment).

ERIC Educational Resources Information Center

Deimling, Paula

1992-01-01

Describes a three-part assignment in which each student writes a complaint letter and an adjustment letter responding to another student's complaint letter. Discusses how the third part of the assignment--journal entries--allows students to formulate their own criteria for excellent letters based upon their reactions to the letters they receive.…

Design Criteria for Low Risk Re-Entry Vehicles

NASA Astrophysics Data System (ADS)

Monti, R.; Pezzella, G.

2005-02-01

The paper shows how a sharp vehicle with low wing loading, is able to follow re-entry trajectories with low thermal risks by using Ultra High Temperature Ceramics (UHTC) to thermally protect the vehicle front edges. These reusable materials can withstand the global radiative equilibrium temperatures that are experienced during reentry characterized by a longer and a more gradual conversion of the kinetic and potential energy of the vehicle into thermal energy. A number of aerothermodynamic problems are addressed to assess the feasibility of the vehicle design and of the thermal protection of the payload. In particular, the boundary layer thermal protection concept is illustrated to show how a UHTC massive tip edges (fuselage and wings) are able to protect also the remaining vehicle structure made of conventional material, promoting a revolutionary approach to the Thermal Protection System (TPS) configuration for hypersonic vehicle flying at small angle of attack. CFD results and engineering formulations are adopted for the computation of the aerodynamic coefficients and heat fluxes. The analysis identifies the design criteria for a conventional looking vehicle for a crew return from LEO (e.g. from the International Space Station).

A 3D sequence-independent representation of the protein data bank.

PubMed

Fischer, D; Tsai, C J; Nussinov, R; Wolfson, H

1995-10-01

Here we address the following questions. How many structurally different entries are there in the Protein Data Bank (PDB)? How do the proteins populate the structural universe? To investigate these questions a structurally non-redundant set of representative entries was selected from the PDB. Construction of such a dataset is not trivial: (i) the considerable size of the PDB requires a large number of comparisons (there were more than 3250 structures of protein chains available in May 1994); (ii) the PDB is highly redundant, containing many structurally similar entries, not necessarily with significant sequence homology, and (iii) there is no clear-cut definition of structural similarity. The latter depend on the criteria and methods used. Here, we analyze structural similarity ignoring protein topology. To date, representative sets have been selected either by hand, by sequence comparison techniques which ignore the three-dimensional (3D) structures of the proteins or by using sequence comparisons followed by linear structural comparison (i.e. the topology, or the sequential order of the chains, is enforced in the structural comparison). Here we describe a 3D sequence-independent automated and efficient method to obtain a representative set of protein molecules from the PDB which contains all unique structures and which is structurally non-redundant. The method has two novel features. The first is the use of strictly structural criteria in the selection process without taking into account the sequence information. To this end we employ a fast structural comparison algorithm which requires on average approximately 2 s per pairwise comparison on a workstation. The second novel feature is the iterative application of a heuristic clustering algorithm that greatly reduces the number of comparisons required. We obtain a representative set of 220 chains with resolution better than 3.0 A, or 268 chains including lower resolution entries, NMR entries and models. The resulting set can serve as a basis for extensive structural classification and studies of 3D recurring motifs and of sequence-structure relationships. The clustering algorithm succeeds in classifying into the same structural family chains with no significant sequence homology, e.g. all the globins in one single group, all the trypsin-like serine proteases in another or all the immunoglobulin-like folds into a third. In addition, unexpected structural similarities of interest have been automatically detected between pairs of chains. A cluster analysis of the representative structures demonstrates the way the "structural universe' is populated.

Impact of a Commercially Available Clinical Decision Support Program on Provider Ordering Habits.

PubMed

Huber, Timothy C; Krishnaraj, Arun; Patrie, James; Gaskin, Cree M

2018-05-18

Clinical decision support (CDS) software designed around the ACR Appropriateness Criteria assists health care providers in choosing appropriate imaging studies at the time of order entry. The goal of this study was to determine the impact of commercially available CDS on the ordering habits of inpatient and emergency providers. In 2014, ACR Select was integrated into our electronic health record, though without displaying appropriateness scores in a "silent" mode for 6 months. Then, feedback regarding examination appropriateness was "turned on" at order entry for adult patients in the emergency and inpatient settings for 24 months. We retrospectively compared the appropriateness scores of imaging tests before and after displaying feedback at order entry and evaluated these data by modality and attending versus trainee status. The commercially available CDS-generated scores for 34% and 20.4% of pre- and postintervention studies, respectively. After feedback, the relative frequency of low utility studies decreased to 5.4% from 11%, and the relative frequency of indicated studies increased to 82% from 64.5%. This was most pronounced in trainees for whom the percentage of low utility studies decreased from 10.8% (95% confidence interval [CI]: 10.0%, 11.7%) to 4.8% (95% CI: 4.4%, 5.2%) and the percentage of indicated studies increased from 65.6% (95% CI: 64.3%, 66.9%) to 83.7% (83.0%, 84.3%). After implementation of a commercially available decision support tool integrated into the electronic health record, there was a significant improvement in imaging study appropriateness scores, more pronounced in studies ordered by trainees. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Bacillus subtilis spores on artificial meteorites survive hypervelocity atmospheric entry: implications for Lithopanspermia.

PubMed

Fajardo-Cavazos, Patricia; Link, Lindsey; Melosh, H Jay; Nicholson, Wayne L

2005-12-01

An important but untested aspect of the lithopanspermia hypothesis is that microbes situated on or within meteorites could survive hypervelocity entry from space through Earth's atmosphere. The use of high-altitude sounding rockets to test this notion was explored. Granite samples permeated with spores of Bacillus subtilis strain WN511 were attached to the exterior telemetry module of a sounding rocket and launched from White Sands Missile Range, New Mexico into space, reaching maximum atmospheric entry velocity of 1.2 km/s. Maximum recorded temperature during the flight was measured at 145 degrees C. The surfaces of the post-flight granite samples were swabbed and tested for recovery and survival of WN511 spores, using genetic markers and the unique DNA fingerprint of WN511 as recovery criteria. Spore survivors were isolated at high frequency, ranging from 1.2% to 4.4% compared with ground controls, from all surfaces except the forward-facing surface. Sporulation-defective mutants were noted among the spaceflight survivors at high frequency (4%). These experiments constitute the first report of spore survival to hypervelocity atmospheric transit, and indicate that sounding rocket flights can be used to model the high-speed atmospheric entry of bacteria-laden artificial meteorites.

Bacillus subtilis Spores on Artificial Meteorites Survive Hypervelocity Atmospheric Entry: Implications for Lithopanspermia

NASA Astrophysics Data System (ADS)

Fajardo-Cavazos, Patricia; Link, Lindsey; Melosh, H. Jay; Nicholson, Wayne L.

2005-12-01

An important but untested aspect of the lithopanspermia hypothesis is that microbes situated on or within meteorites could survive hypervelocity entry from space through Earth's atmosphere. The use of high-altitude sounding rockets to test this notion was explored. Granite samples permeated with spores of Bacillus subtilis strain WN511 were attached to the exterior telemetry module of a sounding rocket and launched from White Sands Missile Range, New Mexico into space, reaching maximum atmospheric entry velocity of 1.2 km/s. Maximum recorded temperature during the flight was measured at 145°C. The surfaces of the post-flight granite samples were swabbed and tested for recovery and survival of WN511 spores, using genetic markers and the unique DNA fingerprint of WN511 as recovery criteria. Spore survivors were isolated at high frequency, ranging from 1.2% to 4.4% compared with ground controls, from all surfaces except the forward-facing surface. Sporulation-defective mutants were noted among the spaceflight survivors at high frequency (4%). These experiments constitute the first report of spore survival to hypervelocity atmospheric transit, and indicate that sounding rocket flights can be used to model the high-speed atmospheric entry of bacteria-laden artificial meteorites.

Key Attributes of a Successful Physician Order Entry System Implementation in a Multi-hospital Environment

PubMed Central

Ahmad, Asif; Teater, Phyllis; Bentley, Thomas D.; Kuehn, Lynn; Kumar, Rajee R.; Thomas, Andrew; Mekhjian, Hagop S.

2002-01-01

The benefits of computerized physician order entry have been widely recognized, although few institutions have successfully installed these systems. Obstacles to successful implementation are organizational as well as technical. In the spring of 2000, following a 4-year period of planning and customization, a 9-month pilot project, and a 14-month hiatus for year 2000, the Ohio State University Health System extensively implemented physician order entry across inpatient units. Implementation for specialty and community services is targeted for completion in 2002. On implemented units, all orders are processed through the system, with 80 percent being entered by physicians and the rest by nursing or other licensed care providers. The system is deployable across diverse clinical environments, focused on physicians as the primary users, and accepted by clinicians. These are the three criteria by which the authors measured the success of their implementation. They believe that the availability of specialty-specific order sets, the engagement of physician leadership, and a large-scale system implementation were key strategic factors that enabled physician-users to accept a physician order entry system despite significant changes in workflow. PMID:11751800

Presenting an evaluation model of the trauma registry software.

PubMed

Asadi, Farkhondeh; Paydar, Somayeh

2018-04-01

Trauma is a major cause of 10% death in the worldwide and is considered as a global concern. This problem has made healthcare policy makers and managers to adopt a basic strategy in this context. Trauma registry has an important and basic role in decreasing the mortality and the disabilities due to injuries resulted from trauma. Today, different software are designed for trauma registry. Evaluation of this software improves management, increases efficiency and effectiveness of these systems. Therefore, the aim of this study is to present an evaluation model for trauma registry software. The present study is an applied research. In this study, general and specific criteria of trauma registry software were identified by reviewing literature including books, articles, scientific documents, valid websites and related software in this domain. According to general and specific criteria and related software, a model for evaluating trauma registry software was proposed. Based on the proposed model, a checklist designed and its validity and reliability evaluated. Mentioned model by using of the Delphi technique presented to 12 experts and specialists. To analyze the results, an agreed coefficient of %75 was determined in order to apply changes. Finally, when the model was approved by the experts and professionals, the final version of the evaluation model for the trauma registry software was presented. For evaluating of criteria of trauma registry software, two groups were presented: 1- General criteria, 2- Specific criteria. General criteria of trauma registry software were classified into four main categories including: 1- usability, 2- security, 3- maintainability, and 4-interoperability. Specific criteria were divided into four main categories including: 1- data submission and entry, 2- reporting, 3- quality control, 4- decision and research support. The presented model in this research has introduced important general and specific criteria of trauma registry software and sub criteria related to each main criteria separately. This model was validated by experts in this field. Therefore, this model can be used as a comprehensive model and a standard evaluation tool for measuring efficiency and effectiveness and performance improvement of trauma registry software. Copyright © 2018 Elsevier B.V. All rights reserved.

15 CFR 400.23 - Criteria for grants of authority for zones and subzones.

Code of Federal Regulations, 2012 CFR

2012-01-01

... whether to issue a grant of authority for a zone project: (1) The need for zone services in the port of entry area, taking into account existing as well as projected international trade related activities and... government support, as indicated by the compatibility of the zone project with the community's master plan or...

Acculturative Stress and Disengagement: Learning from the Adjustment Challenges Faced by East Asian International Graduate Students

ERIC Educational Resources Information Center

Lyken-Segosebe, D. E.

2017-01-01

International graduate students meet TOEFL, GPA, and other admissions criteria to gain entry into US colleges and universities. During their stay in the USA, they provide educational and economic contributions for their host country. In contrast to their educational and economic potential, international students often demonstrate poor academic and…

[Categorical and dimensional diagnosis in schizoid and narcissistic personality disorders: critical interpretation of literature cases].

PubMed

Coccanari De Fornari, Maria Antonietta; Piccione, Michele; Giampà, Alessio

2010-01-01

In the general reflection inherent categorical and dimensional diagnosis and the opportunity to put neurotic and psychotic personality in the various chapters of the discipline, a never-ending discussion on the similarities and differences between clinical pictures classified in separate entries (think of the comings and goings from one cluster to another between schizoid and avoidant personality disorder). Other cogent discussion focused on the nosographical criteria, targeted to a modified classification that takes into account dimensional rather than descriptive criteria. About personality disorders think of the debate on their degree of severity, as assessed by criteria such dissimilar from various authors, as to be very different in this sense a ranking according to the variables considered (eg, classifications by Kernberg and Millon). As an established tradition that a contribution to psychological studies derives also from the literary and artistic forms in general, we propose, through the interpretation of literary cases, the dimensional affinity between schizoid and narcissistic disorders. The dimensions taken into account are those of affectivity and intersubjectivity, impaired in both disorders.

Evaluation of heterotrophic plate and chromogenic agar colony counting in water quality laboratories.

PubMed

Hallas, Gary; Monis, Paul

2015-01-01

The enumeration of bacteria using plate-based counts is a core technique used by food and water microbiology testing laboratories. However, manual counting of bacterial colonies is both time and labour intensive, can vary between operators and also requires manual entry of results into laboratory information management systems, which can be a source of data entry error. An alternative is to use automated digital colony counters, but there is a lack of peer-reviewed validation data to allow incorporation into standards. We compared the performance of digital counting technology (ProtoCOL3) against manual counting using criteria defined in internationally recognized standard methods. Digital colony counting provided a robust, standardized system suitable for adoption in a commercial testing environment. The digital technology has several advantages:•Improved measurement of uncertainty by using a standard and consistent counting methodology with less operator error.•Efficiency for labour and time (reduced cost).•Elimination of manual entry of data onto LIMS.•Faster result reporting to customers.

Get SET: aligning anatomy demonstrator programmes with Surgical Education and Training selection criteria.

PubMed

Rhodes, Danielle; Fogg, Quentin A; Lazarus, Michelle D

2018-05-01

Prevocational doctors aspiring to surgical careers are commonly recruited as anatomy demonstrators for undergraduate and graduate medical programmes. Entry into Surgical Education and Training (SET) is highly competitive and a unique opportunity exists to align anatomy demonstrator programmes with the selection criteria and core competencies of SET programmes. This study used a qualitative approach to (i) determine what criteria applicants for SET are assessed on and (ii) identify criteria that could be aligned with and enhanced by an anatomy demonstrator programme. The selection guidelines of all nine surgical specialties for the 2017 intake of SET trainees were analysed using qualitative content analysis methodology. The Royal Australasian College of Surgeons adopted a holistic approach to trainee selection that assessed both discipline-specific and discipline-independent skills. Qualitative content analysis identified eight categories of key selection criteria: medical expertise, scholarly activity, professional identity, interpersonal skills, integrity, self-management, insight and self-awareness and community involvement. The structured curriculum vitae was heavily weighted towards discipline-specific skills, such as medical expertise and scholarly activity. Insufficient information was available to determine the weighting of selection criteria assessed by the structured referee reports or interviews. Anatomy demonstrator programmes provide prevocational doctors with unique opportunities to develop surgical skills and competencies in a non-clinical setting. Constructively aligned anatomy demonstrator programmes may be particularly beneficial for prevocational doctors seeking to improve their anatomical knowledge, teaching skills or scholarly activity. © 2017 Royal Australasian College of Surgeons.

The Canadian American Ticlopidine Study (CATS) in thromboembolic stroke. Design, organization, and baseline results.

PubMed

Gent, M; Blakely, J A; Easton, J D; Ellis, D J; Hachinski, V C; Harbison, J W; Panak, E; Roberts, R S; Sicurella, J; Turpie, A G

1988-10-01

The Canadian American Ticlopidine Study is a randomized, placebo-controlled, double-blind, multicenter study to assess the efficacy and safety of ticlopidine hydrochloride in patients who have suffered a thromboembolic stroke no less than 1 week and no more than 4 months before entry into the study. The primary assessment of efficacy will be based on the cluster of outcome events recurrent stroke, myocardial infarction, or vascular death. Twenty-five clinical centers, 12 in Canada and 13 in the United States, entered a total of 1,072 patients during a 3-year recruitment period; these patients were randomly allocated to receive either 250 mg ticlopidine or identical-appearing placebo tablets twice daily for up to 3 years. Patient recruitment was completed in December 1986. Patients were followed for a maximum of 3 years or until the close of the study in December 1987; at that time an average follow-up of 25 months had been achieved. We summarize the protocol and organization of the study and document the methods of execution and analysis, with corresponding criteria, before disclosure of the treatment code to any of the study investigators. We also provide a clinical description of the patients at entry into the study.

Evaluation of selection criteria for graduate students in radiation therapy.

PubMed

Schneider-Kolsky, Michal; Wright, Caroline; Baird, Marilyn

2006-12-01

Selection of suitable students into graduate medical and specialist health professional courses can be difficult. Historically, selection of students was primarily based on prior academic performance. Recently, however, more emphasis has been placed on considering broader academic backgrounds and personal characteristics and attitudes of students, but no reliable measurement tool is available to predict student success and satisfaction with their choice of profession. The aim of this study was to survey practising radiation therapists in Australia to seek their opinions regarding suitable selection criteria for graduate entry radiation therapy (RT) students in order to optimize selection procedures for future applicants. Four hundred questionnaires were sent to nine RT centres in three states within Australia. All nine clinics participated in the survey and 189 questionnaires were returned. Results show that the majority of radiation therapists place a high level of importance upon a sound knowledge of physics and mathematics, as well as life experience, and agree that a visit to an RT clinic plus an interview comprise important components of the selection process. Humanities, psychology and a psychometric test were not viewed as essential entry requirements. Experienced radiation therapists placed less value on academic performance in the primary degree and were more likely to include an interview as a selection criterion than junior practitioners. Empathy for patients was identified as the most important personal attribute. It is thus recommended that not only cognitive but also personal skills be evaluated during the selection of prospective radiation therapists.

2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative

PubMed Central

Neogi, Tuhina; Jansen, Tim L Th A; Dalbeth, Nicola; Fransen, Jaap; Schumacher, H Ralph; Berendsen, Dianne; Brown, Melanie; Choi, Hyon; Edwards, N Lawrence; Janssens, Hein J E M; Lioté, Frédéric; Naden, Raymond P; Nuki, George; Ogdie, Alexis; Perez-Ruiz, Fernando; Saag, Kenneth; Singh, Jasvinder A; Sundy, John S; Tausche, Anne-Kathrin; Vaquez-Mellado, Janitzia; Yarows, Steven A; Taylor, William J

2015-01-01

Objective Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. Methods An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multi-criterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. Results The entry criterion for the new classification criteria requires the occurrence of at least one episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (ie, synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy CT, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). Conclusions The new classification criteria, developed using a data-driven and decision-analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout. PMID:26359487

2015 Gout Classification Criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative

PubMed Central

Jansen, Tim L. Th. A.; Dalbeth, Nicola; Fransen, Jaap; Schumacher, H. Ralph; Berendsen, Dianne; Brown, Melanie; Choi, Hyon; Edwards, N. Lawrence; Janssens, Hein J. E. M.; Lioté, Frédéric; Naden, Raymond P.; Nuki, George; Ogdie, Alexis; Perez‐Ruiz, Fernando; Saag, Kenneth; Singh, Jasvinder A.; Sundy, John S.; Tausche, Anne‐Kathrin; Vaquez‐Mellado, Janitzia; Yarows, Steven A.; Taylor, William J.

2015-01-01

Objective Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. Methods An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multicriterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. Results The entry criterion for the new classification criteria requires the occurrence of at least 1 episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (i.e., synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU‐negative synovial fluid aspirate), and imaging (double‐contour sign on ultrasound or urate on dual‐energy computed tomography, radiographic gout‐related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). Conclusion The new classification criteria, developed using a data‐driven and decision analytic approach, have excellent performance characteristics and incorporate current state‐of‐the‐art evidence regarding gout. PMID:26352873

Mars Science Laboratory Navigation Results

NASA Technical Reports Server (NTRS)

Martin-Mur, Tomas J.; Kruizingas, Gerhard L.; Burkhart, P. Daniel; Wong, Mau C.; Abilleira, Fernando

2012-01-01

The Mars Science Laboratory (MSL), carrying the Curiosity rover to Mars, was launched on November 26, 2011, from Cape Canaveral, Florida. The target for MSL was selected to be Gale Crater, near the equator of Mars, with an arrival date in early August 2012. The two main interplanetary navigation tasks for the mission were to deliver the spacecraft to an entry interface point that would allow the rover to safely reach the landing area, and to tell the spacecraft where it entered the atmosphere of Mars, so it could guide itself accurately to close proximity of the landing target. MSL used entry guidance as it slowed down from the entry speed to a speed low enough to allow for a successful parachute deployment, and this guidance allowed shrinking the landing ellipse to a 99% conservative estimate of 7 by 20 kilometers. Since there is no global positioning system in Mars, achieving this accuracy was predicated on flying a trajectory that closely matched the reference trajectory used to design the guidance algorithm, and on initializing the guidance system with an accurate Mars-relative entry state that could be used as the starting point to integrate the inertial measurement unit data during entry and descent. The pre-launch entry flight path angle (EFPA) delivery requirement was +/- 0.20 deg, but after launch a smaller threshold of +/- 0.05 deg was used as the criteria for late trajectory correction maneuver (TCM) decisions. The pre-launch requirement for entry state knowledge was 2.8 kilometers in position error and 2 meters per second in velocity error, but also smaller thresholds were defined after launch to evaluate entry state update opportunities. The biggest challenge for the navigation team was to accurately predict the trajectory of the spacecraft, so the estimates of the entry conditions could be stable, and late trajectory correction maneuvers or entry parameter updates could be waved off. As a matter of fact, the prediction accuracy was such that the last TCM performed was a small burn executed eight days before landing, and the entry state that was calculated just 36 hours after that TCM, and that was uploaded to the spacecraft the same day, did not need to be updated. The final EFPA was 0.013 deg shallower than the -15.5 deg target, and the on-board entry state was just 200 meters in position and 0.11 meters per second in velocity from the post-landing reconstructed entry state. Overall the entry delivery and knowledge requirements were fulfilled with a margin of more than 90% with respect to the pre-launch thresholds. This excellent accuracy contributed to a very successful and accurate entry, descent, and landing, and surface mission.

Prevalence of DSM-IV Disorder in a Representative, Healthy Birth Cohort at School Entry: Sociodemographic Risks and Social Adaptation

ERIC Educational Resources Information Center

Carter, Alice S.; Wagmiller, Robert J.; Gray, Sarah A. O.; McCarthy, Kimberly J.; Horwitz, Sarah M.; Briggs-Gowan, Margaret J.

2010-01-01

Objective: The aims of this paper are as follows: to present past-year prevalence data for DSM-IV disorders in the early elementary school years; to examine the impact of impairment criteria on prevalence estimates; to examine the relation of sociodemographic and psychosocial risk factors to disorders; and to explore associations between…

The health systems' priority setting criteria for selecting health technologies: A systematic review of the current evidence

PubMed Central

Mobinizadeh, Mohammadreza; Raeissi, Pouran; Nasiripour, Amir Ashkan; Olyaeemanesh, Alireza; Tabibi, Seyed Jamaleddin

2016-01-01

Background: In the recent years, using health technologies to diagnose and treat diseases has had a considerable and accelerated growth. The proper use of these technologies may considerably help in the diagnosis and treatment of different diseases. On the other hand, unlimited and unrestricted entry of these technologies may result in induced demand by service providers. The aim of this study was to determine the appropriate criteria used in health technologies priority-setting models in the world. Methods: Using MESH and free text, we sought and retrieved the relevant articles from the most appropriate medical databases (the Cochrane Library, PubMed and Scopus) through three separate search strategies up to March 2015. The inclusion criteria were as follows: 1) Studies with specific criteria; 2) Articles written in English; 3) Those articles conducted in compliance with priority setting of health technologies. Data were analyzed qualitatively using a thematic synthesis technique. Results: After screening the retrieved papers via PRISMA framework, from the 7,012 papers, 40 studies were included in the final phase. Criteria for selecting health technologies (in pre assessment and in the assessment phase) were categorized into six main themes: 1) Health outcomes; 2) Disease and target population; 3) Technology alternatives; 4) Economic aspects; 5) Evidence; 6) and other factors. "Health effects/benefits" had the maximum frequency in health outcomes (8 studies); "disease severity" had the maximum frequency in disease and target population (12 studies); "the number of alternatives" had the maximum frequency in alternatives (2 studies); "cost-effectiveness" had the maximum frequency in economic aspects (15 studies); "quality of evidence" had the maximum frequency in evidence (4 studies); and "issues concerning the health system" had the maximum frequency in other factors (10 studies). Conclusion: The results revealed an increase in the number of studies on health technologies priority setting around the world, and emphasized the necessity of application of a multi- criteria approach for appropriate decision making about healthcare technologies in the health systems. PMID:27390699

The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

PubMed

Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

2016-09-01

To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns

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

Cunha, J. A. M.; Hsu, I-C.; Pouliot, J.

2009-01-15

Purpose: To determine whether alternative high dose rate prostate brachytherapy catheter patterns can result in similar or improved dose distributions while providing better access and reducing trauma. Materials and Methods: Standard prostate cancer high dose rate brachytherapy uses a regular grid of parallel needle positions to guide the catheter insertion. This geometry does not easily allow the physician to avoid piercing the critical structures near the penile bulb nor does it provide position flexibility in the case of pubic arch interference. This study used CT datasets with 3 mm slice spacing from ten previously treated patients and digitized new cathetersmore » following three hypothetical catheter patterns: conical, bi-conical, and fireworks. The conical patterns were used to accommodate a robotic delivery using a single entry point. The bi-conical and fireworks patterns were specifically designed to avoid the critical structures near the penile bulb. For each catheter distribution, a plan was optimized with the inverse planning algorithm, IPSA, and compared with the plan used for treatment. Irrelevant of catheter geometry, a plan must fulfill the RTOG-0321 dose criteria for target dose coverage (V{sub 100}{sup Prostate}>90%) and organ-at-risk dose sparing (V{sub 75}{sup Bladder}<1 cc, V{sub 75}{sup Rectum}<1 cc, V{sub 125}{sup Urethra}<<1 cc). Results: The three nonstandard catheter patterns used 16 nonparallel, straight divergent catheters, with entry points in the perineum. Thirty plans from ten patients with prostate sizes ranging from 26 to 89 cc were optimized. All nonstandard patterns fulfilled the RTOG criteria when the clinical plan did. In some cases, the dose distribution was improved by better sparing the organs-at-risk. Conclusion: Alternative catheter patterns can provide the physician with additional ways to treat patients previously considered unsuited for brachytherapy treatment (pubic arch interference) and facilitate robotic guidance of catheter insertion. In addition, alternative catheter patterns may decrease toxicity by avoidance of the critical structures near the penile bulb while still fulfilling the RTOG criteria.« less

A Survey of Athletic Training Employers' Hiring Criteria

PubMed Central

Andrews, Lanna

2001-01-01

Objective: To identify athletic training employers' hiring criteria and to determine if the importance of individual hiring criteria vary by setting. Design and Setting: The Athletic Training Employer Needs Assessment Survey was mailed to athletic training employers advertising in the National Athletic Trainers' Association (NATA) placement vacancy notice between October 1996 and October 1998. Subjects: A total of 111 athletic training employers in NATA Districts 7, 8, and 10 were surveyed. Measurements: Employers rated the importance of hiring criteria on a 7-point Likert scale. Means and standard deviations were calculated for each criterion and compared these values to ascertain the importance of individual criteria. A principal component analysis was done to determine the underlying factors. Results: Hiring characteristics can be divided into 4 factors that include highly related criteria: (1) personal characteristics, (2) educational experience, (3) professional experience, and (4) work-related attributes. In addition, the hiring characteristics desired by employers varied among athletic training settings. Conclusions: When interviewing and presenting themselves for entry-level positions, athletic trainers should pay particular attention to the attributes within the 4 hiring criteria factors. Also, the desired hiring criteria of athletic training employers differed by setting. Applicants need to pay particular attention to these hiring criteria differences when constructing résumés, cover letters, and professional correspondence and when interviewing with prospective employers. PMID:12937484

Comparison of native versus nonnative English-speaking nurses on critical thinking assessments at entry and exit.

PubMed

Whitehead, Tanya D

2006-01-01

Diversity of language among healthcare employees and nursing students is growing as diversity increases among the general population. Institutions have begun to develop systems to accommodate diversity and to assimilate workers. One barrier to nonnative English-speaking nurse hires may be posed by readiness for the licensure exam and the critical thinking assessments that are now an expected outcome of nursing programs, and act as a gatekeeper to graduation and to employment. To assist in preparing for high-stakes testing, the Assessment Technologies Institute Critical Thinking Assessment was developed in compliance with credentialing bodies' educational outcomes criteria. This pilot study of 209 nursing students was designed to reveal any possible language bias that might act as a barrier to nonnative English speakers. Nursing students were entered as whole classes to the study to control for selection bias. A sample representative of national nursing enrollment was obtained from 21 universities, with 192 (92%) native English-speaking students and 17 (8%) nonnative English speakers participating in the study. All students were given the Assessment Technologies Institute Critical Thinking Assessment at entry and exit to their nursing program. Average scores on entry were 66% for nonnative speakers and 72% for native speakers. At exit, the nonnative speakers had closed the gap in academic outcomes. They had an average score of 72% compared to 73% for native speakers. The study found that the slight differences between the native and nonnative speakers on 2 exit outcome measures-National Council licensure examination (NCLEX-RN) pass rates and Critical Thinking Assessment-were not statistically significant, demonstrating that nonnative English speakers achieved parity with native English-speaking peers on the Critical Thinking Assessment tool, which is often believed to be related to employment readiness.

Clinical and laboratory variability in a cohort of patients diagnosed with type 1 VWD in the United States

PubMed Central

Christopherson, Pamela A.; Gill, Joan Cox; Friedman, Kenneth D.; Haberichter, Sandra L.; Bellissimo, Daniel B.; Udani, Rupa A.; Dasgupta, Mahua; Hoffmann, Raymond G.; Ragni, Margaret V.; Shapiro, Amy D.; Lusher, Jeanne M.; Lentz, Steven R.; Abshire, Thomas C.; Leissinger, Cindy; Hoots, W. Keith; Manco-Johnson, Marilyn J.; Gruppo, Ralph A.; Boggio, Lisa N.; Montgomery, Kate T.; Goodeve, Anne C.; James, Paula D.; Lillicrap, David; Peake, Ian R.; Montgomery, Robert R.

2016-01-01

von Willebrand disease (VWD) is the most common inherited bleeding disorder, and type 1 VWD is the most common VWD variant. Despite its frequency, diagnosis of type 1 VWD remains the subject of debate. In order to study the spectrum of type 1 VWD in the United States, the Zimmerman Program enrolled 482 subjects with a previous diagnosis of type 1 VWD without stringent laboratory diagnostic criteria. von Willebrand factor (VWF) laboratory testing and full-length VWF gene sequencing was performed for all index cases and healthy control subjects in a central laboratory. Bleeding phenotype was characterized using the International Society on Thrombosis and Haemostasis bleeding assessment tool. At study entry, 64% of subjects had VWF antigen (VWF:Ag) or VWF ristocetin cofactor activity below the lower limit of normal, whereas 36% had normal VWF levels. VWF sequence variations were most frequent in subjects with VWF:Ag <30 IU/dL (82%), whereas subjects with type 1 VWD and VWF:Ag ≥30 IU/dL had an intermediate frequency of variants (44%). Subjects whose VWF testing was normal at study entry had a similar rate of sequence variations as the healthy controls (14%). All subjects with severe type 1 VWD and VWF:Ag ≤5 IU/dL had an abnormal bleeding score (BS), but otherwise BS did not correlate with VWF:Ag. Subjects with a historical diagnosis of type 1 VWD had similar rates of abnormal BS compared with subjects with low VWF levels at study entry. Type 1 VWD in the United States is highly variable, and bleeding symptoms are frequent in this population. PMID:26862110

Clinical and laboratory variability in a cohort of patients diagnosed with type 1 VWD in the United States.

PubMed

Flood, Veronica H; Christopherson, Pamela A; Gill, Joan Cox; Friedman, Kenneth D; Haberichter, Sandra L; Bellissimo, Daniel B; Udani, Rupa A; Dasgupta, Mahua; Hoffmann, Raymond G; Ragni, Margaret V; Shapiro, Amy D; Lusher, Jeanne M; Lentz, Steven R; Abshire, Thomas C; Leissinger, Cindy; Hoots, W Keith; Manco-Johnson, Marilyn J; Gruppo, Ralph A; Boggio, Lisa N; Montgomery, Kate T; Goodeve, Anne C; James, Paula D; Lillicrap, David; Peake, Ian R; Montgomery, Robert R

2016-05-19

von Willebrand disease (VWD) is the most common inherited bleeding disorder, and type 1 VWD is the most common VWD variant. Despite its frequency, diagnosis of type 1 VWD remains the subject of debate. In order to study the spectrum of type 1 VWD in the United States, the Zimmerman Program enrolled 482 subjects with a previous diagnosis of type 1 VWD without stringent laboratory diagnostic criteria. von Willebrand factor (VWF) laboratory testing and full-length VWF gene sequencing was performed for all index cases and healthy control subjects in a central laboratory. Bleeding phenotype was characterized using the International Society on Thrombosis and Haemostasis bleeding assessment tool. At study entry, 64% of subjects had VWF antigen (VWF:Ag) or VWF ristocetin cofactor activity below the lower limit of normal, whereas 36% had normal VWF levels. VWF sequence variations were most frequent in subjects with VWF:Ag <30 IU/dL (82%), whereas subjects with type 1 VWD and VWF:Ag ≥30 IU/dL had an intermediate frequency of variants (44%). Subjects whose VWF testing was normal at study entry had a similar rate of sequence variations as the healthy controls (14%). All subjects with severe type 1 VWD and VWF:Ag ≤5 IU/dL had an abnormal bleeding score (BS), but otherwise BS did not correlate with VWF:Ag. Subjects with a historical diagnosis of type 1 VWD had similar rates of abnormal BS compared with subjects with low VWF levels at study entry. Type 1 VWD in the United States is highly variable, and bleeding symptoms are frequent in this population. © 2016 by The American Society of Hematology.

Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

PubMed

Parrino, Thomas A

2005-02-01

To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

A randomized controlled trial of interim methadone maintenance.

PubMed

Schwartz, Robert P; Highfield, David A; Jaffe, Jerome H; Brady, Joseph V; Butler, Carol B; Rouse, Charles O; Callaman, Jason M; O'Grady, Kevin E; Battjes, Robert J

2006-01-01

Effective alternatives to long waiting lists for entry into methadone hydrochloride maintenance treatment are needed to reduce the complications of continuing heroin dependence and to increase methadone treatment entry. To compare the effectiveness of interim methadone maintenance with that of the usual waiting list condition in facilitating methadone treatment entry and reducing heroin and cocaine use and criminal behavior. Randomized, controlled, clinical trial using 2 conditions, with treatment assignment on a 3:2 basis to interim maintenance-waiting list control. A methadone treatment program in Baltimore. A total of 319 individuals meeting the criteria for current heroin dependence and methadone maintenance treatment. Participants were randomly assigned to either interim methadone maintenance, consisting of an individually determined methadone dose and emergency counseling only for up to 120 days, or referral to community-based methadone treatment programs. Entry into comprehensive methadone maintenance therapy at 4 months from baseline; self-reported days of heroin use, cocaine use, and criminal behavior; and number of urine drug test results positive for heroin and cocaine at the follow-up interview conducted at time of entry into comprehensive methadone treatment (or at 4 months from baseline for participants who did not enter regular treatment). Significantly more participants assigned to the interim methadone maintenance condition entered comprehensive methadone maintenance treatment by the 120th day from baseline (75.9%) than those assigned to the waiting list control condition (20.8%) (P<.001). Overall, in the past 30 days at follow-up, interim participants reported significantly fewer days of heroin use (P<.001), had a significant reduction in heroin-positive drug test results (P<.001), reported spending less money on drugs (P<.001), and received less illegal income (P<.02) than the waiting list participants. Interim methadone maintenance results in a substantial increase in the likelihood of entry into comprehensive treatment, and is an effective means of reducing heroin use and criminal behavior among opioid-dependent individuals awaiting entry into a comprehensive methadone treatment program.

Documentation of penicillin adverse drug reactions in electronic health records: inconsistent use of allergy and intolerance labels.

PubMed

Inglis, Joshua M; Caughey, Gillian E; Smith, William; Shakib, Sepehr

2017-11-01

The majority of patients with penicillin allergy labels tolerate penicillins. Inappropriate avoidance of penicillin is associated with increased hospitalisation, infections and healthcare costs. To examine the documentation of penicillin adverse drug reactions (ADR) in a large-scale hospital-based electronic health record. Penicillin ADR were extracted from 96 708 patient records in the Enterprise Patient Administration System in South Australia. Expert criteria were used to determine consistency of ADR entry and suitability for further evaluation. Of 43 011 unique ADR reports, there were 5023 ADR to penicillins with most being entered as allergy (n = 4773, 95.0%) rather than intolerance (n = 250, 5.0%). A significant proportion did not include a reaction description (n = 1052, 20.9%). Using pre-set criteria, 10.1% of reports entered as allergy had a reaction description that was consistent with intolerance and 31.0% of the entered intolerances had descriptions consistent with allergy. Virtually all ADR (n = 4979, 99.1%) were appropriate for further evaluation by history taking or immunological testing and half (50.7%, n = 2549) had documented reactions suggesting low-risk of penicillin allergy. The frequency of penicillin allergy label in this data set is consistent with the known overdiagnosis of penicillin allergy in the hospital population. ADR documentation was poor with incomplete entries and inconsistent categorisation. The concepts of allergy and intolerance for ADR classification, whilst mechanistically valid, may not be useful at the point of ADR entry by generalist clinicians. Systematic evaluation of reported ADR is needed to improve the quality of information for future prescribers. © 2017 Royal Australasian College of Physicians.

How Do Private Health Plans Manage Specialty Behavioral Health Treatment Entry and Continuing Care?

PubMed

Quinn, Amity E; Reif, Sharon; Merrick, Elizabeth L; Horgan, Constance M; Garnick, Deborah W; Stewart, Maureen T

2017-09-01

This study examined private health plans' arrangements for accessing and continuing specialty behavioral health treatment in 2010 as federal health reforms were being implemented. These management practices have historically been stricter in behavioral health care than in general medical care; however, the Mental Health Parity and Addiction Equity Act of 2010 required parity in management policies. The data source was a nationally representative survey of private health plans' behavioral health treatment management approaches in 2010. Health plan executives were asked about activities for their plan's three products with highest enrollment (weighted N=8,427, 88% response rate). Prior authorization for outpatient behavioral health care was rarely required (4.7% of products), but 75% of products required authorization for ongoing care and over 90% required prior authorization for other levels of care. The most common medical necessity criteria were self-developed and American Society of Addiction Medicine criteria. Nearly all products had formal standards to limit waiting time for routine and urgent treatment, but almost 30% lacked such standards for detoxification services. A range of wait time-monitoring approaches was used. Health plans used a variety of methods to influence behavioral health treatment entry and continuing care. Few relied on prior authorization for outpatient care, but the use of other approaches to influence, manage, or facilitate access was common. Results provide a baseline for understanding the current management environment for specialty behavioral health care. Tracking health plans' approaches over time will be important to ensure that access to behavioral health care is not prohibitively restrictive.

Interruption as a test of the user-computer interface

NASA Technical Reports Server (NTRS)

Kreifeldt, J. G.; Mccarthy, M. E.

1981-01-01

In order to study the effects different logic systems might have on interrupted operation, an algebraic calculator and a reverse polish notation calculator were compared when trained users were interrupted during problem entry. The RPN calculator showed markedly superior resistance to interruption effects compared to the AN calculator although no significant differences were found when the users were not interrupted. Causes and possible remedies for interruption effects are speculated. It is proposed that because interruption is such a common occurrence, it be incorporated into comparative evaluation tests of different logic system and control/display system and that interruption resistance be adopted as a specific design criteria for such design.

Therapeutic hypothermia in the prevention of hypoxic-ischaemic encephalopathy: new categories to be enrolled.

PubMed

Gancia, Paolo; Pomero, Giulia

2012-10-01

Therapeutic hypothermia is now the standard of care for brain injury control in term infants with perinatal hypoxic ischemic encephalopathy (HIE). Accumulated evidence shows a reduction in mortality and long-term neurodevelopmental disability at 12-24 months of age, with more favourable effects in the less severe forms of HIE. Only few trials recruited newborns <36 weeks gestational age, or mild-to-moderate encephalopathy with base deficit (BD) <16. The new categories of patients to be enrolled should include (late) preterm infants, neonates with unexpected postnatal collapse, and newborns with stroke. Preterm HIE: Therapeutic hypothermia shows a good safety profile in clinical studies, and no adverse effects were noted in the preterm fetal animal model. Recently, it has been shown that mild hypothermia in preterm newborns with necrotizing enterocolitis (NEC) and multiple organ dysfunction syndrome (MODS) does not increase mortality, bleeding, infection, or need for inotropes in cooled newborns. A pilot study (NCT00620711) is currently recruiting newborns of > 32 but < 36 weeks gestation with standard criteria for HIE. Postnatal Collapse: The postnatal collapse (PNC) is a rare (0.03-0.5/1000 live births) but life-threatening hypoxic-ischemic event. No clinical trials of therapeutic hypothermia have specifically addressed to PNC. Nevertheless, a beneficial effect of brain cooling is expectable, and it has been proposed to include in brain hypothermia trials the infants with PNC fulfilling the entry criteria for HIE. Stroke: Perinatal arterial ischemic stroke is the most common cause of cerebral palsy (CP) in term and near-term newborn. In a systematic review and meta-analysis of animal studies of focal cerebral ischemia, hypothermia reduced the infarct size by 44%. No specific neuroprotective interventions are available for the management of acute perinatal stroke. Hypothermia may decrease seizures in newborns with encephalopathy and a focal infarct, potentially improving the long-term outcome for these infants. Future studies of therapeutic hypothermia should include the categories of newborns excluded from the published clinical trials, that is infants <36 weeks gestation, PNC or stroke, or admitted outside of the established 6-hour window, and with encephalopathy not imputable to HIE. New entry criteria will allow significant number of newborns to benefit from the treatment.

Early Lupus Project - A multicentre Italian study on systemic lupus erythematosus of recent onset.

PubMed

Sebastiani, G D; Prevete, I; Piga, M; Iuliano, A; Bettio, S; Bortoluzzi, A; Coladonato, L; Tani, C; Spinelli, F R; Fineschi, I; Mathieu, A

2015-10-01

Systemic lupus erythematosus (SLE) is an autoimmune disease with a high degree of variability at onset that is problematic for a correct and prompt diagnosis. We undertook this project with the purpose of collecting an inception cohort of Italian patients with recent-onset SLE, in order to obtain information on the main clinical and serological characteristics at the beginning of the disease. In this first report we describe the characteristics of this cohort at study entry. All patients with a diagnosis of SLE (1997 ACR criteria) and a disease duration less than 12 months were consecutively enrolled between 1 January 2012 and 31 December 2013 in a multicentre prospective study. Information on clinical and serological characteristics at study entry and then every six months was collected into a specific electronic database. Statistical analysis was performed by means of the Openstat program. Among 122 patients enrolled (103 F) 94.3% were Caucasians. Mean age (SD) of patients at study entry was 37.3 (14.3) years, mean age at disease onset was 34.8 (14.3) years, mean age at diagnosis was 36.9 (14.3) years, and mean disease duration was 2.9 (3.9) months. The frequency of the manifestations included in the 1997 ACR criteria was as follows: ANA 97.5%, immunologic disorders (anti-dsDNA, anti-Sm, antiphospholipid antibodies) 85.2%, arthritis 61.8%, haematologic disorders 55.7%, malar rash 31.1%, photosensitivity 29.5%, serositis 27%, renal disorders 27%, oral/nasal ulcers 11.5%, neurologic disorders 8.2%, and discoid rash 5.7%. The cumulative frequency of mucocutaneous symptoms was 77.8%. At enrolment, autoantibody frequency was: ANA 100%, anti-dsDNA 83.6%, anti-SSA 28%, anticardiolipin 24.5%, anti-nRNP 20.4%, anti-beta2GPI 17.2%, lupus anticoagulant 16.3%, anti-Sm 16%, and anti-SSB 13.1%. In this paper we describe the main clinical and serological characteristics of an Italian inception cohort of patients with recent-onset SLE. At disease onset, mucocutaneous manifestations, arthritis and haematologic manifestations were the most frequent symptoms; ANA, anti-dsDNA and complement reduction were the most frequent laboratory findings. Our data confirm that the diagnosis of SLE is a challenging one, and that SLE is a severe disease even at onset, since the majority of patients require at least a hospitalization before the diagnosis. © The Author(s) 2015.

Entry of Yersinia pestis into the viable but nonculturable state in a low-temperature tap water microcosm.

PubMed

Pawlowski, David R; Metzger, Daniel J; Raslawsky, Amy; Howlett, Amy; Siebert, Gretchen; Karalus, Richard J; Garrett, Stephanie; Whitehouse, Chris A

2011-03-16

Yersinia pestis, the causative agent of plague, has caused several pandemics throughout history and remains endemic in the rodent populations of the western United States. More recently, Y. pestis is one of several bacterial pathogens considered to be a potential agent of bioterrorism. Thus, elucidating potential mechanisms of survival and persistence in the environment would be important in the event of an intentional release of the organism. One such mechanism is entry into the viable but non-culturable (VBNC) state, as has been demonstrated for several other bacterial pathogens. In this study, we showed that Y. pestis became nonculturable by normal laboratory methods after 21 days in a low-temperature tap water microcosm. We further show evidence that, after the loss of culturability, the cells remained viable by using a variety of criteria, including cellular membrane integrity, uptake and incorporation of radiolabeled amino acids, and protection of genomic DNA from DNase I digestion. Additionally, we identified morphological and ultrastructural characteristics of Y. pestis VBNC cells, such as cell rounding and large periplasmic spaces, by electron microscopy, which are consistent with entry into the VBNC state in other bacteria. Finally, we demonstrated resuscitation of a small number of the non-culturable cells. This study provides compelling evidence that Y. pestis persists in a low-temperature tap water microcosm in a viable state yet is unable to be cultured under normal laboratory conditions, which may prove useful in risk assessment and remediation efforts, particularly in the event of an intentional release of this organism.

Entry of Yersinia pestis into the Viable but Nonculturable State in a Low-Temperature Tap Water Microcosm

PubMed Central

Pawlowski, David R.; Metzger, Daniel J.; Raslawsky, Amy; Howlett, Amy; Siebert, Gretchen; Karalus, Richard J.; Garrett, Stephanie; Whitehouse, Chris A.

2011-01-01

Yersinia pestis, the causative agent of plague, has caused several pandemics throughout history and remains endemic in the rodent populations of the western United States. More recently, Y. pestis is one of several bacterial pathogens considered to be a potential agent of bioterrorism. Thus, elucidating potential mechanisms of survival and persistence in the environment would be important in the event of an intentional release of the organism. One such mechanism is entry into the viable but non-culturable (VBNC) state, as has been demonstrated for several other bacterial pathogens. In this study, we showed that Y. pestis became nonculturable by normal laboratory methods after 21 days in a low-temperature tap water microcosm. We further show evidence that, after the loss of culturability, the cells remained viable by using a variety of criteria, including cellular membrane integrity, uptake and incorporation of radiolabeled amino acids, and protection of genomic DNA from DNase I digestion. Additionally, we identified morphological and ultrastructural characteristics of Y. pestis VBNC cells, such as cell rounding and large periplasmic spaces, by electron microscopy, which are consistent with entry into the VBNC state in other bacteria. Finally, we demonstrated resuscitation of a small number of the non-culturable cells. This study provides compelling evidence that Y. pestis persists in a low-temperature tap water microcosm in a viable state yet is unable to be cultured under normal laboratory conditions, which may prove useful in risk assessment and remediation efforts, particularly in the event of an intentional release of this organism. PMID:21436885

Mild cognitive impairment, amnestic type: an epidemiologic study.

PubMed

Ganguli, Mary; Dodge, Hiroko H; Shen, Changyu; DeKosky, Steven T

2004-07-13

To estimate the prevalence and examine the course of mild cognitive impairment (MCI), amnestic type, using current criteria, within a representative community sample. Retroactive application of MCI criteria to data collected during a prospective epidemiologic study was performed. The subjects were drawn from voter registration lists, composing a cohort of 1,248 individuals with mean age of 74.6 (5.3) years, who were nondemented at entry and who were assessed biennially over 10 years of follow-up. The Petersen amnestic MCI criteria were operationalized as 1) impaired memory: Word List Delayed Recall score of <1 SD below mean; 2) normal mental status: Mini-Mental State Examination score of 25+; 3) normal daily functioning: no instrumental impairments; 4) memory complaint: subjective response to standardized question; 5) not demented: Clinical Dementia Rating Scale score of <1. At the five assessments, amnestic MCI criteria were met by 2.9 to 4.0% of the cohort. Of 40 persons with MCI at the first assessment, 11 (27%) developed dementia over the next 10 years. Over each 2-year interval, MCI persons showed increased risk of dementing (odds ratio = 3.9, 95% CI = 2.1 to 7.2); 11.1 to 16.7% progressed to Alzheimer disease and 0 to 5.0% progressed to other dementias. Over the same intervals, 11.1 to 21.2% of those with MCI remained MCI; of 33.3 to 55.6% who no longer had MCI, half had reverted to normal. In this community-based sample, 3 to 4% of nondemented persons met MCI operational criteria; despite increased risk of progressing to dementia, a substantial proportion also remained stable or reverted to normal during follow-up. Amnestic MCI as currently defined is a high-risk but unstable and heterogeneous group.

Tutorial Guide: Computer-Aided Structural Modeling (CASM). Version 5.00

DTIC Science & Technology

1994-04-01

2-3 SITE-SPECIFIC DATA DIALOG WINDOW ................. 2-4 SAVING PROJECT DATA ....................... 2-7 PRINTING PROJECT CRITERIA DATA...you to the main CASM screen without saving changes. REGIONAL DATA DIALOG WINDOW The Regonal• Dtadlalg windtow contim ms0•twrmofogoik hronimdon.The...Information so that It will be Included In your hardcopy output. 3. Select OK to save your Regional Data entries. The Regional Data dalog window will disappear

Economic Education Experiences of Enterprising Teachers, Volume 13. A Report Developed from the 1974-75 Entries in The International Paper Company Foundation Awards Program for the Teaching of Economics.

ERIC Educational Resources Information Center

Dawson, George G., Ed.

The publication outlines 19 award winning economic education projects for use on levels K through college. The projects have been judged original and interesting to students and have met contest criteria by describing class situation, scope and sequence, goals, motivational devices, teaching techniques, samples of student work, culmination…

In What Ways is the New Jersey County Vocational School Admissions Criteria a Predictor of Student Success on State Mandated Tests?

ERIC Educational Resources Information Center

Rubin, Scott; Ramaswami, Soundaram

2013-01-01

Vocational and Technical Education (VTE) at the secondary-school level has undergone transformation, especially in the last 25 to 30 years brought about by the implementation of the Carl D. Perkins Vocational and Technical Education Act of 1984. Earlier, the VTE education focus was to prepare students for entry-level jobs that did not require a…

Fallout Protection in School Construction. Proceedings, Association of School Business Officials of the United States and Canada (49th, Denver, Colorado, November 3-8, 1963).

ERIC Educational Resources Information Center

Roembke, James E.

Discussion of the effects of nuclear weapons and consequent radiation fallout precedes justification of the need for fallout shelters. Competition for the design of an elementary school with a population of 300-500 and an emergency population of 600-1000 is then described. Criteria and requirements are detailed. The winning entries illustrate…

Technology Against Terrorism: The Federal Effort

DTIC Science & Technology

1991-07-01

control appli - control and airport security plans. Some difficulties cations, irises of those seeking entry would be have arisen: now that specific...Washington International Air- tion. Among more advanced technologies are four of port as a test-bed. Sandia is applying to airport interest: voice...and 300 by 1999. criteria as well as evaluation standards and proce- In further tests carried out at JFK Airport in New dures for future EDS devices

Molecular Characterization of Indolent Prostate Cancer

DTIC Science & Technology

2013-10-01

SUPPLEMENTARY NOTES 14. ABSTRACT Indolent prostate cancers that pose very low risk to aged men occur frequently and may be detected at biopsy, leading...Introduction Indolent prostate cancers that pose very low risk to aged men occur frequently and may be detected at biopsy, leading to the...cancer at the time of biopsy detection and thus meeting the entry criteria for active surveillance. The scope of the proposed research is: 1) to

Targeted Entry via Somatostatin Receptors Using a Novel Modified Retrovirus Glycoprotein That Delivers Genes at Levels Comparable to Those of Wild-Type Viral Glycoproteins

PubMed Central

Li, Fang; Ryu, Byoung Y.; Krueger, Robin L.; Heldt, Scott A.

2012-01-01

Here we report a novel viral glycoprotein created by replacing a natural receptor-binding sequence of the ecotropic Moloney murine leukemia virus envelope glycoprotein with the peptide ligand somatostatin. This new chimeric glycoprotein, which has been named the Sst receptor binding site (Sst-RBS), gives targeted transduction based on three criteria: (i) a gain of the use of a new entry receptor not used by any known virus; (ii) targeted entry at levels comparable to gene delivery by wild-type ecotropic Moloney murine leukemia virus and vesicular stomatitis virus (VSV) G glycoproteins; and (iii) a loss of the use of the natural ecotropic virus receptor. Retroviral vectors coated with Sst-RBS gained the ability to bind and transduce human 293 cells expressing somatostatin receptors. Their infection was specific to target somatostatin receptors, since a synthetic somatostatin peptide inhibited infection in a dose-dependent manner and the ability to transduce mouse cells bearing the natural ecotropic receptor was effectively lost. Importantly, vectors coated with the Sst-RBS glycoprotein gave targeted entry of up to 1 × 106 transducing U/ml, a level comparable to that seen with infection of vectors coated with the parental wild-type ecotropic Moloney murine leukemia virus glycoprotein through the ecotropic receptor and approaching that of infection of VSV G-coated vectors through the VSV receptor. To our knowledge, this is the first example of a glycoprotein that gives targeted entry of retroviral vectors at levels comparable to the natural capacity of viral envelope glycoproteins. PMID:22013043

A mixed-methods research approach to the review of competency standards for orthotist/prosthetists in Australia.

PubMed

Ash, Susan; O'Connor, Jackie; Anderson, Sarah; Ridgewell, Emily; Clarke, Leigh

2015-06-01

The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach. A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis - a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups - an expert and a recent graduate group of Australian orthotist/prosthetists - were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages. In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards. This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.

Borderline Personality Disorder Features in Nonclinical Young Adults: 2. Two-Year Outcome

PubMed Central

Trull, Timothy J.; Useda, J. David; Conforti, Kelly; Doan, Bao-Tran

2013-01-01

Borderline personality disorder (BPD) is thought to develop by early adulthood, and it is characterized by lack of control of anger, intense and frequent mood changes, impulsive acts, disturbed interpersonal relationships, and life-threatening behaviors. We describe data from a 2-year follow-up study of nonclinical young adults who, at study entry, exhibited a significant number of BPD features. Individuals with borderline features were more likely to have academic difficulties over the succeeding 2 years, and these participants were more likely to meet lifetime criteria for a mood disorder and to experience interpersonal dysfunction than their peers at the 2-year follow-up assessment. These findings indicate that BPD features are associated with poorer outcome even within a nonclinical population. PMID:9131850

The mineralogy and petrology of I-type cosmic spherules: Implications for their sources, origins and identification in sedimentary rocks

NASA Astrophysics Data System (ADS)

Genge, Matthew J.; Davies, Bridie; Suttle, Martin D.; van Ginneken, Matthias; Tomkins, Andrew G.

2017-12-01

I-type cosmic spherules are micrometeorites that formed by melting during atmospheric entry and consist mainly of iron oxides and FeNi metal. I-types are important because they can readily be recovered from sedimentary rocks allowing study of solar system events over geological time. We report the results of a study of the mineralogy and petrology of 88 I-type cosmic spherules recovered from Antarctica in order to evaluate how they formed and evolved during atmospheric entry, to constrain the nature of their precursors and to establish rigorous criteria by which they may be conclusively identified within sediments and sedimentary rocks. Two textural types of I-type cosmic spherule are recognised: (1) metal bead-bearing (MET) spherules dominated by Ni-poor (<1.5 wt%) wüstite and FeNi metal (10-95 wt% Ni) with minor magnetite, and (2) metal bead-free (OX) spherules dominated by Ni-rich wüstite (0.5-22.5 wt%) and magnetite. Two varieties of OX spherule are distinguished, magnetite-poor dendritic spherules and magnetite-rich coarse spherules. Six OXMET particles having features of both MET and OX spherules were also observed. The wüstite to magnetite ratios and metal contents of the studied particles testify to their formation by melting of extraterrestrial FeNi grains during progressive oxidation in the atmosphere. Precursors are suggested to be mainly kamacite and rare taenite grains. Vesicle formation within metal beads and extrusion of metallic liquid into surrounding wüstite grain boundaries suggests an evaporated iron sulphide or carbide component within at least 23% of particles. The Ni/Co ratios of metal vary from 14 to >100 and suggest that metal from H-group ordinary, CM, CR and iron meteorites may form the majority of particles. Oxidation during entry heating increases in the series MET < magnetite-poor OX < magnetite-rich OX spherules owing to differences in particle size, entry angle and velocity. Magnetite-poor OX spherules are shown to form by crystallisation of non-stoichiometric wüstite at the liquidus followed by sub-solidus decomposition to magnetite, whilst in magnetite-rich OX spherules magnetite crystallises directly at the liquidus. Magnetite rims found on most particles are suggested to form by oxidation during sub-solidus flight. The separation of metal beads due to deceleration is proposed to have been minor with most OX spherules shown to have been in equilibrium with metal beads containing >80 wt% Ni comprising a particle mass fraction of <0.2. Non-equilibrium effects in the exchange of Ni between wüstite and metal, and magnetite and wüstite are suggested as proxies for the rate of oxidation and cooling rate respectively. Variations in magnetite and wüstite crystal sizes are also suggested to relate to cooling rate allowing relative entry angle of particles to be evaluated. The formation of secondary metal in the form of sub-micron Ni-rich or Pt-group nuggets and as symplectite with magnetite was also identified and suggested to occur largely due to the exsolution of metallic alloys during decomposition of non-stoichiometric wüstite. Weathering is restricted to replacement of metal by iron hydroxides. The following criteria are recommended for the conclusive identification of I-type spherules within sediments and sedimentary rocks: (i) spherical particle morphologies, (ii) dendritic crystal morphologies, (iii) the presence of wüstite and magnetite, (iv) Ni-bearing wüstite and magnetite, and (v) the presence of relict FeNi metal.

The HepTestContest: a global innovation contest to identify approaches to hepatitis B and C testing.

PubMed

Tucker, Joseph D; Meyers, Kathrine; Best, John; Kaplan, Karyn; Pendse, Razia; Fenton, Kevin A; Andrieux-Meyer, Isabelle; Figueroa, Carmen; Goicochea, Pedro; Gore, Charles; Ishizaki, Azumi; Khwairakpam, Giten; Miller, Veronica; Mozalevskis, Antons; Ninburg, Michael; Ocama, Ponsiano; Peeling, Rosanna; Walsh, Nick; Colombo, Massimo G; Easterbrook, Philippa

2017-11-01

Innovation contests are a novel approach to elicit good ideas and innovative practices in various areas of public health. There remains limited published literature on approaches to deliver hepatitis testing. The purpose of this innovation contest was to identify examples of different hepatitis B and C approaches to support countries in their scale-up of hepatitis testing and to supplement development of formal recommendations on service delivery in the 2017 World Health Organization hepatitis B and C testing guidelines. This contest involved four steps: 1) establishment of a multisectoral steering committee to coordinate a call for contest entries; 2) dissemination of the call for entries through diverse media (Facebook, Twitter, YouTube, email listservs, academic journals); 3) independent ranking of submissions by a panel of judges according to pre-specified criteria (clarity of testing model, innovation, effectiveness, next steps) using a 1-10 scale; 4) recognition of highly ranked entries through presentation at international conferences, commendation certificate, and inclusion as a case study in the WHO 2017 testing guidelines. The innovation contest received 64 entries from 27 countries and took a total of 4 months to complete. Sixteen entries were directly included in the WHO testing guidelines. The entries covered testing in different populations, including primary care patients (n = 5), people who inject drugs (PWID) (n = 4), pregnant women (n = 4), general populations (n = 4), high-risk groups (n = 3), relatives of people living with hepatitis B and C (n = 2), migrants (n = 2), incarcerated individuals (n = 2), workers (n = 2), and emergency department patients (n = 2). A variety of different testing delivery approaches were employed, including integrated HIV-hepatitis testing (n = 12); integrated testing with harm reduction and addiction services (n = 9); use of electronic medical records to support targeted testing (n = 8); decentralization (n = 8); and task shifting (n = 7). The global innovation contest identified a range of local hepatitis testing approaches that can be used to inform the development of testing strategies in different settings and populations. Further implementation and evaluation of different testing approaches is needed.

Quality improvement in neurology residency programs. Report of the Quality Improvement Committee of the Association of University Professors of Neurology.

PubMed

Bradley, W G; Daube, J; Mendell, J R; Posner, J; Richman, D; Troost, B T; Swift, T R

1997-11-01

The neurology residency programs in the United States are facing a crisis of quality. The Association of University Professors of Neurology (AUPN) approved the Quality Improvement Committee to examine this situation and make recommendations, which have been accepted by the AUPN. The recommendations are (1) that the educational goals of neurology residency training be dissociated from patient-care needs in academic medical centers and (2) that minimum levels of quality be applied to residents in neurology residency programs and to these programs themselves. These minimum criteria should include minimum educational criteria for entry into the program, minimum criteria for advancement from one year to the next in the program, and minimum criteria for performance of the graduates of neurology residency programs for program accreditation. The implementation of these recommendations will require a shift of funding of the care of indigent patients from the graduate medical education budget to direct patient-care sources. These recommendations will significantly improve the quality of neurologists and neurologic care in the United States.

The Entry Psychiatric Screen (EPS): A Psychiatric Screening Procedure for Applicants for Military Service

DTIC Science & Technology

2004-12-01

Structured Clinical Interview for DSM-IV-TR (First, et al., 2001) and the Hare Psychopathy Checklist (Hart, Cox, & Hare, 1995). In total, 96 induction...psychotic characteristics. EPS Antisocial Scale Here again, the lack of participants in our sample who manifested clinical levels of psychopathy ... Psychopathy Checklist revealed that no members of our sample met the criteria for clinical psychopathy . For each of the three remaining diagnostic

Risk, Predictors, and Outcomes of Acute Kidney Injury in Patients Admitted to Intensive Care Units in Egypt.

PubMed

Abd ElHafeez, Samar; Tripepi, Giovanni; Quinn, Robert; Naga, Yasmine; Abdelmonem, Sherif; AbdelHady, Mohamed; Liu, Ping; James, Matthew; Zoccali, Carmine; Ravani, Pietro

2017-12-07

Epidemiology of acute kidney injury (AKI) in developing countries is under-studied. We evaluated the risk and prognosis of AKI in patients admitted to intensive care units (ICUs) in Egypt. We recruited consecutive adults admitted to ICUs in Alexandria Teaching Hospitals over six months. We used the KDIGO criteria for AKI. We followed participants until the earliest of ICU discharge, death, day 30 from entry or study end. Of the 532 participants (median age 45 (Interquartile range [IQR]: 30-62) years, 41.7% male, 23.7% diabetics), 39.6% had AKI at ICU admission and 37.4% developed AKI after 24 hours of ICU admission. Previous need of diuretics, sepsis and low education were associated with AKI at ICU admission; APACHE II score independently predicted AKI after ICU admission. A total of 120 (22.6%) patients died during 30-day follow-up. Compared to patients who remained AKI-free, mortality was significantly higher in patients who had AKI at study entry (Hazard Ratio [HR] 2.14; 95% Confidence Interval [CI] 1.02-4.48) or developed AKI in ICU (HR 2.74; 95% CI 1.45-5.17). The risk of AKI is high in critically ill people and predicts poor outcomes. Further studies are needed to estimate the burden of AKI among patients before ICU admission.

The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis

PubMed Central

2014-01-01

Background The Health Information Technology for Economic and Clinical Health (HITECH) Act subsidizes implementation by hospitals of electronic health records with computerized provider order entry (CPOE), which may reduce patient injuries caused by medication errors (preventable adverse drug events, pADEs). Effects on pADEs have not been rigorously quantified, and effects on medication errors have been variable. The objectives of this analysis were to assess the effectiveness of CPOE at reducing pADEs in hospital-related settings, and examine reasons for heterogeneous effects on medication errors. Methods Articles were identified using MEDLINE, Cochrane Library, Econlit, web-based databases, and bibliographies of previous systematic reviews (September 2013). Eligible studies compared CPOE with paper-order entry in acute care hospitals, and examined diverse pADEs or medication errors. Studies on children or with limited event-detection methods were excluded. Two investigators extracted data on events and factors potentially associated with effectiveness. We used random effects models to pool data. Results Sixteen studies addressing medication errors met pooling criteria; six also addressed pADEs. Thirteen studies used pre-post designs. Compared with paper-order entry, CPOE was associated with half as many pADEs (pooled risk ratio (RR) = 0.47, 95% CI 0.31 to 0.71) and medication errors (RR = 0.46, 95% CI 0.35 to 0.60). Regarding reasons for heterogeneous effects on medication errors, five intervention factors and two contextual factors were sufficiently reported to support subgroup analyses or meta-regression. Differences between commercial versus homegrown systems, presence and sophistication of clinical decision support, hospital-wide versus limited implementation, and US versus non-US studies were not significant, nor was timing of publication. Higher baseline rates of medication errors predicted greater reductions (P < 0.001). Other context and implementation variables were seldom reported. Conclusions In hospital-related settings, implementing CPOE is associated with a greater than 50% decline in pADEs, although the studies used weak designs. Decreases in medication errors are similar and robust to variations in important aspects of intervention design and context. This suggests that CPOE implementation, as subsidized under the HITECH Act, may benefit public health. More detailed reporting of the context and process of implementation could shed light on factors associated with greater effectiveness. PMID:24894078

Vertical Spin Tunnel Testing and Stability Analysis of Multi-Mission Earth Entry Vehicles

NASA Technical Reports Server (NTRS)

Glaab, Louis J.; Morelli, Eugene A.; Fremaux, C. Michael; Bean, Jacob

2014-01-01

Multi-Mission Earth Entry Vehicles (MMEEVs) are blunt-body vehicles designed with the purpose of transporting payloads from space to the surface of the Earth. To achieve high reliability and minimum weight, MMEEVs avoid using limited-reliability systems, such as parachutes, retro-rockets, and reaction control systems and rely on the natural aerodynamic stability of the vehicle throughout the Entry, Descent, and Landing phases of flight. Testing in NASA Langley's 20-FT Vertical Spin Tunnel (20-FT VST), dynamically-scaled MMEEV models was conducted to improve subsonic aerodynamic models and validate stability criteria for this class of vehicle. This report documents the resulting data from VST testing for an array of 60-deg sphere-cone MMEEVs. Model configurations included were 1.2 meter, and 1.8 meter designs. The addition of a backshell extender, which provided a 150% increase in backshell diameter for the 1.2 meter design, provided a third test configuration. Center of Gravity limits were established for all MMEEV configurations. An application of System Identification (SID) techniques was performed to determine the aerodynamic coefficients in order to provide databases for subsequent 6-degree-of-freedom simulations.

The efficacy of self-directed modules for clinical learning: advanced competencies in entry-level physical therapy education.

PubMed

Peck, Kirk; Paschal, Karen; Black, Lisa; Nelson, Kelly

2014-01-01

Prior to graduation, students often express an interest to advance clinical and professional skills in teaching, research, administration, and various niche practice areas. The acquisition of advanced education in selected areas of practice is believed to improve employment opportunities, accelerate career advancement including eligibility for professional certifications, and contribute to personal satisfaction in the profession. The purpose of this paper is to (1) describe an innovative model of education, the Directed Practice Experience (DPE) elective, that incorporates a student-initiated learning process designed to achieve student-identified professional goals, and (2) report the outcomes for graduates who have completed the DPE in an entry-level program in physical therapy education. Students who met select criteria were eligible to complete a DPE. Applicants designed a 4- to 6-week clinical education experience consisting of stated rationale for personal and professional growth, examples of leadership and service, and self-directed objectives that are beyond entry-level expectations as measured by the revised Physical Therapist Clinical Performance Instrument, version 2006. Twenty-six students have completed DPEs since 2005. Fifty percent resulted in new academic partnerships. At least 25% of graduates now serve as clinical instructors for the entry-level program. Those who participated in DPEs have also completed post-graduate residencies, attained ABPTS Board certifications, authored peer-reviewed publications, and taught in both PT and residency programs. The DPE model allows qualified students to acquire advanced personal skills and knowledge prior to graduation in areas of professional practice that exceed entry-level expectations. The model is applicable to all CAPTE accredited physical therapy education programs and is especially beneficial for academic programs desiring to form new community partnerships for student clinical education.

Enrichment of clinical study populations.

PubMed

Temple, R

2010-12-01

Those who conduct clinical trials "enrich" study populations in a variety of ways in order to identify a population of patients in whom a drug effect, if present, is more likely to be demonstrable. The principal ways to do this are as follows: (i) practical enrichment, i.e., generally seeking to reduce noise (variability of measurement) and heterogeneity (by avoiding the enrollment of patients with other diseases and individuals in whom the disease disappears spontaneously), (ii) prognostic enrichment, i.e., finding patients who are likely to have the event of interest when enrolling for risk-reduction studies, and (iii) predictive enrichment, i.e., finding the individuals who are more likely to respond. Enrichment fits well into the growing interest in "individualization" of therapy but creates some tension with another trend, namely, the desire for "real-world studies" with less restrictive entry criteria and other requirements.

Prognosis of constipation: clinical factors and colonic transit time

PubMed Central

de Lorijn, F; van Wijk, M P; Reitsma, J; van Ginkel, R; Taminiau, J; Benninga, M

2004-01-01

Background: Measurement of colonic transit time (CTT) is sometimes used in the evaluation of patients with chronic constipation. Aim: To investigate the relation between symptoms and CTT, and to assess the importance of symptoms and CTT in predicting outcome. Methods: Between 1995 and 2000, 169 consecutive patients (median age 8.4 years, 65% boys) fulfilling the criteria for constipation were enrolled. During the intervention and follow up period, all kept a diary to record symptoms. CTT was measured at entry to the study. Results: At entry, defecation frequency was lower in girls than in boys, while the frequency of encopresis episodes was higher in boys. CTT values were significantly higher in those with a low defecation frequency (⩽1/week) and a high frequency of encopresis (⩾2/day). However, 50% had CTT values within the normal range. Successful outcome occurred more often in those with a rectal impaction. CTT results <100 hours were not predictive of outcome. However, those with CTT >100 hours were less likely to have had a successful outcome. Conclusion: The presence of a rectal impaction at presentation is associated with a better outcome at one year. A CTT >100 hours is associated with a poor outcome at one year. PMID:15269069

Nutritional and cognitive status of entry-level primary school children in Zomba, rural Malawi.

PubMed

Nkhoma, Owen W W; Duffy, Maresa E; Davidson, Philip W; Cory-Slechta, Deborah A; McSorley, Emeir M; Strain, J J; O'Brien, Gerard M

2013-05-01

Entry-level Malawian children (n = 226) aged 6-8 years from two public primary schools, one a participant in a national school feeding programme (FP), the other not, were investigated for differences in nutritional and cognitive status. Stunted growth (42%) and underweight (25%) were prevalent, with no significant differences between the schools, although the school attended was a significant predictor of mid-upper arm circumference. Previous attendance at a community-based childcare centre was significantly associated with lower body weight and height. There were no significant differences in memory, reversal learning and attention outcomes between the schools. These findings report no major significant difference in nutrition or cognitive statuses between the schools, and on this basis suggest that both schools were equally in need of FP participation. More inclusive interventions and broadening/review of FP participation criteria are recommended.

GEOTHERM Data Set

DOE Data Explorer

DeAngelo, Jacob

1983-01-01

GEOTHERM is a comprehensive system of public databases and software used to store, locate, and evaluate information on the geology, geochemistry, and hydrology of geothermal systems. Three main databases address the general characteristics of geothermal wells and fields, and the chemical properties of geothermal fluids; the last database is currently the most active. System tasks are divided into four areas: (1) data acquisition and entry, involving data entry via word processors and magnetic tape; (2) quality assurance, including the criteria and standards handbook and front-end data-screening programs; (3) operation, involving database backups and information extraction; and (4) user assistance, preparation of such items as application programs, and a quarterly newsletter. The principal task of GEOTHERM is to provide information and research support for the conduct of national geothermal-resource assessments. The principal users of GEOTHERM are those involved with the Geothermal Research Program of the U.S. Geological Survey.

Current status of cardiovascular surgery in Japan, 2013 and 2014: A report based on the Japan Cardiovascular Surgery Database (JCVSD). 1: Mission and history of JCVSD.

PubMed

Takamoto, Shinichi; Motomura, Noboru; Miyata, Hiroaki; Tsukihara, Hiroyuki

2018-01-01

The Japan Cardiovascular Surgery Database (JCVSD) was created in 2000 with the support of the Society of Thoracic Surgeons (STS). The STS database content was translated to Japanese using the same disease criteria and in 2001, data entry for adult cardiac surgeries was initiated online using the University Hospital Medical Information Network (UMIN). In 2008, data entry for congenital heart surgeries was initiated in the congenital section of JCVSD and preoperative expected mortality (JapanSCORE) in adult cardiovascular surgeries was first calculated using the risk model of JCVSD. The Japan Surgical Board system merged with JCVSD in 2011, and all cardiovascular surgical data were registered in the JCVSD from 2012 onward. The reports resulting from the data analyses of the JCVSD will encourage further improvements in the quality of cardiovascular surgeries, patient safety, and medical care in Japan.

Entry characteristics and performance in a Masters module in Tropical Medicine: a 5-year analysis.

PubMed

Weigel, R; Robinson, D; Stewart, M; Assinder, S

2016-06-01

Postgraduate courses can contribute to better-qualified personnel in resource-limited settings. We aimed to identify how entry characteristics of applicants predict performance in order to provide support measures early. We describe demographic data and end-of-module examination marks of medical doctors who enrolled in a first semester module of two one-year MSc programmes between 2010 and 2014. We used t-tests and one-way anova to compare, and post hoc tests to locate differences of mean marks between categories of entry characteristics in univariate analysis. After exclusion of collinear variables, multiple regression examined the effect of several characteristics in multivariable analysis. Eighty-nine students (47% male) with a mean age of 32 (SD 6.4) years who received their medical degree in the UK (19%), other European (22%), African (35%) or other countries (24%) attended the 3-months module. Their mean mark was 69.1% (SD 10.9). Medical graduates from UK universities achieved significantly higher mean marks than graduates from other countries. Students' age was significantly negatively correlated with the module mark. In multiple linear regression, place of medical degree (β = -0.44, P < 0.001) and time since graduation (β = -0.28, P = 0.007) were strongest predictors of performance, explaining 32% of the variation of mean marks. Students' performance substantially differs based on their entry criteria in this 1st semester module. Non-UK graduates and mature students might benefit from early support. © 2016 John Wiley & Sons Ltd.

Community engagement in diverse populations for Alzheimer disease prevention trials.

PubMed

Romero, Heather R; Welsh-Bohmer, Kathleen A; Gwyther, Lisa P; Edmonds, Henry L; Plassman, Brenda L; Germain, Cassandra M; McCart, Michelle; Hayden, Kathleen M; Pieper, Carl; Roses, Allen D

2014-01-01

The recruitment of asymptomatic volunteers has been identified as a critical factor that is delaying the development and validation of preventive therapies for Alzheimer disease (AD). Typical recruitment strategies involve the use of convenience samples or soliciting participation of older adults with a family history of AD from clinics and outreach efforts. However, high-risk groups, such as ethnic/racial minorities, are traditionally less likely to be recruited for AD prevention studies, thus limiting the ability to generalize findings for a significant proportion of the aging population. A community-engagement approach was used to create a registry of 2311 research-ready, healthy adult volunteers who reflect the ethnically diverse local community. Furthermore, the registry's actual commitment to research was examined, through demonstrated participation rates in a clinical study. The approach had varying levels of success in establishing a large, diverse pool of individuals who are interested in participating in pharmacological prevention trials and meet the criteria for primary prevention research trials designed to delay the onset of AD. Our efforts suggest that entry criteria for the clinical trials need to be carefully considered to be inclusive of African Americans, and that sustained effort is needed to engage African Americans in pharmacological prevention approaches.

Outcome measurement in clinical trials for Ulcerative Colitis: towards standardisation

PubMed Central

Cooney, Rachel M; Warren, Bryan F; Altman, Douglas G; Abreu, Maria T; Travis, Simon PL

2007-01-01

Clinical trials on novel drug therapies require clear criteria for patient selection and agreed definitions of disease remission. This principle has been successfully applied in the field of rheumatology where agreed disease scoring systems have allowed multi-centre collaborations and facilitated audit across treatment centres. Unfortunately in ulcerative colitis this consensus is lacking. Thirteen scoring systems have been developed but none have been properly validated. Most trials choose different endpoints and activity indices, making comparison of results from different trials extremely difficult. International consensus on endoscopic, clinical and histological scoring systems is essential as these are the key components used to determine entry criteria and outcome measurements in clinical trials on ulcerative colitis. With multiple new therapies under development, there is a pressing need for consensus to be reached. PMID:17592647

Classification of non-demented patients attending a memory clinic using the new diagnostic criteria for Alzheimer's disease with disease-related biomarkers.

PubMed

Ivanoiu, Adrian; Dricot, Laurence; Gilis, Nathalie; Grandin, Cécile; Lhommel, Renaud; Quenon, Lisa; Hanseeuw, Bernard

2015-01-01

New diagnostic criteria for predemential Alzheimer's disease (AD) advocate the use of biomarkers. However, the benefit of using biomarkers has not been clearly demonstrated in clinical practice. To investigate whether a combination of biomarkers may be helpful in classifying a population of non-demented patients attending a Memory Clinic. Sixty non-demented patients were compared with 31 healthy elderly subjects. All subjects underwent a neuropsychological examination, brain 3T magnetic resonance imaging, [F18]-fluorodeoxyglucose and [F18]-flutemetamol positron emission tomography. According to their performance on memory, language, executive, and visuo-spatial domains, the patients were classified as mild cognitive impairment (amnestic, non-amnestic, single, or multiple domain) or subjective cognitive impairment. Patients were then classified according to the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria, using the normalized mean hippocampal volume (Freesurfer), [F18]-FDG PALZAD, and [F18]-flutemetamol standard uptake value ratio (SUVr) (cut-off at the 10th percentile of controls). The standard of truth was the clinical status at study entry (patient versus control). The sensitivity/specificity of the clinical classification was 65/84%. The NIA-AA criteria were applicable in 85% of patients and 87% of controls. For biomarkers the best sensitivity (72%) at a fixed specificity of 84% was achieved by a combination of the three biomarkers. The clinical diagnosis was reconsidered in more than one third of the patients (42%) as a result of including the biomarker results. Application of the new NIA-AA AD diagnostic criteria based on biomarkers in an unselected sample of non-demented patients attending a Memory Clinic was useful in allowing for a better classification of the subjects.

Optimal firm growth under the threat of entry

PubMed Central

Kort, Peter M.; Wrzaczek, Stefan

2015-01-01

The paper studies the incumbent-entrant problem in a fully dynamic setting. We find that under an open-loop information structure the incumbent anticipates entry by overinvesting, whereas in the Markov perfect equilibrium the incumbent slightly underinvests in the period before the entry. The entry cost level where entry accommodation passes into entry deterrence is lower in the Markov perfect equilibrium. Further we find that the incumbent’s capital stock level needed to deter entry is hump shaped as a function of the entry time, whereas the corresponding entry cost, where the entrant is indifferent between entry and non-entry, is U-shaped. PMID:26435573

High-intensity Focused Ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: predictors of disease response.

PubMed

Dason, Shawn; Wong, Nathan C; Allard, Christopher B; Hoogenes, Jen; Orovan, William; Shayegan, Bobby

2018-01-01

Some men with localized radio-recurrent prostate cancer may benefit from salvage high-intensity focused ultrasound (HIFU). Herein, we describe oncologic outcomes and predictors of disease response after salvage whole gland HIFU from our prospective cohort. Patients with localized radio-recurrent prostate cancer were prospectively enrolled from January 2005 to December 2014. Participants had to meet both biochemical and histological definitions of recurrence. Exclusion criteria included the receipt of prior salvage therapy, presence of metastatic disease, and administration of ADT in the 6-months prior to enrollment. Participants were treated with a single session of whole-gland HIFU ablation with the AblathermTM device (EDAP, France). The primary endpoint was recurrence-free survival (RFS), defined as a composite endpoint of PSA progression (Phoenix criteria), receipt of any further salvage therapy, receipt of ADT, clinical progression, or death. Kaplan-Meier survival analysis was used to determine the primary end-point and stratifications were used to determine the significance of 6 pre-specified predictors of improved RFS (TRUS biopsy grade, number of study entry TRUS biopsy cores positive, palpable disease at study enrollment, pre-HIFU PSA, an undetectable post-HIFU PSA nadir, and receipt of prior hormone therapy). Survival analysis was performed on participants with a minimum of 1-year follow-up. Twenty-four participants were eligible for study inclusion with a median follow-up of 31.0 months. Median PSA at study entry was 4.02ng/ml. Median time to PSA nadir was 3 months after treatment and median post-HIFU PSA nadir was 0.04ng/ ml. Median 2-year and 5-year RFS was 66.3% and 51.6% respectively. Of our 6 pre-specified predictors, an undetectable PSA nadir was the only significant predictor of improved RFS (HR 0.07, 95% CI 0.02-0.29, log-rank P<0.001). One participant underwent an intervention for a urethral stricture. No participants developed osteitis pubis or rectourethral fistulae. Salvage HIFU allows for disease control in selected patients with localized radio-recurrent prostate cancer. An undetectable PSA nadir serves as an early predictor of disease response. Copyright® by the International Brazilian Journal of Urology.

Effectiveness of a computerized alert system based on re-testing intervals for limiting the inappropriateness of laboratory test requests.

PubMed

Lippi, Giuseppe; Brambilla, Marco; Bonelli, Patrizia; Aloe, Rosalia; Balestrino, Antonio; Nardelli, Anna; Ceda, Gian Paolo; Fabi, Massimo

2015-11-01

There is consolidated evidence that the burden of inappropriate laboratory test requests is very high, up to 70%. We describe here the function of a computerized alert system linked to the order entry, designed to limit the number of potentially inappropriate laboratory test requests. A computerized alert system based on re-testing intervals and entailing the generation of pop-up alerts when preset criteria of appropriateness for 15 laboratory tests were violated was implemented in two clinical wards of the University Hospital of Parma. The effectiveness of the system for limiting potentially inappropriate tests was monitored for 6months. Overall, 765/3539 (22%) test requests violated the preset criteria of appropriateness and generated the appearance of electronic alert. After alert appearance, 591 requests were annulled (17% of total tests requested and 77% of tests alerted, respectively). The total number of test requests violating the preset criteria of inappropriateness constantly decreased over time (26% in the first three months of implementation versus 17% in the following period; p<0.001). The total financial saving of test withdrawn was 3387 Euros (12.8% of the total test cost) throughout the study period. The results of this study suggest that a computerized alert system may be effective to limit the inappropriateness of laboratory test requests, generating significant economic saving and educating physicians to a more efficient use of laboratory resources. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Medical student selection criteria as predictors of intended rural practice following graduation.

PubMed

Puddey, Ian B; Mercer, Annette; Playford, Denese E; Pougnault, Sue; Riley, Geoffrey J

2014-10-14

Recruiting medical students from a rural background, together with offering them opportunities for prolonged immersion in rural clinical training environments, both lead to increased participation in the rural workforce after graduation. We have now assessed the extent to which medical students' intentions to practice rurally may also be predicted by either medical school selection criteria and/or student socio-demographic profiles. The study cohort included 538 secondary school-leaver entrants to The University of Western Australia Medical School from 2006 to 2011. On entry they completed a questionnaire indicating intention for either urban or rural practice following graduation. Selection factors (standardised interview score, percentile score from the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance (Australian Tertiary Admissions Rank), together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and an index of rurality) were examined in relation to intended rural or urban destination of practice. In multivariate logistic regression, students from a rural background had a nearly 8-fold increase in the odds of intention to practice rurally after graduation compared to those from urban backgrounds (OR 7.84, 95% CI 4.10, 14.99, P < 0.001). Those intending to be generalists rather than specialists had a more than 4-fold increase in the odds of intention to practice rurally (OR 4.36, 95% CI 1.69, 11.22, P < 0.001). After controlling for these 2 factors, those with rural intent had significantly lower academic entry scores (P = 0.002) and marginally lower interview scores (P = 0.045). UMAT percentile scores were no different. Those intending to work in a rural location were also more likely to be female (OR 1.93, 95% CI 1.08, 3.48, P = 0.027), to come from the lower eight IRSAD deciles (OR 2.52, 95% CI 1.47, 4.32, P = 0.001) and to come from Government vs independent schools (OR 2.02, 95% CI 1.15, 3.55, P = 0.015). Very high academic scores generally required for medical school entry may have the unintended consequence of selecting fewer graduates interested in a rural practice destination. Increased efforts to recruit students from lower socioeconomic backgrounds may be beneficial in terms of an ultimate intended rural practice destination.

Evaluation of DNA Repair Function as a Predictor of Response in a Clinical Trial of PARP Inhibitor Monotherapy for Recurrent Ovarian Carcinoma

DTIC Science & Technology

2016-12-01

no specifi c biomarkers were tested in a trial of a PARP inhibitor in patients with ovarian carcinoma with measurable disease . There is currently no... disease that was measurable with the Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST) and amenable to biopsy at trial entry. Patients...have measurable disease treated with a PARP inhibitor, thereby testing the assay as a biomarker for PARP inhibitor response. Other prospective

[Current aspects of systemic lupus erythematosus in Dakar. About 74 cases].

PubMed

Fall, S; Dia, D; Ka, E F; Diallo, S; Pouye, A; Kane, A; Niang, A; Dieng, M T; Ka, M M; Diouf, B; Ndiaye, B; Moreira, Diop T

2007-01-01

previously reported studies on systemic lupus erythematosus in Senegal were more then ten years old and reported few cases of patients. Our objectives were to update epidemiological, clinical, laboratory and evolutive aspects of systemic lupus erythematosus throughout a study of 74 patients. we conducted a retrospective study in the internal medicine and the dermatology units of the university teaching hospital Aristide Le Dantec from January 1993 to December 2002. All patients with systemic lupus erythematosus according to the ACR criteria were included. Those who didn't meet ACR criteria were excluded. we included 74 patients; their mean age was 32 years and the sex ratio 0.1 (male to female). At the entry general symptoms were constants, and cutaneous signs were found in 96% of cases, joints signs in 58.1% and renal sign in 56.8%. Haematological and immunologic abnormalities were nearly constant. All the patients received corticosteroids and in 35.71% they had in addition immunosuppressive drugs. Shorts term evolution was satisfactory. At the medium term 27.02% of the patients were lost and 10.81% of them died. currents aspects of systemic lupus erythematosus in Dakar are improved by the early diagnosis when the disease is pauci-symptomatic and by the use immunosuppressive drugs in association with corticosteroids.

Clinical presentation and outcome of avoidant/restrictive food intake disorder in a Japanese sample.

PubMed

Nakai, Yoshikatsu; Nin, Kazuko; Noma, Shun'ichi; Hamagaki, Seiji; Takagi, Ryuro; Teramukai, Satoshi; Wonderlich, Stephen A

2017-01-01

We conducted a study of the clinical presentation and outcome in patients with avoidant/restrictive food intake disorder (ARFID), aged 15-40years, and compared this group to an anorexia nervosa (AN) group in a Japanese sample. A retrospective chart review was completed on 245 patients with feeding and eating disorders (FEDs), analyzing prevalence, clinical presentation, psychopathological properties, and outcomes. Using the DSM-5 criteria, 27 (11.0%) out of the 245 patients with a FED met the criteria for ARFID at entry. All patients with ARFID were women. In terms of eating disorder symptoms, all patients with ARFID had restrictive eating related to emotional problems and/or gastrointestinal symptoms. However, none of the ARFID patients reported food avoidance related to sensory characteristics or functional dysphagia. Additionally, none of them exhibited binge eating or purging behaviors, and none of them reported excessive exercise. The ARFID group had a significantly shorter duration of illness, lower rates of admission history, and less severe psychopathology than the AN group. The ARFID group reported significantly better outcome results than the AN group. These results suggest that patients with ARFID in this study were clinically distinct from those with AN and somewhat different from pediatric patients with ARFID in previous studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intelligent retrieval of medical images from the Internet

NASA Astrophysics Data System (ADS)

Tang, Yau-Kuo; Chiang, Ted T.

1996-05-01

The object of this study is using Internet resources to provide a cost-effective, user-friendly method to access the medical image archive system and to provide an easy method for the user to identify the images required. This paper describes the prototype system architecture, the implementation, and results. In the study, we prototype the Intelligent Medical Image Retrieval (IMIR) system as a Hypertext Transport Prototype server and provide Hypertext Markup Language forms for user, as an Internet client, using browser to enter image retrieval criteria for review. We are developing the intelligent retrieval engine, with the capability to map the free text search criteria to the standard terminology used for medical image identification. We evaluate retrieved records based on the number of the free text entries matched and their relevance level to the standard terminology. We are in the integration and testing phase. We have collected only a few different types of images for testing and have trained a few phrases to map the free text to the standard medical terminology. Nevertheless, we are able to demonstrate the IMIR's ability to search, retrieve, and review medical images from the archives using general Internet browser. The prototype also uncovered potential problems in performance, security, and accuracy. Additional studies and enhancements will make the system clinically operational.

Development of a Screening Tool for Predicting Adverse Outcomes of Gestational Diabetes Mellitus: A Retrospective Cohort Study.

PubMed

Park, Jee Soo; Kim, Deok Won; Kwon, Ja-Young; Park, Yong Won; Kim, Young Han; Cho, Hee Young

2016-01-01

Gestational diabetes mellitus (GDM) is a common disease in pregnancy causing maternal and fetal complications. To prevent these adverse outcomes, optimal screening and diagnostic criteria must be adequate, timely, and efficient. This study suggests a novel approach that is practical, efficient, and patient- and clinician-friendly in predicting adverse outcomes of GDM. The authors conducted a retrospective cohort study via medical record review of patients admitted between March 2001 and April 2013 at the Severance Hospital, Seoul, South Korea. Patients diagnosed by a conventional 2-step method were evaluated according to the presence of adverse outcomes (neonatal hypoglycemia, hyperbilirubinemia, and hyperinsulinemia; admission to the neonatal intensive care unit; large for gestational age; gestational insulin therapy; and gestational hypertension). Of 802 women who had an abnormal 50-g, 1-hour glucose challenge test, 306 were diagnosed with GDM and 496 did not have GDM (false-positive group). In the GDM group, 218 women (71.2%) had adverse outcomes. In contrast, 240 women (48.4%) in the false-positive group had adverse outcomes. Women with adverse outcomes had a significantly higher body mass index (BMI) at entry (P = 0.03) and fasting blood glucose (FBG) (P = 0.03). Our logistic regression model derived from 2 variables, BMI at entry and FBG, predicted GDM adverse outcome with an area under the curve of 0.642, accuracy of 61.3%, sensitivity of 57.2%, and specificity of 66.9% compared with the conventional 2-step method with an area under the curve of 0.610, accuracy of 59.1%, sensitivity of 47.6%, and specificity of 74.4%. Our model performed better in predicting GDM adverse outcomes than the conventional 2-step method using only BMI at entry and FBG. Moreover, our model represents a practical, inexpensive, efficient, reproducible, easy, and patient- and clinician-friendly approach.

Estimating the risk of communicable diseases aboard cargo ships.

PubMed

Schlaich, Clara C; Oldenburg, Marcus; Lamshöft, Maike M

2009-01-01

International travel and trade are known to be associated with the risk of spreading communicable diseases across borders. No international surveillance system for infectious diseases on ships exists. Outbreak reports and systematic studies mainly focus on disease activity on cruise ships. The study aims to assess the relevance of communicable disease occurrence on cargo ships. Retrospective analysis of all documented entries to 49 medical log books from seagoing cargo ships under German flag between 2000 and 2008. Incidence rates were calculated per 100 person-years at sea. Case series of acute respiratory illness, influenza-like illness, and infectious gastrointestinal illness affecting more than two persons within 1 successive week were classified as an outbreak. Attack rates were calculated based on number of entries to the medical log book in comparison to the average shipboard population during outbreak periods. During more than 1.5 million person-days of observation, 21% of the visits to the ship's infirmary were due to presumably communicable diseases (45.8 consultations per 100 person-years). As many as 33.9 patients per 100 person-years sought medical attention for acute respiratory symptoms. Of the 68 outbreaks that met predefined criteria, 66 were caused by acute respiratory illness with a subset of 12 outbreaks caused by influenza-like illness. Attack rates ranged between 3 and 10 affected seafarers per ship (12.5&-41.6% of the crew). Two outbreaks of gastrointestinal illness were detected. Respiratory illness is the most common cause of presumably communicable diseases aboard cargo ships and may cause outbreaks of considerable morbidity. Although the validity of the data is limited due to the use of nonprofessional diagnoses, missing or illegible entries, and restriction of the study population to German ships, the results provide guidance to ship owners and to Port Health Authorities to allocate resources and build capacities under International Health Regulations 2005.

Methodological factors in determining rates of dementia in transient ischemic attack and stroke: (I) impact of baseline selection bias.

PubMed

Pendlebury, Sarah T; Chen, Ping-Jen; Bull, Linda; Silver, Louise; Mehta, Ziyah; Rothwell, Peter M

2015-03-01

Many previous studies on dementia in stroke have restrictive inclusion criteria, which may result in underestimation of dementia rates. We undertook a large prospective population-based study of all transient ischemic attack and stroke to determine the impact of study entry criteria on measured rates of pre- and postevent dementia. All patients with acute transient ischemic attack or stroke from a defined population of 92 728 are referred from primary care or at hospital admission to the Oxford Vascular Study (2002-2007) and have baseline clinical and cognitive assessment and follow-up. We examined the impact of early death, other nonavailability, and commonly used selection criteria, on measured rates of dementia. Among 1236 patients (mean age/SD 75.2/12.1 years, 582 men, 403 transient ischemic attack), 139 died or were otherwise unavailable for baseline assessment, 319 had prior dependency, 425 had comorbidity, 512 were aged ≥80 years, 85 were dysphasic, and 502 were hospitalized. Pre-event dementia was 3-fold higher in patients dying preascertainment (10/47, 21%) and twice as high in other nonassessed (14/92, 15%) versus assessed patients (69/1097, 6%; P=0.0006 and P=0.002) and was several-fold higher in those with prior functional impairment (24% versus 3%; P<0.0001), age >80 years (13% versus 3%; P<0.0001), dysphasia (11% versus 7%; P<0.0001), and comorbidity (10% versus 6%; P=0.04). Findings for postevent dementia were similar: prior functional impairment (40% versus 13%; P<0.0001), age >80 years (28% versus 10%; P<0.0001), dysphasia (39% versus 15%; P<0.0001), and comorbidity (20% versus 15%; P=0.04). Exclusion of patients unavailable for assessment, and other widely used selection criteria, results in underestimation of the measured rate of dementia associated with transient ischemic attack and stroke. © 2015 American Heart Association, Inc.

A Study on Re-entry Predictions of Uncontrolled Space Objects for Space Situational Awareness

NASA Astrophysics Data System (ADS)

Choi, Eun-Jung; Cho, Sungki; Lee, Deok-Jin; Kim, Siwoo; Jo, Jung Hyun

2017-12-01

The key risk analysis technologies for the re-entry of space objects into Earth’s atmosphere are divided into four categories: cataloguing and databases of the re-entry of space objects, lifetime and re-entry trajectory predictions, break-up models after re-entry and multiple debris distribution predictions, and ground impact probability models. In this study, we focused on re- entry prediction, including orbital lifetime assessments, for space situational awareness systems. Re-entry predictions are very difficult and are affected by various sources of uncertainty. In particular, during uncontrolled re-entry, large spacecraft may break into several pieces of debris, and the surviving fragments can be a significant hazard for persons and properties on the ground. In recent years, specific methods and procedures have been developed to provide clear information for predicting and analyzing the re-entry of space objects and for ground-risk assessments. Representative tools include object reentry survival analysis tool (ORSAT) and debris assessment software (DAS) developed by National Aeronautics and Space Administration (NASA), spacecraft atmospheric re-entry and aerothermal break-up (SCARAB) and debris risk assessment and mitigation analysis (DRAMA) developed by European Space Agency (ESA), and semi-analytic tool for end of life analysis (STELA) developed by Centre National d’Etudes Spatiales (CNES). In this study, various surveys of existing re-entry space objects are reviewed, and an efficient re-entry prediction technique is suggested based on STELA, the life-cycle analysis tool for satellites, and DRAMA, a re-entry analysis tool. To verify the proposed method, the re-entry of the Tiangong-1 Space Lab, which is expected to re-enter Earth’s atmosphere shortly, was simulated. Eventually, these results will provide a basis for space situational awareness risk analyses of the re-entry of space objects.

Abort-once-around entry corridor analysis program document

NASA Technical Reports Server (NTRS)

Kyle, H. C.

1975-01-01

The abort once around entry target corridor analysis program (ABECAP) was studied. The allowable range of flight path angles at entry interface for acceptable entry trajectories from a shuttle abort once around (AOA) situation was established. The solutions thus determined may be shown as corridor plots of entry interface flight path angle versus range from entry interface (EI) to the target.

HSV-1 infection of human corneal epithelial cells: receptor-mediated entry and trends of re-infection.

PubMed

Shah, Arpeet; Farooq, Asim V; Tiwari, Vaibhav; Kim, Min-Jung; Shukla, Deepak

2010-11-20

The human cornea is a primary target for herpes simplex virus-1 (HSV-1) infection. The goals of the study were to determine the cellular modalities of HSV-1 entry into human corneal epithelial (HCE) cells. Specific features of the study included identifying major entry receptors, assessing pH dependency, and determining trends of re-infection. A recombinant HSV-1 virus expressing beta-galactosidase was used to ascertain HSV-1 entry into HCE cells. Viral replication within cells was confirmed using a time point plaque assay. Lysosomotropic agents were used to test for pH dependency of entry. Flow cytometry and immunocytochemistry were used to determine expression of three cellular receptors--nectin-1, herpesvirus entry mediator (HVEM), and paired immunoglobulin-like 2 receptor alpha (PILR-a). The necessity of these receptors for viral entry was tested using antibody-blocking. Finally, trends of re-infection were investigated using viral entry assay and flow cytometry post-primary infection. Cultured HCE cells showed high susceptibility to HSV-1 entry and replication. Entry was demonstrated to be pH dependent as blocking vesicular acidification decreased entry. Entry receptors expressed on the cell membrane include nectin-1, HVEM, and PILR-α. Receptor-specific antibodies blocked entry receptors, reduced viral entry and indicated nectin-1 as the primary receptor used for entry. Cells re-infected with HSV-1 showed a decrease in entry, which was correlated to decreased levels of nectin-1 as demonstrated by flow cytometry. HSV-1 is capable of developing an infection in HCE cells using a pH dependent entry process that involves primarily nectin-1 but also the HVEM and PILR-α receptors. Re-infected cells show decreased levels of entry, correlated with a decreased level of nectin-1 receptor expression.

Developing Health-Based Pre-Planning Clearance Goals for Airport Remediation Following a Chemical Terrorist Attack: Decision Criteria for Multipathway Exposure Routes

PubMed Central

Watson, Annetta; Dolislager, Fredrick; Hall, Linda; Raber, Ellen; Hauschild, Veronique D.; Love, Adam H.

2011-01-01

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility re-use and re-entry could require hours to multiple days. While timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical release. What follows is the second of a two-part analysis identifying key considerations, critical information and decision criteria to facilitate post-attack and post-decontamination consequence management activities. Decision criteria analysis presented here provides first-time, open-literature documentation of multi-pathway, health-based remediation exposure guidelines for selected toxic industrial compounds, chemical warfare agents, and agent degradation products for pre-planning application in anticipation of a chemical terrorist attack. Guideline values are provided for inhalation and direct ocular vapor exposure routes as well as percutaneous vapor, surface contact, and ingestion. Target populations include various employees as well as transit passengers. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination. PMID:21399674

Developing health-based pre-planning clearance goals for airport remediation following a chemical terrorist attack: Decision criteria for multipathway exposure routes

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

Watson, Annetta Paule; Dolislager, Frederick; Hall, Dr. Linda

2011-01-01

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility re-use and re-entry could require hours to multiple days. While timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical release. What follows is the second of a two-part analysis identifying key considerations, critical information and decision criteria to facilitate post-attack and post-decontamination consequence management activities. Decision criteria analysis presented here provides first-time, open-literature documentation of multi-pathway, health-based remediation exposure guidelines for selected toxic industrial compounds, chemicalmore » warfare agents, and agent degradation products for pre-planning application in anticipation of a chemical terrorist attack. Guideline values are provided for inhalation and direct ocular vapor exposure routes as well as percutaneous vapor, surface contact, and ingestion. Target populations include various employees as well as transit passengers. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination.« less

Budget impact analysis of medicines: updated systematic review and implications.

PubMed

Faleiros, Daniel Resende; Álvares, Juliana; Almeida, Alessandra Maciel; de Araújo, Vânia Eloisa; Andrade, Eli Iola Gurgel; Godman, Brian B; Acurcio, Francisco A; Guerra Júnior, Augusto A

2016-01-01

This evaluation determines whether published studies to date meet the key characteristics identified for budget impact analyses (BIA) for medicines, accomplished through a systematic review and assessment against identified key characteristics. Studies from 2001-2015 on 'budget impact analysis' with 'drug' interventions were assessed, selected based on their titles/abstracts and full texts, and their characteristics checked according to key criteria. Out of 1,984 studies, 92 were subsequently identified for review. Of these, 95% were published in Europe and the USA. 2012 saw the largest number of publications (16%) with a decline thereafter. 48% met up to 7 out of the 9 key characteristics. Only 22% stated no conflict of interest. The results indicate low adherence to the key characteristics that should be considered for BIAs and strong conflict of interest. This is an issue since BIAs can be of fundamental importance in managing the entry of new medicines including reimbursement decisions.

Entry Pathways of Herpes Simplex Virus Type 1 into Human Keratinocytes Are Dynamin- and Cholesterol-Dependent

PubMed Central

Hsu, Mei-Ju; Rixon, Frazer J.; Knebel-Mörsdorf, Dagmar

2011-01-01

Herpes simplex virus type 1 (HSV-1) can enter cells via endocytic pathways or direct fusion at the plasma membrane depending on the cell line and receptor(s). Most studies into virus entry have used cultured fibroblasts but since keratinocytes represent the primary entry site for HSV-1 infection in its human host, we initiated studies to characterize the entry pathway of HSV-1 into human keratinocytes. Electron microscopy studies visualized free capsids in the cytoplasm and enveloped virus particles in vesicles suggesting viral uptake both by direct fusion at the plasma membrane and by endocytic vesicles. The ratio of the two entry modes differed in primary human keratinocytes and in the keratinocyte cell line HaCaT. Inhibitor studies further support a role for endocytosis during HSV-1 entry. Infection was inhibited by the cholesterol-sequestering drug methyl-β-cyclodextrin, which demonstrates the requirement for host cholesterol during virus entry. Since the dynamin-specific inhibitor dynasore and overexpression of a dominant-negative dynamin mutant blocked infection, we conclude that the entry pathways into keratinocytes are dynamin-mediated. Electron microscopy studies confirmed that virus uptake is completely blocked when the GTPase activity of dynamin is inhibited. Ex vivo infection of murine epidermis that was treated with dynasore further supports the essential role of dynamin during entry into the epithelium. Thus, we conclude that HSV-1 can enter human keratinocytes by alternative entry pathways that require dynamin and host cholesterol. PMID:22022400

The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

PubMed

Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

2014-12-01

We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

Five-year course and outcome of dysthymic disorder: A prospective, naturalistic follow-up study.

PubMed

Klein, D N; Schwartz, J E; Rose, S; Leader, J B

2000-06-01

There have been few naturalistic follow-up studies of dysthymic disorder. This study describes the 5-year course and outcome of dysthymic disorder. The authors conducted a prospective, longitudinal follow-up study of 86 outpatients with early-onset dysthymic disorder and 39 outpatients with episodic major depressive disorder. Follow-ups, conducted 30 and 60 months after entry into the study, rated patients on the Longitudinal Interval Follow-Up Evaluation and the Modified Hamilton Rating Scale for Depression. The estimated 5-year recovery rate from dysthymic disorder was 52.9%. Among patients who recovered, the estimated risk of relapse was 45.2% during a mean of 23 months of observation. Patients with dysthymic disorder spent approximately 70% of the follow-up period meeting the full criteria for a mood disorder. During the course of the follow-up the patients with dysthymic disorder exhibited significantly greater levels of symptoms and lower functioning and were significantly more likely to attempt suicide and to be hospitalized than were patients with episodic major depressive disorder. Finally, among patients with dysthymic disorder who had never experienced a major depressive episode before entry into the study, the estimated risk of having a first lifetime major depressive episode was 76.9%. Dysthymic disorder is a chronic condition with a protracted course and a high risk of relapse. In addition, almost all patients with dysthymic disorder eventually develop superimposed major depressive episodes. Although patients with dysthymic disorder tend to show mild to moderate symptoms, from a longitudinal perspective, the condition is severe.

Analysis of appropriateness of outpatient CT and MRI referred from primary care clinics at an academic medical center: how critical is the need for improved decision support?

PubMed

Lehnert, Bruce E; Bree, Robert L

2010-03-01

The aim of this study was to retrospectively analyze a large group of CT and MRI examinations for appropriateness using evidence-based guidelines. The authors reviewed medical records from 459 elective outpatient CT and MR examinations from primary care physicians. Evidence-based appropriateness criteria from a radiology benefit management company were used to determine if the examination would have met criteria for approval. Submitted clinical history at the time of interpretation and clinic notes and laboratory results preceding the date of the imaging study were examined to simulate a real-time consultation with the referring provider. The radiology reports and subsequent clinic visits were analyzed for outcomes. Of the 459 examinations reviewed, 284 (62%) were CT and 175 (38%) were MRI. Three hundred forty-one (74%) were considered appropriate, and 118 (26%) were not considered appropriate. Examples of inappropriate examinations included brain CT for chronic headache, lumbar spine MR for acute back pain, knee or shoulder MRI in patients with osteoarthritis, and CT for hematuria during a urinary tract infection. Fifty-eight percent of the appropriate studies had positive results and affected subsequent management, whereas only thirteen percent [corrected] of inappropriate studies had positive results and affected management. A high percentage of examinations not meeting appropriateness criteria and subsequently yielding negative results suggests a need for tools to help primary care physicians improve the quality of their imaging decision requests. In the current environment, which stresses cost containment and comparative effectiveness, traditional radiology benefit management tools are being challenged by clinical decision support, with an emphasis on provider education coupled with electronic order entry systems.

Evaluation of Mars Entry Reconstructured Trajectories Based on Hypothetical 'Quick-Look' Entry Navigation Data

NASA Technical Reports Server (NTRS)

Pastor, P. Rick; Bishop, Robert H.; Striepe, Scott A.

2000-01-01

A first order simulation analysis of the navigation accuracy expected from various Navigation Quick-Look data sets is performed. Here quick-look navigation data are observations obtained by hypothetical telemetried data transmitted on the fly during a Mars probe's atmospheric entry. In this simulation study, navigation data consists of 3-axis accelerometer sensor and attitude information data. Three entry vehicle guidance types are studied: I. a Maneuvering entry vehicle (as with Mars 01 guidance where angle of attack and bank angle are controlled); II. Zero angle-of-attack controlled entry vehicle (as with Mars 98); and III. Ballistic, or spin stabilized entry vehicle (as with Mars Pathfinder);. For each type, sensitivity to progressively under sampled navigation data and inclusion of sensor errors are characterized. Attempts to mitigate the reconstructed trajectory errors, including smoothing, interpolation and changing integrator characteristics are also studied.

Geotherm: the U.S. geological survey geothermal information system

USGS Publications Warehouse

Bliss, J.D.; Rapport, A.

1983-01-01

GEOTHERM is a comprehensive system of public databases and software used to store, locate, and evaluate information on the geology, geochemistry, and hydrology of geothermal systems. Three main databases address the general characteristics of geothermal wells and fields, and the chemical properties of geothermal fluids; the last database is currently the most active. System tasks are divided into four areas: (1) data acquisition and entry, involving data entry via word processors and magnetic tape; (2) quality assurance, including the criteria and standards handbook and front-end data-screening programs; (3) operation, involving database backups and information extraction; and (4) user assistance, preparation of such items as application programs, and a quarterly newsletter. The principal task of GEOTHERM is to provide information and research support for the conduct of national geothermal-resource assessments. The principal users of GEOTHERM are those involved with the Geothermal Research Program of the U.S. Geological Survey. Information in the system is available to the public on request. ?? 1983.

Trajectory optimization study of a lifting body re-entry vehicle for medium to intermediate range applications

NASA Astrophysics Data System (ADS)

Rizvi, S. Tauqeer ul Islam; Linshu, He; ur Rehman, Tawfiq; Rafique, Amer Farhan

2012-11-01

A numerical optimization study of lifting body re-entry vehicles is presented for nominal as well as shallow entry conditions for Medium and Intermediate Range applications. Due to the stringent requirement of a high degree of accuracy for conventional vehicles, lifting re-entry can be used to attain the impact at the desired terminal flight path angle and speed and thus can potentially improve accuracy of the re-entry vehicle. The re-entry of a medium range and intermediate range vehicles is characterized by very high negative flight path angle and low re-entry speed as compared to a maneuverable re-entry vehicle or a common aero vehicle intended for an intercontinental range. Highly negative flight path angles at the re-entry impose high dynamic pressure as well as heat loads on the vehicle. The trajectory studies are carried out to maximize the cross range of the re-entry vehicle while imposing a maximum dynamic pressure constraint of 350 KPa with a 3 MW/m2 heat rate limit. The maximum normal acceleration and the total heat load experienced by the vehicle at the stagnation point during the maneuver have been computed for the vehicle for possible future conceptual design studies. It has been found that cross range capability of up to 35 km can be achieved with a lifting-body design within the heat rate and the dynamic pressure boundary at normal entry conditions. For shallow entry angle of -20 degree and intermediate ranges a cross range capability of up to 250 km can be attained for a lifting body design with less than 10 percent loss in overall range. The normal acceleration also remains within limits. The lifting-body results have also been compared with wing-body results at shallow entry condition. An hp-adaptive pseudo-spectral method has been used for constrained trajectory optimization.

ESA Venus Entry Probe Study

NASA Technical Reports Server (NTRS)

vandenBerg, M. L.; Falkner, P.; Phipps, A.; Underwood, J. C.; Lingard, J. S.; Moorhouse, J.; Kraft, S.; Peacock, A.

2005-01-01

The Venus Entry Probe is one of ESA s Technology Reference Studies (TRS). The purpose of the Technology Reference Studies is to provide a focus for the development of strategically important technologies that are of likely relevance for future scientific missions. The aim of the Venus Entry Probe TRS is to study approaches for low cost in-situ exploration of Venus and other planetary bodies with a significant atmosphere. In this paper, the mission objectives and an outline of the mission concept of the Venus Entry Probe TRS are presented.

Atmospheric Entry Studies for Uranus

NASA Astrophysics Data System (ADS)

Agrawal, P.; Allen, G. A.; Hwang, H. H.; Marley, M. S.; McGuire, M. K.; Garcia, J. A.; Sklyanskiy, E.; Huynh, L. C.; Moses, R. W.

2014-06-01

To better understand the technology requirements for a Uranus atmospheric entry probe, an internal NASA study funded by ISPT program was conducted. The talk describes two different approaches to the planet: 1) direct ballistic entry and 2) Aerocapture.

Technology, design and dementia: an exploratory survey of developers.

PubMed

Jiancaro, Tizneem; Jaglal, Susan B; Mihailidis, Alex

2017-08-01

Despite worldwide surges in dementia, we still know relatively little about the design of home technologies that support this population. The purpose of this study was to investigate design considerations from the perspective of developers. Participants, including technical and clinical specialists, were recruited internationally and answered web-based survey questions comprising Likert-type responses with text entry options. Developers were queried on 23 technology acceptance characteristics and 24 design practices. In all, forty developers completed the survey. Concerning "technology acceptance", cost, learnability, self-confidence (during use) and usability were deemed very important. Concerning "design practice", developers overwhelmingly valued user-centred design (UCD). In terms of general assistive technology (AT) models, these were largely unknown by technical specialists compared to clinical specialists. Recommendations based on this study include incorporating "self-confidence" into design protocols; examining the implications of "usability" and UCD in this context; and considering empathy-based design approaches to suit a diverse user population. Moreover, clinical specialists have much to offer development teams, particularly concerning the use of conceptual AT models. Implications of rehabilitation Stipulate precise usability criteria. Consider "learnability" and "self-confidence" as technology adoption criteria. Recognize the important theoretical role that clinical specialists can fulfil concerning the use of design schemas. Acknowledge the diversity amongst users with dementia, potentially adopting techniques, such as designing for "extraordinary users".

Eligibility for Statin Therapy by the JUPITER Trial Criteria and Subsequent Mortality (From the REGARDS Cohort)

PubMed Central

Cushman, Mary; McClure, Leslie A.; Lakoski, Susan G.; Jenny, Nancy S.

2009-01-01

The Justification of the Use of Statins in Primary Prevention: an Intervention Trial Using Rosuvastatin (JUPITER) reported reduced cardiovascular and all-cause mortality with statin treatment in patients with elevated C-reactive protein (CRP) and average cholesterol, who were not eligible for lipid-lowering treatment based on existing guidelines. We determined the prevalence of eligibility and mortality in a general population sample based on eligibility for statin treatment using JUPITER criteria. We studied 30,229 participants of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, an observational study of US African-American and white participants aged 45 and older, enrolled in their homes between 2003–2007, and followed biannually by telephone. Among 11,339 participants age-eligible for JUPITER and without a vascular diagnosis or using lipid-lowering treatment, 21% (2,342) met JUPITER entry criteria. Compared to JUPITER participants, they had similar LDL cholesterol and CRP, were more often women, black, had metabolic syndrome and used aspirin for cardioprotection. Over 3.5 years follow-up, the mortality rate among REGARDS participants eligible for JUPITER was 1.17 per 100 person-years (95% CI 0.94–1.42). Compared to those otherwise JUPITER eligible who had CRP <2 mg/L (n=2,620), those with CRP ≥2 mg/L had a multivariable-adjusted relative risk of 1.5 (95% CI, 1.1–2.2) for total mortality. In conclusion, 21% not otherwise eligible would be newly eligible for lipid-lowering treatment based on JUPITER trial eligibility. PMID:20102894

Texting while driving: is speech-based text entry less risky than handheld text entry?

PubMed

He, J; Chaparro, A; Nguyen, B; Burge, R J; Crandall, J; Chaparro, B; Ni, R; Cao, S

2014-11-01

Research indicates that using a cell phone to talk or text while maneuvering a vehicle impairs driving performance. However, few published studies directly compare the distracting effects of texting using a hands-free (i.e., speech-based interface) versus handheld cell phone, which is an important issue for legislation, automotive interface design and driving safety training. This study compared the effect of speech-based versus handheld text entries on simulated driving performance by asking participants to perform a car following task while controlling the duration of a secondary text-entry task. Results showed that both speech-based and handheld text entries impaired driving performance relative to the drive-only condition by causing more variation in speed and lane position. Handheld text entry also increased the brake response time and increased variation in headway distance. Text entry using a speech-based cell phone was less detrimental to driving performance than handheld text entry. Nevertheless, the speech-based text entry task still significantly impaired driving compared to the drive-only condition. These results suggest that speech-based text entry disrupts driving, but reduces the level of performance interference compared to text entry with a handheld device. In addition, the difference in the distraction effect caused by speech-based and handheld text entry is not simply due to the difference in task duration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Development of a Screening Tool for Predicting Adverse Outcomes of Gestational Diabetes Mellitus

PubMed Central

Park, Jee Soo; Kim, Deok Won; Kwon, Ja-Young; Park, Yong Won; Kim, Young Han; Cho, Hee Young

2016-01-01

Abstract Gestational diabetes mellitus (GDM) is a common disease in pregnancy causing maternal and fetal complications. To prevent these adverse outcomes, optimal screening and diagnostic criteria must be adequate, timely, and efficient. This study suggests a novel approach that is practical, efficient, and patient- and clinician-friendly in predicting adverse outcomes of GDM. The authors conducted a retrospective cohort study via medical record review of patients admitted between March 2001 and April 2013 at the Severance Hospital, Seoul, South Korea. Patients diagnosed by a conventional 2-step method were evaluated according to the presence of adverse outcomes (neonatal hypoglycemia, hyperbilirubinemia, and hyperinsulinemia; admission to the neonatal intensive care unit; large for gestational age; gestational insulin therapy; and gestational hypertension). Of 802 women who had an abnormal 50-g, 1-hour glucose challenge test, 306 were diagnosed with GDM and 496 did not have GDM (false-positive group). In the GDM group, 218 women (71.2%) had adverse outcomes. In contrast, 240 women (48.4%) in the false-positive group had adverse outcomes. Women with adverse outcomes had a significantly higher body mass index (BMI) at entry (P = 0.03) and fasting blood glucose (FBG) (P = 0.03). Our logistic regression model derived from 2 variables, BMI at entry and FBG, predicted GDM adverse outcome with an area under the curve of 0.642, accuracy of 61.3%, sensitivity of 57.2%, and specificity of 66.9% compared with the conventional 2-step method with an area under the curve of 0.610, accuracy of 59.1%, sensitivity of 47.6%, and specificity of 74.4%. Our model performed better in predicting GDM adverse outcomes than the conventional 2-step method using only BMI at entry and FBG. Moreover, our model represents a practical, inexpensive, efficient, reproducible, easy, and patient- and clinician-friendly approach. PMID:26735528

Characterization of the receptor-binding domain of Ebola glycoprotein in viral entry.

PubMed

Wang, Jizhen; Manicassamy, Balaji; Caffrey, Michael; Rong, Lijun

2011-06-01

Ebola virus infection causes severe hemorrhagic fever in human and non-human primates with high mortality. Viral entry/infection is initiated by binding of glycoprotein GP protein on Ebola virion to host cells, followed by fusion of virus-cell membrane also mediated by GP. Using an human immunodeficiency virus (HIV)-based pseudotyping system, the roles of 41 Ebola GP1 residues in the receptor-binding domain in viral entry were studied by alanine scanning substitutions. We identified that four residues appear to be involved in protein folding/structure and four residues are important for viral entry. An improved entry interference assay was developed and used to study the role of these residues that are important for viral entry. It was found that R64 and K95 are involved in receptor binding. In contrast, some residues such as I170 are important for viral entry, but do not play a major role in receptor binding as indicated by entry interference assay and/or protein binding data, suggesting that these residues are involved in post-binding steps of viral entry. Furthermore, our results also suggested that Ebola and Marburg viruses share a common cellular molecule for entry.

Eligibility for statin therapy by the JUPITER trial criteria and subsequent mortality.

PubMed

Cushman, Mary; McClure, Leslie A; Lakoski, Susan G; Jenny, Nancy S

2010-01-01

Justification for the Use of Statins in Primary Prevention: An Intervention Trial Using Rosuvastatin (JUPITER) reported reduced cardiovascular and all-cause mortality with statin treatment in patients with elevated C-reactive protein (CRP) and average cholesterol levels who were not eligible for lipid-lowering treatment on the basis of existing guidelines. The aim of this study was to determine the prevalence of eligibility and mortality in a general population sample on the basis of eligibility for statin treatment using the JUPITER criteria. The study group consisted of 30,229 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, an observational study of US African American and white participants aged > or =45 years, enrolled in their homes from 2003 to 2007 and followed biannually by telephone. Among 11,339 participants age eligible for JUPITER and without vascular diagnoses or using lipid-lowering treatment, 21% (n = 2,342) met JUPITER entry criteria. Compared with JUPITER participants, they had similar low-density lipoprotein cholesterol and CRP levels, were more often women, were more often black, had metabolic syndrome, and used aspirin for cardioprotection. Over 3.5 years of follow-up, the mortality rate in REGARDS participants eligible for JUPITER was 1.17 per 100 patient-years (95% confidence interval 0.94 to 1.42). Compared with those otherwise JUPITER eligible who had CRP levels <2 mg/L (n = 2,620), those with CRP levels > or =2 mg/L had a multivariate-adjusted relative risk of 1.5 (95% confidence interval 1.1 to 2.2) for total mortality. In conclusion, 21% not otherwise eligible would be newly eligible for lipid lowering treatment on the basis of JUPITER trial eligibility.

The Management of Schizophrenia in Clinical Practice (MOSAIC) Registry: a focus on patients, caregivers, illness severity, functional status, disease burden and healthcare utilization.

PubMed

Nasrallah, Henry A; Harvey, Philip D; Casey, Daniel; Csoboth, Csilla T; Hudson, James I; Julian, Laura; Lentz, Ellen; Nuechterlein, Keith H; Perkins, Diana O; Kotowsky, Nirali; Skale, Tracey G; Snowden, Lonnie R; Tandon, Rajiv; Tek, Cenk; Velligan, Dawn; Vinogradov, Sophia; O'Gorman, Cedric

2015-08-01

The Management of Schizophrenia in Clinical Practice (MOSAIC), a disease-based registry of schizophrenia, was initiated in December 2012 to address important gaps in our understanding of the impact and burden of schizophrenia and to provide insight into the current status of schizophrenia care in the US. Recruitment began in December 2012 with ongoing assessment continuing through May 2014. Participants were recruited from a network of 15 centralized Patient Assessment Centers supporting proximal care sites. Broad entry criteria included patients diagnosed with schizophrenia, schizophreniform or schizoaffective disorder, presenting within the normal course of care, in usual treatment settings, aged ≥18years and able to read and speak English. By May 2014, 550 participants (65.8% male, 59.8% White, 64.4% single, mean age 42.9years), were enrolled. The majority had a diagnosis of schizophrenia (62.0%). Mean illness duration at entry was 15.0years. Common comorbidities at entry were high lipid levels (26.9%), hypertension (23.1%) and type II diabetes (13%). Participants were categorized by baseline overall Clinical Global Impression-Schizophrenia Severity Score as minimally (9.1%), mildly (25.3%), moderately (39.9%), markedly (22.3%) and severely (3.4%) ill. Most commonly used second generation antipsychotics at entry were risperidone (17.8%), clozapine (16.5%), olanzapine (14.0%), aripiprazole (13.6%) and quetiapine (5.6%). No large-scale patient registry has been conducted in the US to longitudinally follow patients with schizophrenia and describe symptom attributes, support network, care access and disease burden. These data provide important epidemiological, clinical and outcome insights into the burden of schizophrenia in the US. Copyright © 2015 Elsevier B.V. All rights reserved.

Natural Resource Management Schemes as Entry Points for Integrated Landscape Approaches: Evidence from Ghana and Burkina Faso.

PubMed

Foli, Samson; Ros-Tonen, Mirjam A F; Reed, James; Sunderland, Terry

2018-07-01

In recognition of the failures of sectoral approaches to overcome global challenges of biodiversity loss, climate change, food insecurity and poverty, scientific discourse on biodiversity conservation and sustainable development is shifting towards integrated landscape governance arrangements. Current landscape initiatives however very much depend on external actors and funding, raising the question of whether, and how, and under what conditions, locally embedded resource management schemes can serve as entry points for the implementation of integrated landscape approaches. This paper assesses the entry point potential for three established natural resource management schemes in West Africa that target landscape degradation with involvement of local communities: the Chantier d'Aménagement Forestier scheme encompassing forest management sites across Burkina Faso and the Modified Taungya System and community wildlife resource management initiatives in Ghana. Based on a review of the current literature, we analyze the extent to which design principles that define a landscape approach apply to these schemes. We found that the CREMA meets most of the desired criteria, but that its scale may be too limited to guarantee effective landscape governance, hence requiring upscaling. Conversely, the other two initiatives are strongly lacking in their design principles on fundamental components regarding integrated approaches, continual learning, and capacity building. Monitoring and evaluation bodies and participatory learning and negotiation platforms could enhance the schemes' alignment with integrated landscape approaches.

Effect of sperm entry on blastocyst development after in vitro fertilization and intracytoplasmic sperm injection - mouse model.

PubMed

Piotrowska-Nitsche, Karolina; Chan, Anthony W S

2013-01-01

To investigate whether in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), influence the embryo's development and its quality using the mouse as a model. Assisted fertilization was performed using ICSI and IVF. Fluorescent beads were adhered to the fertilization cone or place of previous sperm injection in the natural mated (NM), IVF and ICSI embryos, respectively. Embryo examination was carried out at the two-cell and blastocyst stage to determine the position of fluorescent bead. Protein expression was detected by fluorescence immunocytochemical staining and confocal microscopic imaging of blastocysts. IVF and ICSI embryos developed at rates comparable to NM group. Embryos show similar expression patterns of two transcription factors, Oct4 and Cdx2. The most preferred place for spermatozoa attachment was the equatorial site of the egg, whether fertilization occurred in vitro or under natural conditions. We also link the sperm entry position (SEP) to embryo morphology and the number of cells at the blastocyst stage, with no influence of the method of fertilization. IVF and ICSI, do not compromise in vitro pre-implantation development. Additional data, related to sperm entry, could offer further criteria to predict embryos that will implant successfully. Based on embryo morphology, developmental rate and protein expression level of key transcription factors, our results support the view that ART techniques, such as IVF and ICSI, do not perturb embryonic development or quality.

An Experimental Trial of Adaptive Programming in Drug Court: Outcomes at 6, 12 and 18 Months.

PubMed

Marlowe, Douglas B; Festinger, David S; Dugosh, Karen L; Benasutti, Kathleen M; Fox, Gloria; Harron, Ashley

2014-06-01

Test whether an adaptive program improves outcomes in drug court by adjusting the schedule of court hearings and clinical case-management sessions pursuant to a priori performance criteria. Consenting participants in a misdemeanor drug court were randomly assigned to the adaptive program (n = 62) or to a baseline-matching condition (n = 63) in which they attended court hearings based on the results of a criminal risk assessment. Outcome measures were re-arrest rates at 18 months post-entry to the drug court and urine drug test results and structured interview results at 6 and 12 months post-entry. Although previously published analyses revealed significantly fewer positive drug tests for participants in the adaptive condition during the first 18 weeks of drug court, current analyses indicate the effects converged during the ensuing year. Between-group differences in new arrest rates, urine drug test results and self-reported psychosocial problems were small and non-statistically significant at 6, 12 and 18 months post-entry. A non-significant trend (p = .10) suggests there may have been a small residual impact (Cramer's ν = .15) on new misdemeanor arrests after 18 months. Adaptive programming shows promise for enhancing short-term outcomes in drug courts; however, additional efforts are needed to extend the effects beyond the first 4 to 6 months of enrollment.

Full kinetics of CO entry, internal diffusion, and exit in myoglobin from transition-path theory simulations.

PubMed

Yu, Tang-Qing; Lapelosa, Mauro; Vanden-Eijnden, Eric; Abrams, Cameron F

2015-03-04

We use Markovian milestoning molecular dynamics (MD) simulations on a tessellation of the collective variable space for CO localization in myoglobin to estimate the kinetics of entry, exit, and internal site-hopping. The tessellation is determined by analysis of the free-energy surface in that space using transition-path theory (TPT), which provides criteria for defining optimal milestones, allowing short, independent, cell-constrained MD simulations to provide properly weighted kinetic data. We coarse grain the resulting kinetic model at two levels: first, using crystallographically relevant internal cavities and their predicted interconnections and solvent portals; and second, as a three-state side-path scheme inspired by similar models developed from geminate recombination experiments. We show semiquantitative agreement with experiment on entry and exit rates and in the identification of the so-called "histidine gate" at position 64 through which ≈90% of flux between solvent and the distal pocket passes. We also show with six-dimensional calculations that the minimum free-energy pathway of escape through the histidine gate is a "knock-on" mechanism in which motion of the ligand and the gate are sequential and interdependent. In total, these results suggest that such TPT simulations are indeed a promising approach to overcome the practical time-scale limitations of MD to allow reliable estimation of transition mechanisms and rates among metastable states.

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

PubMed

Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

2014-11-01

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system. Copyright © 2014 Elsevier Ltd. All rights reserved.

Knowledge Translation of the PERC Rule for Suspected Pulmonary Embolism: A Blueprint for Reducing the Number of CT Pulmonary Angiograms.

PubMed

Drescher, Michael J; Fried, Jeremy; Brass, Ryan; Medoro, Amanda; Murphy, Timothy; Delgado, João

2017-10-01

Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA) for pulmonary embolism (PE) ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC) rule, multi-modal education using principles of knowledge translation (KT), and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9-11.2]) to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3-9.4]) p<0.001. The absolute reduction in PACT ordered was 1.72 per 1,000 visits (a 16% reduction). Patient characteristics were similar for both periods. Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.

PG medical training and accreditation: responsibility of the government for the adequate health service delivery.

PubMed

Bhattarai, M D

2012-09-01

On one hand there is obvious inadequate health coverage to the rural population and on the other hand the densely populated urban area is facing the triple burden of increasing non-communicable and communicable health problems and the rising health cost. The postgraduate medical training is closely interrelated with the adequate health service delivery and health economics. In relation to the prevailing situation, the modern medical education trend indicates the five vital issues. These are i). Opportunity needs to be given to all MBBS graduates for General Specialist and Sub-Specialist Training inside the country to complete their medical education, ii). Urgent need for review of PG residential training criteria including appropriate bed and teacher criteria as well as entry criteria and eligibility criteria, iii). Involvement of all available units of hospitals fulfilling the requirements of the residential PG training criteria, iv). PG residential trainings involve doing the required work in the hospitals entitling them full pay and continuation of the service without any training fee or tuition fee, and v). Planning of the proportions of General Specialty and Sub-Specialty Training fields, particularly General Practice (GP) including its career and female participation. With increased number of medical graduates, now it seems possible to plan for optimal health coverage to the populations with appropriate postgraduate medical training. The medical professionals and public health workers must make the Government aware of the vital responsibility and the holistic approach required.

Modelling vocabulary development among multilingual children prior to and following the transition to school entry.

PubMed

MacLeod, Andrea A N; Castellanos-Ryan, Natalie; Parent, Sophie; Jacques, Sophie; Séguin, Jean R

2018-01-01

Differences between monolingual and multilingual vocabulary development have been observed but few studies provide a longitudinal perspective on vocabulary development before and following school entry. This study compares vocabulary growth profiles of 106 multilingual children to 211 monolingual peers before and after school entry to examine whether: (1) school entry coincides with different rates of vocabulary growth compared to prior to school entry, (2) compared to monolingual peers, multilingual children show different vocabulary sizes or rates of vocabulary growth, (3) the age of onset of second-language acquisition for multilingual children is associated with vocabulary size or rate of vocabulary growth, and (4) the sociolinguistic context of the languages spoken by multilingual children is associated with vocabulary size or rate of vocabulary growth. Results showed increases in vocabulary size across time for all children, with a steeper increase prior to school entry. A significant difference between monolingual and multilingual children who speak a minority language was observed with regards to vocabulary size at school entry and vocabulary growth prior to school entry, but growth rate differences were no longer present following school entry. Taken together, results suggest that which languages children speak may matter more than being multilingual per se.

Demographic and academic-related differences between standard-entry and graduate-entry nursing students: a prospective correlational survey.

PubMed

Everett, Bronwyn; Salamonson, Yenna; Trajkovski, Suza; Fernandez, Ritin

2013-07-01

Students who enroll in graduate-entry nursing programs are described as more highly motivated, scoring higher in most learning strategies, and achieving greater academic success than standard-entry nursing students. A prospective correlational design was used to compare the demographic and academic-related characteristics of standard-entry and graduate-entry nursing students in their first year of study. Between 2007 and 2011, students enrolled in the Bachelor of Nursing, Standard Entry and the Bachelor Nursing, Graduate Entry at a large Australian university were surveyed in the first year of their program. Data included English-language usage and time spent in paid work, as well as four dimensions of Pintrich's Motivated Strategies for Learning Questionnaire. Survey data was linked to students' academic grades at the end of the semester. A total of 730 students completed the survey and consented to collection of their academic grades. Graduate-entry students were more likely to be older (28.6 vs. 24.3 years, P < 0.001), and there was a higher percentage of males (25.2% vs. 15.9%, P = 0.003). Although no difference was identified between groups for use of Extrinsic Goal Orientation as a learning strategy, the graduate-entry students were more likely to identify Peer Learning, Help Seeking and Critical Thinking as strategies for learning than the standard-entry students (P < 0.001). Further, while this group of students achieved a higher mean GPA (4.8 vs. 4.0, P < 0.001) compared to the standard-entry students, regression analyses revealed that in both groups, lower levels of English-language proficiency and increased time spent in paid work were predictors of poorer academic performance. Similar to US-based studies, demographic and academic-related differences were identified between standard-entry and graduate-entry nursing students. However, the study also highlights lower levels of English-language proficiency and increased time spent in paid work negatively impacted academic performance in both groups of nursing students. Copyright © 2013 Elsevier Ltd. All rights reserved.

Hospitalisation of older people before and after long-term care entry in Auckland, New Zealand.

PubMed

Boyd, Michal; Broad, Joanna B; Zhang, Tony Xian; Kerse, Ngaire; Gott, Merryn; Connolly, Martin J

2016-07-01

global population projections forecast large growth in demand for long-term care (LTC) and acute hospital services for older people. Few studies report changes in hospitalisation rates before and after entry into LTC. This study compares hospitalisation rates 1 year before and after LTC entry. the Older Persons' Ability Level (OPAL) study was a 2008 census-type survey of LTC facilities in Auckland, New Zealand. OPAL resident hospital admissions and deaths were obtained from routinely collected national databases. all 2,244 residents (66% = female) who entered LTC within 12 months prior to OPAL were included. There were 3,363 hospitalisations, 2,424 in 12 months before and 939 in 12 months after entry, and 364 deaths. In the 6 to 12 months before LTC entry, the hospitalisation rate/100 person-years was 67.3 (95% confidence interval [CI] 62.5-72.1). Weekly rates then rose steeply to over 450/100 person-years in the 6 months immediately before LTC entry. In the 6 months after LTC entry, the rate fell to 49.1 (CI 44.9-53.3; RR 0.73 (CI 0.65-0.82, P < 0.0001)) and decreased further 6 to 12 months after entry to 41.1 (CI 37.1-45.1; rate ratio [RR] 0.61 (CI 0.54-0.69, P < 0.0001)). increased hospitalisations a few months before LTC entry suggest functional and medical instability precipitates LTC entry. New residents utilise hospital beds less frequently than when at home before that unstable period. Further research is needed to determine effective interventions to avoid some hospitalisations and possibly also LTC entry. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Entry, Descent, and Landing technological barriers and crewed MARS vehicle performance analysis

NASA Astrophysics Data System (ADS)

Subrahmanyam, Prabhakar; Rasky, Daniel

2017-05-01

Mars has been explored historically only by robotic crafts, but a crewed mission encompasses several new engineering challenges - high ballistic coefficient entry, hypersonic decelerators, guided entry for reaching intended destinations within acceptable margins for error in the landing ellipse, and payload mass are all critical factors for evaluation. A comprehensive EDL parametric analysis has been conducted in support of a high mass landing architecture by evaluating three types of vehicles -70° Sphere Cone, Ellipsled and SpaceX hybrid architecture called Red Dragon as potential candidate options for crewed entry vehicles. Aerocapture at the Martian orbit of about 400 km and subsequent Entry-from-orbit scenarios were investigated at velocities of 6.75 km/s and 4 km/s respectively. A study on aerocapture corridor over a range of entry velocities (6-9 km/s) suggests that a hypersonic L/D of 0.3 is sufficient for a Martian aerocapture. Parametric studies conducted by varying aeroshell diameters from 10 m to 15 m for several entry masses up to 150 mt are summarized and results reveal that vehicles with entry masses in the range of about 40-80 mt are capable of delivering cargo with a mass on the order of 5-20 mt. For vehicles with an entry mass of 20 mt to 80 mt, probabilistic Monte Carlo analysis of 5000 cases for each vehicle were run to determine the final landing ellipse and to quantify the statistical uncertainties associated with the trajectory and attitude conditions during atmospheric entry. Strategies and current technological challenges for a human rated Entry, Descent, and Landing to the Martian surface are presented in this study.

Low prevalence of work disability in early inflammatory arthritis (EIA) and early rheumatoid arthritis at enrollment into a multi-site registry: results from the catch cohort.

PubMed

Mussen, Lauren; Boyd, Tristan; Bykerk, Vivian; de Leon, Faye; Li, Lihua; Boire, Gilles; Hitchon, Carol; Haraoui, Boulos; Thorne, J Carter; Pope, Janet

2013-02-01

We determined the prevalence of work disability in early rheumatoid arthritis (ERA) and undifferentiated early inflammatory arthritis (EIA) patients at first enrollment into the Canadian Early Arthritis Cohort (CATCH) who met the 2010 ACR criteria versus those not meeting criteria, to determine the impact of meeting new criteria on work disability status. Data at first visit into the cohort were analyzed. Descriptive statistics and logistic regression analyses were performed to investigate the association of other variables in our database with work disability. 1,487 patients were enrolled in the CATCH study, a multi-site observational, prospective cohort of patients with EIA. 934 patients were excluded (505 based on missing criteria for ACR 2010 classification, as anti-CCP was absent, and 429 were not working for other reasons). Of the 553 patients included, 71 % were female with mean disease duration of 6.4 months. 524 (94.8 %) were employed while 29 (5.2 %) reported work disability at first visit. There were no differences between those meeting 2010 ACR criteria versus those who did not. Baseline characteristics associated with work disability were male gender, age, education, income, HAQ, and positive RF status. The mean HAQ score in work disabled patients was 1.4 versus 0.9 in those who were working (p < 0.001). Disease activity score (DAS28) was not associated with work disability (p = 0.069), nor was tender joint count, swollen joint count, anti-CCP, patient global assessment, or SF-12v2. In the regression model, work disability was associated with lower income levels (p = 0.01) and worse HAQ scores (OR 2.33; p = 0.001), but not significantly associated with male gender (p = 0.08), older age (>50 years; p = 0.3), lower education (p = 0.3) or RF positivity (p = 0.6). We found rates of work disability to be low at entry into this EIA cohort compared to previous studies. There may be potential for intervention in ERA to prevent the development of work disability.

CLT and CLS job responsibilities: current distinctions and updates.

PubMed

Doig, K; Beck, S J; Kolenc, K

2001-01-01

This study was undertaken to address the following questions: 1. What tasks distinguish the job of a clinical laboratory scientist (CLS) from that of a clinical laboratory technician (CLT)? 2. What changes in role distinctions, have occurred for entry-level CLS and CLT practitioners over the five-year period 1993-98? 3. What tasks have been deleted from the CLT and CLS content outlines because they were not frequently performed or not considered entry-level? 4. What changes in practice are reflected in the current job analyses? A national job analysis of tasks constituting the job of clinical laboratory scientists (CLSs) and clinical laboratory technicians (CLTs) was conducted in 1998-99 as part of a standard setting process for the certifying examinations of the National Credentialing Agency for Laboratory Personnel (NCA). The job analyses relied upon mail surveys to 1200 individuals for each job level asking respondents to identify tasks significant to effective practice at job entry. The task lists resulting from statistical analysis of those surveys were examined to answer the study questions. The sample for each survey included 1200 practitioners, educators and laboratory managers selected at random from membership in professional organizations or from NCA certificant lists. Sampling was stratified to insure adequate practitioner representation. The mean rating on a four point scale for each item on the surveys was evaluated for overall significance as well as significance across geographic regions. The tasks meeting specified criteria were retained in the final task lists. Tasks were counted and their content evaluated to compare CLS and CLT job tasks. The response rates to the surveys were 33% for CLT and 21% for CLS. Reliability was judged based on average intraclass correlation coefficients of .86 and .82 for the CLT and CLS surveys, respectively. There were 952 tasks retained on the CLS content outline and 725 retained on the CLT content outline of the 1151 tasks on the original survey. Seven hundred and twenty two tasks were found on content outlines of both job levels, representing a 76% overlap. Tasks found only on the CLS outline included advanced technical tasks, a few management tasks, and more communication tasks. The jobs of CLS and CLT practitioners are distinct at job entry level with CLSs performing a broader array of technical and communication tasks as well as some management tasks. Though CLS staff uses few management skills at job entry, those tasks are performed by CLS staff in the laboratory and curricula must help prepare graduates for these tasks expected of experienced staff. CLTs perform tasks requiring problem solving and high level reasoning. CLT curricula must address the need for CLTs to perform these tasks.

Confirmation of translatability and functionality certifies the dual endothelin1/VEGFsp receptor (DEspR) protein.

PubMed

Herrera, Victoria L M; Steffen, Martin; Moran, Ann Marie; Tan, Glaiza A; Pasion, Khristine A; Rivera, Keith; Pappin, Darryl J; Ruiz-Opazo, Nelson

2016-06-14

In contrast to rat and mouse databases, the NCBI gene database lists the human dual-endothelin1/VEGFsp receptor (DEspR, formerly Dear) as a unitary transcribed pseudogene due to a stop [TGA]-codon at codon#14 in automated DNA and RNA sequences. However, re-analysis is needed given prior single gene studies detected a tryptophan [TGG]-codon#14 by manual Sanger sequencing, demonstrated DEspR translatability and functionality, and since the demonstration of actual non-translatability through expression studies, the standard-of-excellence for pseudogene designation, has not been performed. Re-analysis must meet UNIPROT criteria for demonstration of a protein's existence at the highest (protein) level, which a priori, would override DNA- or RNA-based deductions. To dissect the nucleotide sequence discrepancy, we performed Maxam-Gilbert sequencing and reviewed 727 RNA-seq entries. To comply with the highest level multiple UNIPROT criteria for determining DEspR's existence, we performed various experiments using multiple anti-DEspR monoclonal antibodies (mAbs) targeting distinct DEspR epitopes with one spanning the contested tryptophan [TGG]-codon#14, assessing: (a) DEspR protein expression, (b) predicted full-length protein size, (c) sequence-predicted protein-specific properties beyond codon#14: receptor glycosylation and internalization, (d) protein-partner interactions, and (e) DEspR functionality via DEspR-inhibition effects. Maxam-Gilbert sequencing and some RNA-seq entries demonstrate two guanines, hence a tryptophan [TGG]-codon#14 within a compression site spanning an error-prone compression sequence motif. Western blot analysis using anti-DEspR mAbs targeting distinct DEspR epitopes detect the identical glycosylated 17.5 kDa pull-down protein. Decrease in DEspR-protein size after PNGase-F digest demonstrates post-translational glycosylation, concordant with the consensus-glycosylation site beyond codon#14. Like other small single-transmembrane proteins, mass spectrometry analysis of anti-DEspR mAb pull-down proteins do not detect DEspR, but detect DEspR-protein interactions with proteins implicated in intracellular trafficking and cancer. FACS analyses also detect DEspR-protein in different human cancer stem-like cells (CSCs). DEspR-inhibition studies identify DEspR-roles in CSC survival and growth. Live cell imaging detects fluorescently-labeled anti-DEspR mAb targeted-receptor internalization, concordant with the single internalization-recognition sequence also located beyond codon#14. Data confirm translatability of DEspR, the full-length DEspR protein beyond codon#14, and elucidate DEspR-specific functionality. Along with detection of the tryptophan [TGG]-codon#14 within an error-prone compression site, cumulative data demonstrating DEspR protein existence fulfill multiple UNIPROT criteria, thus refuting its pseudogene designation.

Ablative Heat Shield Studies for NASA Mars/Earth Return Entry Vehicles

DTIC Science & Technology

1990-09-01

RETURN ENTRY VEHICLES by Michael K. Hamm September, 1990 NASA Thesis Advisor: William D. Henline Thesis Co-Advisor: Max F. Platzer Approved for public...STUDIES FOR NASA MARS/EARTH RETURN ENTRY VEHICLES (UNCLASSIFIED) 12. PERSONAL AUTHOR(S) Harm, Michael, K. 13a TYPE OF REPORT 13b TIME COVERED 14 DATE OF...theoretical values. The tests were performed to ascertain if RSI type materials could be used for entry vehicles proposed in NASA Mars missions. 20

Preentry communications study. Outer planets atmospheric entry probe

NASA Technical Reports Server (NTRS)

Hinrichs, C. A.

1976-01-01

A pre-entry communications study is presented for a relay link between a Jupiter entry probe and a spacecraft in hyperbolic orbit. Two generic communications links of interest are described: a pre-entry link to a spun spacecraft antenna, and a pre-entry link to a despun spacecraft antenna. The propagation environment of Jupiter is defined. Although this is one of the least well known features of Jupiter, enough information exists to reasonably establish bounds on the performance of a communications link. Within these bounds, optimal carrier frequencies are defined. The next step is to identify optimal relative geometries between the probe and the spacecraft. Optimal trajectories are established for both spun and despun spacecraft antennas. Given the optimal carrier frequencies, and the optimal trajectories, the data carrying capacities of the pre-entry links are defined. The impact of incorporating pre-entry communications into a basic post entry probe is then assessed. This assessment covers the disciplines of thermal control, power source, mass properties and design layout. A conceptual design is developed of an electronically despun antenna for use on a Pioneer class of spacecraft.

Developing Health-Based Pre-Planning Clearance Goals for Airport Remediation Following Chemical Terrorist Attack: Introduction and Key Assessment Considerations

PubMed Central

Watson, Annetta; Hall, Linda; Raber, Ellen; Hauschild, Veronique D.; Dolislager, Fredrick; Love, Adam H.; Hanna, M. Leslie

2011-01-01

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility reuse and re-entry could require hours to multiple days. While restoration timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical terrorist release. What follows is the first of a two-part analysis identifying key considerations, critical information, and decision criteria to facilitate post-attack and post-decontamination consequence management activities. A conceptual site model and human health-based exposure guidelines are developed and reported as an aid to site-specific pre-planning in the current absence of U.S. state or Federal values designated as compound-specific remediation or re-entry concentrations, and to safely expedite facility recovery to full operational status. Chemicals of concern include chemical warfare nerve and vesicant agents and the toxic industrial compounds phosgene, hydrogen cyanide, and cyanogen chloride. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination. PMID:21390292

Developing Health-Based Pre-Planning Clearance Goals for Airport Remediation Following Chemical Terrorist Attack: Introduction and Key Assessment Considerations.

PubMed

Watson, Annetta; Hall, Linda; Raber, Ellen; Hauschild, Veronique D; Dolislager, Fredrick; Love, Adam H; Hanna, M Leslie

2011-02-13

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility reuse and re-entry could require hours to multiple days. While restoration timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical terrorist release. What follows is the first of a two-part analysis identifying key considerations, critical information, and decision criteria to facilitate post-attack and post-decontamination consequence management activities. A conceptual site model and human health-based exposure guidelines are developed and reported as an aid to site-specific pre-planning in the current absence of U.S. state or Federal values designated as compound-specific remediation or re-entry concentrations, and to safely expedite facility recovery to full operational status. Chemicals of concern include chemical warfare nerve and vesicant agents and the toxic industrial compounds phosgene, hydrogen cyanide, and cyanogen chloride. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination.

Developing health-based pre-planning clearance goals for airport remediation following chemical terrorist attack: Introduction and key assessment considerations

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

Watson, Annetta Paule; Raber, Ellen; Dolislager, Frederick

2011-01-01

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility re-use and re-entry could require hours to multiple days. While restoration timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical terrorist release. What follows is the first of a two-part analysis identifying key considerations, critical information, and decision criteria to facilitate post-attack and post-decontamination consequence management activities. A conceptual site model and human health-based exposure guidelines are developed and reported as an aid to site-specific pre-planningmore » in the current absence of U.S. state or Federal values designated as compound-specific remediation or re-entry concentrations, and to safely expedite facility recovery to full operational status. Chemicals of concern include chemical warfare nerve and vesicant agents and the toxic industrial compounds phosgene, hydrogen cyanide, and cyanogen chloride. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination.« less

Planetary/DOD entry technology flight experiments. Volume 2: Planetary entry flight experiments

NASA Technical Reports Server (NTRS)

Christensen, H. E.; Krieger, R. J.; Mcneilly, W. R.; Vetter, H. C.

1976-01-01

The technical feasibility of launching a high speed, earth entry vehicle from the space shuttle to advance technology for the exploration of the outer planets' atmospheres was established. Disciplines of thermodynamics, orbital mechanics, aerodynamics propulsion, structures, design, electronics and system integration focused on the goal of producing outer planet environments on a probe shaped vehicle during an earth entry. Major aspects of analysis and vehicle design studied include: planetary environments, earth entry environment capability, mission maneuvers, capabilities of shuttle upper stages, a comparison of earth entry planetary environments, experiment design and vehicle design.

English Language Learners and Kindergarten Entry Age: Achievement and Social-Emotional Effects

ERIC Educational Resources Information Center

Gottfried, Michael; Le, Vi-Nhuan; Datar, Ashlesha

2016-01-01

In evaluating the role of kindergarten entry age, previous researchers have not examined the entry-age effects for English language learners (ELL). Additionally, little work has assessed the role of entry age on both achievement and social-emotional outcomes. This study is the first to do both simultaneously. The authors used data from a…

Modelling vocabulary development among multilingual children prior to and following the transition to school entry

PubMed Central

MacLeod, Andrea A. N.; Castellanos-Ryan, Natalie; Parent, Sophie; Jacques, Sophie; Séguin, Jean R.

2017-01-01

Differences between monolingual and multilingual vocabulary development have been observed but few studies provide a longitudinal perspective on vocabulary development before and following school entry. This study compares vocabulary growth profiles of 106 multilingual children to 211 monolingual peers before and after school entry to examine whether: (1) school entry coincides with different rates of vocabulary growth compared to prior to school entry, (2) compared to monolingual peers, multilingual children show different vocabulary sizes or rates of vocabulary growth, (3) the age of onset of second-language acquisition for multilingual children is associated with vocabulary size or rate of vocabulary growth, and (4) the sociolinguistic context of the languages spoken by multilingual children is associated with vocabulary size or rate of vocabulary growth. Results showed increases in vocabulary size across time for all children, with a steeper increase prior to school entry. A significant difference between monolingual and multilingual children who speak a minority language was observed with regards to vocabulary size at school entry and vocabulary growth prior to school entry, but growth rate differences were no longer present following school entry. Taken together, results suggest that which languages children speak may matter more than being multilingual per se. PMID:29354017

Separability of three qubit Greenberger-Horne-Zeilinger diagonal states

NASA Astrophysics Data System (ADS)

Han, Kyung Hoon; Kye, Seung-Hyeok

2017-04-01

We characterize the separability of three qubit GHZ diagonal states in terms of entries. This enables us to check separability of GHZ diagonal states without decomposition into the sum of pure product states. In the course of discussion, we show that the necessary criterion of Gühne (2011 Entanglement criteria and full separability of multi-qubit quantum states Phys. Lett. A 375 406-10) for (full) separability of three qubit GHZ diagonal states is sufficient with a simpler formula. The main tool is to use entanglement witnesses which are tri-partite Choi matrices of positive bi-linear maps.

[Categories of immigrants and "levels of immigration" in Canada: a voluntarist policy].

PubMed

Crepeau, F

1986-11-01

Because Canada has no terrestrial border other than that with the US, the potential for significant uncontrolled migration is low and the country is able to implement a selective and relatively voluntarist immigration policy. The government prepares an annual report indicating the number of immigrants to be admitted and the demographic considerations used to arrive at the number. Immigrants are classified as familial, humanitarian, or economic, and each category has its own selection criteria designed to determine the capacity of the candidate to become successfully established in Canada. Canadian immigration authorities have very wide latitude in interpreting selection criteria and evaluating candidates. Family members can seek entry if they will be sponsored by a Canadian citizen or permanent resident at least 18 years old who is judged able to do so by an immigration agent. Humanitarian immigration includes refugees, "voluntary exiles" from Eastern European countries excluding Yugoslavia, "Indochinese", and "political prisoners and oppressed persons" from Chile, El Salvador, Guatemala, Uruguay, and Poland. Special arrangements sometimes made in emergencies have benefitted Haitians, Italian earthquake victims, unaccompanied Indochinese minors, Iranian Bahais, and others. The category of "economic immigrants" includes independent, unsponsored individuals who wish to establish themselves in Canada to exercise a profession. Such candidates are awarded points for educational level, specific professional preparation, experience, need for workers in their profession, age, knowledge of English or French, and other factors, but the immigration agent can disregard the points if in his opinion they do not accurately reflect the candidate's chances of establishing himself successfully in Canada. Various categories of workers have slightly different admissions criteria: retired persons, businessmen and investers, and other workers. The order of priority for consideration of visa requests as well as the requirements for entry make clear the goal of reconciling the possibility of significant contribution to the Canadian economy, respect for international obligations, and protection of the Canadian labor market. The total number admitted in 1984, 88,239, was much lower than the average of over 140,000 annually between 1961-82. In 1982, entry of economic immigrants began to be discouraged because of poor economic conditions following the 3rd oil price increases. In 1985, after widespread consultation prompted by concern over flowing population growth, the government announced the admission in 1986 of 105,000-115,000 immigrants, a 30% rise over the 1985 level. 115,000-125,000 are to be admitted in 1987. Migration policy for comming years is intended to restore balance between the 3 components by a greater openness to economic immigration, especially to migrants with substantial capital and demonstrated entrepreneurial competence. In Canada, immigration policies and obtaining of citizenship are by tradition closely linked, and the majority of immigrants become Canadian citizens after 3 years.

The identification of knowledge content and function in manual labour.

PubMed

Shalin, Valerie; Verdile, Charles

2003-06-10

Calls for an alternative conceptualization of cognition for applied concerns retain the core commitment of the basic research community to abstract cognition detached from a physical environment. The present paper attempts to break out of the dominant, narrow view of cognition and cognitive domains, with a cognitive analysis of digging ditches for the utility industry. To illustrate knowledge-based cognition in manual labour excerpts are presented from the journal entries of a moderately experienced student working a summer job, organized with a representation that distinguishes between the goals and methods of work. The journal entries illustrate the functions of knowledge for interacting with a physical environment; knowledge enables the selection, execution and monitoring of work methods, the interpretation of perceptual information, the application of task completion criteria and the ability for explanation and generalization. To emphasize the generality of the functions of cognition in ditch digging, comparable functions are indicated in a domain rarely regarded as a form of manual labour: the practice of internal medicine. Discussion of the results includes the implications for cognitive theory as well as practical implications for productivity, training and task analysis.

The Mission Accessibility of Near-Earth Asteroids

NASA Technical Reports Server (NTRS)

Barbee, Brent W.; Abell, Paul A.; Adamo, Daniel R.; Mazanek, Daniel D.; Johnson, Lindley N.; Yeomans, Donald K.; Chodas, Paul W.; Chamberlin, Alan B.; Benner, Lance A. M.; Taylor, Patrick;

Evidence for a meteoritic origin of the September 15, 2007, Carancas crater

NASA Astrophysics Data System (ADS)

Le Pichon, A.; Antier, K.; Cansi, Y.; Hernandez, B.; Minaya, E.; Burgoa, B.; Drob, D.; Evers, L. G.; Vaubaillon, J.

2008-11-01

On September 15th, 2007, around 11:45 local time in Peru, near the Bolivian border, the atmospheric entry of a meteoroid produced bright lights in the sky and intense detonations. Soon after, a crater was discovered south of Lake Titicaca. These events have been detected by the Bolivian seismic network and two infrasound arrays operating for the Comprehensive Nuclear-Test-Ban Treaty Organization, situated at about 80 and 1620 km from the crater. The localization and origin time computed with the seismic records are consistent with the reported impact. The entry elevation and azimuthal angles of the trajectory are estimated from the observed signal time sequences and back-azimuths. From the crater diameter and the airwave amplitudes, the kinetic energy, mass and explosive energy are calculated. Using the estimated velocity of the meteoroid and similarity criteria between orbital elements, an association with possible parent asteroids is attempted. The favorable setting of this event provides a unique opportunity to evaluate physical and kinematic parameters of the object that generated the first actual terrestrial meteorite impact seismically recorded.

Entry-Level Worker Study: Phase 1 Report. Program Report.

ERIC Educational Resources Information Center

Owens, Thomas; And Others

A study examined innovative workplace practices in companies that employ significant numbers of entry-level workers. Findings were based on a series of personal interviews with human resource directors in 58 companies in the Northwest and the Pacific. Asked about the quality of current entry-level workers, employers reported that a disturbing…

In Situ Magnetohydrodynamic Energy Generation for Planetary Entry Vehicles

NASA Astrophysics Data System (ADS)

Ali, H. K.; Braun, R. D.

2014-06-01

This work aims to study the suitability of multi-pass entry trajectories for harnessing of vehicle kinetic energy through magnetohydrodynamic power generation from the high temperature entry plasma. Potential mission configurations are analyzed.

A high throughput Cre–lox activated viral membrane fusion assay identifies pharmacological inhibitors of HIV entry

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

Esposito, Anthony M.; Cheung, Pamela; Swartz, Talia H.

Enveloped virus entry occurs when viral and cellular membranes fuse releasing particle contents into the target cell. Human immunodeficiency virus (HIV) entry occurs by cell-free virus or virus transferred between infected and uninfected cells through structures called virological synapses. We developed a high-throughput cell-based assay to identify small molecule inhibitors of cell-free or virological synapse-mediated entry. An HIV clone carrying Cre recombinase as a Gag-internal gene fusion releases active Cre into cells upon viral entry activating a recombinatorial gene switch changing dsRed to GFP-expression. A screen of a 1998 known-biological profile small molecule library identified pharmacological HIV entry inhibitors thatmore » block both cell-free and cell-to-cell infection. Many top hits were noted as HIV inhibitors in prior studies, but not previously recognized as entry antagonists. Modest therapeutic indices for simvastatin and nigericin were observed in confirmatory HIV infection assays. This robust assay is adaptable to study HIV and heterologous viral pseudotypes. - Highlights: • Cre recombinase viral fusion assay screens cell-free or cell–cell entry inhibitors. • This Gag-iCre based assay is specific for the entry step of HIV replication. • Screened a library of known pharmacologic compounds for HIV fusion antagonists. • Many top hits were previously noted as HIV inhibitors, but here are classified as entry antagonists. Many top hits were previously noted as HIV inhibitors, but not as entry antagonists. • The assay is compatible with pseudotyping with HIV and heterologous viruses.« less

A scrutiny of tools used for assessment of hospital disaster preparedness in Iran.

PubMed

Heidaranlu, Esmail; Ebadi, Abbas; Ardalan, Ali; Khankeh, Hamidreza

2015-01-01

In emergencies and disasters, hospitals are among the first and most vital organizations involved. To determine preparedness of a hospital to deal with crisis, health system requires tools compatible with the type of crisis. The present study aimed to evaluate the accuracy of tools used for assessment of hospitals preparedness for major emergencies and disasters in Iran. In this review study, all studies conducted on hospital preparedness to deal with disasters in Iran in the interim 2000-2015 were examined. The World Health Organization (WHO) criteria were used to assess focus of studies for entry in this study. Of the 36 articles obtained, 28 articles that met inclusion criteria were analyzed. In accordance with the WHO standards, focus of tools used was examined in three areas (structural, nonstructural, and functional). In nonstructural area, the most focus of preparation tools was on medical gases, and the least focus on office and storeroom furnishings and equipment. In the functional area, the most focus was on operational plan, and the least on business continuity. Half of the tools in domestic studies considered structural safety as indicator of hospital preparedness. The present study showed that tools used contain a few indicators approved by the WHO, especially in the functional area. Moreover, a lack of a standard indigenous tool was evident, especially in the functional area. Thus, to assess hospital disaster preparedness, the national health system requires new tools compatible with scientific tool design principles, to enable a more accurate prediction of hospital preparedness in disasters before they occur.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR DATA ENTRY AND DATA VERIFICATION (HAND ENTRY) (UA-D-15.0)

EPA Science Inventory

The purpose of this SOP is to define the steps involved in data entry and data verification of physical forms. It applies to the data entry and data verification of all physical forms. The procedure defined herein was developed for use in the Arizona NHEXAS project and the "Bor...

The implementation of mastery learning concept and cognitive entry behavior to increase the students’ competency in accordance with iqf qualification

NASA Astrophysics Data System (ADS)

Suandi, I. K.; Aryaningsih, N. N.; Abdi, I. M.

2018-01-01

The objectives of this study are: (1) to describe the difference of the students’ competence between the students following mastery learning and conventional instruction, (2) to describe the difference of the students’ competence between the students have high cognitive entry behavior and low cognitive entry behavior, and (3) to analyze the interaction effect between instructional model and cognitive entry behavior to the achievement of students’ competence. Quasi experiment was conducted at accounting department of Politeknik Negeri Bali and research design is nonrandomized control group pretest-posttest. The variable in this study are: (1) students’ competence, (2) instructional model, and (3) cognitive entry behavior. The total samples are 168 students and each treatment decided 25 subjects as analysis unit, therefore the total of analysis unit are 100 subjects. The results of the study are: (1) there is a significant deference of the students’ competence between the students following mastery learning and conventional instruction (F=7.514; P<0.05), (2) there is a significant difference of the students’ competence between the students have high cognitive entry behavior and low cognitive entry behavior (F=8.035; P<0.05), (3) there is a significant interaction effect between instructional model and cognitive entry behavior to the achievement of students’ competence (F=8.392; P<0.05).

Comparative genomics study for the identification of drug and vaccine targets in Staphylococcus aureus: MurA ligase enzyme as a proposed candidate.

PubMed

Ghosh, Soma; Prava, Jyoti; Samal, Himanshu Bhusan; Suar, Mrutyunjay; Mahapatra, Rajani Kanta

2014-06-01

Now-a-days increasing emergence of antibiotic-resistant pathogenic microorganisms is one of the biggest challenges for management of disease. In the present study comparative genomics, metabolic pathways analysis and additional parameters were defined for the identification of 94 non-homologous essential proteins in Staphylococcus aureus genome. Further study prioritized 19 proteins as vaccine candidates where as druggability study reports 34 proteins suitable as drug targets. Enzymes from peptidoglycan biosynthesis, folate biosynthesis were identified as candidates for drug development. Furthermore, bacterial secretory proteins and few hypothetical proteins identified in our analysis fulfill the criteria of vaccine candidates. As a case study, we built a homology model of one of the potential drug target, MurA ligase, using MODELLER (9v12) software. The model has been further selected for in silico docking study with inhibitors from the DrugBank database. Results from this study could facilitate selection of proteins for entry into drug design and vaccine production pipelines. Copyright © 2014 Elsevier B.V. All rights reserved.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR DEFINING WORKING DATABASES AND DATA ENTRY FORMS (HAND ENTRY) (UA-D-3.0)

EPA Science Inventory

The purpose of this SOP is to outline a standard approach to naming and defining variables, data types, and data entry forms. This procedure applies to all working databases created during the NHEXAS project and the "Border" study. Keywords: databases; standards.

The National...

Re-Thinking Re-Entry: New Approaches to Supporting Students after Study Abroad

ERIC Educational Resources Information Center

Brubaker, Cate

2017-01-01

While participation in study abroad continues to increase, and both pre-departure and in-country support and interventions have become more robust, the re-entry experience after a program ends still typically takes a back seat to other priorities. Consequently, most students are left to navigate the re-entry transition on their own. This article…

Attacking 22 entries in rugby union: running demands and differences between successful and unsuccessful entries.

PubMed

Tierney, P; Tobin, D P; Blake, C; Delahunt, E

2017-12-01

Global Positioning System (GPS) technology is commonly utilized in team sports, including rugby union. It has been used to describe the average running demands of rugby union. This has afforded an enhanced understanding of the physical fitness requirements for players. However, research in team sports has suggested that training players relative to average demands may underprepare them for certain scenarios within the game. To date, no research has investigated the running demands of attacking 22 entries in rugby union. Additionally, no research has been undertaken to determine whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries in rugby union. The first aim of this study was to describe the running intensity of attacking 22 entries. The second aim of this study was to investigate whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries. Running intensity was measured using meters per minute (m min -1 ) for (a) total distance, (b) running distance, (c) high-speed running distance, and (d) very high-speed running distance. This study provides normative data for the running intensity of attacking 22 entries in rugby union. Forwards achieved greater high-speed running intensity in successful (3.6 m min -1 ) compared to unsuccessful (1.8 m min -1 ) attacking 22 entries. Forwards should try and achieve greater high-speed running intensity in attacking 22 entries to increase the likelihood of successful outcomes during this period of gameplay. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Review of information technology for surgical patient care.

PubMed

Robinson, Jamie R; Huth, Hannah; Jackson, Gretchen P

2016-06-01

Electronic health records (EHRs), computerized provider order entry (CPOE), and patient portals have experienced increased adoption by health care systems. The objective of this study was to review evidence regarding the impact of such health information technologies (HIT) on surgical practice. A search of Medline, EMBASE, CINAHL, and the Cochrane Library was performed to identify data-driven, nonsurvey studies about the effects of HIT on surgical care. Domain experts were queried for relevant articles. Two authors independently reviewed abstracts for inclusion criteria and analyzed full text of eligible articles. A total of 2890 citations were identified. Of them, 32 observational studies and two randomized controlled trials met eligibility criteria. EHR or CPOE improved appropriate antibiotic administration for surgical procedures in 13 comparative observational studies. Five comparative observational studies indicated that electronically generated operative notes had increased accuracy, completeness, and availability in the medical record. The Internet as an information resource about surgical procedures was generally inadequate. Surgical patients and providers demonstrated rapid adoption of patient portals, with increasing proportions of online versus inperson outpatient surgical encounters. The overall quality of evidence about the effects of HIT in surgical practice was low. Current data suggest an improvement in appropriate perioperative antibiotic administration and accuracy of operative reports from CPOE and EHR applications. Online consumer health educational resources and patient portals are popular among patients and families, but their impact has not been studied well in surgical populations. With increasing adoption of HIT, further research is needed to optimize the efficacy of such tools in surgical care. Copyright © 2016 Elsevier Inc. All rights reserved.

Re-Entry of Women to the Labour Market After an Interruption in Employment.

ERIC Educational Resources Information Center

Seear, B. N.

The problems involved in the re-entry of women into employment were studied, and the extent to which there exists a demand for employment for re-entry women was examined. A growing number of women are seeking re-entry in a wide range of income levels. The demand for part-time work appears to exceed supply. Official machinery for assisting re-entry…

Is there a bone-nail specific entry point? Automated fit quantification of tibial nail designs during the insertion for six different nail entry points.

PubMed

Amarathunga, J P; Schuetz, M A; Yarlagadda, K V D; Schmutz, B

2015-04-01

Intramedullary nailing is the standard fixation method for displaced diaphyseal fractures of tibia. Selection of the correct nail insertion point is important for axial alignment of bone fragments and to avoid iatrogenic fractures. However, the standard entry point (SEP) may not always optimise the bone-nail fit due to geometric variations of bones. This study aimed to investigate the optimal entry for a given bone-nail pair using the fit quantification software tool previously developed by the authors. The misfit was quantified for 20 bones with two nail designs (ETN and ETN-Proximal Bend) related to the SEP and 5 entry points which were 5 mm and 10 mm away from the SEP. The SEP was the optimal entry point for 50% of the bones used. For the remaining bones, the optimal entry point was located 5 mm away from the SEP, which improved the overall fit by 40% on average. However, entry points 10 mm away from the SEP doubled the misfit. The optimised bone-nail fit can be achieved through the SEP and within the range of a 5 mm radius, except posteriorly. The study results suggest that the optimal entry point should be selected by considering the fit during insertion and not only at the final position. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

A Study of the Effects of Atmospheric Phenomena on Mars Science Laboratory Entry Performance

NASA Technical Reports Server (NTRS)

Cianciolo, Alicia D.; Way, David W.; Powell, Richard W.

2008-01-01

At Earth during entry the shuttle has experienced what has come to be known as potholes in the sky or regions of the atmosphere where the density changes suddenly. Because of the small data set of atmospheric information where the Mars Science Laboratory (MSL) parachute deploys, the purpose of this study is to examine the effect similar atmospheric pothole characteristics, should they exist at Mars, would have on MSL entry performance. The study considers the sensitivity of entry design metrics, including altitude and range error at parachute deploy and propellant use, to pothole like density and wind phenomena.

Comparative analyses of basal rate of metabolism in mammals: data selection does matter.

PubMed

Genoud, Michel; Isler, Karin; Martin, Robert D

2018-02-01

Basal rate of metabolism (BMR) is a physiological parameter that should be measured under strictly defined experimental conditions. In comparative analyses among mammals BMR is widely used as an index of the intensity of the metabolic machinery or as a proxy for energy expenditure. Many databases with BMR values for mammals are available, but the criteria used to select metabolic data as BMR estimates have often varied and the potential effect of this variability has rarely been questioned. We provide a new, expanded BMR database reflecting compliance with standard criteria (resting, postabsorptive state; thermal neutrality; adult, non-reproductive status for females) and examine potential effects of differential selectivity on the results of comparative analyses. The database includes 1739 different entries for 817 species of mammals, compiled from the original sources. It provides information permitting assessment of the validity of each estimate and presents the value closest to a proper BMR for each entry. Using different selection criteria, several alternative data sets were extracted and used in comparative analyses of (i) the scaling of BMR to body mass and (ii) the relationship between brain mass and BMR. It was expected that results would be especially dependent on selection criteria with small sample sizes and with relatively weak relationships. Phylogenetically informed regression (phylogenetic generalized least squares, PGLS) was applied to the alternative data sets for several different clades (Mammalia, Eutheria, Metatheria, or individual orders). For Mammalia, a 'subsampling procedure' was also applied, in which random subsamples of different sample sizes were taken from each original data set and successively analysed. In each case, two data sets with identical sample size and species, but comprising BMR data with different degrees of reliability, were compared. Selection criteria had minor effects on scaling equations computed for large clades (Mammalia, Eutheria, Metatheria), although less-reliable estimates of BMR were generally about 12-20% larger than more-reliable ones. Larger effects were found with more-limited clades, such as sciuromorph rodents. For the relationship between BMR and brain mass the results of comparative analyses were found to depend strongly on the data set used, especially with more-limited, order-level clades. In fact, with small sample sizes (e.g. <100) results often appeared erratic. Subsampling revealed that sample size has a non-linear effect on the probability of a zero slope for a given relationship. Depending on the species included, results could differ dramatically, especially with small sample sizes. Overall, our findings indicate a need for due diligence when selecting BMR estimates and caution regarding results (even if seemingly significant) with small sample sizes. © 2017 Cambridge Philosophical Society.

ENTRYSAT: A 3U Cubesat to Study the Re-Entry Atmospheric Environment

NASA Astrophysics Data System (ADS)

Garcia, R. F.; Chaix, J.; Mimoun, D.; EntrySat student Team

2014-04-01

The EntrySat is a 3U CubeSat designed to study the uncontrolled atmospheric re-entry. The project, developed by ISAE in collaboration with ONERA, is funded by CNES and is intended to be launched in January 2016, in the context of the QB50 network. The scientific goal is to relate the kinematics of the satellite with the aerothermodynamic environment during re-entry. In particular, data will be compared with the computations of MUSIC/FAST, a new 6-degree of freedom code developed by ONERA to predict the trajectory of space debris. According to these requirements, the satellite will measure the temperature, pressure, heat flux, and drag force during re-entry, as well as the trajectory and attitude of the satellite. One of the major technological challenges is the retrieval of data during the re-entry phase, which will be based on the Iridium satellite network. The system design is based on the use of commercial COTS components, and is mostly developed by students from ISAE. As such, the EntrySat has an important educational value in the formation of young engineers.

Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study.

PubMed

Bensimon, Gilbert; Ludolph, Albert; Agid, Yves; Vidailhet, Marie; Payan, Christine; Leigh, P Nigel

2009-01-01

Parkinson plus diseases, comprising mainly progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are rare neurodegenerative conditions. We designed a double-blind randomized placebo-controlled trial of riluzole as a potential disease-modifying agent in Parkinson plus disorders (NNIPPS: Neuroprotection and Natural History in Parkinson Plus Syndromes). We analysed the accuracy of our clinical diagnostic criteria, and studied prognostic factors for survival. Patients with an akinetic-rigid syndrome diagnosed as having PSP or MSA according to modified consensus diagnostic criteria were considered for inclusion. The psychometric validity (convergent and predictive) of the NNIPPS diagnostic criteria were tested prospectively by clinical and pathological assessments. The study was powered to detect a 40% decrease in relative risk of death within PSP or MSA strata. Patients were randomized to riluzole or matched placebo daily and followed up to 36 months. The primary endpoint was survival. Secondary efficacy outcomes were rates of disease progression assessed by functional measures. A total of 767 patients were randomized and 760 qualified for the Intent to Treat (ITT) analysis, stratified at entry as PSP (362 patients) or MSA (398 patients). Median follow-up was 1095 days (range 249-1095). During the study, 342 patients died and 112 brains were examined for pathology. NNIPPS diagnostic criteria showed for both PSP and MSA excellent convergent validity with the investigators' assessment of diagnostic probability (point-biserial correlation: MSA r(pb) = 0.93, P < 0.0001; PSP, r(pb) = 0.95, P < 0.0001), and excellent predictive validity against histopathology [sensitivity and specificity (95% CI) for PSP 0.95 (0.88-0.98) and 0.84 (0.77-0.87); and for MSA 0.96 (0.88-0.99) and 0.91 (0.86-0.93)]. There was no evidence of a drug effect on survival in the PSP or MSA strata (3 year Kaplan-Meier estimates PSP-riluzole: 0.51, PSP-placebo: 0.50; MSA-riluzole: 0.53, MSA-placebo: 0.58; P = 0.66 and P = 0.48 by the log-rank test, respectively), or in the population as a whole (P = 0.42, by the stratified-log-rank test). Likewise, rate of progression was similar in both treatment groups. There were no unexpected adverse effects of riluzole, and no significant safety concerns. Riluzole did not have a significant effect on survival or rate of functional deterioration in PSP or MSA, although the study reached over 80% power to detect the hypothesized drug effect within strata. The NNIPPS diagnostic criteria were consistent and valid. They can be used to distinguish between PSP and MSA with high accuracy, and should facilitate research into these conditions relatively early in their evolution.

Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: The NNIPPS Study

PubMed Central

Bensimon, Gilbert; Ludolph, Albert; Agid, Yves; Vidailhet, Marie; Payan, Christine; Leigh, P. Nigel

2009-01-01

Parkinson plus diseases, comprising mainly progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are rare neurodegenerative conditions. We designed a double-blind randomized placebo-controlled trial of riluzole as a potential disease-modifying agent in Parkinson plus disorders (NNIPPS: Neuroprotection and Natural History in Parkinson Plus Syndromes). We analysed the accuracy of our clinical diagnostic criteria, and studied prognostic factors for survival. Patients with an akinetic-rigid syndrome diagnosed as having PSP or MSA according to modified consensus diagnostic criteria were considered for inclusion. The psychometric validity (convergent and predictive) of the NNIPPS diagnostic criteria were tested prospectively by clinical and pathological assessments. The study was powered to detect a 40% decrease in relative risk of death within PSP or MSA strata. Patients were randomized to riluzole or matched placebo daily and followed up to 36 months. The primary endpoint was survival. Secondary efficacy outcomes were rates of disease progression assessed by functional measures. A total of 767 patients were randomized and 760 qualified for the Intent to Treat (ITT) analysis, stratified at entry as PSP (362 patients) or MSA (398 patients). Median follow-up was 1095 days (range 249–1095). During the study, 342 patients died and 112 brains were examined for pathology. NNIPPS diagnostic criteria showed for both PSP and MSA excellent convergent validity with the investigators’ assessment of diagnostic probability (point-biserial correlation: MSA rpb = 0.93, P < 0.0001; PSP, rpb = 0.95, P < 0.0001), and excellent predictive validity against histopathology [sensitivity and specificity (95% CI) for PSP 0.95 (0.88–0.98) and 0.84 (0.77–0.87); and for MSA 0.96 (0.88–0.99) and 0.91 (0.86–0.93)]. There was no evidence of a drug effect on survival in the PSP or MSA strata (3 year Kaplan–Meier estimates PSP-riluzole: 0.51, PSP-placebo: 0.50; MSA-riluzole: 0.53, MSA-placebo: 0.58; P = 0.66 and P = 0.48 by the log-rank test, respectively), or in the population as a whole (P = 0.42, by the stratified-log-rank test). Likewise, rate of progression was similar in both treatment groups. There were no unexpected adverse effects of riluzole, and no significant safety concerns. Riluzole did not have a significant effect on survival or rate of functional deterioration in PSP or MSA, although the study reached over 80% power to detect the hypothesized drug effect within strata. The NNIPPS diagnostic criteria were consistent and valid. They can be used to distinguish between PSP and MSA with high accuracy, and should facilitate research into these conditions relatively early in their evolution. PMID:19029129

Effectiveness of a real-time clinical decision support system for computerized physician order entry of plasma orders.

PubMed

Yazer, Mark H; Triulzi, Darrell J; Reddy, Vivek; Waters, Jonathan H

2013-12-01

We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria. In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4-month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5-month period. In the 4-month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5-month period thereafter the alert rate was significantly lower at 27.9% (p < 0.0001). The percentage of heeded alerts increased during the adaptive alert period (24.3% vs. 17.1%, respectively, p = 0.004). A significant percentage (45%) of other plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders. Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non-evidence-based ordering. © 2013 American Association of Blood Banks.

Occupational mobility among individuals in entry-level healthcare jobs in the USA.

PubMed

Snyder, Cyndy R; Dahal, Arati; Frogner, Bianca K

2018-07-01

The aim of this study was to explore career transitions among individuals in select entry-level healthcare occupations. Entry-level healthcare occupations are among the fastest growing occupations in the USA. Public perception is that the healthcare industry provides an opportunity for upward career mobility given the low education requirements to enter many healthcare occupations. The assumption that entry-level healthcare occupations, such as nursing assistant, lead to higher-skilled occupations, such as Registered Nurse, is under-explored. We analysed data from the Panel Study of Income Dynamics, which is a nationally representative and publicly available longitudinal survey of US households. Using longitudinal survey data, we examined the job transitions and associated characteristics among individuals in five entry-level occupations at the aide/assistant level over 10 years timeline (2003-2013) to determine whether they stayed in health care and/or moved up in occupational level over time. This study found limited evidence of career progression in health care in that only a few of the individuals in entry-level healthcare occupations moved into occupations such as nursing that required higher education. While many individuals remained in their occupations throughout the study period, we found that 28% of our sample moved out of these entry-level occupations and into another occupation. The most common "other" occupation categories were "office/administrative" and "personal care/services occupations." Whether these moves helped individuals advance their careers remains unclear. Employers and educational institutions should consider efforts to help clarify pathways to advance the careers of individuals in entry-level healthcare occupations. © 2018 John Wiley & Sons Ltd.

The graduate entry generation: a qualitative study exploring the factors influencing the career expectations and aspirations of a graduating cohort of graduate entry dental students in one London institution

PubMed Central

2011-01-01

Background Dentistry in the UK has a number of new graduate-entry programmes. The aim of the study was to explore the motivation, career expectations and experiences of final year students who chose to pursue a dental career through the graduate entry programme route in one institution; and to explore if, and how, their intended career expectations and aspirations were informed by this choice. Method In-depth interviews of 14 graduate entry students in their final year of study. Data were transcribed verbatim and analysed using framework analysis. Results There were three categories of factors influencing students' choice to study dentistry through graduate entry: 'push', 'pull' and 'mediating'. Mediating factors related to students' personal concerns and circumstances, whereas push and pull factors related to features of their previous and future careers and wider social factors. Routes to Graduate Entry study comprised: 'early career changers', 'established career changers' and those pursuing 'routes to specialisation'. These routes also influenced the students' practice of dentistry, as students integrated skills in their dental studies, and encountered new challenges. Factors which students believed would influence their future careers included: vocational training; opportunities for specialisation or developing special interests and policy-related issues, together with wider professional and social concerns. The graduate entry programme was considered 'hard work' but a quick route to a professional career which had much to offer. Students' felt more could have been made of their pre-dental studies and/or experience during the programme. Factors perceived as influencing students' future contribution to dentistry included personal and social influences. Overall there was strong support for the values of the NHS and 'giving back' to the system in their future career. Conclusion Graduate entry students appear to be motivated to enter dentistry by a range of factors which suit their preferences and circumstances. They generally embrace the programme enthusiastically and seek to serve within healthcare, largely in the public sector. These students, who carry wider responsibilities, bring knowledge, skills and experience to dentistry which could be harnessed further during the programme. The findings suggest that graduate entry students, facilitated by varied career options, will contribute to an engaged workforce. PMID:21942994

The graduate entry generation: a qualitative study exploring the factors influencing the career expectations and aspirations of a graduating cohort of graduate entry dental students in one London institution.

PubMed

Newton, Paul; Cabot, Lyndon; Wilson, Nairn H F; Gallagher, Jennifer E

2011-09-24

Dentistry in the UK has a number of new graduate-entry programmes. The aim of the study was to explore the motivation, career expectations and experiences of final year students who chose to pursue a dental career through the graduate entry programme route in one institution; and to explore if, and how, their intended career expectations and aspirations were informed by this choice. In-depth interviews of 14 graduate entry students in their final year of study. Data were transcribed verbatim and analysed using framework analysis. There were three categories of factors influencing students' choice to study dentistry through graduate entry: 'push', 'pull' and 'mediating'. Mediating factors related to students' personal concerns and circumstances, whereas push and pull factors related to features of their previous and future careers and wider social factors. Routes to Graduate Entry study comprised: 'early career changers', 'established career changers' and those pursuing 'routes to specialisation'. These routes also influenced the students' practice of dentistry, as students integrated skills in their dental studies, and encountered new challenges.Factors which students believed would influence their future careers included: vocational training; opportunities for specialisation or developing special interests and policy-related issues, together with wider professional and social concerns.The graduate entry programme was considered 'hard work' but a quick route to a professional career which had much to offer. Students' felt more could have been made of their pre-dental studies and/or experience during the programme. Factors perceived as influencing students' future contribution to dentistry included personal and social influences. Overall there was strong support for the values of the NHS and 'giving back' to the system in their future career. Graduate entry students appear to be motivated to enter dentistry by a range of factors which suit their preferences and circumstances. They generally embrace the programme enthusiastically and seek to serve within healthcare, largely in the public sector. These students, who carry wider responsibilities, bring knowledge, skills and experience to dentistry which could be harnessed further during the programme. The findings suggest that graduate entry students, facilitated by varied career options, will contribute to an engaged workforce. © 2011 Newton et al; licensee BioMed Central Ltd.

Ink dating, part I: Statistical distribution of selected ageing parameters in a ballpoint inks reference population.

PubMed

Koenig, Agnès; Weyermann, Céline

2018-01-01

The development of ink dating methods requires an important amount of work in order to be reliably applicable in practice. Major tasks include the definition of ageing parameters to monitor ink ageing. An adequate parameter should ideally fulfil the following criteria: it should evolve as a function of time in a monotonic way, be measurable in a majority of ink entries, be as accurate and reproducible as possible, and finally it should not be influenced too much by transfer and storage conditions. This work aimed at evaluating the potential of seven ageing parameters for ink dating purposes: the phenoxyethanol quantity, relative peak areas (RPA), three solvent loss ratios (R%, R%*, NR%) and two solvent loss parameters (R NORM, NR NORM ). These were calculated over approximately one year for 25 inks selected from a large database to represent different ageing behaviours. Ink entries were analysed using liquid extraction followed by GC/MS analysis. Results showed that natural ageing parameters (NR% and NR NORM ) were not suitable ageing parameters for ink entries older than a few weeks. RPA used other compounds present in ink formulations in combination to PE in order to normalise the results. However, it presented particular difficulties as they could not be defined for all inks and were thus applicable only for 64% of the studied inks. Finally, the PE quantity, R% and R NORM allowed to follow the ageing of the selected inks over the whole time frame and were identified as the most promising. These were thus selected to test three different interpretation models in the second part of this article. The possibilities and limitations of ink dating methods will be discussed in a legal perspective. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

Design and Evaluation of an Electronic Override Mechanism for Medication Alerts to Facilitate Communication Between Prescribers and Pharmacists.

PubMed

Russ, Alissa L; Chen, Siying; Melton, Brittany L; Saleem, Jason J; Weiner, Michael; Spina, Jeffrey R; Daggy, Joanne K; Zillich, Alan J

2015-07-01

Computerized medication alerts can often be bypassed by entering an override rationale, but prescribers' override reasons are frequently ambiguous to pharmacists who review orders. To develop and evaluate a new override mechanism for adverse reaction and drug-drug interaction alerts. We hypothesized that the new mechanism would improve usability for prescribers and increase the clinical appropriateness of override reasons. A counterbalanced, crossover study was conducted with 20 prescribers in a simulated prescribing environment. We modified the override mechanism timing, navigation, and text entry. Instead of free-text entry, the new mechanism presented prescribers with a predefined set of override reasons. We assessed usability (learnability, perceived efficiency, and usability errors) and used a priori criteria to evaluate the clinical appropriateness of override reasons entered. Prescribers rated the new mechanism as more efficient (Wilcoxon signed-rank test, P = 0.032). When first using the new design, 5 prescribers had difficulty finding the new mechanism, and 3 interpreted the navigation to mean that the alert could not be overridden. The number of appropriate override reasons significantly increased with the new mechanism compared with the original mechanism (median change of 3.0; interquartile range = 3.0; P < 0.0001). When prescribers were given a menu-based choice for override reasons, clinical appropriateness of these reasons significantly improved. Further enhancements are necessary, but this study is an important first step toward a more standardized menu of override choices. Findings may be used to improve communication through e-prescribing systems between prescribers and pharmacists. © The Author(s) 2015.

Development of motor fusion in patients with a history of strabismic amblyopia who are treated part-time with Bangerter foils.

PubMed

Abrams, Michael S; Duncan, Candace L; McMurtrey, Ryan

2011-04-01

To document the development of motor fusion when patients with a history of strabismic amblyopia are treated part-time with Bangerter foils. This was a prospective interventional outcome study of consecutive patients with a history of strabismic amblyopia, horizontal strabismus (only) ≤20(∆), visual acuity of 20/60 or better in the nonfixating eye, and no motor fusion (as indicated by the absence of prism vergence) for 1 year before entry into the study. Subjects wore a 0.1 density Bangerter foil for 3-4 hours daily. Data on visual acuity, alignment, and motor fusion status were collected for a minimum of 2 years. Patients with motor fusion were then followed for a minimum of 18 months to assess the stability of their motor fusion status after the Bangerter foil was discontinued. Of the 46 patients meeting entry criteria (mean age, 5.3 ± 1.7 years) who completed follow-up, 28 (61%) developed motor fusion. Motor fusion was retained in all 17 patients who were followed after their foils were discontinued for a mean of 13.3 months. A child's motor fusion status is generally believed to be established during an early formative period of visual development. The development of motor fusion in many of our patients during the course of part-time Bangerter foil treatment suggests that improvements in motor fusion status can occur at a later age than previously believed. Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Automated Developmental Disabilities Out-Patient Treatment Review System (ADDOPTRS)—Development and Automation of a Microcomputer Based Case Management System

PubMed Central

Fisch, Clifford B.; Fisch, Martin L.

1979-01-01

The Stanley S. Lamm Institute for Developmental Disabilities of The Long Island College Hospital, in conjunction with Micro-Med Systems has developed a low cost micro-computer based information system (ADDOP TRS) which monitors quality of care in outpatient settings rendering services to the developmentally disabled population. The process of conversion from paper record keeping systems to direct key-to-disk data capture at the point of service delivery is described. Data elements of the information system including identifying patient information, coded and English-grammar entry procedures for tracking elements of service as well as their delivery status are described. Project evaluation criteria are defined including improved quality of care, improved productivity for clerical and professional staff and enhanced decision making capability. These criteria are achieved in a cost effective manner as a function of more efficient information flow. Administrative applications including staff/budgeting procedures, submissions for third party reimbursement and case reporting to utilization review committees are considered.

PDB_REDO: constructive validation, more than just looking for errors.

PubMed

Joosten, Robbie P; Joosten, Krista; Murshudov, Garib N; Perrakis, Anastassis

2012-04-01

Developments of the PDB_REDO procedure that combine re-refinement and rebuilding within a unique decision-making framework to improve structures in the PDB are presented. PDB_REDO uses a variety of existing and custom-built software modules to choose an optimal refinement protocol (e.g. anisotropic, isotropic or overall B-factor refinement, TLS model) and to optimize the geometry versus data-refinement weights. Next, it proceeds to rebuild side chains and peptide planes before a final optimization round. PDB_REDO works fully automatically without the need for intervention by a crystallographic expert. The pipeline was tested on 12 000 PDB entries and the great majority of the test cases improved both in terms of crystallographic criteria such as R(free) and in terms of widely accepted geometric validation criteria. It is concluded that PDB_REDO is useful to update the otherwise `static' structures in the PDB to modern crystallographic standards. The publically available PDB_REDO database provides better model statistics and contributes to better refinement and validation targets.

PDB_REDO: constructive validation, more than just looking for errors

PubMed Central

Joosten, Robbie P.; Joosten, Krista; Murshudov, Garib N.; Perrakis, Anastassis

2012-01-01

Developments of the PDB_REDO procedure that combine re-refinement and rebuilding within a unique decision-making framework to improve structures in the PDB are presented. PDB_REDO uses a variety of existing and custom-built software modules to choose an optimal refinement protocol (e.g. anisotropic, isotropic or overall B-factor refinement, TLS model) and to optimize the geometry versus data-refinement weights. Next, it proceeds to rebuild side chains and peptide planes before a final optimization round. PDB_REDO works fully automatically without the need for intervention by a crystallographic expert. The pipeline was tested on 12 000 PDB entries and the great majority of the test cases improved both in terms of crystallographic criteria such as R free and in terms of widely accepted geometric validation criteria. It is concluded that PDB_REDO is useful to update the otherwise ‘static’ structures in the PDB to modern crystallographic standards. The publically available PDB_REDO database provides better model statistics and contributes to better refinement and validation targets. PMID:22505269

Identification of the Characteristics and Attributes Needed for Career Success in Entry-Level Management Positions in Selected Retailing Industry.

ERIC Educational Resources Information Center

Ahearn, Anne C. Erikson

A study examined the characteristics and attributes needed by individuals for career success in entry-level management positions in the retailing industry. Included among the specific objectives of the study were the following: identification of the educational level and retailing experience needed by successful entry-level retail managers,…

A Qualitative Descriptive Case Study of the Requirements of the IT Industry for Entry-Level IT Positions

ERIC Educational Resources Information Center

Feuerherm, Todd Michael

2009-01-01

This qualitative descriptive case study explored the requirements of the IT industry for education, IT certification, and work experience for entry-level IT professionals. Research has shown a growing problem where IT graduates were not able to meet the requirements for entry-level IT jobs. IT enrollment has decreased considerably over the past…

Entry Risk into the Juvenile Justice System: African American, American Indian, Asian American, European American, and Hispanic Children and Adolescents

ERIC Educational Resources Information Center

Vazsonyi, Alexander T.; Chen, Pan

2010-01-01

Background: Findings on disproportionate minority contact remain mixed. Few empirical studies have examined to what extent entry risk into juvenile justice varies across ethnic/racial groups, and to what extent childhood aggressive behaviors foretell later deviance and entry risk. In the current study, we sought to address these shortcomings by…

Designing Computerized Provider Order Entry Software in Iran: The Nurses' and Physicians' Viewpoints.

PubMed

Khammarnia, Mohammad; Sharifian, Roxana; Zand, Farid; Keshtkaran, Ali; Barati, Omid

2016-09-01

This study aimed to identify the functional requirements of computerized provider order entry software and design this software in Iran. This study was conducted using review documentation, interview, and focus group discussions in Shiraz University of Medical Sciences, as the medical pole in Iran, in 2013-2015. The study sample consisted of physicians (n = 12) and nurses (n = 2) in the largest hospital in the southern part of Iran and information technology experts (n = 5) in Shiraz University of Medical Sciences. Functional requirements of the computerized provider order entry system were examined in three phases. Finally, the functional requirements were distributed in four levels, and accordingly, the computerized provider order entry software was designed. The software had seven main dimensions: (1) data entry, (2) drug interaction management system, (3) warning system, (4) treatment services, (5) ability to write in software, (6) reporting from all sections of the software, and (7) technical capabilities of the software. The nurses and physicians emphasized quick access to the computerized provider order entry software, order prescription section, and applicability of the software. The software had some items that had not been mentioned in other studies. Ultimately, the software was designed by a company specializing in hospital information systems in Iran. This study was the first specific investigation of computerized provider order entry software design in Iran. Based on the results, it is suggested that this software be implemented in hospitals.

Re-entry Adjustment and Job Embeddedness: The Mediating Role of Professional Identity in Indonesian Returnees.

PubMed

Andrianto, Sonny; Jianhong, Ma; Hommey, Confidence; Damayanti, Devi; Wahyuni, Honey

2018-01-01

The present study examined the relationship between difficulty in re-entry adjustment and job embeddedness, considering the mediating role of sense of professional identity. The online data on demographic characteristics, difficulty on re-entry adjustment, sense of professional identity, and job embeddedness were collected from 178 Indonesian returnees from multiple organizations. The results showed that difficulty in re-entry adjustment was a significant predictor of a sense of professional identity; a sense of professional identity was a significant predictor of job embeddedness. Furthermore, sense of professional identity is an effective mediating variable, bridging the relationship between post-return conditions to the home country and work atmosphere. Finally, the key finding of this study was that sense of professional identity mediated the effect of difficulty in re-entry adjustment on job embeddedness. The theoretical and practical implications, study limitations, and future research needs of our findings are noted.

Study of advanced atmospheric entry systems for Mars

NASA Technical Reports Server (NTRS)

1978-01-01

Entry system designs are described for various advanced Mars missions including sample return, hard lander, and Mars airplane. The Mars exploration systems for sample return and the hard lander require decleration from direct approach entry velocities of about 6 km/s to terminal velocities consistent with surface landing requirements. The Mars airplane entry system is decelerated from orbit at 4.6 km/s to deployment near the surface. Mass performance characteristics of major elements of the Mass performance characteristics are estimated for the major elements of the required entry systems using Viking technology or logical extensions of technology in order to provide a common basis of comparison for the three entry modes mission mode approaches. The entry systems, although not optimized, are based on Viking designs and reflect current hardware performance capability and realistic mass relationships.

Feasibility study of low angle planetary entry. [probe design for Jovian entry

NASA Technical Reports Server (NTRS)

Defrees, R. E.

1975-01-01

The feasibility of a Jovian entry by a probe originally designed for Saturn and Uranus entries is examined. An entry probe is described which is capable of release near an outer planet's sphere of influence and descent to a predetermined target entry point in the planet's atmosphere. The probe is designed so as to survive the trapped particle radiation belts and an entry heating pulse. Data is gathered and relayed to an overflying spacecraft bus during descent. Probe variations for two similar missions are described. In the first flyby of Jupiter by a Pioneer spacecraft launched during the 1979 opportunity is examined parametrically. In the second mission an orbiter based on Pioneer and launched in 1980 is defined in specific terms. The differences rest in the science payloads and directly affected wiring and electronics packages.

Simulation and experimental research on trans-media vehicle water-entry motion characteristics at low speed

PubMed Central

Yang, Jian; Feng, Jinfu; Hu, Junhua; Liu, An

2017-01-01

The motion characteristics of trans-media vehicles during the water-entry process were explored in this study in an effort to obtain the optimal water-entry condition of the vehicle for developing a novel, single control strategy integrating underwater non-control and in-air control. A water-entry dynamics model is established by combining the water-entry motion characteristics of the vehicle in uncontrolled conditions at low speed with time-varying parameters (e.g. buoyancy, added mass). A water-entry experiment is designed to confirm the effectiveness of the established model. After that, by comparing the experimental results with the simulated results, the model is further modified to more accurately reflect water-entry motion. The change laws of the vehicle’s attitude and position during the water-entry process are also obtained by analyzing the simulation of the modified model under different velocity, angle, and angle of attack conditions. The results presented here have guiding significance for the future realization of reaching the stable underwater navigation state of the vehicle after water-entry process. PMID:28558012

Simulation and experimental research on trans-media vehicle water-entry motion characteristics at low speed.

PubMed

Yang, Jian; Li, Yongli; Feng, Jinfu; Hu, Junhua; Liu, An

2017-01-01

The motion characteristics of trans-media vehicles during the water-entry process were explored in this study in an effort to obtain the optimal water-entry condition of the vehicle for developing a novel, single control strategy integrating underwater non-control and in-air control. A water-entry dynamics model is established by combining the water-entry motion characteristics of the vehicle in uncontrolled conditions at low speed with time-varying parameters (e.g. buoyancy, added mass). A water-entry experiment is designed to confirm the effectiveness of the established model. After that, by comparing the experimental results with the simulated results, the model is further modified to more accurately reflect water-entry motion. The change laws of the vehicle's attitude and position during the water-entry process are also obtained by analyzing the simulation of the modified model under different velocity, angle, and angle of attack conditions. The results presented here have guiding significance for the future realization of reaching the stable underwater navigation state of the vehicle after water-entry process.

Analysis of flight test transition and turbulent heating data. Part 1: Boundary layer transition results

NASA Technical Reports Server (NTRS)

Martellucci, A.; Maguire, B. L.; Neff, R. S.

1972-01-01

The objective of the study was to provide a detailed post flight evaluation of ballistic vehicle flight test boundary layer transition data. A total of fifty-five vehicles were selected for analysis. These vehicles were chosen from a data sampling of roughly two hundred flights and the criteria for vehicle selection is delineated herein. The results of the analysis indicate that frustum transition of re-entry vehicles appears to be nose tip dominated. Frustum related parameters and materials apparently have a second order effect on transition. This implies that local viscous parameters on the frustum should not correlate flight test transition data, and in fact they do not. Specific parameters relative to the nose tip have been identified as the apparent dominant factors that characterize the transition phenomena and a correlation of flight test data is presented.

NCCN Guidelines Insights: Central Nervous System Cancers, Version 1.2017.

PubMed

Nabors, Louis Burt; Portnow, Jana; Ammirati, Mario; Baehring, Joachim; Brem, Henry; Butowski, Nicholas; Fenstermaker, Robert A; Forsyth, Peter; Hattangadi-Gluth, Jona; Holdhoff, Matthias; Howard, Steven; Junck, Larry; Kaley, Thomas; Kumthekar, Priya; Loeffler, Jay S; Moots, Paul L; Mrugala, Maciej M; Nagpal, Seema; Pandey, Manjari; Parney, Ian; Peters, Katherine; Puduvalli, Vinay K; Ragsdale, John; Rockhill, Jason; Rogers, Lisa; Rusthoven, Chad; Shonka, Nicole; Shrieve, Dennis C; Sills, Allen K; Swinnen, Lode J; Tsien, Christina; Weiss, Stephanie; Wen, Patrick Yung; Willmarth, Nicole; Bergman, Mary Anne; Engh, Anita

2017-11-01

For many years, the diagnosis and classification of gliomas have been based on histology. Although studies including large populations of patients demonstrated the prognostic value of histologic phenotype, variability in outcomes within histologic groups limited the utility of this system. Nonetheless, histology was the only proven and widely accessible tool available at the time, thus it was used for clinical trial entry criteria, and therefore determined the recommended treatment options. Research to identify molecular changes that underlie glioma progression has led to the discovery of molecular features that have greater diagnostic and prognostic value than histology. Analyses of these molecular markers across populations from randomized clinical trials have shown that some of these markers are also predictive of response to specific types of treatment, which has prompted significant changes to the recommended treatment options for grade III (anaplastic) gliomas. Copyright © 2017 by the National Comprehensive Cancer Network.

Performance-oriented: toward a successful strategy.

PubMed

Kumar, K; Subramanian, R; Yauger, C

1997-01-01

Changes in the health care industry have profoundly affected hospital management and have caused severe declines in hospital profitability. In 1993, Health Care Management Review reported that the average operating profit margin, around 2% in 1984, had declined to a 0.2% loss by 1990. In the past, hospitals were buffered by entry regulations and cost reimbursement; thus, they rarely dealt with traditional market pressures. But the changed terrain means that competitive factors now underscore all strategic decisions. This study examines the strategic significance of market orientation in the health care industry. The authors identified forms of market orientation by emphasizing different components, and discovered that hospitals fell into four distinct clusters or groups. They also found a critical relationship between market orientation and performance scores on a number of criteria. Finally, the authors suggest that different forms of market orientation should be employed to target specific performance measures.

Description and User Manual for a Web-Based Interface to a Transit-Loss Accounting Program for Monument and Fountain Creeks, El Paso and Pueblo Counties, Colorado

USGS Publications Warehouse

Kuhn, Gerhard; Krammes, Gary S.; Beal, Vivian J.

2007-01-01

The U.S. Geological Survey, in cooperation with Colorado Springs Utilities, the Colorado Water Conservation Board, and the El Paso County Water Authority, began a study in 2004 with the following objectives: (1) Apply a stream-aquifer model to Monument Creek, (2) use the results of the modeling to develop a transit-loss accounting program for Monument Creek, (3) revise an existing accounting program for Fountain Creek to easily incorporate ongoing and future changes in management of return flows of reusable water, and (4) integrate the two accounting programs into a single program and develop a Web-based interface to the integrated program that incorporates simple and reliable data entry that is automated to the fullest extent possible. This report describes the results of completing objectives (2), (3), and (4) of that study. The accounting program for Monument Creek was developed first by (1) using the existing accounting program for Fountain Creek as a prototype, (2) incorporating the transit-loss results from a stream-aquifer modeling analysis of Monument Creek, and (3) developing new output reports. The capabilities of the existing accounting program for Fountain Creek then were incorporated into the program for Monument Creek and the output reports were expanded to include Fountain Creek. A Web-based interface to the new transit-loss accounting program then was developed that provided automated data entry. An integrated system of 34 nodes and 33 subreaches was integrated by combining the independent node and subreach systems used in the previously completed stream-aquifer modeling studies for the Monument and Fountain Creek reaches. Important operational criteria that were implemented in the new transit-loss accounting program for Monument and Fountain Creeks included the following: (1) Retain all the reusable water-management capabilities incorporated into the existing accounting program for Fountain Creek; (2) enable daily accounting and transit-loss computations for a variable number of reusable return flows discharged into Monument Creek at selected locations; (3) enable diversion of all or a part of a reusable return flow at any selected node for purposes of storage in off-stream reservoirs or other similar types of reusable water management; (4) and provide flexibility in the accounting program to change the number of return-flow entities, the locations at which the return flows discharge into Monument or Fountain Creeks, or the locations to which the return flows are delivered. The primary component of the Web-based interface is a data-entry form that displays data stored in the accounting program input file; the data-entry form allows for entry and modification of new data, which then is rewritten to the input file. When the data-entry form is displayed, up-to-date discharge data for each station are automatically computed and entered on the data-entry form. Data for native return flows, reusable return flows, reusable return flow diversions, and native diversions also are entered automatically or manually, if needed. In computing the estimated quantities of reusable return flow and the associated transit losses, the accounting program uses two sets of computations. The first set of computations is made between any two adjacent streamflow-gaging stations (termed 'stream-segment loop'); the primary purpose of the stream-segment loop is to estimate the loss or gain in native discharge between the two adjacent streamflow-gaging stations. The second set of computations is made between any two adjacent nodes (termed 'subreach loop'); the actual transit-loss computations are made in the subreach loop, using the result from the stream-segment loop. The stream-segment loop is completed for a stream segment, and then the subreach loop is completed for each subreach within the segment. When the subreach loop is completed for all subreaches within a stream segment, the stream-segment loop is initiated for the ne

Pathological implications of cell cycle re-entry in Alzheimer disease.

PubMed

Bonda, David J; Lee, Hyun-pil; Kudo, Wataru; Zhu, Xiongwei; Smith, Mark A; Lee, Hyoung-gon

2010-06-29

The complex neurodegeneration underlying Alzheimer disease (AD), although incompletely understood, is characterised by an aberrant re-entry into the cell cycle in neurons. Pathological evidence, in the form of cell cycle markers and regulatory proteins, suggests that cell cycle re-entry is an early event in AD, which precedes the formation of amyloid-beta plaques and neurofibrillary tangles (NFTs). Although the exact mechanisms that induce and mediate these cell cycle events in AD are not clear, significant advances have been made in further understanding the pathological role of cell cycle re-entry in AD. Importantly, recent studies indicate that cell cycle re-entry is not a consequence, but rather a cause, of neurodegeneration, suggesting that targeting of cell cycle re-entry may provide an opportunity for therapeutic intervention. Moreover, multiple inducers of cell cycle re-entry and their interactions in AD have been proposed. Here, we review the most recent advances in understanding the pathological implications of cell cycle re-entry in AD.

Comparison of reporting phase III randomized controlled trials of antibiotic treatment for common bacterial infections in ClinicalTrials.gov and matched publications.

PubMed

Shepshelovich, D; Yelin, D; Gafter-Gvili, A; Goldman, S; Avni, T; Yahav, D

2018-02-15

Discrepancies between ClinicalTrials.gov entries and matching publications were previously described in general medicine. We aimed to evaluate the consistency of reporting in trials addressing systemic antibiotic therapy. We searched ClinicalTrials.gov for completed phase III trials comparing antibiotic regimens until May 2017. Matched publications were identified in PubMed. Two independent reviewers extracted data and identified inconsistencies. Reporting was assessed among studies started before and after 1 July 2005, when the International Committee of Medical Journal Editors (ICMJE) required mandatory registration as a prerequisite for considering a trial for publication. Matching publications were identified for 75 (70%) of 107 ClinicalTrials.gov entries. Median time from study completion to publication was 26 months (interquartile range 19-42). Primary outcome definition was inconsistent between ClinicalTrials.gov and publications in seven trials (7/72, 10%) and reporting of the primary outcome timeframe was inconsistent in 14 (14/71, 20%). Secondary outcomes definitions were inconsistent in 36 trials (36/66, 55%). Reporting of inclusion criteria and study timeline were inconsistent in 17% (13/65) and 3% (2/65), respectively. Trials started after July 2005 were significantly less likely to have reporting inconsistencies and were published in higher impact factor journals. We found a lower inconsistency rate of outcome reporting compared with other medical disciplines. Reporting completeness and consistency were significantly better after July 2005. The ICMJE requirement for mandatory registration was associated with significant improvement in reporting quality in infectious diseases trials. Prolonged time lag to publication and missing data from unpublished trials should raise a discussion on current reporting and publishing procedures. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Foster care re-entry: Exploring the role of foster care characteristics, in-home child welfare services and cross-sector services.

PubMed

Lee, Sangmoo; Jonson-Reid, Melissa; Drake, Brett

2012-09-01

This study seeks to advance our understanding of how modifiable and non-modifiable factors may impact the likelihood of re-entry into foster care. Children who entered foster care for the first time following at least one report of maltreatment and were then reunified were followed from exit to re-entry, age 18 or the end of the study period using longitudinal administrative data. Risk of re-entry was explored according to a range of modifiable and non-modifiable case and service characteristics. Children removed from homes with parents who had multiple risk factors (e.g., no high school diploma, mental health diagnosis, criminal record, or teen parents) or were receiving AFDC prior to entry were more likely to re-enter. The receipt of in-home child welfare services during or after foster care was associated with reduced risk of re-entry. Having the longest placement with a relative was associated with decreased risk of re-entry. In conclusion, both modifiable and non-modifiable factors are associated with re-entry into foster care. Among modifiable factors, services appear to have a particularly strong relationship to re-entry. Our data also suggest that in-home child welfare services provided during and after foster care may be associated with improved long-term permanency after return home. Given the continued import of caregiver risk factors even among reunified families, services provided to support reunification should include attention to caregiver needs outside parenting.

Foster care re-entry: Exploring the role of foster care characteristics, in-home child welfare services and cross-sector services☆

PubMed Central

Lee, Sangmoo; Jonson-Reid, Melissa; Drake, Brett

2013-01-01

This study seeks to advance our understanding of how modifiable and non-modifiable factors may impact the likelihood of re-entry into foster care. Children who entered foster care for the first time following at least one report of maltreatment and were then reunified were followed from exit to re-entry, age 18 or the end of the study period using longitudinal administrative data. Risk of re-entry was explored according to a range of modifiable and non-modifiable case and service characteristics. Children removed from homes with parents who had multiple risk factors (e.g., no high school diploma, mental health diagnosis, criminal record, or teen parents) or were receiving AFDC prior to entry were more likely to re-enter. The receipt of in-home child welfare services during or after foster care was associated with reduced risk of re-entry. Having the longest placement with a relative was associated with decreased risk of re-entry. In conclusion, both modifiable and non-modifiable factors are associated with re-entry into foster care. Among modifiable factors, services appear to have a particularly strong relationship to re-entry. Our data also suggest that in-home child welfare services provided during and after foster care may be associated with improved long-term permanency after return home. Given the continued import of caregiver risk factors even among reunified families, services provided to support reunification should include attention to caregiver needs outside parenting. PMID:23729947

Patient demographics and health plan paid costs in chronic inflammatory demyelinating polyneuropathy.

PubMed

Guptill, Jeffrey T; Bromberg, Mark B; Zhu, Li; Sharma, Bal K; Thompson, Amy R; Krueger, Andrew; Sanders, Donald B

2014-07-01

We determined health plan paid costs and healthcare resource usage of patients with chronic inflammatory demyelinating polyneuropathy (CIDP). CIDP patients from 9 U.S. commercial health plans with claims in 2011 were identified from the Accordant Health Services claims database. We examined demographics, prevalence of comorbidities, prescribed drugs, place of service, and mean annual health plan paid costs per patient. From 6.5 million covered lives, 73 (56% men; mean age 47) met study entry criteria. The most prescribed therapies were intravenous immunoglobulin (IVIg) (26% of patients), gabapentin (26%), and prednisone (16%). The annual health plan paid cost was $56,953. Pharmacy cost was the major cost driver (57% of the total), and IVIg totaled 90% of the pharmacy costs. Healthcare costs for CIDP patients are substantial, with a large burden in pharmacy usage. Studies are needed to determine optimal long-term treatment strategies for CIDP, particularly related to IVIg. Copyright © 2013 Wiley Periodicals, Inc.

Trial Prospector: Matching Patients with Cancer Research Studies Using an Automated and Scalable Approach

PubMed Central

Sahoo, Satya S; Tao, Shiqiang; Parchman, Andrew; Luo, Zhihui; Cui, Licong; Mergler, Patrick; Lanese, Robert; Barnholtz-Sloan, Jill S; Meropol, Neal J; Zhang, Guo-Qiang

2014-01-01

Cancer is responsible for approximately 7.6 million deaths per year worldwide. A 2012 survey in the United Kingdom found dramatic improvement in survival rates for childhood cancer because of increased participation in clinical trials. Unfortunately, overall patient participation in cancer clinical studies is low. A key logistical barrier to patient and physician participation is the time required for identification of appropriate clinical trials for individual patients. We introduce the Trial Prospector tool that supports end-to-end management of cancer clinical trial recruitment workflow with (a) structured entry of trial eligibility criteria, (b) automated extraction of patient data from multiple sources, (c) a scalable matching algorithm, and (d) interactive user interface (UI) for physicians with both matching results and a detailed explanation of causes for ineligibility of available trials. We report the results from deployment of Trial Prospector at the National Cancer Institute (NCI)-designated Case Comprehensive Cancer Center (Case CCC) with 1,367 clinical trial eligibility evaluations performed with 100% accuracy. PMID:25506198

Superintendent Communication Strategies and Experiences That Promote Trust and Positive Relationships with the School Board during the Entry Period: A Case Study

ERIC Educational Resources Information Center

Jimenez, Alfonso

2012-01-01

Superintendents have vast demands placed upon them by their school boards and via the political pipeline. The purpose of the study was to identify strategies/behaviors that successful superintendents used to build strong relationships and trust with their school boards within their entry period. It is during the entry period that determines…

Entry-Level Doctorate for Occupational Therapists: An Assessment of Attitudes of Occupational Therapists and Occupational Therapy Assistants

ERIC Educational Resources Information Center

McCombie, Randy P.

2016-01-01

Purpose: The purpose of this study was to survey occupational therapists (OTs) and occupational therapy assistants (OTAs) on their attitudes toward a possible move to the entry-level doctorate as the mandated singular point of entry into the profession for OTs. Method: The study surveyed a random sample of 600 OTs and 600 OTAs from two…

Superintendents' Entry Periods: Strategies and Behaviors That Successful Superintendents Use to Build Strong Relationships and Trust with Their School Boards during Their Entry Period

ERIC Educational Resources Information Center

Howland, Sean J.

2012-01-01

The purpose of the study was to identify strategies/behaviors that successful superintendents used to build strong relationships and trust with their school boards during their entry periods. Three research questions guided the study: (1) What strategies/behaviors are successful superintendents using to build strong relationships and trust with…

School Entry Age and Children's Social-Behavioral Skills: Evidence From a National Longitudinal Study of U.S. Kindergartners

ERIC Educational Resources Information Center

Datar, Ashlesha; Gottfried, Michael A.

2015-01-01

Prior research evaluating school entry age effects has largely overlooked the effects on social-behavioral skills despite the growing recognition of returns to such skills. This study is the first to examine the effects of kindergarten entry age on children's social-behavioral outcomes using 9 years of panel data on a national sample of U.S.…

Crew Characteristics and Ship Condition (Maintenance Personnel Effectiveness Study (MPES))

DTIC Science & Technology

1977-03-01

and destroyers are used to study how the productivity of enlisted personnel varies systematically with high school graduation, entry test scores...personnel verte* itemstlcally with high school graduation» entry test scores, paygrade» experience, race and marital status. Six OCCUPatlona end three...for example, is most important for STs maintaining sonar equipment. Ser 96/91264 c. Entry test scores and high school graduation reflected

Predictors of student success in entry-level science courses

NASA Astrophysics Data System (ADS)

Singh, Mamta K.

Although the educational evaluation process is useful and valuable and is supported by the Higher Education Act, a strong research base for program evaluation of college entry-level science courses is still lacking. Studies in science disciplines such as, biology, chemistry, and physics have addressed various affective and demographic factors and their relationships to student achievement. However, the literature contains little information that specifically addresses student biology content knowledge skills (basics and higher order thinking skills) and identifies factors that affect students' success in entry-level college science courses. These gate-keeping courses require detailed evaluation if the goal of an institution is to increase students' performance and success in these courses. These factors are, in fact, a stepping stone for increasing the number of graduates in Science, Technology, Engineering, and Mathematics (STEM) majors. The present study measured students' biology content knowledge and investigated students' performance and success in college biology, chemistry, and physics entry-level courses. Seven variables---gender, ethnicity, high school Grade Point Average (GPA), high school science, college major, school financial aid support, and work hours were used as independent variables and course final performance as a dichotomous dependent variable. The sample comprised voluntary student participants in entry-level science courses. The study attempted to explore eight research questions. Content knowledge assessments, demographic information analysis, multiple regression analysis, and binary logistic regression analysis were used to address research questions. The results suggested that high school GPA was a consistently good predictor of students' performance and success in entry-level science courses. Additionally, high school chemistry was a significant predictor variable for student success in entry-level biology and chemistry courses. Similarly, students' performance and success in entry-level physics courses were influenced by high school physics. Finally, the study developed student success equation with high school GAP and high school chemistry as good predictors of students' success in entry-level science courses.

"Our commonality is our past:" a qualitative analysis of re-entry community health workers' meaningful experiences.

PubMed

Bedell, Precious; Wilson, John L; White, Ann Marie; Morse, Diane S

Re-entry community health workers (CHWs) are individuals who connect diverse community residents at risk for chronic health issues such as Hepatitis C virus and cardiovascular disease with post-prison healthcare and re-entry services. While the utilization of CHWs has been documented in other marginalized populations, there is little knowledge surrounding the work of re-entry CHWs with individuals released from incarceration. Specifically, CHWs' experiences and perceptions of the uniqueness of their efforts to link individuals to healthcare have not been documented systematically. This study explored what is meaningful to formerly incarcerated CHWs as they work with released individuals. The authors conducted a qualitative thematic analysis of twelve meaningful experiences written by re-entry CHWs employed by the Transitions Clinic Network who attended a CHW training program during a conference in San Francisco, CA. Study participants were encouraged to recount meaningful CHW experiences and motivations for working with re-entry populations in a manner consistent with journal-based qualitative analysis techniques. Narratives were coded using an iterative process and subsequently organized according to themes in ATLAS.ti. Study personnel came to consensus with coding and major themes. The narratives highlighted thought processes and meaning related to re-entry CHWs' work helping patients navigate complex social services for successful re-integration. Six major themes emerged from the analysis: advocacy and support, empathy relating to a personal history of incarceration, giving back, professional satisfaction and responsibilities, resiliency and educational advancement, and experiences of social inequities related to race. Re-entry CHWs described former incarceration, employment, and social justice as sources of meaning for assisting justice-involved individuals receive effective, efficient, and high-quality healthcare. Health clinics for individuals released from incarceration provide a unique setting that links high risk patients to needed care and professionalizes career opportunities for formerly incarcerated re-entry CHWs. The commonality of past correctional involvement is a strong indicator of the meaning and perceived effectiveness re-entry CHWs find in working with individuals leaving prison. Expansion of reimbursable visits with re-entry CHWs in transitions clinics designed for re-entering individuals is worthy of further consideration.

Therapeutic endorsement enhances compliance with national glaucoma guidelines in Australian and New Zealand optometrists.

PubMed

Zangerl, Barbara; Hayen, Andrew; Mitchell, Paul; Jamous, Khalid F; Stapleton, Fiona; Kalloniatis, Michael

2015-03-01

Previous studies confirmed that optometrists have access to and confidence in applying clinical tests recommended for glaucoma assessment. Less is known about factors best predicting compliance with national clinical guidelines and thus by inference, the provision of suitable care by primary care ophthalmic practitioners. We utilised the unique two-tiered profession (therapeutic and non-therapeutic scope of practice) in Australia and New Zealand to assess the prospective adherence to glaucoma guidelines dependent on the clinician's background. Australian and New Zealand optometrists were surveyed on ophthalmic techniques for glaucoma assessment, criteria for the evaluation of the optic nerve head, glaucoma risk categories and review times while also recording background, training, and experience. Parameters identifying progression/conversion and patients' risk levels were analysed comparatively to ophthalmologists' opinions. Linear regression analysis identified variables significantly improving the likelihood of concordance with guidelines. Reported application of techniques complied well with glaucoma guidelines although gonioscopy and pachymetry, pupil dilation for optic nerve head examination, and acquisition of permanent records were less frequently employed. The main predictors for entry-level diagnostic standards were therapeutic endorsement together with the associated knowledge of relevant guidance and procedural confidence. Other findings suggested a potential underestimation in the value of optic disc size and intraocular pressure for the prediction of glaucoma risk, while optometrists more frequently relied on the outcomes of non-standardised automated perimetry and auxiliary imaging. Optometrists in Australia and New Zealand may not always exercise optimal clinical acumen regarding techniques/criteria for glaucoma diagnosis. Therapeutic endorsement was gradually adopted in different jurisdictions in various forms since 1999 and is mandatory for registration since late 2014. The result of the two-tiered optometric cohorts suggest that inclusion of therapeutic training as part of the core training is likely a key factor to enhanced compliance with glaucoma guidelines. Improved adherence to the current clinical standards should positively impact on the facilitation of appropriate glaucoma diagnosis and management. Obligatory knowledge and possibly accreditation of available guidelines might ensure a uniform standard in glaucoma testing protocols in concordance with compulsory entry-level skills. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

Characteristics and problems of 600 adolescent cannabis abusers in outpatient treatment.

PubMed

Tims, Frank M; Dennis, Michael L; Hamilton, Nancy; J Buchan, Betty; Diamond, Guy; Funk, Rod; Brantley, Laura B

2002-12-01

Risk factors among adolescent substance abusers have been shown to correlate with substance use severity. Characteristics related to severity, such as demographic and family factors, peer influences, psychiatric co-morbidity and HIV risk behaviors, are examined for a sample of adolescent cannabis users entering treatment. These data are from a clinical trial study utilizing blocked random assignment of clients to one of five treatment conditions. The study targeted adolescents entering outpatient treatment for primarily cannabis abuse or dependence. Treatment and research facilities in four metropolitan areas of the US were used to recruit study participants. Treatment was delivered in outpatient drug-free settings. Participants were 600 clients, ages 12-18, admitted to outpatient substance abuse treatment programs for cannabis problems, 96% with DSM-IV diagnoses of substance abuse or dependence, with the remaining 4% having at least one symptom of dependence plus significant problems indicating need for treatment. The Global Appraisal of Individual Needs (GAIN) was used to collect the information presented in this paper. The GAIN incorporates DSM-IV criteria for substance use disorders, conduct disorder and attention deficit hyperactivity disorder, as well as dimensional (scale) measures for physical and mental health. All participants reported at least one symptom of substance use disorders, and 46% met the DSM-IV criteria for substance dependence, while 50% met criteria for a diagnosis of abuse. Only 20% of the participants perceived any need for help with problems associated with their drug or alcohol use. Clients participating in the study typically presented multiple problems at treatment entry, most often including conduct disorder, attention deficit hyperactivity disorder (ADHD), internal (mental) distress, and physical health distress. The co-occurrence of conduct disorder and ADHD was found in 30% of the sample. Clients meeting criteria for substance dependence tended to have more co-occurring problems and significantly less denial at admission. The characteristics of this sample exemplify the complex nature of adolescent substance use and abuse among adolescents entering outpatient treatment programs. Patterns of co-occurring problems are at rates comparable to those found in other clinical studies. Those with more severe substance use disorders tend to manifest more problems of social functioning, more mental health problems, and physical health problems. Implications of these findings are discussed in terms of treatment needs, challenges, and prognostic implications.

Target assessment for antiparasitic drug discovery

PubMed Central

Frearson, Julie A.; Wyatt, Paul G.; Gilbert, Ian H.; Fairlamb, Alan H.

2010-01-01

Drug discovery is a high-risk, expensive and lengthy process taking at least 12 years and costing upwards of US$500 million per drug to reach the clinic. For neglected diseases, the drug discovery process is driven by medical need and guided by pre-defined target product profiles. Assessment and prioritisation of the most promising targets for entry into screening programmes is crucial for maximising chances of success. Here we describe criteria used in our drug discovery unit for target assessment and introduce the ‘traffic light’ system as a prioritisation and management tool. We hope this brief review will stimulate basic scientists to acquire additional information necessary for drug discovery. PMID:17962072

Entry Guidance for the Reusable Launch Vehicle

NASA Technical Reports Server (NTRS)

Lu, Ping

1999-01-01

The X-33 Advanced Technology Demonstrator is a half-scale prototype developed to test the key technologies needed for a full-scale single-stage reusable launch vehicle (RLV). The X-33 is a suborbital vehicle that will be launched vertically, and land horizontally. The goals of this research were to develop an alternate entry guidance scheme for the X-33 in parallel to the actual X-33 entry guidance algorithms, provide comparative and complementary study, and identify potential new ways to improve entry guidance performance. Toward these goals, the nominal entry trajectory is defined by a piecewise linear drag-acceleration-versus-energy profile, which is in turn obtained by the solution of a semi-analytical parameter optimization problem. The closed-loop guidance is accomplished by tracking the nominal drag profile with primarily bank-angle modulation on-board. The bank-angle is commanded by a single full-envelope nonlinear trajectory control law. Near the end of the entry flight, the guidance logic is switched to heading control in order to meet strict conditions at the terminal area energy management interface. Two methods, one on ground-track control and the other on heading control, were proposed and examined for this phase of entry guidance where lateral control is emphasized. Trajectory dispersion studies were performed to evaluate the effectiveness of the entry guidance algorithms against a number of uncertainties including those in propulsion system, atmospheric properties, winds, aerodynamics, and propellant loading. Finally, a new trajectory-regulation method is introduced at the end as a promising precision entry guidance method. The guidance principle is very different and preliminary application in X-33 entry guidance simulation showed high precision that is difficult to achieve by existing methods.

What principles should govern the use of managed entry agreements?

PubMed

Klemp, Marianne; Frønsdal, Katrine B; Facey, Karen

2011-01-01

To ensure rapid access to new potentially beneficial health technologies, obtain best value for money, and ensure affordability, healthcare payers are adopting a range of innovative reimbursement approaches that may be called Managed Entry Agreements (MEAs). The Health Technology Assessment International (HTAi) Policy Forum sought to identify why MEAs might be used, issues associated with implementation and develop principles for their use. A 2-day deliberative workshop discussed key papers, members' experiences, and collectively addressed four policy questions that resulted in this study. MEAs are used to give access to new technologies where traditional reimbursement is deemed inappropriate. Three different forms of MEAs have been identified: management of budget impact, management of uncertainty relating to clinical and/or cost-effectiveness, and management of utilization to optimize performance. The rationale for using these approaches and their advantages and disadvantages differ. However, all forms of MEA should take the form of a formal written agreement among stakeholders, clearly identifying the rationale for the agreement, aspects to be assessed, methods of data collection and review, and the criteria for ending the agreement. MEAs should only be used when HTA identifies issues or concerns about key outcomes and/or costs and/or organizational/budget impacts that are material to a reimbursement decision. They provide patient access and can be useful to manage technology diffusion and optimize use. However, they are administratively complex and may be difficult to negotiate and their effectiveness has yet to be evaluated.

Causal Inference Regarding Infectious Aetiology of Chronic Conditions: A Systematic Review

PubMed Central

Orrskog, Sofia; Medin, Emma; Tsolova, Svetla; Semenza, Jan C.

2013-01-01

Background The global burden of disease has shifted from communicable diseases in children to chronic diseases in adults. This epidemiologic shift varies greatly by region, but in Europe, chronic conditions account for 86% of all deaths, 77% of the disease burden, and up to 80% of health care expenditures. A number of risk factors have been implicated in chronic diseases, such as exposure to infectious agents. A number of associations have been well established while others remain uncertain. Methods and Findings We assessed the body of evidence regarding the infectious aetiology of chronic diseases in the peer-reviewed literature over the last decade. Causality was assessed with three different criteria: First, the total number of associations documented in the literature between each infectious agent and chronic condition; second, the epidemiologic study design (quality of the study); third, evidence for the number of Hill's criteria and Koch's postulates that linked the pathogen with the chronic condition. We identified 3136 publications, of which 148 were included in the analysis. There were a total of 75 different infectious agents and 122 chronic conditions. The evidence was strong for five pathogens, based on study type, strength and number of associations; they accounted for 60% of the associations documented in the literature. They were human immunodeficiency virus, hepatitis C virus, Helicobacter pylori, hepatitis B virus, and Chlamydia pneumoniae and were collectively implicated in the aetiology of 37 different chronic conditions. Other pathogens examined were only associated with very few chronic conditions (≤3) and when applying the three different criteria of evidence the strength of the causality was weak. Conclusions Prevention and treatment of these five pathogens lend themselves as effective public health intervention entry points. By concentrating research efforts on these promising areas, the human, economic, and societal burden arising from chronic conditions can be reduced. PMID:23935899

Generic aerocapture atmospheric entry study, volume 1

NASA Technical Reports Server (NTRS)

1980-01-01

An atmospheric entry study to fine a generic aerocapture vehicle capable of missions to Mars, Saturn, and Uranus is reported. A single external geometry was developed through atmospheric entry simulations. Aerocapture is a system design concept which uses an aerodynamically controlled atmospheric entry to provide the necessary velocity depletion to capture payloads into planetary orbit. Design concepts are presented which provide the control accuracy required while giving thermal protection for the mission payload. The system design concepts consist of the following elements: (1) an extendable biconic aerodynamic configuration with lift to drag ratio between 1.0 and 2.0; (2) roll control system concepts to control aerodynamic lift and disturbance torques; (3) aeroshell design concepts capable of meeting dynamic pressure loads during aerocapture; and (4) entry thermal protection system design concepts to meet thermodynamic loads during aerocapture.

Transportation Services in Rural Areas. January 1979-December 1988. Quick Bibliography Series.

ERIC Educational Resources Information Center

La Caille John, Patricia, Comp.

This bibliography contains 137 entries of English-language materials available from the National Agricultural Library's (NAL) AGRICOLA database. Each of the bibliography's 137 entries pertains to some aspect of transportation services in rural areas. Each entry, including books, reports, studies, and so forth, offers bibliographical information…

Re-Entry: Managing Cross-Cultural Transitions.

ERIC Educational Resources Information Center

Adler, Nancy J.

1981-01-01

Studied the re-entry process of corporate and governmental employees (N=200) returning to Canada after working overseas. Research found re-entry into the original culture was a more difficult transition than moving to the foreign culture. Home-country managers tended to exhibit xenophobia in assessing the potential and actual effectiveness of…

Students' Understanding of Dictionary Entries: A Study with Respect to Four Learners' Dictionaries.

ERIC Educational Resources Information Center

Jana, Abhra; Amritavalli, Vijaya; Amritavalli, R.

2003-01-01

Investigates the effects of definitional information in the form of dictionary entries, on second language learners' vocabulary learning in an instructed setting. Indian students (Native Hindi speakers) of English received monolingual English dictionary entries of five previously unknown words from four different learner's dictionaries. Results…

Medical student selection criteria and socio-demographic factors as predictors of ultimately working rurally after graduation.

PubMed

Puddey, Ian B; Mercer, Annette; Playford, Denese E; Riley, Geoffrey J

2015-04-14

We have previously demonstrated that both coming from a rural background and spending a year-long clinical rotation in our Rural Clinical School (RCS) have independent and additive effects to increase the likelihood of medical students practicing rurally following graduation. The current study assesses the extent to which medical school selection criteria and/or the socio-demographic profile of medical students may further facilitate or hamper the selection of students ultimately destined for the rural medical workforce. The study comprised 729 students, admitted from secondary school since 1999 and having graduated by 2011, whose actual workplace location in 2014 was classified as either urban or rural using the Australian Health Practitioner Regulation Agency database. Selection factors on entry (score from a standardised interview, percentile scores for the 3 components of the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance as assessed by the Australian Tertiary Admissions Rank) together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD)), were examined in relation to ultimate rural destination of practice. In logistic regression, those practicing in a rural location in 2014 were more likely to have come from the lower 6 IRSAD deciles (OR 2.75, 95% CI 1.44, 5.23, P = 0.002), to be older (OR 1.86, 95% CI 1.09, 3.18, p = 0.023) and to have a lower UMAT-3 (Non-verbal communication) score (OR 0.98, 95% CI 0.97, 0.99, P = 0.005). After further controlling for either rural background or RCS participation, only age and UMAT-3 remained as independent predictors of current rural practice. In terms of the socio-demographic profiles of those selected for medical school entry from secondary school, only older age weakly augmented the selection of graduates likely to ultimately work in a rural destination. Among the selection factors, having achieved higher scores in UMAT-3 tended to mitigate this outcome. The major focus in attempts to grow the rural medical workforce should therefore remain on recruiting medical students from a rural background together with providing maximal opportunity for prolonged immersion in rural clinical environments during their training.

Patterns of drinking and driving offenses among nightclub patrons in Brazil.

PubMed

Wagner, Gabriela A; Sanchez, Zila M

2017-05-01

Brazil has a strict drinking and driving law known as the Brazilian "Dry Law". The aim of the present study was to investigate characteristics associated with the breaking of the Brazilian traffic law, on drinking and driving, at nightclub exit among a representative sample of nightclub patrons in the city of São Paulo, Brazil. Portal survey realized with a two-stage cluster sampling survey design to collect data from 2422 patrons at the entrance and 1822 patrons at the exit of 31 nightclubs in the city of São Paulo, Brazil. Patrons' breath alcohol concentrations (BrACs) at the entrance and exit of the nightclubs were categorized according to the law as either a "traffic offense" or a "traffic offense and crime". Weighted multinomial logistic regression was used to analyze factors associated with different patterns of drinking and driving offenses. Of the subjects, 16.5% (n=369) were identified as driving patrons at the entrance and exit of the nightclubs. At entry, 80.1% of the patrons had a zero BrAC, 14.9% had a BrAC meeting the traffic offense criteria and 5.0% had a BrAC meeting the traffic offense and crime criteria. Women were less likely to have BrACs meeting the traffic offense criteria. At nightclub exit, 63.4% of patrons had maintained a zero BrAC, 24.7% had a BrAC that had increased and now met the traffic offense and crime criteria, and 11.9% had a decreased or stable BrAC. An increased BrAC was more frequently identified in patrons who were men, were single, and had used illicit drugs inside the nightclub. Despite the existence of a strict law regarding drinking and driving, a significant proportion of nightclub patrons in the city of São Paulo had violated this law, suggesting a perception of impunity and need for law enforcement. Copyright © 2017 Elsevier B.V. All rights reserved.

Human Mars Lander Design for NASA's Evolvable Mars Campaign

NASA Technical Reports Server (NTRS)

Polsgrove, Tara; Chapman, Jack; Sutherlin, Steve; Taylor, Brian; Fabisinski, Leo; Collins, Tim; Cianciolo Dwyer, Alicia; Samareh, Jamshid; Robertson, Ed; Studak, Bill;

Equilibrium radiative heating tables for Earth entry

NASA Astrophysics Data System (ADS)

Sutton, Kenneth; Hartung, Lin C.

1990-05-01

The recent resurgence of interest in blunt-body atmospheric entry for applications such as aeroassisted orbital transfer and planetary return has engendered a corresponding revival of interest in radiative heating. Radiative heating may be of importance in these blunt-body flows because of the highly energetic shock layer around the blunt nose. Sutton developed an inviscid, stagnation point, radiation coupled flow field code for investigating blunt-body atmospheric entry. The method has been compared with ground-based and flight data, and reasonable agreement has been found. To provide information for entry body studies in support of lunar and Mars return scenarios of interest in the 1970's, the code was exercised over a matrix of Earth entry conditions. Recently, this matrix was extended slightly to reflect entry vehicle designs of current interest. Complete results are presented.

Optogenetic manipulation of anatomical re-entry by light-guided generation of a reversible local conduction block.

PubMed

Watanabe, Masaya; Feola, Iolanda; Majumder, Rupamanjari; Jangsangthong, Wanchana; Teplenin, Alexander S; Ypey, Dirk L; Schalij, Martin J; Zeppenfeld, Katja; de Vries, Antoine A F; Pijnappels, Daniël A

2017-03-01

Anatomical re-entry is an important mechanism of ventricular tachycardia, characterized by circular electrical propagation in a fixed pathway. It's current investigative and therapeutic approaches are non-biological, rather unspecific (drugs), traumatizing (electrical shocks), or irreversible (ablation). Optogenetics is a new biological technique that allows reversible modulation of electrical function with unmatched spatiotemporal precision using light-gated ion channels. We therefore investigated optogenetic manipulation of anatomical re-entry in ventricular cardiac tissue. Transverse, 150-μm-thick ventricular slices, obtained from neonatal rat hearts, were genetically modified with lentiviral vectors encoding Ca2+-translocating channelrhodopsin (CatCh), a light-gated depolarizing ion channel, or enhanced yellow fluorescent protein (eYFP) as control. Stable anatomical re-entry was induced in both experimental groups. Activation of CatCh was precisely controlled by 470-nm patterned illumination, while the effects on anatomical re-entry were studied by optical voltage mapping. Regional illumination in the pathway of anatomical re-entry resulted in termination of arrhythmic activity only in CatCh-expressing slices by establishing a local and reversible, depolarization-induced conduction block in the illuminated area. Systematic adjustment of the size of the light-exposed area in the re-entrant pathway revealed that re-entry could be terminated by either wave collision or extinction, depending on the depth (transmurality) of illumination. In silico studies implicated source-sink mismatches at the site of subtransmural conduction block as an important factor in re-entry termination. Anatomical re-entry in ventricular tissue can be manipulated by optogenetic induction of a local and reversible conduction block in the re-entrant pathway, allowing effective re-entry termination. These results provide distinctively new mechanistic insight into re-entry termination and a novel perspective for cardiac arrhythmia management. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Financial Conflicts of Interest: An Association between Funding and Findings in Plastic Surgery.

PubMed

Lopez, Joseph; Lopez, Sandra; Means, Jessica; Mohan, Raja; Soni, Ashwin; Milton, Jacqueline; Tufaro, Anthony P; May, James W; Dorafshar, Amir

2015-11-01

Despite a growing interest in examining the effects of industry funding on research in plastic surgery, no study to date has comprehensively examined the effects of financial conflicts of interest on publication outcomes. The authors investigated the association between financial conflicts of interest and reported study findings in plastic surgery research. The authors reviewed all entries in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Journal of Plastic, Reconstructive & Aesthetic Surgery from January 1, 2012, to December 31, 2012. All clinical and basic science articles were analyzed. The following article characteristics were extracted: self-reported financial conflicts of interest, sample size, level of evidence, study design, and prospectiveness. The findings reported in each abstract were blindly graded as not applicable, negative, or positive. Of the 1650 abstracts that resulted from the authors' initial search, 568 fulfilled the inclusion criteria. The majority of the included articles covered breast (20.8 percent), experimental (19.7 percent), and general reconstruction (31.69 percent). Financial conflicts of interest were disclosed in only 17.6 percent of the articles. Of the total studies that met inclusion criteria, 66.2 percent were reviewed as having positive outcomes, and 33.8 percent were reviewed as having negative or not applicable results. Studies that disclosed a financial conflict of interest were 7.12 times more likely (p < 0.0001) to present a positive outcome over a negative outcome compared with studies with no financial conflict of interest. Investigators with a financial conflict of interest are significantly more likely to publish plastic surgery studies with a positive conclusion compared with investigators with no conflicts of interest.

Atmospheric Entry Studies for Venus Missions: 45 deg Sphere-Cone Rigid Aeroshells and Ballistic Entries

NASA Technical Reports Server (NTRS)

Prabu, Dinesh K.; Allen, Gary A., Jr.; Cappuccio, Gelsomina; Spilker, Thomas R.; Hwang, Helen H.; Moses, Robert W.

2013-01-01

The present study considers ballistic entries into the atmosphere of Venus using a 45deg sphere-cone rigid aeroshell, a legacy shape that has been used successfully in the past in the Pioneer Venus Multiprobe Mission. For a number of entry mass and capsule diameter combinations (i.e., various ballistic coefficients) and entry velocities, the trajectory space in terms of entry flight path angles between skip out and -30 is explored with a 3DOF trajectory code, TRAJ. Assuming that the thermal protection material of choice is carbon phenolic of flight heritage, the entry flight path angle space is constrained a posteriori by the mechanical and thermal performance parameters of the material. For mechanical performance, a 200 g limit is placed on the peak deceleration load and 10 bar is assumed as the limit for heritage carbon-phenolic material. It is shown that both constraints cannot be active simultaneously. For thermal performance, a heat flux 2.5 kW/sq cm is utilized as a threshold below which the heritage carbon phenolic is considered mass inefficient. Using these constraints, viable entry flight path angle corridors are determined. Analysis of the results also hints at the existence of a range of "critical" ballistic coefficients beyond which the steepest possible entries are determined by the pressure limit of 10 bar. The results are verified against known performance of the various probes used in the Pioneer Venus mission. It is anticipated that the results presented here will serve as a baseline in the development of a new class of ablative materials for future Venus missions.

Arachidonic acid-induced Ca2+ entry and migration in a neuroendocrine cancer cell line.

PubMed

Goswamee, Priyodarshan; Pounardjian, Tamar; Giovannucci, David R

2018-01-01

Store-operated Ca 2+ entry (SOCE) has been implicated in the migration of some cancer cell lines. The canonical SOCE is defined as the Ca 2+ entry that occurs in response to near-maximal depletion of Ca 2+ within the endoplasmic reticulum. Alternatively, arachidonic acid (AA) has been shown to induce Ca 2+ entry in a store-independent manner through Orai1/Orai3 hetero-multimeric channels. However, the role of this AA-induced Ca 2+ entry pathway in cancer cell migration has not been adequately assessed. The present study investigated the involvement of AA-induced Ca 2+ entry in migration in BON cells, a model gastro-enteropancreatic neuroendocrine tumor (GEPNET) cell line using pharmacological and gene knockdown methods in combination with live cell fluorescence imaging and standard migration assays. We showed that both the store-dependent and AA-induced Ca 2+ entry modes could be selectively activated and that exogenous administration of AA resulted in Ca 2+ entry that was pharmacologically distinct from SOCE. Also, whereas homomeric Orai1-containing channels appeared to largely underlie SOCE, the AA-induced Ca 2+ entry channel required the expression of Orai3 as well as Orai1. Moreover, we showed that AA treatment enhanced the migration of BON cells and that this migration could be abrogated by selective inhibition of the AA-induced Ca 2+ entry. Taken together, these data revealed that an alternative Orai3-dependent Ca 2+ entry pathway is an important signal for GEPNET cell migration.

Integrating professional behavior development across a professional allied health curriculum.

PubMed

Tsoumas, Linda J; Pelletier, Deborah

2007-01-01

Professional behaviors are an integral part of clinical practice in all allied health and medical fields. A systematic process for instruction, the education, and development of professional behaviors, cannot be taught in the same way that memorization of human anatomy or medical terminology is taught. One cannot expect professional behaviors to just appear in an individual upon graduation and entry into a health care field. Professional behavior development is an essential component of physical therapy professional education and is clearly defined through the guiding documents of the American Physical Therapy Association, which include 'A Normative Model of Physical Therapist Professional Education,' 'Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists,' and the 'Guide to Physical Therapist Practice.' Building a comprehensive and progressive curricular thread for professional behaviors can pose a challenge for a professional program and the core faculty. This paper will present a curricular model of weaving professional behaviors into a core entry-level professional curriculum using a specific curricular thread, activities for different levels of students, and assessment at each point in the path. This paper will demonstrate the potential for universal application of a professional behaviors.

Change between Entry and Graduation in MSW Student Views on Social Work's Traditional Mission, Career Motivations, and Practice Preferences: Caucasian, Student of Color, and American Indian Group Comparisons

ERIC Educational Resources Information Center

Limb, Gordon E.; Organista, Kurt C.

2006-01-01

The current study builds on a previous study that examined change in student views on social work's traditional mission, career motivations, and practice preferences between entry into and graduation from master of social work programs. Results from 6,987 students at entry and 3,451 students at graduation showed that students at graduation…

Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

ERIC Educational Resources Information Center

Kirby, Kimberly C.; Versek, Brian; Kerwin, MaryLouise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia; Meyers, Robert J.

2015-01-01

We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however,…

Simulation and analysis of a proposed replacement for the McCook port of entry inspection station

DOT National Transportation Integrated Search

1999-04-01

This report describes a study of a proposed replacement for the McCook Port of Entry inspection station at the entry to South Dakota. In order to assess the potential for a low-speed weigh in motion (WIM) scale within the station to pre-screen trucks...

Welfare Effects of Entry into International Markets with Licensing

NASA Astrophysics Data System (ADS)

Ferreira, F. A.; Ferreira, Fl.

2008-10-01

We study the effects of entry of a foreign firm on domestic welfare in the presence of licensing, when the entrant is technologically inferior to the incumbent. We show that foreign entry increases domestic welfare for intermediate (respectively, sufficiently large) technological differences between the firms under licensing with fixed fee (respectively, output royalty).

Prestige-Oriented Market Entry Strategy: The Case of Australian Universities

ERIC Educational Resources Information Center

Tayar, Mark; Jack, Robert

2013-01-01

Through an exploratory case study of four Australian universities this article finds that foreign market entry strategies are shaped by prestige-seeking motivations and a culture of risk aversion. From the market selection, entry mode and higher education literature, a conceptual model, embedded with four propositions, is presented. The model sees…

The Language Functioning of Youth at Entry to Residential Treatment

ERIC Educational Resources Information Center

Trout, Alexandra L.; Huscroft-D'Angelo, Jacqueline; DeSalvo, Catherine; Gehringer, Robert

2011-01-01

Although much is known about the behavioral and educational characteristics of youth at entry to residential care, little is known about youth language performance. Given the impact of language deficits on outcomes, this study assessed the specific language skills of 70 adolescents at entry to a residential treatment setting. Results revealed…

A Rigid Mid-Lift-to-Drag Ratio Approach to Human Mars Entry, Descent, and Landing

NASA Technical Reports Server (NTRS)

Cerimele, Christopher J.; Robertson, Edward A.; Sostaric, Ronald R.; Campbell, Charles H.; Robinson, Phil; Matz, Daniel A.; Johnson, Breanna J.; Stachowiak, Susan J.; Garcia, Joseph A.; Bowles, Jeffrey V.;

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

Bose, Sayantan, E-mail: sayantan_bose@hms.harvard.edu; Jardetzky, Theodore S.; Lamb, Robert A., E-mail: ralamb@northwestern.edu

The Paramyxoviridae include some of the great and ubiquitous disease-causing viruses of humans and animals. In most paramyxoviruses, two viral membrane glycoproteins, fusion protein (F) and receptor binding protein (HN, H or G) mediate a concerted process of recognition of host cell surface molecules followed by fusion of viral and cellular membranes, resulting in viral nucleocapsid entry into the cytoplasm. The interactions between the F and HN, H or G viral glycoproteins and host molecules are critical in determining host range, virulence and spread of these viruses. Recently, atomic structures, together with biochemical and biophysical studies, have provided major insightsmore » into how these two viral glycoproteins successfully interact with host receptors on cellular membranes and initiate the membrane fusion process to gain entry into cells. These studies highlight the conserved core mechanisms of paramyxovirus entry that provide the fundamental basis for rational anti-viral drug design and vaccine development. - Highlights: • New structural and functional insights into paramyxovirus entry mechanisms. • Current data on paramyxovirus glycoproteins suggest a core conserved entry mechanism. • Diverse mechanisms preventing premature fusion activation exist in these viruses. • Precise spacio-temporal interplay between paramyxovirus glycoproteins initiate entry.« less

A case study of multi-seam coal mine entry stability analysis with strength reduction method

PubMed Central

Tulu, Ihsan Berk; Esterhuizen, Gabriel S; Klemetti, Ted; Murphy, Michael M.; Sumner, James; Sloan, Michael

2017-01-01

In this paper, the advantage of using numerical models with the strength reduction method (SRM) to evaluate entry stability in complex multiple-seam conditions is demonstrated. A coal mine under variable topography from the Central Appalachian region is used as a case study. At this mine, unexpected roof conditions were encountered during development below previously mined panels. Stress mapping and observation of ground conditions were used to quantify the success of entry support systems in three room-and-pillar panels. Numerical model analyses were initially conducted to estimate the stresses induced by the multiple-seam mining at the locations of the affected entries. The SRM was used to quantify the stability factor of the supported roof of the entries at selected locations. The SRM-calculated stability factors were compared with observations made during the site visits, and the results demonstrate that the SRM adequately identifies the unexpected roof conditions in this complex case. It is concluded that the SRM can be used to effectively evaluate the likely success of roof supports and the stability condition of entries in coal mines. PMID:28239503

A case study of multi-seam coal mine entry stability analysis with strength reduction method.

PubMed

Tulu, Ihsan Berk; Esterhuizen, Gabriel S; Klemetti, Ted; Murphy, Michael M; Sumner, James; Sloan, Michael

2016-03-01

In this paper, the advantage of using numerical models with the strength reduction method (SRM) to evaluate entry stability in complex multiple-seam conditions is demonstrated. A coal mine under variable topography from the Central Appalachian region is used as a case study. At this mine, unexpected roof conditions were encountered during development below previously mined panels. Stress mapping and observation of ground conditions were used to quantify the success of entry support systems in three room-and-pillar panels. Numerical model analyses were initially conducted to estimate the stresses induced by the multiple-seam mining at the locations of the affected entries. The SRM was used to quantify the stability factor of the supported roof of the entries at selected locations. The SRM-calculated stability factors were compared with observations made during the site visits, and the results demonstrate that the SRM adequately identifies the unexpected roof conditions in this complex case. It is concluded that the SRM can be used to effectively evaluate the likely success of roof supports and the stability condition of entries in coal mines.

Flavivirus infection from mosquitoes in vitro reveals cell entry at the plasma membrane

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

Vancini, Ricardo; Kramer, Laura D.; Ribeiro, Mariana

2013-01-20

Dengue and West Nile viruses are enveloped RNA viruses that belong to genus Flavivirus (family Flaviviridae) and are considered important mosquito-borne viral pathogenic agents worldwide. A potential target for intervention strategies is the virus cell entry mechanism. Previous studies of flavivirus entry have focused on the effects of biochemical and molecular inhibitors on viral entry leading to controversial conclusions suggesting that the process is dependent upon endocytosis and low pH mediated membrane fusion. In this study we analyzed the early events in the infection process by means of electron microscopy and immuno-gold labeling of viral particles during cell entry, andmore » used as a new approach for infecting cells with viruses obtained directly from mosquitoes. The results show that Dengue and West Nile viruses may infect cells by a mechanism that involves direct penetration of the host cell plasma membrane as proposed for alphaviruses.« less

Poliovirus Cell Entry: Common Structural Themes in Viral Cell Entry Pathways

PubMed Central

Hogle, James M.

2006-01-01

Structural studies of polio- and closely related viruses have provided a series of snapshots along their cell entry pathways. Based on the structures and related kinetic, biochemical, and genetic studies, we have proposed a model for the cell entry pathway for polio- and closely related viruses. In this model a maturation cleavage of a capsid protein precursor locks the virus in a metastable state, and the receptor acts like a transition-state catalyst to overcome an energy barrier and release the mature virion from the metastable state. This initiates a series of conformational changes that allow the virus to attach to membranes, form a pore, and finally release its RNA genome into the cytoplasm. This model has striking parallels with emerging models for the maturation and cell entry of more complex enveloped viruses such as influenza virus and HIV. PMID:12142481

Novice nurse educator entry-level competency to teach: a national study.

PubMed

Poindexter, Kathleen

2013-10-01

Expert nurse clinicians who are transitioning into academic positions after successful clinical careers often find they are unprepared to assume their new educator roles. Although nursing clinical expertise may be a necessary expectation, this knowledge is not sufficient to assume a nurse educator position. The purpose of this study was to identify essential entry-level nurse educator competencies, as reported by nurse administrators of accredited prelicensure nursing programs in the United States. Responses were categorized according to the type of academic institution housing the prelicensure nursing program and type of entry-level nurse educator position. A total of 374 program administrators representing 48 states participated, for a 44% response rate. The results indicate that administrators expect entry-level nurse educators to acquire teaching competencies prior to obtaining an entry-level position. Expected proficiency levels of competencies differed based on the position type and the academic setting. Copyright 2013, SLACK Incorporated.

State of Idaho Port of Entry Study

DOT National Transportation Integrated Search

2016-05-01

The purpose of this study was to evaluate Idaho's Ports of Entry (POE) Program to identify its strengths and weaknesses, and provide recommendations for future program development and operations. As part of the study, current Idaho POE business proce...

Who applies and who gets admitted to UK graduate entry medicine? - an analysis of UK admission statistics

PubMed Central

2011-01-01

Background Graduate-entry medicine is a recent development in the UK, intended to expand and broaden access to medical training. After eight years, it is time to evaluate its success in recruitment. Objectives This study aimed to compare the applications and admissions profiles of graduate-entry programmes in the UK to traditional 5 and 6-year courses. Methods Aggregate data on applications and admissions were obtained from the Universities and Colleges Admission Service covering 2003 to 2009. Data were extracted, grouped as appropriate and analysed with the Statistical Package for the Social Sciences. Results Graduate-entry attracts 10,000 applications a year. Women form the majority of applicants and admissions to graduate-entry and traditional medicine programmes. Graduate-entry age profile is older, typically 20's or 30's compared to 18 or 19 years in traditional programmes. Graduate-entry applications and admissions were higher from white and black UK ethnic communities than traditional programmes, and lower from southern and Chinese Asian groups. Graduate-entry has few applications or admissions from Scotland or Northern Ireland. Secondary educational achievement is poorer amongst graduate-entry applicants and admissions than traditional programmes. Conclusions Graduate-entry has succeeded in recruiting substantial additional numbers of older applicants to medicine, in which white and black groups are better represented and Asian groups more poorly represented than in traditional undergraduate programmes. PMID:21943332

Expectations among the elderly about nursing home entry.

PubMed Central

Lindrooth, R C; Hoerger, T J; Norton, E C

2000-01-01

OBJECTIVE: To assess whether the covariates that explain expectations of nursing home entry are consistent with the characteristics of those who enter nursing homes. DATA SOURCES: Waves 1 and 2 of the Assets and Health Dynamics Among the Oldest Old (AHEAD) survey. STUDY DESIGN: We model expectations about nursing home entry as a function of expectations about leaving a bequest, living at least ten years, health condition, and other observed characteristics. We use an instrumental variables and generalized least squares (IV-GLS) method based on Hausman and Taylor (1981) to obtain more efficient estimates than fixed effects, without the restrictive assumptions of random effects. PRINCIPAL FINDINGS: Expectations about nursing home entry are reasonably close to the actual probability of nursing home entry. Most of the variables that affect actual entry also have significant effects on expectations about entry. Medicaid subsidies for nursing home care may have little effect on expectations about nursing home entry; individuals in the lowest asset quartile, who are most likely to receive these subsidies, report probabilities not significantly different from those in other quartiles. Application of the IV-GLS approach is supported by a series of specification tests. CONCLUSIONS: We find that expectations about future nursing home entry are consistent with the characteristics of actual entrants. Underestimation of risk of nursing home entry as a reason for low levels of long-term care insurance is not supported by this analysis. PMID:11130816

NASA's Advanced TPS Materials and Technology Development: Multi-Functional Materials and Systems for Space Exploration

NASA Technical Reports Server (NTRS)

Venkatapathy, Ethiraj; Feldman, Jay; Ellerby, Donald T.; Wercinski, Paul F.; Beck, Robin A S.

2017-01-01

NASA's future missions will be more demanding. They require materials to be mass efficient, robust, multi-functional, scalable and able to be integrated with other subsystems to enable innovative missions to accomplish future science missions. Thermal protection systems and materials (TPSM) are critical for the robotic and human exploration of the solar system when it involves entry. TPSM is a single string system with no back-up. Mass efficiency and robustness are required. Integration of TPSM with the aeroshell is both a challenge and an opportunity. Since 2010, NASA's Space Technology Mission Directorate has invested in innovative new materials and systems across a spectrum of game changing technologies. In this keynote address, we plan to highlight and present our successful approaches utilized in developing four different materials and system technologies that use innovative new manufacturing techniques to meet mission needs. 3-D weaving and felt manufacturing allowed us to successfully propose new ways of addressing TPSM challenges. In the 3-D MAT project, we developed and delivered a multi-functional TPS materials solution, in under three years that is an enabler for Lunar Capable Orion Spacecraft. Under the HEEET project, we are developing a robust heat-shield that can withstand extreme entry conditions, both thermally and mechanically, for entry at Venus, Saturn or higher speed sample return missions. The improved efficiency of HEEET allows science missions entry at much reduced G'loads enabling delicate science instruments to be used. The ADEPT concept is a foldable and deployable entry system and the critical component is a multi-functional fabric that is foldable and deployable and also functions as a mechanical aeroshell and a TPS. The fourth technology we will highlight involves felt to address integration challenges of rigid ablative system such as PICA that was used on MSL. The felt technology allows us to develop a compliant TPS for easy integration. The above four technology developments have focused on mission infusion as the success criteria. These technologies are in different stages of mission infusion. These innovations have led to new mission concepts to be proposed in the future. In our keynote address we will present approaches we have employed throughout the project to create the bridge to transition from low TRL to mission infusion and to overcome the traditional TRL valley of death.

Evaluation of manhole inserts as structural barriers to mosquito entry into belowground stormwater systems using a simulated treatment device.

PubMed

Harbison, Justin E; Metzger, Marco E; Allen, Vaikko; Hu, Renjie

2009-09-01

Belowground proprietary stormwater treatment devices can produce mosquitoes, including vectors of West Nile virus. Elimination of vertical entry points such as pick holes in manhole covers may reduce the number of mosquitoes entering and reproducing in these structures. Plastic manhole dish inserts were evaluated as structural barriers against mosquito entry through pick holes in a simulated stormwater treatment device. Inserts were 100% effective at preventing mosquito entry through covers when no other openings existed. In devices configured with an open lateral conveyance pipe, the addition of an insert under the cover reduced mosquito oviposition significantly. Subsequent trials to further elucidate mosquito entry through manhole covers found a significant positive correlation between increasing number of pick holes and mosquito oviposition. Results of the study suggest the potential for manhole dish inserts to decrease the number of mosquitoes entering belowground structures. The different available stormwater treatment systems and site-specific installations may, however, provide a much greater variety of possible alternate entry points for mosquitoes than was addressed in the current study. Further work is needed in field installations to quantify the significance of pick holes to mosquito entry and determine under what conditions, if any, manhole dish inserts would be most effective and appropriate.

The ubiquitin-proteasome system is essential for the productive entry of Japanese encephalitis virus.

PubMed

Wang, Shaobo; Liu, Haibin; Zu, Xiangyang; Liu, Yang; Chen, Liman; Zhu, Xueqin; Zhang, Leike; Zhou, Zheng; Xiao, Gengfu; Wang, Wei

2016-11-01

The host-virus interaction during the cellular entry of Japanese encephalitis virus (JEV) is poorly characterized. The ubiquitin-proteasome system (UPS), the major intracellular proteolytic pathway, mediates diverse cellular processes, including endocytosis and signal transduction, which may be involved in the entry of virus. Here, we showed that the proteasome inhibitors, MG132 and lactacystin, impaired the productive entry of JEV by effectively interfering with viral intracellular trafficking at the stage between crossing cell membrane and the initial translation of the viral genome after uncoating. Using confocal microscopy, it was demonstrated that a proportion of the internalized virions were misdirected to lysosomes following treatment with MG132, resulting in non-productive entry. In addition, using specific siRNAs targeting ubiquitin, we verified that protein ubiquitination was involved in the entry of JEV. Overall, our study demonstrated the UPS is essential for the productive entry of JEV and might represent a potential antiviral target for JEV infection. Copyright © 2016 Elsevier Inc. All rights reserved.

Spatial and temporal variation in evacuee risk perception throughout the evacuation and return-entry process.

PubMed

Siebeneck, Laura K; Cova, Thomas J

2012-09-01

Developing effective evacuation and return-entry plans requires understanding the spatial and temporal dimensions of risk perception experienced by evacuees throughout a disaster event. Using data gathered from the 2008 Cedar Rapids, Iowa Flood, this article explores how risk perception and location influence evacuee behavior during the evacuation and return-entry process. Three themes are discussed: (1) the spatial and temporal characteristics of risk perception throughout the evacuation and return-entry process, (2) the relationship between risk perception and household compliance with return-entry orders, and (3) the role social influences have on the timing of the return by households. The results indicate that geographic location and spatial variation of risk influenced household risk perception and compliance with return-entry plans. In addition, sociodemographic characteristics influenced the timing and characteristics of the return groups. The findings of this study advance knowledge of evacuee behavior throughout a disaster and can inform strategies used by emergency managers throughout the evacuation and return-entry process. © 2012 Society for Risk Analysis.

The influence of critical thinking skills on performance and progression in a pre-registration nursing program.

PubMed

Pitt, Victoria; Powis, David; Levett-Jones, Tracy; Hunter, Sharyn

2015-01-01

The importance of developing critical thinking skills in preregistration nursing students is recognized worldwide. Yet, there has been limited exploration of how students' critical thinking skill scores on entry to pre-registration nursing education influence their academic and clinical performance and progression. The aim of this study was to: i) describe entry and exit critical thinking scores of nursing students enrolled in a three year bachelor of nursing program in Australia in comparison to norm scores; ii) explore entry critical thinking scores in relation to demographic characteristics, students' performance and progression. This longitudinal correlational study used the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills in a sample (n=134) of students, at entry and exit (three years later). A one sample t-test was used to determine if differences existed between matched student critical thinking scores between entry and exit points. Academic performance, clinical performance and progression data were collected and correlations with entry critical thinking scores were examined. There was a significant relationship between critical thinking scores, academic performance and students' risk of failing, especially in the first semester of study. Critical thinking scores were predictive of program completion within three years. The increase in critical thinking scores from entry to exit was significant for the 28 students measured. In comparison to norm scores, entry level critical thinking scores were significantly lower, but exit scores were comparable. Critical thinking scores had no significant relationship to clinical performance. Entry critical thinking scores significantly correlate to academic performance and predict students risk of course failure and ability to complete a nursing degree in three years. Students' critical thinking scores are an important determinant of their success and as such can inform curriculum development and selection strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Journal entries facilitating preprofessional scientific literacy and mutualistic symbiotic relationships

NASA Astrophysics Data System (ADS)

Vander Vliet, Valerie J.

This study explored journal writing as an alternative assessment to promote the development of pre-professional scientific literacy and mutualistic symbiotic relationships between teaching and learning, instruction and assessment, and students and teachers. The larger context of this study is an action reaction project of the attempted transformation of a traditional first year undergraduate pre-professional biology class to sociocultural constructivist principles. The participants were commuter and residential, full and part-time students ranging in age from 18 to 27 and 18/21 were female. The backgrounds of the students varied considerably, ranging from low to upper middle income, including students of Black and Asian heritage. The setting was a medium-sized Midwestern university. The instructor has twenty years of experience teaching Biology at the college level. The data were analyzed using the constant comparative method and the development of grounded theory. The journal entries were analyzed as to their function and form in relationship to the development of multiple aspects of pre-professional scientific literacy. The perceptions of the students as to the significance of the use of journal entries were also determined through the analysis of their use of journal entries in their portfolios and statements in surveys and portfolios. The analysis revealed that journal entries promoted multiple aspects of pre-professional scientific literacy in both students and the instructor and facilitated the development of mutualistic symbiotic relationships between teaching and learning, instruction and assessment, and students and teachers. The function analysis revealed that the journal entries fulfilled the functions intended for the development of multiple aspects of pre-professional scientific literacy. The complexity of journal writing emerged from the form analysis, which revealed the multiple form elements inherent in journal entries. Students perceived journal entries to act as cognitive, affective, and social catalysts of pre-professional scientific literacy. This study has shown that journal entries facilitate the development of multiple aspects of scientific literacy and mutualistic symbiotic relationships between teaching and learning, instruction and assessment, and students and teachers.

Variations over time in the effects of age and sex on hospitalization rates before and after admission to a nursing home: A German cohort study.

PubMed

Hoffmann, Falk; Allers, Katharina

2017-08-01

We examined hospitalization rates for nursing home residents before and after their entry to the home, stratified by sex and age. A cohort study was conducted using data from a large health insurance fund on 127,227 residents aged 65 years and over newly admitted to a nursing home between January 1, 2010, and December 31, 2014. We assessed hospitalization rates and proportions being hospitalized in 6-month intervals one year before nursing home placement and up to 5 years thereafter. Multiple Poisson regression models were fitted to calculate relative risks (RR). Mean age was 84.0 years and 74.6% of the cohort were females. Hospitalization rates were 194.4 per 100 person-years (PY) in the 12 months before entry to the nursing home and 120.0 per 100 PY thereafter. Rates were highest immediately before entry in both sexes. The influence of age was most pronounced in the 12-7 months before entry (RR: 2.37 for 65-74 vs. 95+ years) and declined thereafter (1.29-1.38 up to month 24 after entry). In contrast, the influence of sex was greater after entry (RR: 1.13 for males vs. females in the 12-7 months before and 1.23-1.31 up to month 24 after entry). Hospitalization rates of nursing home residents are much higher in Germany than in other Western countries. We have provided some insight into the influence of age and sex on hospitalization rates, which varied over the period (time before and after entry to the nursing home) analyzed. We urgently recommend that future studies on the hospitalization of residents stratify their analyses by sex, age and period. Copyright © 2017 Elsevier B.V. All rights reserved.

Circumferential and functional re-entry of in vivo slow-wave activity in the porcine small intestine.

PubMed

Angeli, T R; O'Grady, G; Du, P; Paskaranandavadivel, N; Pullan, A J; Bissett, I P; Cheng, L K

2013-05-01

Slow-waves modulate the pattern of small intestine contractions. However, the large-scale spatial organization of intestinal slow-wave pacesetting remains uncertain because most previous studies have had limited resolution. This study applied high-resolution (HR) mapping to evaluate intestinal pacesetting mechanisms and propagation patterns in vivo. HR serosal mapping was performed in anesthetized pigs using flexible arrays (256 electrodes; 32 × 8; 4 mm spacing), applied along the jejunum. Slow-wave propagation patterns, frequencies, and velocities were calculated. Slow-wave initiation sources were identified and analyzed by animation and isochronal activation mapping. Analysis comprised 32 recordings from nine pigs (mean duration 5.1 ± 3.9 min). Slow-wave propagation was analyzed, and a total of 26 sources of slow-wave initiation were observed and classified as focal pacemakers (31%), sites of functional re-entry (23%) and circumferential re-entry (35%), or indeterminate sources (11%). The mean frequencies of circumferential and functional re-entry were similar (17.0 ± 0.3 vs 17.2 ± 0.4 cycle min(-1) ; P = 0.5), and greater than that of focal pacemakers (12.7 ± 0.8 cycle min(-1) ; P < 0.001). Velocity was anisotropic (12.9 ± 0.7 mm s(-1) circumferential vs 9.0 ± 0.7 mm s(-1) longitudinal; P < 0.05), contributing to the onset and maintenance of re-entry. This study has shown multiple patterns of slow-wave initiation in the jejunum of anesthetized pigs. These results constitute the first description and analysis of circumferential re-entry in the gastrointestinal tract and functional re-entry in the in vivo small intestine. Re-entry can control the direction, pattern, and frequency of slow-wave propagation, and its occurrence and functional significance merit further investigation. © 2013 Blackwell Publishing Ltd.

Reducing errors from the electronic transcription of data collected on paper forms: a research data case study.

PubMed

Wahi, Monika M; Parks, David V; Skeate, Robert C; Goldin, Steven B

2008-01-01

We conducted a reliability study comparing single data entry (SE) into a Microsoft Excel spreadsheet to entry using the existing forms (EF) feature of the Teleforms software system, in which optical character recognition is used to capture data off of paper forms designed in non-Teleforms software programs. We compared the transcription of data from multiple paper forms from over 100 research participants representing almost 20,000 data entry fields. Error rates for SE were significantly lower than those for EF, so we chose SE for data entry in our study. Data transcription strategies from paper to electronic format should be chosen based on evidence from formal evaluations, and their design should be contemplated during the paper forms development stage.

Reducing Errors from the Electronic Transcription of Data Collected on Paper Forms: A Research Data Case Study

PubMed Central

Wahi, Monika M.; Parks, David V.; Skeate, Robert C.; Goldin, Steven B.

2008-01-01

We conducted a reliability study comparing single data entry (SE) into a Microsoft Excel spreadsheet to entry using the existing forms (EF) feature of the Teleforms software system, in which optical character recognition is used to capture data off of paper forms designed in non-Teleforms software programs. We compared the transcription of data from multiple paper forms from over 100 research participants representing almost 20,000 data entry fields. Error rates for SE were significantly lower than those for EF, so we chose SE for data entry in our study. Data transcription strategies from paper to electronic format should be chosen based on evidence from formal evaluations, and their design should be contemplated during the paper forms development stage. PMID:18308994

Angle of Attack Modulation for Mars Entry Terminal State Optimization

NASA Technical Reports Server (NTRS)

Lafleur, Jarret M.; Cerimele, Christopher J.

2009-01-01

From the perspective of atmospheric entry, descent, and landing (EDL), one of the most foreboding destinations in the solar system is Mars due in part to its exceedingly thin atmosphere. To benchmark best possible scenarios for evaluation of potential Mars EDL system designs, a study is conducted to optimize the entry-to-terminal-state portion of EDL for a variety of entry velocities and vehicle masses, focusing on the identification of potential benefits of enabling angle of attack modulation. The terminal state is envisioned as one appropriate for the initiation of terminal descent via parachute or other means. A particle swarm optimizer varies entry flight path angle, ten bank profile points, and ten angle of attack profile points to find maximum-final-altitude trajectories for a 10 30 m ellipsled at 180 different combinations of values for entry mass, entry velocity, terminal Mach number, and minimum allowable altitude. Parametric plots of maximum achievable altitude are shown, as are examples of optimized trajectories. It is shown that appreciable terminal state altitude gains (2.5-4.0 km) over pure bank angle control may be possible if angle of attack modulation is enabled for Mars entry vehicles. Gains of this magnitude could prove to be enabling for missions requiring high-altitude landing sites. Conclusions are also drawn regarding trends in the bank and angle of attack profiles that produce the optimal trajectories in this study, and directions for future work are identified.

Equine herpesvirus 1 entry via endocytosis is facilitated by alphaV integrins and an RSD motif in glycoprotein D.

PubMed

Van de Walle, Gerlinde R; Peters, Sarah T; VanderVen, Brian C; O'Callaghan, Dennis J; Osterrieder, Nikolaus

2008-12-01

Equine herpesvirus 1 (EHV-1) is a member of the Alphaherpesvirinae, and its broad tissue tropism suggests that EHV-1 may use multiple receptors to initiate virus entry. EHV-1 entry was thought to occur exclusively through fusion at the plasma membrane, but recently entry via the endocytic/phagocytic pathway was reported for Chinese hamster ovary cells (CHO-K1 cells). Here we show that cellular integrins, and more specifically those recognizing RGD motifs such as alphaVbeta5, are important during the early steps of EHV-1 entry via endocytosis in CHO-K1 cells. Moreover, mutational analysis revealed that an RSD motif in the EHV-1 envelope glycoprotein D (gD) is critical for entry via endocytosis. In addition, we show that EHV-1 enters peripheral blood mononuclear cells predominantly via the endocytic pathway, whereas in equine endothelial cells entry occurs mainly via fusion at the plasma membrane. Taken together, the data in this study provide evidence that EHV-1 entry via endocytosis is triggered by the interaction between cellular integrins and the RSD motif present in gD and, moreover, that EHV-1 uses different cellular entry pathways to infect important target cell populations of its natural host.

Studies of Ebola Virus Glycoprotein-Mediated Entry and Fusion by Using Pseudotyped Human Immunodeficiency Virus Type 1 Virions: Involvement of Cytoskeletal Proteins and Enhancement by Tumor Necrosis Factor Alpha

PubMed Central

Yonezawa, Akihito; Cavrois, Marielle; Greene, Warner C.

2005-01-01

The Ebola filoviruses are aggressive pathogens that cause severe and often lethal hemorrhagic fever syndromes in humans and nonhuman primates. To date, no effective therapies have been identified. To analyze the entry and fusion properties of Ebola virus, we adapted a human immunodeficiency virus type 1 (HIV-1) virion-based fusion assay by substituting Ebola virus glycoprotein (GP) for the HIV-1 envelope. Fusion was detected by cleavage of the fluorogenic substrate CCF2 by β-lactamase-Vpr incorporated into virions and released as a result of virion fusion. Entry and fusion induced by the Ebola virus GP occurred with much slower kinetics than with vesicular stomatitis virus G protein (VSV-G) and were blocked by depletion of membrane cholesterol and by inhibition of vesicular acidification with bafilomycin A1. These properties confirmed earlier studies and validated the assay for exploring other properties of Ebola virus GP-mediated entry and fusion. Entry and fusion of Ebola virus GP pseudotypes, but not VSV-G or HIV-1 Env pseudotypes, were impaired in the presence of the microtubule-disrupting agent nocodazole but were enhanced in the presence of the microtubule-stabilizing agent paclitaxel (Taxol). Agents that impaired microfilament function, including cytochalasin B, cytochalasin D, latrunculin A, and jasplakinolide, also inhibited Ebola virus GP-mediated entry and fusion. Together, these findings suggest that both microtubules and microfilaments may play a role in the effective trafficking of vesicles containing Ebola virions from the cell surface to the appropriate acidified vesicular compartment where fusion occurs. In terms of Ebola virus GP-mediated entry and fusion to various target cells, primary macrophages proved highly sensitive, while monocytes from the same donors displayed greatly reduced levels of entry and fusion. We further observed that tumor necrosis factor alpha, which is released by Ebola virus-infected monocytes/macrophages, enhanced Ebola virus GP-mediated entry and fusion to human umbilical vein endothelial cells. Thus, Ebola virus infection of one target cell may induce biological changes that facilitate infection of secondary target cells that play a key role in filovirus pathogenesis. Finally, these studies indicate that pseudotyping in the HIV-1 virion-based fusion assay may be a valuable approach to the study of entry and fusion properties mediated through the envelopes of other viral pathogens. PMID:15613320

Online Quadrat Study - Site Index

Science.gov Websites

Study Project - Prairie Advocates Project ) Background Information - Data Collection and Entry - Data Data Entry Data Summaries and Graphs Quadrat Study Poster for your classroom. Directions for Looking at by Prairie Study Prairie Experts For Non-Fermilab Prairie researchers: Complete step-by-step

Accommodating those Most at Risk. Responding to a Mismatch in Programme Selection Criteria and Foundation Biology Performance

NASA Astrophysics Data System (ADS)

Kirby, Nicola F.; Dempster, Edith R.

2015-12-01

In South Africa, foundation programmes are a well-established alternative access route to tertiary science study for educationally disadvantaged students. Student access to, and performance in, one such foundation programme has been researched by the authors seeking opportunities to improve student retention. The biology module in particular has been recognised to place students at risk of failing the foundation programme, thereby reducing throughput into mainstream science programmes. This study uses decision tree analysis to provide a detailed description of foundation biology student performance so that points of weakness and opportunities for remedial action may be pinpointed. While students' alternative-entry selection scores have previously been found to most effectively account for performance in the programme as a whole, no similar positive relationship was identified for any subgroup of students in the foundation biology module. Conversely, academic language proficiency in the medium of instruction (English), formerly found to play no role in overall student performance, was revealed as primary in explaining achievement in foundation biology, most adversely affecting students rendered particularly vulnerable by an additional academic and/or socio-economic disadvantage. A pass in the stand-alone foundation academic literacy module did not necessarily correspond to a pass in biology. Compromised by educational disadvantage, compounded by a mismatch in programme selection criteria and inadequate academic literacy support, discipline-specific, fundamental literacy development in the biology curriculum is proposed to enable students towards epistemic access in the module. Pending this intervention, formal access to mainstream study is unlikely for the foundation students most at risk of failure.

Role of Nectin-1 and Herpesvirus Entry Mediator as Cellular Receptors for Herpes Simplex Virus 1 on Primary Murine Dermal Fibroblasts.

PubMed

Petermann, Philipp; Rahn, Elena; Thier, Katharina; Hsu, Mei-Ju; Rixon, Frazer J; Kopp, Sarah J; Knebel-Mörsdorf, Dagmar

2015-09-01

The cellular proteins nectin-1 and herpesvirus entry mediator (HVEM) can both mediate the entry of herpes simplex virus 1 (HSV-1). We have recently shown how these receptors contribute to infection of skin by investigating HSV-1 entry into murine epidermis. Ex vivo infection studies reveal nectin-1 as the primary receptor in epidermis, whereas HVEM has a more limited role. Although the epidermis represents the outermost layer of skin, the contribution of nectin-1 and HVEM in the underlying dermis is still open. Here, we analyzed the role of each receptor during HSV-1 entry in murine dermal fibroblasts that were deficient in expression of either nectin-1 or HVEM or both receptors. Because infection was not prevented by the absence of either nectin-1 or HVEM, we conclude that they can act as alternative receptors. Although HVEM was found to be highly expressed on fibroblasts, entry was delayed in nectin-1-deficient cells, suggesting that nectin-1 acts as the more efficient receptor. In the absence of both receptors, entry was strongly delayed leading to a much reduced viral spread and virus production. These results suggest an unidentified cellular component that acts as alternate but inefficient receptor for HSV-1 on dermal fibroblasts. Characterization of the cellular entry mechanism suggests that HSV-1 can enter dermal fibroblasts both by direct fusion with the plasma membrane and via endocytic vesicles and that this is not dependent on the presence or absence of nectin-1. Entry was also shown to require dynamin and cholesterol, suggesting comparable entry pathways in keratinocytes and dermal fibroblasts. Herpes simplex virus (HSV) is a human pathogen which infects its host via mucosal surfaces or abraded skin. To understand how HSV-1 overcomes the protective barrier of mucosa or skin and reaches its receptors in tissue, it is essential to know which receptors contribute to the entry into individual skin cells. Previously, we have explored the contribution of nectin-1 and herpesvirus entry mediator (HVEM) as receptors for HSV-1 entry into murine epidermis, where keratinocytes form the major cell type. Since the underlying dermis consists primarily of fibroblasts, we have now extended our study of HSV-1 entry to dermal fibroblasts isolated from nectin-1- or HVEM-deficient mice or from mice deficient in both receptors. Our results demonstrate a role for both nectin-1 and HVEM as receptors and suggest a further receptor which appears much less efficient. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

A Venus/Saturn Mission Study: 45deg Sphere-Cone Rigid Aeroshells and Ballistic Entries

NASA Technical Reports Server (NTRS)

Prabhu, Dinesh K.; Allen, Gary A.; Cappuccio, Gelsomina

2012-01-01

The present study considers ballistic entries into the atmospheres of Saturn and Venus using a 45deg sphere-cone rigid aeroshell (a legacy shape that has been successfully used in the Pioneer Venus and Galileo missions). For a number of entry mass and diameter combinations (i.e., various entries ballistic coefficients), entry velocities, and heading angles, the trajectory space in terms of entry flight path angles between skip out and -30deg is explored with a 3DOF trajectory code, TRAJ. Assuming that the thermal protection material of choice is carbon phenolic of flight heritage, the entry flight path angle space is constrained a posteriori by the mechanical and thermal performance parameters of the material. For mechanical performance, a 200 g limit is place on the peak deceleration load and 10 bar is assumed as the spallation pressure threshold for the legacy material. It is shown that both constraints cannot be active simultaneously. For thermal performance, a minimum margined heat flux threshold of 2.5 kW/sq cm is assumed for the heritage material. Using these constraints, viable entry flight path angle corridors are determined. Analysis of the results also hints at the existence of a "critical" ballistic coefficient beyond which the steepest possible entries are determined by the spallation pressure threshold. The results are verified against known performance of the various probes used in the Galileo and Pioneer Venus missions. It is hoped that the results presented here will serve as a baseline in the development of a new class of ablative materials for Venus and Saturn missions being considered in a future New Frontiers class of NASA missions.

1994 Entry-Level Athletic Training Salaries

PubMed Central

Moss, Crayton L.

1996-01-01

In this study, I examined salaries for entry-level positions in athletic training during the year 1994. An entry-level position was defined as a position to be filled with an athletic trainer certified by the NATA, with no full-time paid employment experience. According to the “Placement Vacancy Notice” (NATA, Dallas, TX) and “BYLINE” (Athletic Trainer Services, Inc, Mt Pleasant, MI), there were 432 entry-level vacancies in hospital/clinics, college/universities, and high school settings. A total of 271 surveys (63%) were returned. Overall, beginning salaries for entry-level athletic training positions were $23,228 (±$3,177) for a bachelor's degree and $25,362 (±$3,883) for a master's degree. A stipend ($4,216 ± $2,039) was included in 86% of the high school positions. The term of contract for high school was usually a 10-month position (10.0 ± .9 months), hospital/clinic, 12-months (11.7 ± .7 months), while the college/university varied from 9 to 12 months (10.5 ± 1.2 months). Also included in the study was fringe benefit information: pension (other than Social Security), life, medical, dental, and vision insurance. Continued studies are recommended to establish salary norms and trends for entry-level positions so that athletic trainers will understand what monetary compensation to expect for their services. PMID:16558367

Housing first on a large scale: Fidelity strengths and challenges in the VA's HUD-VASH program.

PubMed

Kertesz, Stefan G; Austin, Erika L; Holmes, Sally K; DeRussy, Aerin J; Van Deusen Lukas, Carol; Pollio, David E

2017-05-01

Housing First (HF) combines permanent supportive housing and supportive services for homeless individuals and removes traditional treatment-related preconditions for housing entry. There has been little research describing strengths and shortfalls of HF implementation outside of research demonstration projects. The U.S. Department of Veterans Affairs (VA) has transitioned to an HF approach in a supportive housing program serving over 85,000 persons. This offers a naturalistic window to study fidelity when HF is adopted on a large scale. We operationalized HF into 20 criteria grouped into 5 domains. We assessed 8 VA medical centers twice (1 year apart), scoring each criterion using a scale ranging from 1 ( low fidelity ) to 4 ( high fidelity ). There were 2 HF domains (no preconditions and rapidly offering permanent housing) for which high fidelity was readily attained. There was uneven progress in prioritizing the most vulnerable clients for housing support. Two HF domains (sufficient supportive services and a modern recovery philosophy) had considerably lower fidelity. Interviews suggested that operational issues such as shortfalls in staffing and training likely hindered performance in these 2 domains. In this ambitious national HF program, the largest to date, we found substantial fidelity in focusing on permanent housing and removal of preconditions to housing entry. Areas of concern included the adequacy of supportive services and adequacy in deployment of a modern recovery philosophy. Under real-world conditions, large-scale implementation of HF is likely to require significant additional investment in client service supports to assure that results are concordant with those found in research studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Randomized, controlled trial of Interpersonal and Social Rhythm Therapy for young people with bipolar disorder.

PubMed

Inder, Maree L; Crowe, Marie T; Luty, Suzanne E; Carter, Janet D; Moor, Stephanie; Frampton, Christopher M; Joyce, Peter R

2015-03-01

This randomized, controlled clinical trial compared the effect of interpersonal and social rhythm therapy (IPSRT) to that of specialist supportive care (SSC) on depressive outcomes (primary), social functioning, and mania outcomes over 26-78 weeks in young people with bipolar disorder receiving psychopharmacological treatment. Subjects were aged 15-36 years, recruited from a range of sources, and the patient groups included bipolar I disorder, bipolar II disorder, and bipolar disorder not otherwise specified. Exclusion criteria were minimal. Outcome measures were the Longitudinal Interval Follow-up Evaluation and the Social Adjustment Scale. Paired-sample t-tests were used to determine the significance of change from baseline to outcome period. Analyses of covariance were used to determine the impact of therapy, impact of lifetime and current comorbidity, interaction between comorbidity and therapy, and impact of age at study entry on depression. A group of 100 participants were randomized to IPSRT (n = 49) or SSC (n = 51). The majority had bipolar I disorder (78%) and were female (76%), with high levels of comorbidity. After treatment, both groups had improved depressive symptoms, social functioning, and manic symptoms. Contrary to our hypothesis, there was no significant difference between therapies. There was no impact of lifetime or current Axis I comorbidity or age at study entry. There was a relative impact of SSC for patients with current substance use disorder. IPSRT and SSC used as an adjunct to pharmacotherapy appear to be effective in reducing depressive and manic symptoms and improving social functioning in adolescents and young adults with bipolar disorder and high rates of comorbidity. Identifying effective treatments that particularly address depressive symptoms is important in reducing the burden of bipolar disorder. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Forget the Desk Job: Current Roles and Responsibilities in Entry-Level Reference Job Advertisements

ERIC Educational Resources Information Center

Detmering, Robert; Sproles, Claudene

2012-01-01

This study examines the evolving roles and responsibilities of entry-level academic reference positions, as stated in recent job advertisements posted on the American Library Association's JobLIST Web site and other sources. Findings from a content analysis of these advertisements indicate that current entry-level reference positions in academic…

From Higher Education to Work Patterns of Labor Market Entry in Germany and the US

ERIC Educational Resources Information Center

Jacob, Marita; Weiss, Felix

2010-01-01

Comparative studies describing the transition from higher education to work have often simplified the complex transition processes involved. In this paper we extend previous research by taking into account several steps that comprise labor market entry, e.g., recurrent education leading to more than one instance of labor market entry. By comparing…

The Impact of a Selective Entry Examination on Children's Feelings as They Approach the Transition to Secondary School

ERIC Educational Resources Information Center

Skipper, Yvonne; Douglas, Karen M.

2016-01-01

In the current study we examined how different experiences of a selective entry examination influenced children's feelings about themselves, school and intelligence as they approached transition to secondary school. Children were recruited from three English schools that use a selective entry examination to stream students into secondary schools…

Dental Hygiene Entry-Level Program Administrators' Strategies for Overcoming Challenges of Distance Education

ERIC Educational Resources Information Center

Buchanan, Bette A.

2009-01-01

The use of distance education by entry-level dental hygiene programs is increasing. The focus of this study was to determine the number of entry-level dental hygiene program administrators with experience developing and/or maintaining dental hygiene education by distance, the challenges encountered, and the strategies used to overcome the…

Characterisation of re-entrant circuit (or rotational activity) in vitro using the HL1-6 myocyte cell line.

PubMed

Houston, Charles; Tzortzis, Konstantinos N; Roney, Caroline; Saglietto, Andrea; Pitcher, David S; Cantwell, Chris D; Chowdhury, Rasheda A; Ng, Fu Siong; Peters, Nicholas S; Dupont, Emmanuel

2018-06-01

Fibrillation is the most common arrhythmia observed in clinical practice. Understanding of the mechanisms underlying its initiation and maintenance remains incomplete. Functional re-entries are potential drivers of the arrhythmia. Two main concepts are still debated, the "leading circle" and the "spiral wave or rotor" theories. The homogeneous subclone of the HL1 atrial-derived cardiomyocyte cell line, HL1-6, spontaneously exhibits re-entry on a microscopic scale due to its slow conduction velocity and the presence of triggers, making it possible to examine re-entry at the cellular level. We therefore investigated the re-entry cores in cell monolayers through the use of fluorescence optical mapping at high spatiotemporal resolution in order to obtain insights into the mechanisms of re-entry. Re-entries in HL1-6 myocytes required at least two triggers and a minimum colony area to initiate (3.5 to 6.4 mm 2 ). After electrical activity was completely stopped and re-started by varying the extracellular K + concentration, re-entries never returned to the same location while 35% of triggers re-appeared at the same position. A conduction delay algorithm also allows visualisation of the core of the re-entries. This work has revealed that the core of re-entries is conduction blocks constituted by lines and/or groups of cells rather than the round area assumed by the other concepts of functional re-entry. This highlights the importance of experimentation at the microscopic level in the study of re-entry mechanisms. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

The 'bioscience problem' for nursing students: an integrative review of published evaluations of Year 1 bioscience, and proposed directions for curriculum development.

PubMed

McVicar, Andrew; Andrew, Sharon; Kemble, Ross

2015-03-01

The difficulties that nursing students have in learning human biosciences have given cause for concern for over 20 years but the problem remains. To conduct an integrative review of published primary research into the 'bioscience problem', evaluate their outcomes, and provide a contemporary analysis of potential directions for curriculum planners. A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar was conducted for empirical research studies, published between 1990 and 2013, designed to either predict performance of students in bioscience assessments in Year 1 of their studies or identify in-course curriculum delivery issues. The search generated nineteen papers that met inclusion criteria. Twelve papers involved predictive factors for bioscience attainment and seven surveyed student views on curriculum issues. Four others that surveyed reflections of later-year students or qualified nurses on Year 1 outcomes were also retained for additional context. Prediction based on pre-admission academic achievement was not reliable. Student factors including age at entry, self-efficacy in science, and having appropriate study skills in particular appear to be confounding factors. In-course influences such as teaching strategy or lecturer skills are also inconsistent and likely to represent confounders operating at local, institutional level. The integrative review approach enabled analysis of incongruencies between studies that have been a barrier to curriculum development. Sound admissions criteria based on pre-university academic performance show promise in resolving the 'bioscience problem' but will likely be contingent on innovative support early in Year 1 for study skills and the fundamentals of human bioscience, plus attention to local quality assurance for curriculum delivery. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using Minitel Network and New Software Engineering Techniques for Randomized Clinical Trials Management

PubMed Central

Lepage, E.; Tavernier, H.; Bouhaddou, O.; Jais, JP.; Gisselbrecht, C.; Aurengo, A.; Boiron, M.

1989-01-01

The usual Randomized Clinical Trials (RCT) management using an anachronic procedure involving a flowsheet exchange between the remote centers and the coordinating center presents a number of inadequacies. Eligibility criteria are not always verified by the coordinating center before inclusion in the trial and randomization. Laboratory tests and therapeutic adjustments are frequently decided from memory by the clinician which often leads to data oversight and variability of therapeutic decisions. This results in protocol deviations and alteration of the efficiency of the RCT. HICREN is a medical consultation system designed to take into account the different difficulties encountered during RCT driving. The system integrates a clinical database with artificial intelligence technics to manage clinical trial data on non-expensive and widely available Minitel® terminals. Randomization is then possible, after eligibility criteria are satisfied, anytime and anywhere in France through the national telematic network. HICREN also includes an intuitive graphic interface to increase physician's compliance: a user friendly dialogue manager supports on line data entry with multi-windowing facilities and pull down menus. Interactive data validation is achieved through an interface to dedicated C programs. Patient follow up is achieved by an expert system that proposes appropriate dose of treatment according to the rules defined in the trial. At present, HICREN is implemented on the CISARC system for conducting three randomized clinical trials and one epidemiologic study.

Comparable Stocks, Boundedly Rational Stock Markets and IPO Entry Rates

PubMed Central

Chok, Jay; Qian, Jifeng

2013-01-01

In this study, we examine how initial public offerings (IPO) entry rates are affected when stock markets are boundedly rational and IPO firms infer information from their counterparts in the market. We hypothesize a curvilinear relationship between the number of comparable stocks and initial public offerings (IPO) entry rates into the NASDAQ Stock Exchange. Furthermore, we argue that trading volume and changes in stock returns partially mediates the relationship between the number of comparable stocks and IPO entry rates. The statistical evidence provides strong support for the hypotheses. PMID:23690924

Comparable stocks, boundedly rational stock markets and IPO entry rates.

PubMed

Chok, Jay; Qian, Jifeng

2013-01-01

In this study, we examine how initial public offerings (IPO) entry rates are affected when stock markets are boundedly rational and IPO firms infer information from their counterparts in the market. We hypothesize a curvilinear relationship between the number of comparable stocks and initial public offerings (IPO) entry rates into the NASDAQ Stock Exchange. Furthermore, we argue that trading volume and changes in stock returns partially mediates the relationship between the number of comparable stocks and IPO entry rates. The statistical evidence provides strong support for the hypotheses.

Application of a fast skyline computation algorithm for serendipitous searching problems

NASA Astrophysics Data System (ADS)

Koizumi, Kenichi; Hiraki, Kei; Inaba, Mary

2018-02-01

Skyline computation is a method of extracting interesting entries from a large population with multiple attributes. These entries, called skyline or Pareto optimal entries, are known to have extreme characteristics that cannot be found by outlier detection methods. Skyline computation is an important task for characterizing large amounts of data and selecting interesting entries with extreme features. When the population changes dynamically, the task of calculating a sequence of skyline sets is called continuous skyline computation. This task is known to be difficult to perform for the following reasons: (1) information of non-skyline entries must be stored since they may join the skyline in the future; (2) the appearance or disappearance of even a single entry can change the skyline drastically; (3) it is difficult to adopt a geometric acceleration algorithm for skyline computation tasks with high-dimensional datasets. Our new algorithm called jointed rooted-tree (JR-tree) manages entries using a rooted tree structure. JR-tree delays extend the tree to deep levels to accelerate tree construction and traversal. In this study, we presented the difficulties in extracting entries tagged with a rare label in high-dimensional space and the potential of fast skyline computation in low-latency cell identification technology.

An Efficient User Interface Design for Nursing Information System Based on Integrated Patient Order Information.

PubMed

Chu, Chia-Hui; Kuo, Ming-Chuan; Weng, Shu-Hui; Lee, Ting-Ting

2016-01-01

A user friendly interface can enhance the efficiency of data entry, which is crucial for building a complete database. In this study, two user interfaces (traditional pull-down menu vs. check boxes) are proposed and evaluated based on medical records with fever medication orders by measuring the time for data entry, steps for each data entry record, and the complete rate of each medical record. The result revealed that the time for data entry is reduced from 22.8 sec/record to 3.2 sec/record. The data entry procedures also have reduced from 9 steps in the traditional one to 3 steps in the new one. In addition, the completeness of medical records is increased from 20.2% to 98%. All these results indicate that the new user interface provides a more user friendly and efficient approach for data entry than the traditional interface.

Pay attention to reflux/feed entry design

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

Fleming, B.; Martin, G.R.; Hartman, E.L.

1996-01-01

Trays generally are forgiving pieces of equipment and can conceal the effects of poorly designed feed and reflux entries. When one tries to push a tower to its hydraulic limit, however, poor entry design can penalize the performance of the trays and result in a lower final capacity. Normally, new towers are not as susceptible to entry design problems as ones being revamped. This is because new towers usually have some degree of capacity oversizing.Standard design practices used for new columns having spare capacity, though, may not be suitable for revamped towers. In this article, the authors detail the basicmore » principles of reflux and feed entry design, good practices to follow, and poor practices to avoid. They also include a case study of a large-diameter light hydrocarbon splitter revamped with high capacity trays to illustrate the potential pitfalls associated with incorrectly designed reflux and feed entry arrangements.« less

Catch-up growth assessment in long-term physically neglected and emotionally abused preschool age male children.

PubMed

Oliván, Gonzalo

2003-01-01

To assess the catch-up growth of long-term physically neglected and emotionally abused preschool male children who have entered foster residential care and remained 1 year after initial placement. Longitudinal study over a 7-year period (1994-2001). So that a child was eligible for the study, three selection criteria were included: (1) aged between 24 and 48 months at the time of entry into residential facility, (2) having suffered both long-term (more than 6 months) physically neglected and emotionally abused, and (3) having stayed in foster care for 1 year after initial placement. Weight, height, and head circumference were established upon entry and re-assessed 1 year after initial placement, calculating the annual growth velocity. Results were compared with normal regional longitudinal standards of reference (Z score). Student's t test was used to assess statistically significant differences. During the study period, 87 children aged between 24 and 48 months (54 male/33 female) were admitted to residential facility after having suffered both long-term physical neglect and emotional abuse. Nevertheless, only 20 children (23% of the total admissions) met the third selection criteria (having remained 1 year after initial placement). Of these children, all were males and at placement they were between the ages of 30 and 42 months, with an average age of 36 months (1.9 SD). At placement, the analyzed parameters were below the normal standards, showing a statistically significant difference for height (Z score = -1.29; p = .008) and weight (Z score = -.75; p = .038). The annual growth velocity for all parameters was above the normal standards showing a statistically significant difference for height (Z score = +1.43; p = .009). One year after initial placement, the significant differences for height (Z score = -.68; p = .102) and weight (Z score = -.31; p = .435) with respect to the normal standards disappeared, though still remained below, showing a significant catch-up growth for height (improvement height Z = +.61 SD). At placement, the both long-term physically neglected and emotionally abused preschool age male children showed a mild form of chronic malnutrition with growth failure. Growth failure was reversible after the first year of stay, which demonstrates that this delay in growth was secondary to nutritional and psychosocial factors. Placement in foster residential care was beneficial for the catch-up growth of these patients. Copyright 2002 Elsevier Science Ltd.

Risk Factors for Antimicrobial Resistance in Escherichia coli in Pigs Receiving Oral Antimicrobial Treatment: A Systematic Review.

PubMed

Burow, Elke; Käsbohrer, Annemarie

2017-03-01

The aim of this literature review was to identify risk factors in addition to antimicrobial treatment for antimicrobial resistance (AMR) occurrence in commensal Escherichia coli in pigs. A variety of studies were searched in 2014 and 2015. Studies identified as potentially relevant were assessed against eligibility criteria such as observation or experiment (no review), presentation of risk factors in addition to (single dosage) antimicrobial use, risk factors for but not resulting from AMR, and the same antimicrobial used and tested. Thirteen articles (nine on observational, four on experimental studies) were finally selected as relevant. It was reported that space allowance, production size/stage, cleanliness, entry of animals and humans into herds, dosage/frequency/route of administration, time span between treatment and sampling date, herd size, distance to another farm, coldness, and season had an impact on AMR occurrence. Associations were shown by one to four studies per factor and differed in magnitude, direction, and level of significance. The risk of bias was unclear in nearly half of the information of observational studies and in most of the information from experimental studies. Further research on the effects of specific management practices is needed to develop well-founded management advice.

STCRDab: the structural T-cell receptor database

PubMed Central

de Oliveira, Saulo H P; Krawczyk, Konrad

2018-01-01

Abstract The Structural T–cell Receptor Database (STCRDab; http://opig.stats.ox.ac.uk/webapps/stcrdab) is an online resource that automatically collects and curates TCR structural data from the Protein Data Bank. For each entry, the database provides annotations, such as the α/β or γ/δ chain pairings, major histocompatibility complex details, and where available, antigen binding affinities. In addition, the orientation between the variable domains and the canonical forms of the complementarity-determining region loops are also provided. Users can select, view, and download individual or bulk sets of structures based on these criteria. Where available, STCRDab also finds antibody structures that are similar to TCRs, helping users explore the relationship between TCRs and antibodies. PMID:29087479

Use of Admission Criteria to Predict Performance of Students in an Entry-Level Master's Program on Fieldwork Placements and in Academic Courses.

PubMed

Kirchner, G L; Stone, R G; Holm, M B

2001-01-01

The relationships among clinical outcomes, academic success, and predictors used to screen applicants for entrance into a Master in Occupational Therapy Program (MOT) were examined. The dependent variables were grade point average in occupational therapy courses (OT-GPA), client therapy outcomes at the clinic, and ratings of MOT students by Level II Fieldwork supervisors. Predictor variables included undergraduate GPA, scores on the Graduate Record Examination (GRE), and an essay. Both undergraduate GPA and scores on the GRE were found to predict OT-GPA. The analytical section of the GRE was also positively correlated with fieldwork supervisors' ratings of students.

Entry Vehicle Control System Design for the Mars Smart Lander

NASA Technical Reports Server (NTRS)

Calhoun, Philip C.; Queen, Eric M.

2002-01-01

The NASA Langley Research Center, in cooperation with the Jet Propulsion Laboratory, participated in a preliminary design study of the Entry, Descent and Landing phase for the Mars Smart Lander Project. This concept utilizes advances in Guidance, Navigation and Control technology to significantly reduce uncertainty in the vehicle landed location on the Mars surface. A candidate entry vehicle controller based on the Reaction Control System controller for the Apollo Lunar Excursion Module digital autopilot is proposed for use in the entry vehicle attitude control. A slight modification to the phase plane controller is used to reduce jet-firing chattering while maintaining good control response for the Martian entry probe application. The controller performance is demonstrated in a six-degree-of-freedom simulation with representative aerodynamics.

Chemotherapy Order Entry by a Clinical Support Pharmacy Technician in an Outpatient Medical Day Unit

PubMed Central

Neville, Heather; Broadfield, Larry; Harding, Claudia; Heukshorst, Shelley; Sweetapple, Jennifer; Rolle, Megan

2016-01-01

Background: Pharmacy technicians are expanding their scope of practice, often in partnership with pharmacists. In oncology, such a shift in responsibilities may lead to workflow efficiencies, but may also cause concerns about patient risk and medication errors. Objectives: The primary objective was to compare the time spent on order entry and order-entry checking before and after training of a clinical support pharmacy technician (CSPT) to perform chemotherapy order entry. The secondary objectives were to document workflow interruptions and to assess medication errors. Methods: This before-and-after observational study investigated chemotherapy order entry for ambulatory oncology patients. Order entry was performed by pharmacists before the process change (phase 1) and by 1 CSPT after the change (phase 2); order-entry checking was performed by a pharmacist during both phases. The tasks were timed by an independent observer using a personal digital assistant. A convenience sample of 125 orders was targeted for each phase. Data were exported to Microsoft Excel software, and timing differences for each task were tested with an unpaired t test. Results: Totals of 143 and 128 individual orders were timed for order entry during phase 1 (pharmacist) and phase 2 (CSPT), respectively. The mean total time to perform order entry was greater during phase 1 (1:37 min versus 1:20 min; p = 0.044). Totals of 144 and 122 individual orders were timed for order-entry checking (by a pharmacist) in phases 1 and 2, respectively, and there was no difference in mean total time for order-entry checking (1:21 min versus 1:20 min; p = 0.69). There were 33 interruptions not related to order entry (totalling 39:38 min) during phase 1 and 25 interruptions (totalling 30:08 min) during phase 2. Three errors were observed during order entry in phase 1 and one error during order-entry checking in phase 2; the errors were rated as having no effect on patient care. Conclusions: Chemotherapy order entry by a trained CSPT appeared to be just as safe and efficient as order entry by a pharmacist. Changes in pharmacy technicians’ scope of practice could increase the amount of time available for pharmacists to provide direct patient care in the oncology setting. PMID:27402999

Chemotherapy Order Entry by a Clinical Support Pharmacy Technician in an Outpatient Medical Day Unit.

PubMed

Neville, Heather; Broadfield, Larry; Harding, Claudia; Heukshorst, Shelley; Sweetapple, Jennifer; Rolle, Megan

2016-01-01

Pharmacy technicians are expanding their scope of practice, often in partnership with pharmacists. In oncology, such a shift in responsibilities may lead to workflow efficiencies, but may also cause concerns about patient risk and medication errors. The primary objective was to compare the time spent on order entry and order-entry checking before and after training of a clinical support pharmacy technician (CSPT) to perform chemotherapy order entry. The secondary objectives were to document workflow interruptions and to assess medication errors. This before-and-after observational study investigated chemotherapy order entry for ambulatory oncology patients. Order entry was performed by pharmacists before the process change (phase 1) and by 1 CSPT after the change (phase 2); order-entry checking was performed by a pharmacist during both phases. The tasks were timed by an independent observer using a personal digital assistant. A convenience sample of 125 orders was targeted for each phase. Data were exported to Microsoft Excel software, and timing differences for each task were tested with an unpaired t test. Totals of 143 and 128 individual orders were timed for order entry during phase 1 (pharmacist) and phase 2 (CSPT), respectively. The mean total time to perform order entry was greater during phase 1 (1:37 min versus 1:20 min; p = 0.044). Totals of 144 and 122 individual orders were timed for order-entry checking (by a pharmacist) in phases 1 and 2, respectively, and there was no difference in mean total time for order-entry checking (1:21 min versus 1:20 min; p = 0.69). There were 33 interruptions not related to order entry (totalling 39:38 min) during phase 1 and 25 interruptions (totalling 30:08 min) during phase 2. Three errors were observed during order entry in phase 1 and one error during order-entry checking in phase 2; the errors were rated as having no effect on patient care. Chemotherapy order entry by a trained CSPT appeared to be just as safe and efficient as order entry by a pharmacist. Changes in pharmacy technicians' scope of practice could increase the amount of time available for pharmacists to provide direct patient care in the oncology setting.

Human Mars Entry, Descent and Landing Architectures Study Overview

NASA Technical Reports Server (NTRS)

Polsgrove, Tara T.; Dwyer Cianciolo, Alicia

2016-01-01

Landing humans on Mars will require entry, descent and landing (EDL) capability beyond the current state of the art. Nearly twenty times more delivered payload and an order of magnitude improvement in precision landing capability will be necessary. Several EDL technologies capable of meeting the human class payload delivery requirements are being considered. The EDL technologies considered include low lift-to-drag vehicles like Hypersonic Inflatable Aerodynamic Decelerators (HIAD), Adaptable Deployable Entry and Placement Technology (ADEPT), and mid range lift-to-drag vehicles like rigid aeroshell configurations. To better assess EDL technology options and sensitivities to future human mission design variations, a series of design studies has been conducted. The design studies incorporate EDL technologies with conceptual payload arrangements defined by the Evolvable Mars Campaign to evaluate the integrated system with higher fidelity than have been performed to date. This paper describes the results of the design studies for a lander design using the HIAD, ADEPT and rigid shell entry technologies and includes system and subsystem design details including mass and power estimates. This paper will review the point design for three entry configurations capable of delivering a 20 t human class payload to the surface of Mars.

Single-Particle Tracking of Human Immunodeficiency Virus Type 1 Productive Entry into Human Primary Macrophages.

PubMed

Li, Qin; Li, Wei; Yin, Wen; Guo, Jia; Zhang, Zhi-Ping; Zeng, Dejun; Zhang, Xiaowei; Wu, Yuntao; Zhang, Xian-En; Cui, Zongqiang

2017-04-25

Macrophages are one of the major targets of human immunodeficiency virus (HIV-1), but the viral entry pathway remains poorly understood in these cells. Noninvasive virus labeling and single-virus tracking are effective tools for studying virus entry. Here, we constructed a quantum dot (QD)-encapsulated infectious HIV-1 particle to track viral entry at a single-particle level in live human primary macrophages. QDs were encapsulated in HIV-1 virions by incorporating viral accessory protein Vpr-conjugated QDs during virus assembly. With the HIV-1 particles encapsulating QDs, we monitored the early phase of viral infection in real time and observed that, during infection, HIV-1 was endocytosed in a clathrin-mediated manner; the particles were translocated into Rab5A-positive endosomes, and the core was released into the cytoplasm by viral envelope-mediated endosomal fusion. Drug inhibition assays verified that endosome fusion contributes to HIV-1 productive infection in primary macrophages. Additionally, we observed that a dynamic actin cytoskeleton is critical for HIV-1 entry and intracellular migration in primary macrophages. HIV-1 dynamics and infection could be blocked by multiple different actin inhibitors. Our study revealed a productive entry pathway in macrophages that requires both endosomal function and actin dynamics, which may assist in the development of inhibitors to block the HIV entry in macrophages.

Perception of Business and Industry: Basic Skills Necessary for Successful Employment Compared to Competencies of Entry Level Employees.

ERIC Educational Resources Information Center

Junge, Denis A.; And Others

This study was conducted to assess business and industry's perceptions of the basic skills needed for entry-level successful employment. It also assessed business and industry's perceptions of the competencies that entry-level employees now have. Information was gathered via a basic skills questionnaire that was mailed to the personnel directors…

The Resume Characteristics Determining Job Interviews for Middle-Aged Women Seeking Entry-Level Employment

ERIC Educational Resources Information Center

Johnson, Emily; Lahey, Joanna

2011-01-01

Obtaining an entry-level job can be critically important for women with little education, particularly those who have taken time out of the labor force. This article uses archival data from a field experiment, called a resume audit study, to examine the characteristics of entry-level resumes that are important to potential employers. In accordance…

Numerical and experimental study of the thermal degradation process during the atmospheric re-entry of a TiAl6V4 tank

NASA Astrophysics Data System (ADS)

Prévereaud, Y.; Vérant, J.-L.; Balat-Pichelin, M.; Moschetta, J.-M.

2016-05-01

To answer the question of space debris survivability during atmospheric entry ONERA uses its software named MUSIC/FAST. So, the first part of this paper is dedicated to the presentation of the ONERA tool and its validation by comparison with flight data and CFD computations. However, the influence of oxidation on the thermal degradation process and material properties in atmospheric entry conditions is still unknown. A second step is then devoted to the presentation of an experimental campaign investigating TA6V oxidation in atmospheric entry conditions, as the most of the debris found on ground are made of this material. Experiments have been realized using the MESOX facility implemented at the 6 kW solar furnace in PROMES-CNRS laboratory. Finally, an application of MUSIC/FAST is proposed on the atmospheric re-entry of a generic TA6V tank. Aiming at degradation assessment, a sensitive study to initial conditions is conducted. To complete computational analysis regarding degradation process by melting, a numerical analysis of the influence of oxidation on the thermal wall degradation during the tank atmospheric re-entry is presented as well.

Reporting of occupational injury and illness in the semiconductor manufacturing industry.

PubMed

McCurdy, S A; Schenker, M B; Samuels, S J

1991-01-01

In the United States, occupational illness and injury cases meeting specific reporting criteria are recorded on company Occupational Safety and Health Administration (OSHA) 200 logs; case description data are submitted to participating state agencies for coding and entry in the national Supplementary Data System (SDS). We evaluated completeness of reporting (the percentage of reportable cases that were recorded in the company OSHA 200 log) in the semiconductor manufacturing industry by reviewing company health clinic records for 1984 of 10 manufacturing sites of member companies of a national semiconductor manufacturing industry trade association. Of 416 randomly selected work-related cases, 101 met OSHA reporting criteria. Reporting completeness was 60 percent and was lowest for occupational illnesses (44 percent). Case-description data from 150 reported cases were submitted twice to state coding personnel to evaluate coding reliability. Reliability was high (kappa 0.82-0.93) for "nature," "affected body part," "source," and "type" variables. Coding for the SDS appears reliable; reporting completeness may be improved by use of a stepwise approach by company personnel responsible for reporting decisions.

Dynamic Finite Element Predictions for Mars Sample Return Cellular Impact Test #4

NASA Technical Reports Server (NTRS)

Fasanella, Edwin L.; Billings, Marcus D.

2001-01-01

The nonlinear, transient dynamic finite element code, MSC.Dytran, was used to simulate an impact test of an energy absorbing Earth Entry Vehicle (EEV) that will impact without a parachute. EEVOs are designed to return materials from asteroids, comets, or planets for laboratory analysis on Earth. The EEV concept uses an energy absorbing cellular structure designed to contain and limit the acceleration of space exploration samples during Earth impact. The spherical shaped cellular structure is composed of solid hexagonal and pentagonal foam-filled cells with hybrid graphite-epoxy/Kevlar cell walls. Space samples fit inside a smaller sphere at the center of the EEVOs cellular structure. Pre-test analytical predictions were compared with the test results from a bungee accelerator. The model used to represent the foam and the proper failure criteria for the cell walls were critical in predicting the impact loads of the cellular structure. It was determined that a FOAM1 model for the foam and a 20% failure strain criteria for the cell walls gave an accurate prediction of the acceleration pulse for cellular impact.

Aquatic ecotoxicity of lanthanum - A review and an attempt to derive water and sediment quality criteria.

PubMed

Herrmann, Henning; Nolde, Jürgen; Berger, Svend; Heise, Susanne

2016-02-01

Rare earth elements (REE) used to be taken as tracers of geological origin for fluvial transport. Nowadays their increased applications in innovative environmental-friendly technology (e.g. in catalysts, superconductors, lasers, batteries) and medical applications (e.g. MRI contrast agent) lead to man-made, elevated levels in the environment. So far, no regulatory thresholds for REE concentrations and emissions to the environment have been set because information on risks from REE is scarce. However, evidence gathers that REE have to be acknowledged as new, emerging contaminants with manifold ways of entry into the environment, e.g. through waste water from hospitals or through industrial effluents. This paper reviews existing information on bioaccumulation and ecotoxicity of lanthanum in the aquatic environment. Lanthanum is of specific interest as one of the major lanthanides in industrial effluents. This review focuses on the freshwater and the marine environment, and tackles the water column and sediments. From these data, methods to derive quality criteria for sediment and water are discussed and preliminary suggestions are made. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Vulnerability to re-entry in simulated two-dimensional cardiac tissue: effects of electrical restitution and stimulation sequence.

PubMed

Tran, Diana X; Yang, Ming-Jim; Weiss, James N; Garfinkel, Alan; Qu, Zhilin

2007-12-01

Ventricular fibrillation is a lethal arrhythmia characterized by multiple wavelets usually starting from a single or figure-of-eight re-entrant circuit. Understanding the factors regulating vulnerability to the re-entry is essential for developing effective therapeutic strategies to prevent ventricular fibrillation. In this study, we investigated how pre-existing tissue heterogeneities and electrical restitution properties affect the initiation of re-entry by premature extrastimuli in two-dimensional cardiac tissue models. We studied two pacing protocols for inducing re-entry following the "sinus" rhythm (S1) beat: (1) a single premature (S2) extrastimulus in heterogeneous tissue; (2) two premature extrastimuli (S2 and S3) in homogeneous tissue. In the first case, the vulnerable window of re-entry is determined by the spatial dimension and extent of the heterogeneity, and is also affected by electrical restitution properties and the location of the premature stimulus. The vulnerable window first increases as the action potential duration (APD) difference between the inside and outside of the heterogeneous region increases, but then decreases as this difference increases further. Steeper APD restitution reduces the vulnerable window of re-entry. In the second case, electrical restitution plays an essential role. When APD restitution is flat, no re-entry can be induced. When APD restitution is steep, re-entry can be induced by an S3 over a range of S1S2 intervals, which is also affected by conduction velocity restitution. When APD restitution is even steeper, the vulnerable window is reduced due to collision of the spiral tips.

Venus In Situ Explorer Mission design using a mechanically deployed aerodynamic decelerator

NASA Astrophysics Data System (ADS)

Smith, B.; Venkatapathy, E.; Wercinski, P.; Yount, B.; Prabhu, D.; Gage, P.; Glaze, L.; Baker, C.

The Venus In Situ Explorer (VISE) Mission addresses the highest priority science questions within the Venus community outlined in the National Research Council's Decadal Survey. The heritage Venus atmospheric entry system architecture, a 45° sphere-cone rigid aeroshell with a carbon phenolic thermal protection system, may no longer be the preferred entry system architecture compared to other viable alternatives being explored at NASA. A mechanically-deployed aerodynamic decelerator, known as the Adaptive Deployable Entry and Placement Technology (ADEPT), is an entry system alternative that can provide key operational benefits and risk reduction compared to a rigid aeroshell. This paper describes a mission feasibility study performed with the objectives of identifying potential adverse interactions with other mission elements and establishing requirements on decelerator performance. Feasibility is assessed through a launch-to-landing mission design study where the Venus Intrepid Tessera Lander (VITaL), a VISE science payload designed to inform the Decadal Survey results, is repackaged from a rigid aeroshell into the ADEPT decelerator. It is shown that ADEPT reduces the deceleration load on VITaL by an order of magnitude relative to a rigid aeroshell. The more benign entry environment opens up the VISE mission design environment for increased science return, reduced risk, and reduced cost. The ADEPT-VITAL mission concept of operations is presented and details of the entry vehicle structures and mechanisms are given. Finally, entry aerothermal analysis is presented that defines the operational requirements for a revolutionary structural-TPS material employed by ADEPT: three-dimensionally woven carbon cloth. Ongoing work to mitigate key risks identified in this feasibility study is presented.

The current impact of entry-level associate and baccalaureate degree education on the diversity of respiratory therapists.

PubMed

Becker, Ellen A; Nguyen, Xuan T

2014-12-01

Transitioning from an associate degree to a baccalaureate degree for respiratory therapists has been suggested as a new entry-level educational standard. One potential risk for this change is that it may limit the diversity of potential applicants for entry-level education. A diverse workforce is important to achieve the goal of reducing healthcare disparities. This study evaluated characteristics of therapists who completed associate and baccalaureate degree entry-level education. A secondary analysis of data collected from the 2009 AARC Respiratory Therapist Human Resource Survey explored relationships between the choice of entry-level associate or baccalaureate education and variables of gender, race, salary, career advancement, and job satisfaction. There were no differences between therapists with entry-level associate and baccalaureate degrees in gender, race, number of additional healthcare credentials, numbers of life support credentials, wages, delivering respiratory care by protocol, and job satisfaction. There were significantly higher percentages of advanced academic degrees, desire to pursue a higher academic degree, registered respiratory therapist credentials, total National Board for Respiratory Care credentials, and leadership roles for therapists with baccalaureate entry-level degrees. Current entry-level associate and baccalaureate degree graduates have similar gender and race proportions. This finding challenges concerns that an entry-level baccalaureate degree would decrease the diversity of the respiratory therapist workforce. Copyright © 2014 by Daedalus Enterprises.

Evolved atmospheric entry corridor with safety factor

NASA Astrophysics Data System (ADS)

Liang, Zixuan; Ren, Zhang; Li, Qingdong

2018-02-01

Atmospheric entry corridors are established in previous research based on the equilibrium glide condition which assumes the flight-path angle to be zero. To get a better understanding of the highly constrained entry flight, an evolved entry corridor that considers the exact flight-path angle is developed in this study. Firstly, the conventional corridor in the altitude vs. velocity plane is extended into a three-dimensional one in the space of altitude, velocity, and flight-path angle. The three-dimensional corridor is generated by a series of constraint boxes. Then, based on a simple mapping method, an evolved two-dimensional entry corridor with safety factor is obtained. The safety factor is defined to describe the flexibility of the flight-path angle for a state within the corridor. Finally, the evolved entry corridor is simulated for the Space Shuttle and the Common Aero Vehicle (CAV) to demonstrate the effectiveness of the corridor generation approach. Compared with the conventional corridor, the evolved corridor is much wider and provides additional information. Therefore, the evolved corridor would benefit more to the entry trajectory design and analysis.

Characteristics of Coupled Nongray Radiating Gas Flows with Ablation Product Effects About Blunt Bodies During Planetary Entries. Ph.D. Thesis - North Carolina State Univ.

NASA Technical Reports Server (NTRS)

Sutton, K.

1973-01-01

A computational method was developed for the fully-coupled solution of nongray, radiating gas flows with ablation product effects about blunt bodies during planetary entries. The treatment of radiation accounts for molecular band, continuum, and atomic line transitions with a detailed frequency dependence of the absorption coefficient. The ablation of the entry body was solved as part of the solution for a steady-state ablation process. The method was applied by results at typical conditions during entry to Venus. The radiative heating rates along the downstream region of the body can exceed the stagnation point value. The radiative heating to the body is attenuated in the boundary layer at the downstream region of the body and at the stagnation point of the body. A study of the radiation, inviscid flow about spherically capped, conical bodies during planetary entries shows that the nondimensional, radiative heating distributions are nonsimilar with entry conditions. Caution should be exercised in attempting to extrapolate results from known distributions to other entry conditions for which solutions have not yet been obtained.

Lipopolysaccharide structure impacts the entry kinetics of bacterial outer membrane vesicles into host cells

PubMed Central

Hadis, Mohammed; Alderwick, Luke

2017-01-01

Outer membrane vesicles are nano-sized microvesicles shed from the outer membrane of Gram-negative bacteria and play important roles in immune priming and disease pathogenesis. However, our current mechanistic understanding of vesicle-host cell interactions is limited by a lack of methods to study the rapid kinetics of vesicle entry and cargo delivery to host cells. Here, we describe a highly sensitive method to study the kinetics of vesicle entry into host cells in real-time using a genetically encoded, vesicle-targeted probe. We found that the route of vesicular uptake, and thus entry kinetics and efficiency, are shaped by bacterial cell wall composition. The presence of lipopolysaccharide O antigen enables vesicles to bypass clathrin-mediated endocytosis, which enhances both their entry rate and efficiency into host cells. Collectively, our findings highlight the composition of the bacterial cell wall as a major determinant of secretion-independent delivery of virulence factors during Gram-negative infections. PMID:29186191

The use of virtual reality and physical tools in the development and validation of ease of entry and exit in passenger vehicles.

PubMed

Lawson, Glyn; Herriotts, Paul; Malcolm, Louise; Gabrecht, Katharina; Hermawati, Setia

2015-05-01

Ease of entry and exit is important for creating a positive first impression of a car and increasing customer satisfaction. Several methods are used within vehicle development to optimise ease of entry and exit, including CAD reviews, benchmarking and buck trials. However, there is an industry trend towards digital methods to reduce the costs and time associated with developing physical prototypes. This paper reports on a study of entry strategy in three properties (buck, car, CAVE) in which inconsistencies were demonstrated by people entering a vehicle representation in the CAVE. In a second study industry practitioners rated the CAVE as worse than physical methods for identifying entry and exit issues, and having lower perceived validity and reliability. However, the resource issues associated with building bucks were recognised. Recommendations are made for developing the CAVE and for combinations of methods for use at different stages of a vehicle's development. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Auditing an Online Self-reported Interventional Radiology Adverse Event Database for Compliance and Accuracy.

PubMed

Burch, Ezra A; Shyn, Paul B; Chick, Jeffrey F; Chauhan, Nikunj R

2017-04-01

The purpose of this study was to determine whether auditing an online self-reported interventional radiology quality assurance database improves compliance with record entry or improves the accuracy of adverse event (AE) reporting and grading. Physicians were trained in using the database before the study began. An audit of all database entries for the first 3 months, or the first quarter, was performed, at which point physicians were informed of the audit process; entries for the subsequent 3 months, or the second quarter, were again audited. Results between quarters were compared. Compliance with record entry improved from the first to second quarter, but reminders were necessary to ensure 100% compliance with record entry. Knowledge of the audit process did not significantly improve self-reporting of AE or accuracy of AE grading. However, auditing significantly changed the final AE reporting rates and grades. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

International Guillain-Barré Syndrome Outcome Study: protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome.

PubMed

Jacobs, Bart C; van den Berg, Bianca; Verboon, Christine; Chavada, Govindsinh; Cornblath, David R; Gorson, Kenneth C; Harbo, Thomas; Hartung, Hans-Peter; Hughes, Richard A C; Kusunoki, Susumu; van Doorn, Pieter A; Willison, Hugh J

2017-06-01

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy with a highly variable clinical presentation, course, and outcome. The factors that determine the clinical variation of GBS are poorly understood which complicates the care and treatment of individual patients. The protocol of the ongoing International GBS Outcome Study (IGOS), a prospective, observational, multicenter cohort study that aims to identify the clinical and biological determinants and predictors of disease onset, subtype, course and outcome of GBS is presented here. Patients fulfilling the diagnostic criteria for GBS, regardless of age, disease severity, variant forms, or treatment, can participate if included within 2 weeks after onset of weakness. Information about demography, preceding infections, clinical features, diagnostic findings, treatment, course, and outcome is collected. In addition, cerebrospinal fluid and serial blood samples for serum and DNA is collected at standard time points. The original aim was to include at least 1,000 patients with a follow-up of 1-3 years. Data are collected via a web-based data entry system and stored anonymously. IGOS started in May 2012 and by January 2017 included more than 1,400 participants from 143 active centers in 19 countries across 5 continents. The IGOS data/biobank is available for research projects conducted by expertise groups focusing on specific topics including epidemiology, diagnostic criteria, clinimetrics, electrophysiology, antecedent events, antibodies, genetics, prognostic modeling, treatment effects, and long-term outcome of GBS. The IGOS will help to standardize the international collection of data and biosamples for future research of GBS. © 2017 Peripheral Nerve Society.

TEST CELL STUDIES OF RADON ENTRY

EPA Science Inventory

The report gives results of a study to contrast the effectiveness of slab-in-stem wall (SSW) with floating slab (FS) construction practices, to measure radon transport and entry for model testing, to develop protocols relevant to depressurized radon measurements, and to determine...

Entry, Descent and Landing Systems Analysis Study: Phase 1 Report

NASA Technical Reports Server (NTRS)

DwyerCianciolo, Alicia M.; Davis, Jody L.; Komar, David R.; Munk, Michelle M.; Samareh, Jamshid A.; Powell, Richard W.; Shidner, Jeremy D.; Stanley, Douglas O.; Wilhite, Alan W.; Kinney, David J.;

Straight trajectory planning for keyhole neurosurgery in sheep with automatic brain structures segmentation

NASA Astrophysics Data System (ADS)

Favaro, Alberto; Lad, Akash; Formenti, Davide; Zani, Davide Danilo; De Momi, Elena

2017-03-01

In a translational neuroscience/neurosurgery perspective, sheep are considered good candidates to study because of the similarity between their brain and the human one. Automatic planning systems for safe keyhole neurosurgery maximize the probe/catheter distance from vessels and risky structures. This work consists in the development of a trajectories planner for straight catheters placement intended to be used for investigating the drug diffusivity mechanisms in sheep brain. Automatic brain segmentation of gray matter, white matter and cerebrospinal fluid is achieved using an online available sheep atlas. Ventricles, midbrain and cerebellum segmentation have been also carried out. The veterinary surgeon is asked to select a target point within the white matter to be reached by the probe and to define an entry area on the brain cortex. To mitigate the risk of hemorrhage during the insertion process, which can prevent the success of the insertion procedure, the trajectory planner performs a curvature analysis of the brain cortex and wipes out from the poll of possible entry points the sulci, as part of brain cortex where superficial blood vessels are naturally located. A limited set of trajectories is then computed and presented to the surgeon, satisfying an optimality criteria based on a cost function which considers the distance from critical brain areas and the whole trajectory length. The planner proved to be effective in defining rectilinear trajectories accounting for the safety constraints determined by the brain morphology. It also demonstrated a short computational time and good capability in segmenting gyri and sulci surfaces.

Rice-Map: a new-generation rice genome browser.

PubMed

Wang, Jun; Kong, Lei; Zhao, Shuqi; Zhang, He; Tang, Liang; Li, Zhe; Gu, Xiaocheng; Luo, Jingchu; Gao, Ge

2011-03-30

The concurrent release of rice genome sequences for two subspecies (Oryza sativa L. ssp. japonica and Oryza sativa L. ssp. indica) facilitates rice studies at the whole genome level. Since the advent of high-throughput analysis, huge amounts of functional genomics data have been delivered rapidly, making an integrated online genome browser indispensable for scientists to visualize and analyze these data. Based on next-generation web technologies and high-throughput experimental data, we have developed Rice-Map, a novel genome browser for researchers to navigate, analyze and annotate rice genome interactively. More than one hundred annotation tracks (81 for japonica and 82 for indica) have been compiled and loaded into Rice-Map. These pre-computed annotations cover gene models, transcript evidences, expression profiling, epigenetic modifications, inter-species and intra-species homologies, genetic markers and other genomic features. In addition to these pre-computed tracks, registered users can interactively add comments and research notes to Rice-Map as User-Defined Annotation entries. By smoothly scrolling, dragging and zooming, users can browse various genomic features simultaneously at multiple scales. On-the-fly analysis for selected entries could be performed through dedicated bioinformatic analysis platforms such as WebLab and Galaxy. Furthermore, a BioMart-powered data warehouse "Rice Mart" is offered for advanced users to fetch bulk datasets based on complex criteria. Rice-Map delivers abundant up-to-date japonica and indica annotations, providing a valuable resource for both computational and bench biologists. Rice-Map is publicly accessible at http://www.ricemap.org/, with all data available for free downloading.

Surface materials map of Afghanistan: iron-bearing minerals and other materials

USGS Publications Warehouse

King, Trude V.V.; Kokaly, Raymond F.; Hoefen, Todd M.; Dudek, Kathleen B.; Livo, Keith E.

2012-01-01

This map shows the distribution of selected iron-bearing minerals and other materials derived from analysis of HyMap imaging spectrometer data of Afghanistan. Using a NASA (National Aeronautics and Space Administration) WB-57 aircraft flown at an altitude of ~15,240 meters or ~50,000 feet, 218 flight lines of data were collected over Afghanistan between August 22 and October 2, 2007. The HyMap data were converted to apparent surface reflectance, then further empirically adjusted using ground-based reflectance measurements. The reflectance spectrum of each pixel of HyMap data was compared to the spectral features of reference entries in a spectral library of minerals, vegetation, water, ice, and snow. This map shows the spatial distribution of iron-bearing minerals and other materials having diagnostic absorptions at visible and near-infrared wavelengths. These absorptions result from electronic processes in the minerals. Several criteria, including (1) the reliability of detection and discrimination of minerals using the HyMap spectrometer data, (2) the relative abundance of minerals, and (3) the importance of particular minerals to studies of Afghanistan's natural resources, guided the selection of entries in the reference spectral library and, therefore, guided the selection of mineral classes shown on this map. Minerals occurring abundantly at the surface and those having unique spectral features were easily detected and discriminated. Minerals having similar spectral features were less easily discriminated, especially where the minerals were not particularly abundant and (or) where vegetation cover reduced the absorption strength of mineral features. Complications in reflectance calibration also affected the detection and identification of minerals.

Surface materials map of Afghanistan: carbonates, phyllosilicates, sulfates, altered minerals, and other materials

USGS Publications Warehouse

Kokaly, Raymond F.; King, Trude V.V.; Hoefen, Todd M.; Dudek, Kathleen B.; Livo, Keith E.

2012-01-01

This map shows the distribution of selected carbonates, phyllosilicates, sulfates, altered minerals, and other materials derived from analysis of HyMap imaging spectrometer data of Afghanistan. Using a NASA (National Aeronautics and Space Administration) WB-57 aircraft flown at an altitude of ~15,240 meters or ~50,000 feet, 218 flight lines of data were collected over Afghanistan between August 22 and October 2, 2007. The HyMap data were converted to apparent surface reflectance, then further empirically adjusted using ground-based reflectance measurements. The reflectance spectrum of each pixel of HyMap data was compared to the spectral features of reference entries in a spectral library of minerals, vegetation, water, ice, and snow. This map shows the spatial distribution of minerals that have diagnostic absorption features in the shortwave infrared wavelengths. These absorption features result primarily from characteristic chemical bonds and mineralogical vibrations. Several criteria, including (1) the reliability of detection and discrimination of minerals using the HyMap spectrometer data, (2) the relative abundance of minerals, and (3) the importance of particular minerals to studies of Afghanistan's natural resources, guided the selection of entries in the reference spectral library and, therefore, guided the selection of mineral classes shown on this map. Minerals occurring abundantly at the surface and those having unique spectral features were easily detected and discriminated. Minerals having similar spectral features were less easily discriminated, especially where the minerals were not particularly abundant and (or) where vegetation cover reduced the absorption strength of mineral features. Complications in reflectance calibration also affected the detection and identification of minerals.

Intersections of Family Homelessness, CPS Involvement, and Race in Alameda County, California

PubMed Central

Shinn, Marybeth

2016-01-01

The homelessness and child protective services (CPS) systems are closely linked. This study examines the patterns and sequence of families’ involvement with homeless shelters and CPS, as well as whether involvement in each system predicts involvement in the other using linked administrative records for 258 families recruited in emergency shelters in Alameda County, California. More than half of families were reported to CPS at some point, but less than one fifth ever had a report substantiated. Reports that were uninvestigated or unfounded increased in the months leading up to shelter entry and spiked immediately afterward, but substantiations and child removals increased only later. Shelter use before study entry was associated with CPS referrals and investigations after study entry, although not with substantiated cases or child removals. However, CPS involvement before study entry was not associated with returns to shelter after study entry. These results imply that an unsubstantiated report of neglect or abuse may serve as an early warning signal for homelessness and that preventive strategies aiming to affect both homeless and child protective systems should focus on reducing homelessness. CPS workers should evaluate families’ housing needs and attempt to link families to appropriate resources. Black families were disproportionately referred to CPS after shelter entry after controlling for other family characteristics, but race was not associated with substantiations of neglect or abuse or with child removals. Findings lend modest support to human decision-making and institutional explanations of racial disproportionalities in CPS involvement, especially for reporters outside of the CPS system. PMID:27318034

TIM-1 Mediates Dystroglycan-Independent Entry of Lassa Virus.

PubMed

Brouillette, Rachel B; Phillips, Elisabeth K; Patel, Radhika; Mahauad-Fernandez, Wadie; Moller-Tank, Sven; Rogers, Kai J; Dillard, Jacob A; Cooney, Ashley L; Martinez-Sobrido, Luis; Okeoma, Chioma; Maury, Wendy

2018-06-06

Lassa virus (LASV) is an Old World arenavirus responsible for hundreds of thousands of infections in West Africa every year. LASV entry into a variety of cell types is mediated by interactions with glycosyltransferase LARGE-modified O-linked glycans present on the ubiquitous receptor, α-dystroglycan (αDG). Yet, cells lacking αDG are permissive to LASV infection, suggesting that alternative receptors exist. Previous studies demonstrate that phosphatidylserine (PtdSer)-binding receptors, Axl and Tyro3 along with C-type lectin receptors, mediate αDG-independent entry. Here, we demonstrate that another PtdSer receptor, TIM-1, mediates LASV glycoprotein (GP) pseudotyped virions entry into αDG knocked out HEK 293T and wild-type (WT) Vero which express αDG lacking appropriate glycosylation. To investigate the mechanism by which TIM-1 mediates enhancement of entry, we demonstrate that mutagenesis of the TIM-1 IgV domain PtdSer-binding pocket abrogated transduction. Further, the human TIM-1 IgV domain binding monoclonal antibody, ARD5, blocked transduction of pseudovirions bearing LASV GP in a dose-dependent manner. Finally, as we showed previously for other viruses that use TIM-1 for entry, a chimeric TIM-1 protein that substitutes the proline rich region (PRR) from murine leukemia virus envelope (Env) for the mucin-like domain served as a competent receptor. These studies provide evidence that, in the absence of a functional αDG, TIM-1 mediates entry of LASV pseudoviral particles through interactions of virions with the IgV PtdSer binding pocket of TIM-1. Importance PtdSer receptors, such as TIM-1, are emerging as critical entry factors for many enveloped viruses. Most recently, Hepatitis C virus and Zika virus have been added to a growing list. PtdSer receptors engage with enveloped viruses through binding of PtdSer embedded in the viral envelope, defining them as GP-independent receptors. This GP-independent entry mechanism should effectively mediate entry of all enveloped viruses, yet LASV GP pseudotyped viruses were previously found to be unresponsive to PtdSer receptor enhancement in HEK 293T cells. Here we demonstrate that LASV pseudovirions can utilize the PtdSer receptor TIM-1, but only in the absence of appropriately glycosylated α-dystroglycan (αDG), the high affinity cell surface receptor for LASV. Our studies shed light on LASV receptor utilization and explain why earlier studies performed in α-DG-expressing cells did not find that LASV pseudovirions utilize PtdSer receptors for virus uptake. Copyright © 2018 American Society for Microbiology.

Communications Blackout Predictions for Atmospheric Entry of Mars Science Laboratory

NASA Technical Reports Server (NTRS)

Morabito, David D.; Edquist, Karl T.

2005-01-01

The Mars Science Laboratory (MSL) is expected to be a long-range, long-duration science laboratory rover on the Martian surface. MSL will provide a significant milestone that paves the way for future landed missions to Mars. NASA is studying options to launch MSL as early as 2009. There are three elements to the spacecraft; carrier (cruise stage), entry vehicle, and rover. The rover will have a UHF proximity link as the primary path for EDL communications and may have an X-band direct-to-Earth link as a back-up. Given the importance of collecting critical event telemetry data during atmospheric entry, it is important to understand the ability of a signal link to be maintained, especially during the period near peak convective heating. The received telemetry during entry (or played back later) will allow for the performance of the Entry-Descent-Landing technologies to be assessed. These technologies include guided entry for precision landing, a new sky-crane landing system and powered descent. MSL will undergo an entry profile that may result in a potential communications blackout caused by ionized particles for short periods near peak heating. The vehicle will use UHF and possibly X-band during the entry phase. The purpose of this rep0rt is to quantify or bound the likelihood of any such blackout at UHF frequencies (401 MHz) and X-band frequencies (8.4 GHz). Two entry trajectory scenarios were evaluated: a stressful entry trajectory to quantify an upper-bound for any possible blackout period, and a nominal trajectory to quantify likelihood of blackout for such cases.

Exploring the Impact of Identity on the Experiences of Entry-Level Men in Student Affairs

ERIC Educational Resources Information Center

Calhoun, Daniel W.

2010-01-01

The purpose of this study was to understand the experiences of men at the entry-level of the student affairs profession. Using the concepts found in the existing literature related to gender identity as a framework, the research was focused upon the meanings constructed by entry-level men within the field of student affairs and how those meanings…

Entry and Exit.

DTIC Science & Technology

1987-03-01

1. Introduction R Analyses of industrial competition have attained a new vigor with the application of game -theoretic methods. The process of... competition is represented in models that reflect genuine struggles for entry, market power, and continuing survival. Dynamics and informational effects are...presents a few of the models developed recently to study competitive processes that affect a firm’s entry into a market , and the decision to exit. The

Research on the water-entry attitude of a submersible aircraft.

PubMed

Xu, BaoWei; Li, YongLi; Feng, JinFu; Hu, JunHua; Qi, Duo; Yang, Jian

2016-01-01

The water entry of a submersible aircraft, which is transient, highly coupled, and nonlinear, is complicated. After analyzing the mechanics of this process, the change rate of every variable is considered. A dynamic model is build and employed to study vehicle attitude and overturn phenomenon during water entry. Experiments are carried out and a method to organize experiment data is proposed. The accuracy of the method is confirmed by comparing the results of simulation of dynamic model and experiment under the same condition. Based on the analysis of the experiment and simulation, the initial attack angle and angular velocity largely influence the water entry of vehicle. Simulations of water entry with different initial and angular velocities are completed, followed by an analysis, and the motion law of vehicle is obtained. To solve the problem of vehicle stability and control during water entry, an approach is proposed by which the vehicle sails with a zero attack angle after entering water by controlling the initial angular velocity. With the dynamic model and optimization research algorithm, calculation is performed, and the optimal initial angular velocity of water-entry is obtained. The outcome of simulations confirms that the effectiveness of the propose approach by which the initial water-entry angular velocity is controlled.

Macrophage sphingolipids are essential for the entry of mycobacteria.

PubMed

Viswanathan, Gopinath; Jafurulla, Md; Kumar, G Aditya; Raghunand, Tirumalai R; Chattopadhyay, Amitabha

2018-07-01

Mycobacteria are intracellular pathogens that can invade and survive within host macrophages. Mycobacterial infections remain a major cause of mortality and morbidity worldwide, with serious concerns of emergence of multi and extensively drug-resistant tuberculosis. While significant advances have been made in identifying mycobacterial virulence determinants, the detailed molecular mechanism of internalization of mycobacteria into host cells remains poorly understood. Although several studies have highlighted the crucial role of sphingolipids in mycobacterial growth, persistence and establishment of infection, the role of sphingolipids in the entry of mycobacteria into host cells is not known. In this work, we explored the role of host membrane sphingolipids in the entry of Mycobacterium smegmatis into J774A.1 macrophages. Our results show that metabolic depletion of sphingolipids in host macrophages results in a significant reduction in the entry of M. smegmatis. Importantly, the entry of Escherichia coli into host macrophages under similar conditions remained invariant, implying the specificity of the requirement of sphingolipids in mycobacterial entry. To the best of our knowledge, our results constitute the first report demonstrating the role of host macrophage sphingolipids in the entry of mycobacteria. Our results could help in the development of novel therapeutic strategies targeting sphingolipid-mediated entry of mycobacteria into host cells. Copyright © 2018 Elsevier B.V. All rights reserved.

Patterns of missing data in the use of the endometriosis symptom diary.

PubMed

Seitz, Christian; Lanius, Vivian; Lippert, Susanne; Gerlinger, Christoph; Haberland, Claudia; Oehmke, Frank; Tinneberg, Hans-Rudolf

2018-06-08

Endometriosis is a common, chronic condition in women of reproductive age that is characterized by the presence of functional endometriotic lesions outside the uterus. The Endometriosis Symptom Diary (ESD) is an electronic patient-reported outcome (ePRO) instrument that assesses women's experience of endometriosis symptoms, with pain scored using a 0-10 numeric rating scale. This study investigated patterns of data missing from the ESD in the VALEPRO study. Post hoc analyses of missing data were conducted. Of 272 participants using the ESD, 26.5% had no missing diary entries, 46.7% had > 0-5% of entries missing, 13.2% had > 5-10% of entries missing and 13.6% had > 10% of entries missing over the entire study period. The duration of missing episodes (defined as ≥1 consecutive days with missing diary entries) was generally short; most (81.4%) were 1 day. The difference in mean worst pain scores between missing and complete episodes per participant was - 0.1, suggesting that missing episodes were not related to severity of pain. Entries were significantly more likely to be missing on Fridays (18.5%) and Saturdays (22.9%) compared with other days of the week (p < 0.0001). Participants in the USA had significantly more long missing episodes than those in Germany (proportions of missing episodes longer than 1 day, 22.6 and 10.5%, respectively; p < 0.0001). The proportions of women with ≥1 missing entry were 50.0, 70.2 and 79.8% for women with elementary education, secondary education, and a college or university education, respectively. The proportions of women with ≥1 missing entry were similar for those with and without children (72.2 and 74.3%, respectively). Most participants were highly compliant with entering data in the ESD and the amount of missing data was low. Entries were significantly more likely to be missing on Fridays and Saturdays compared with other days of the week, and participants in the USA had significantly more long missing episodes than participants in Germany. Clinicaltrials.gov, NCT01643122 , registered 4 July 2012.

CROSS-SECTIONAL STUDY ON DIFFERENT ENTRY POINTS FOR ANTEROGRADE FEMORAL INTRAMEDULLARY OSTEOSYNTHESIS

PubMed Central

Kanas, Michel; Wajnsztejn, Andre; Roucourt, Danilo; Fiorentino, Eduardo; Fernandes, Hélio Jorge Alvachian; dos Reis, Fernando Baldy

2015-01-01

Objective: To analyze the degree of knowledge among professionals who treat fractures using the recommended technique, with regard to correlating the nail with the entry point that is considered appropriate. Methods: A questionnaire that presented five types of nail and simulated a transverse diaphyseal fracture of the femur was developed. Results: Responses regarding the entry points corresponding to choosing the type of nail were obtained from 370 orthopedists who were participating in the 41st Brazilian Congress of Orthopedics and Traumatology. It was observed that only 20% correctly identified the entry point and that there was no difference between the professionals within the specialty of Traumatology and the others. Conclusion: It was concluded that the majority of the physicians attending the congress were unaware of the entry points. PMID:27027047

19 CFR 142.16 - Entry summary documentation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Entry summary documentation. 142.16 Section 142.16... TREASURY (CONTINUED) ENTRY PROCESS Entry Summary Documentation § 142.16 Entry summary documentation. (a) Entry summary not filed at time of entry. When the entry documentation is filed before the entry summary...

Mechanization of Library Procedures in the Medium-sized Medical Library: IX. Holding Statements in PHILSOM: a Study of their Activity *

PubMed Central

Beckwith, Helen K.

1970-01-01

A study was made of the serial holding statements in PHILSOM over a six-month period, in order to determine the desirability of printing the complete serial holding statements monthly. Attention was given to the frequency of internal and update changes in both active and dead entries. The results indicate that while sufficient activity is observed in active serial entries to warrant their monthly updating, dead serial entries remain constant over this period. This indicates that a large group of PHILSOM entries can be easily identified and isolated, facilitating division and independent updating of the resultant lists. The desirability of such a division, however, must also take into consideration the user's ease in handling such a segmented listing. Images PMID:5439902

Aviation medicine translations : annotated bibliography of recently translated material, X.

DOT National Transportation Integrated Search

1981-01-01

An annotated bibliography of translations of foreign-language articles is presented. Of the 86 listed entries, 53 are concerned with studies of shift work, and 10 are concerned with studies of alcohol. : The remaining entries can be subsumed under th...

Data entry errors and design for model-based tight glycemic control in critical care.

PubMed

Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

2012-01-01

Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. Model-based methods and computerized protocols offer the opportunity to improve TGC quality but require human data entry, particularly of blood glucose (BG) values, which can be significantly prone to error. This study presents the design and optimization of data entry methods to minimize error for a computerized and model-based TGC method prior to pilot clinical trials. To minimize data entry error, two tests were carried out to optimize a method with errors less than the 5%-plus reported in other studies. Four initial methods were tested on 40 subjects in random order, and the best two were tested more rigorously on 34 subjects. The tests measured entry speed and accuracy. Errors were reported as corrected and uncorrected errors, with the sum comprising a total error rate. The first set of tests used randomly selected values, while the second set used the same values for all subjects to allow comparisons across users and direct assessment of the magnitude of errors. These research tests were approved by the University of Canterbury Ethics Committee. The final data entry method tested reduced errors to less than 1-2%, a 60-80% reduction from reported values. The magnitude of errors was clinically significant and was typically by 10.0 mmol/liter or an order of magnitude but only for extreme values of BG < 2.0 mmol/liter or BG > 15.0-20.0 mmol/liter, both of which could be easily corrected with automated checking of extreme values for safety. The data entry method selected significantly reduced data entry errors in the limited design tests presented, and is in use on a clinical pilot TGC study. The overall approach and testing methods are easily performed and generalizable to other applications and protocols. © 2012 Diabetes Technology Society.

Product-line extensions and pricing strategies of brand-name drugs facing patent expiration.

PubMed

Hong, Song Hee; Shepherd, Marvin D; Scoones, David; Wan, Thomas T H

2005-01-01

This study proposed an alternative to brand loyalty as the explanation for the continued price rigidity of patent-expired brand-name prescription drugs despite the increase in market entry of generic drugs facilitated by the 1984 Drug Price Competition and Patent Term Restoration Act. Study hypotheses were to test (1) whether market entries of new-product extensions are associated with market success of original brand-name drugs before generic drug entry, and (2) whether original brand-name drugs exhibit price rigidity to generic entry only when they are extended. The design is a retrospective follow-up study for the prescription drug brands that lost their patents between 1987 and 1992. The drug brands were limited to nonantibiotic, orally administered drugs containing only 1 active pharmaceutical ingredient. Information on patent expiration, entry of a product extension, and market success were determined from the U.S. Food and Drug Administration.s Orange Book, First DataBank, and American Druggist, respectively. Market success was defined as whether an original drug brand was listed in the top 100 prescriptions most frequently dispensed before facing generic entry. Product-line extension was defined as the appearance of another product that a company introduces within the same market after its existing product. Drug prices were average wholesale prices from the Drug Topics Red Book. The relationship between product-line extension and market success was examined using a logistic regression analysis. The price rigidity to entry was tested using a panel regression analysis. A total of 27 drug brands lost their patents between 1987 and 1992. Drug brands that achieved market success were 16 times more likely to be extended than were those that did not (OR=16, 95% confidence interval, 2.12-120.65). The price rigidity to entry existed in drug brands with extensions (beta=2.65%, P <0.033), but not in those brands without extensions (beta=-2.40%, P <0.001). This study provided some support for the alternative explanation to brand loyalty that a new product-line extension introduced for an original brand helps the original price be rigid despite the entry of generic drugs facilitated by the 1984 Drug Price Competition and Patent Term Restoration Act.

Double Sampling with Multiple Imputation to Answer Large Sample Meta-Research Questions: Introduction and Illustration by Evaluating Adherence to Two Simple CONSORT Guidelines

PubMed Central

Capers, Patrice L.; Brown, Andrew W.; Dawson, John A.; Allison, David B.

2015-01-01

Background: Meta-research can involve manual retrieval and evaluation of research, which is resource intensive. Creation of high throughput methods (e.g., search heuristics, crowdsourcing) has improved feasibility of large meta-research questions, but possibly at the cost of accuracy. Objective: To evaluate the use of double sampling combined with multiple imputation (DS + MI) to address meta-research questions, using as an example adherence of PubMed entries to two simple consolidated standards of reporting trials guidelines for titles and abstracts. Methods: For the DS large sample, we retrieved all PubMed entries satisfying the filters: RCT, human, abstract available, and English language (n = 322, 107). For the DS subsample, we randomly sampled 500 entries from the large sample. The large sample was evaluated with a lower rigor, higher throughput (RLOTHI) method using search heuristics, while the subsample was evaluated using a higher rigor, lower throughput (RHITLO) human rating method. Multiple imputation of the missing-completely at-random RHITLO data for the large sample was informed by: RHITLO data from the subsample; RLOTHI data from the large sample; whether a study was an RCT; and country and year of publication. Results: The RHITLO and RLOTHI methods in the subsample largely agreed (phi coefficients: title = 1.00, abstract = 0.92). Compliance with abstract and title criteria has increased over time, with non-US countries improving more rapidly. DS + MI logistic regression estimates were more precise than subsample estimates (e.g., 95% CI for change in title and abstract compliance by year: subsample RHITLO 1.050–1.174 vs. DS + MI 1.082–1.151). As evidence of improved accuracy, DS + MI coefficient estimates were closer to RHITLO than the large sample RLOTHI. Conclusion: Our results support our hypothesis that DS + MI would result in improved precision and accuracy. This method is flexible and may provide a practical way to examine large corpora of literature. PMID:25988135

Quality of life in maltreated children and adult survivors of child maltreatment: a systematic review.

PubMed

Weber, S; Jud, A; Landolt, M A

2016-02-01

To review data on health-related quality of life (HRQoL) in individuals with childhood trauma, including psychological maltreatment, physical maltreatment, sexual abuse, and neglect. The literature search was conducted with pre-defined keywords using the following electronic bibliographic databases: EMBASE, PubMed, MEDLINE, CINAHL, PsyINFO, PSYNDEX, and Cochrane Database of Systematic Reviews. Further databases were searched for relevant dissertations. Study selection and data extraction were completed by two independent reviewers. The literature search yielded 1568 entries. Nineteen articles met all inclusion criteria and were retained for further analysis. Findings quite consistently showed significant negative associations between child maltreatment and both self- and proxy-rated HRQoL. Effect sizes range from small to large. Number of types of maltreatment and HRQoL were found to be negatively related. Data on HRQoL for maltreated children are still rare. Studies often investigate adult survivors of child maltreatment. Considering HRQoL in children and adolescents who suffered maltreatment would allow the planning of effective interventions and the evaluation of treatments to improve HRQoL of these children.

The Edinburgh Primary Care Depression Study: personality disorder and outcome.

PubMed

Patience, D A; McGuire, R J; Scott, A I; Freeman, C P

1995-09-01

Little is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care in the UK. Patients meeting criteria for DSM-III major depressive disorder were randomly allocated to one of four treatments each lasting 16 weeks, then followed up for 18 months. Assessments were made of depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks. The prevalence of personality disorder (PD) in the sample of 113 patients was 26%. Patients with a PD were significantly younger and rated more depressed at entry than patients with no personality disorder (NoPD). On completion of treatment patients with a PD were significantly more depressed and had poorer social functioning than the NoPD group. After 18 months there were no differences in ratings of depression or social functioning between the groups. There was substantial improvement in both the PD and NoPD groups. The presence of personality pathology delays recovery from major depressive illness.

EEG abnormalities and two year outcome in first episode psychosis.

PubMed

Manchanda, R; Norman, R; Malla, A; Harricharan, R; Takhar, J; Northcott, S

2005-03-01

This study examines the relationship of EEG to 2 year symptomatic outcome, duration of illness and untreated psychosis and gender. A total of 122 patients presenting for treatment of first episode psychosis had their baseline EEG classified by modified Mayo Clinic system criteria as normal, essentially normal or dysrhythmia. Positive and negative symptoms of psychoses were rated on entry and after 2 years of treatment. The socio-demographic variables and duration of illness and of untreated psychosis were also recorded. Patients with a normal EEG showed significantly more reduction in both positive and negative symptoms of psychoses over 2 years and were more likely to be in 'remission' as compared with the essentially normal or dysrhythmia group. The dysrhythmic group had significantly higher duration of illness than either the normal or essentially normal groups. There were no gender differences in the distribution of EEGs. An abnormal EEG in patients with first episode psychosis is associated with a poorer prognosis and a longer duration of untreated illness. Copyright (c) Blackwell Munksgaard 2005

Relevance of randomised controlled trials in oncology.

PubMed

Tannock, Ian F; Amir, Eitan; Booth, Christopher M; Niraula, Saroj; Ocana, Alberto; Seruga, Bostjan; Templeton, Arnoud J; Vera-Badillo, Francisco

2016-12-01

Well-designed randomised controlled trials (RCTs) can prevent bias in the comparison of treatments and provide a sound basis for changes in clinical practice. However, the design and reporting of many RCTs can render their results of little relevance to clinical practice. In this Personal View, we discuss the limitations of RCT data and suggest some ways to improve the clinical relevance of RCTs in the everyday management of patients with cancer. RCTs should ask questions of clinical rather than commercial interest, avoid non-validated surrogate endpoints in registration trials, and have entry criteria that allow inclusion of all patients who are fit to receive treatment. Furthermore, RCTs should be reported with complete accounting of frequency and management of toxicities, and with strict guidelines to ensure freedom from bias. Premature reporting of results should be avoided. The bar for clinical benefit should be raised for drug registration, which should require publication and review of mature data from RCTs, post-marketing health outcome studies, and value-based pricing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nature-based experiences and health of cancer survivors.

PubMed

Ray, Heather; Jakubec, Sonya L

2014-11-01

Although exposure to, and interaction with, natural environments are recognized as health-promoting, little is understood about the use of nature contact in treatment and rehabilitation for cancer survivors. This narrative review summarizes the literature exploring the influence of nature-based experiences on survivor health. Key databases included CINAHL, EMBASE, Medline, Web of Science, PubMed, PsycArticles, ProQuest, and Cancerlit databases. Sixteen articles met inclusion criteria and were reviewed. Four major categories emerged: 1) Dragon boat racing may enhance breast cancer survivor quality of life, 2) Natural environment may counteract attentional fatigue in newly diagnosed breast cancer survivors, 3) Adventure programs provide a positive experience for children and adolescent survivors, fostering a sense of belonging and self-esteem, and 4) Therapeutic landscapes may decrease state-anxiety, improving survivor health. This review contributes to a better understanding of the therapeutic effects of nature-based experiences on cancer survivor health, providing a point of entry for future study. Copyright © 2014 Elsevier Ltd. All rights reserved.

Active and passive surveillance for communicable diseases in child care facilities, Seattle-King County, Washington.

PubMed

MacDonald, J K; Boase, J; Stewart, L K; Alexander, E R; Solomon, S L; Cordell, R L

1997-12-01

The purpose of this study was to develop and evaluate models for public health surveillance of illnesses among children in out-of-home child care facilities. Between July 1992 and March 1994, 200 Seattle-King County child care facilities participated in active or enhanced passive surveillance, or both. Reporting was based on easily recognized signs, symptoms, and sentinel events. Published criteria were used in evaluating surveillance effectiveness, and notifiable disease reporting of participating and nonparticipating facilities was compared. Neither surveillance model was well accepted by child care providers. Enhanced passive and active surveillance had comparable sensitivity. Reporting delays and the large amount of time needed for data entry led to problems with timeliness, especially in terms of written reporting during active surveillance. Widespread active public health surveillance in child care facilities is not feasible for most local health departments. Improvements in public health surveillance in child care settings will depend on acceptability to providers.

Green Jobs: Definition and Method of Appraisal of Chemical and Biological Risks

PubMed Central

Cheneval, Erwan; Busque, Marc-Antoine; Ostiguy, Claude; Lavoie, Jacques; Bourbonnais, Robert; Labrèche, France; Bakhiyi, Bouchra; Zayed, Joseph

2016-01-01

In the wake of sustainable development, green jobs are developing rapidly, changing the work environment. However a green job is not automatically a safe job. The aim of the study was to define green jobs, and to establish a preliminary risk assessment of chemical substances and biological agents for workers in Quebec. An operational definition was developed, along with criteria and sustainable development principles to discriminate green jobs from regular jobs. The potential toxicity or hazard associated with their chemical and biological exposures was assessed, and the workers’ exposure appraised using an expert assessment method. A control banding approach was then used to assess risks for workers in selected green jobs. A double entry model allowed us to set priorities in terms of chemical or biological risk. Among jobs that present the highest risk potential, several are related to waste management. The developed method is flexible and could be adapted to better appraise the risks that workers are facing or to propose control measures. PMID:26718400

Mutagenesis Studies of the H5 Influenza Hemagglutinin Stem Loop Region*

PubMed Central

Antanasijevic, Aleksandar; Basu, Arnab; Bowlin, Terry L.; Mishra, Rama K.; Rong, Lijun; Caffrey, Michael

2014-01-01

Influenza outbreaks, particularly the pandemic 1918 H1 and avian H5 strains, are of high concern to public health. The hemagglutinin envelope protein of influenza plays a critical role in viral entry and thus is an attractive target for inhibition of virus entry. The highly conserved stem loop region of hemagglutinin has been shown to undergo critically important conformational changes during the entry process and, moreover, to be a site for inhibition of virus entry by antibodies, small proteins, and small drug-like molecules. In this work we probe the structure-function properties of the H5 hemagglutinin stem loop region by site-directed mutagenesis. We find that most mutations do not disrupt expression, proteolytic processing, incorporation into virus, or receptor binding; however, many of the mutations disrupt the entry process. We further assess the effects of mutations on inhibition of entry by a neutralizing monoclonal antibody (C179) and find examples of increased and decreased sensitivity to the antibody, consistent with the antibody binding site observed by x-ray crystallography. In addition, we tested the sensitivity of the mutants to MBX2329, a small molecule inhibitor of influenza entry. Interestingly, the mutants exhibit increased and decreased sensitivities to MBX2329, which gives further insight into the binding site of the compound on HA and potential mechanisms of escape. Finally, we have modeled the binding site of MBX2329 using molecular dynamics and find that the resulting structure is in good agreement with the mutagenesis results. Together these studies underscore the importance of the stem loop region to HA function and suggest potential sites for therapeutic intervention of influenza entry. PMID:24947513

Mutagenesis studies of the H5 influenza hemagglutinin stem loop region.

PubMed

Antanasijevic, Aleksandar; Basu, Arnab; Bowlin, Terry L; Mishra, Rama K; Rong, Lijun; Caffrey, Michael

2014-08-08

Influenza outbreaks, particularly the pandemic 1918 H1 and avian H5 strains, are of high concern to public health. The hemagglutinin envelope protein of influenza plays a critical role in viral entry and thus is an attractive target for inhibition of virus entry. The highly conserved stem loop region of hemagglutinin has been shown to undergo critically important conformational changes during the entry process and, moreover, to be a site for inhibition of virus entry by antibodies, small proteins, and small drug-like molecules. In this work we probe the structure-function properties of the H5 hemagglutinin stem loop region by site-directed mutagenesis. We find that most mutations do not disrupt expression, proteolytic processing, incorporation into virus, or receptor binding; however, many of the mutations disrupt the entry process. We further assess the effects of mutations on inhibition of entry by a neutralizing monoclonal antibody (C179) and find examples of increased and decreased sensitivity to the antibody, consistent with the antibody binding site observed by x-ray crystallography. In addition, we tested the sensitivity of the mutants to MBX2329, a small molecule inhibitor of influenza entry. Interestingly, the mutants exhibit increased and decreased sensitivities to MBX2329, which gives further insight into the binding site of the compound on HA and potential mechanisms of escape. Finally, we have modeled the binding site of MBX2329 using molecular dynamics and find that the resulting structure is in good agreement with the mutagenesis results. Together these studies underscore the importance of the stem loop region to HA function and suggest potential sites for therapeutic intervention of influenza entry. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

The effects of market structure and payment rate on the entry of private health plans into the Medicare market.

PubMed

Frakt, Austin B; Pizer, Steven D; Feldman, Roger

2012-01-01

Private insurance firms participating in Medicare can offer up to three principal plan types: coordinated care plans (CCPs), prescription drug plans (PDPs), and private fee-for-service (PFFS) plans. Firms can make entry and marketing decisions separately across plan types and geographic regions. In this study, we estimate firm-level models of Medicare private plan entry using data from the years 2007 to 2009. Our models include a measure of market structure and separately identify CCP, PDP, and PFFS entry. We find evidence that entry barriers associated with CCP market concentration affect all three product types. We also find evidence of cross-product competition and common cost or demand factors that make entry with certain product combinations more likely. We predict that the market presence of CCPs and PFFS plans will decrease and that of PDPs will increase in response to payment reductions included in the new health reform law.

Health systems: changes in hospital efficiency and profitability.

PubMed

Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas

2016-06-01

This study investigates potential changes in hospital performance after health system entry, while differentiating between hospital technical and cost efficiency and hospital profitability. In the first stage we obtained (bootstrapped) data envelopment analysis (DEA) efficiency scores. Then, genetic matching is used as a novel matching procedure in this context along with a difference-in-difference approach within a panel regression framework. With the genetic matching procedure, independent and health system hospitals are matched along a number of environmental and organizational characteristics. The results show that health system entry increases hospital technical and cost efficiency by between 0.6 and 3.4 % in four alternative post-entry periods, indicating that health system entry has not a transitory but rather a permanent effect on hospital efficiency. Regarding hospital profitability, the results reveal an increase in hospital profitability only 1 year after health system entry, and the estimations suggest that this effect is a transitional phenomenon. Overall, health system entry may serve as an appropriate management instrument for decision makers to increase hospital performance.

Dynamic Oligomerization of Integrase Orchestrates HIV Nuclear Entry.

PubMed

Borrenberghs, Doortje; Dirix, Lieve; De Wit, Flore; Rocha, Susana; Blokken, Jolien; De Houwer, Stéphanie; Gijsbers, Rik; Christ, Frauke; Hofkens, Johan; Hendrix, Jelle; Debyser, Zeger

2016-11-10

Nuclear entry is a selective, dynamic process granting the HIV-1 pre-integration complex (PIC) access to the chromatin. Classical analysis of nuclear entry of heterogeneous viral particles only yields averaged information. We now have employed single-virus fluorescence methods to follow the fate of single viral pre-integration complexes (PICs) during infection by visualizing HIV-1 integrase (IN). Nuclear entry is associated with a reduction in the number of IN molecules in the complexes while the interaction with LEDGF/p75 enhances IN oligomerization in the nucleus. Addition of LEDGINs, small molecule inhibitors of the IN-LEDGF/p75 interaction, during virus production, prematurely stabilizes a higher-order IN multimeric state, resulting in stable IN multimers resistant to a reduction in IN content and defective for nuclear entry. This suggests that a stringent size restriction determines nuclear pore entry. Taken together, this work demonstrates the power of single-virus imaging providing crucial insights in HIV replication and enabling mechanism-of-action studies.

Structures and Mechanisms Design Concepts for Adaptive Deployable Entry Placement Technology

NASA Technical Reports Server (NTRS)

Yount, Bryan C.; Arnold, James O.; Gage, Peter J.; Mockelman, Jeffrey; Venkatapathy, Ethiraj

2012-01-01

System studies have shown that large deployable aerodynamic decelerators such as the Adaptive Deployable Entry and Placement Technology (ADEPT) concept can revolutionize future robotic and human exploration missions involving atmospheric entry, descent and landing by significantly reducing the maximum heating rate, total heat load, and deceleration loads experienced by the spacecraft during entry [1-3]. ADEPT and the Hypersonic Inflatable Aerodynamic Decelerator (HIAD) [4] share the approach of stowing the entry system in the shroud of the launch vehicle and deploying it to a much larger diameter prior to entry. The ADEPT concept provides a low ballistic coefficient for planetary entry by employing an umbrella-like deployable structure consisting of ribs, struts and a fabric cover that form an aerodynamic decelerator capable of undergoing hypersonic flight. The ADEPT "skin" is a 3-D woven carbon cloth that serves as a thermal protection system (TPS) and as a structural surface that transfers aerodynamic forces to the underlying ribs [5]. This paper focuses on design activities associated with integrating ADEPT components (cloth, ribs, struts and mechanisms) into a system that can function across all configurations and environments of a typical mission concept: stowed during launch, in-space deployment, entry, descent, parachute deployment and separation from the landing payload. The baseline structures and mechanisms were selected via trade studies conducted during the summer and fall of 2012. They are now being incorporated into the design of a ground test article (GTA) that will be fabricated in 2013. It will be used to evaluate retention of the stowed configuration in a launch environment, mechanism operation for release, deployment and locking, and static strength of the deployed decelerator. Of particular interest are the carbon cloth interfaces, underlying hot structure, (Advanced Carbon- Carbon ribs) and other structural components (nose cap, struts, and main body) designed to withstand the pressure and extremely high heating experienced during planetary entry.

GlyCAM1 negatively regulates monocyte entry into the optic nerve head and contributes to radiation-based protection in glaucoma.

PubMed

Williams, Pete A; Braine, Catherine E; Foxworth, Nicole E; Cochran, Kelly E; John, Simon W M

2017-04-26

We previously reported a profound long-term neuroprotection subsequent to a single radiation-therapy in the DBA/2J mouse model of glaucoma. This neuroprotection prevents entry of monocyte-like immune cells into the optic nerve head during glaucoma. Gene expression studies in radiation-treated mice implicated Glycam1 in this protection. Glycam1 encodes a proteoglycan ligand for L-selectin and is an excellent candidate to modulate immune cell entry into the eye. Here, we experimentally test the hypothesis that radiation-induced over-expression of Glycam1 is a key component of the neuroprotection. We generated a null allele of Glycam1 on a DBA/2J background. Gene and protein expression of Glycam1, monocyte entry into the optic nerve head, retinal ganglion cell death, and axon loss in the optic nerve were assessed. Radiation therapy potently inhibits monocyte entry into the optic nerve head and prevents retinal ganglion cell death and axon loss. DBA/2J mice carrying a null allele of Glycam1 show increased monocyte entry and increased retinal ganglion cell death and axon loss following radiation therapy, but the majority of optic nerves were still protected by radiation therapy. Although GlyCAM1 is an L-selectin ligand, its roles in immunity are not yet fully defined. The current study demonstrates a partial role for GlyCAM1 in radiation-mediated protection. Furthermore, our results clearly show that GlyCAM1 levels modulate immune cell entry from the vasculature into neural tissues. As Glycam1 deficiency has a more profound effect on cell entry than on neurodegeneration, further experiments are needed to precisely define the role of monocyte entry in DBA/2J glaucoma. Nevertheless, GlyCAM1's function as a negative regulator of extravasation may lead to novel therapeutic strategies for an array of common conditions involving inflammation.

EntrySat: A 3U CubeStat to study the reentry atmospheric environment

NASA Astrophysics Data System (ADS)

Anthony, Sournac; Raphael, Garcia; David, Mimoun; Jeremie, Chaix

2016-04-01

ISAE France Entrysat has for main scientific objective the study of uncontrolled atmospheric re-entry. This project, is developed by ISAE in collaboration with ONERA and University of Toulouse, is funded by CNES, in the overall frame of the QB50 project. This nano-satellite is a 3U Cubesat measuring 34*10*10 cm3, similar to secondary debris produced during the break up of a spacecraft. EntrySat will collect the external and internal temperatures, pressure, heat flux, attitude variations and drag force of the satellite between ≈150 and 90 km before its destruction in the atmosphere, and transmit them during the re-entry using the IRIDIUM satellite network. The result will be compared with the computations of MUSIC/FAST, a new 6-degree of freedom code developed by ONERA to predict the trajectory of space debris. In order to fulfil the scientific objectives, the satellite will acquire 18 re-entry sensors signals, convert them and compress them, thanks to an electronic board developed by ISAE students in cooperation with EREMS. In order to transmit these data every second during the re-entry phase, the satellite will use an IRIDIUM connection. In order to keep a stable enough attitudes during this phase, a simple attitude orbit and control system using magnetotorquers and an inertial measurement unit (IMU) is developed at ISAE by students. A commercial GPS board is also integrated in the satellite into Entry Sat to determine its position and velocity which are necessary during the re-entry phase. This GPS will also be used to synchronize the on-board clock with the real-time UTC data. During the orbital phase (≈2 year) EntrySat measurements will be recorded transmitted through a more classical "UHF/VHF" connection. Preference for presentation: Poster Most suitable session: Author for correspondence: Dr Raphael F. Garcia ISAE 10, ave E. Belin, 31400 Toulouse, France Raphael.GARCIA@isae.fr +33 5 61 33 81 14

Medicare Payment Reform and Provider Entry and Exit in the Post-Acute Care Market

PubMed Central

Huckfeldt, Peter J; Sood, Neeraj; Romley, John A; Malchiodi, Alessandro; Escarce, José J

2013-01-01

Objective To understand the impacts of Medicare payment reform on the entry and exit of post-acute providers. Data Sources Medicare Provider of Services data, Cost Reports, and Census data from 1991 through 2010. Study Design We examined market-level changes in entry and exit after payment reforms relative to a preexisting time trend. We also compared changes in high Medicare share markets relative to lower Medicare share markets and for freestanding relative to hospital-based facilities. Data Extraction Methods We calculated market-level entry, exit, and total stock of home health agencies, skilled nursing facilities, and inpatient rehabilitation facilities from Provider of Services files between 1992 and 2010. We linked these measures with demographic information from the Census and American Community Survey, information on Certificate of Need laws, and Medicare share of facilities in each market drawn from Cost Report data. Principal Findings Payment reforms reducing average and marginal payments reduced entries and increased exits from the market. Entry effects were larger and more persistent than exit effects. Entry and exit rates fluctuated more for home health agencies than skilled nursing facilities. Effects on number of providers were consistent with entry and exit effects. Conclusions Payment reform affects market entry and exit, which in turn may affect market structure, access to care, quality and cost of care, and patient outcomes. Policy makers should consider potential impacts of payment reforms on post-acute care market structure when implementing these reforms. PMID:23557215

Evaluation and Influence of Brachiocephalic Branch Re-entry in Patients With Type A Acute Aortic Dissection.

PubMed

Yasuda, Shota; Imoto, Kiyotaka; Uchida, Keiji; Karube, Norihisa; Minami, Tomoyuki; Goda, Motohiko; Suzuki, Shinichi; Masuda, Munetaka

2016-12-22

Stanford type A acute aortic dissection (A-AAD) extends to the brachiocephalic branches in some patients. After ascending aortic replacement, a remaining re-entry tear in the distal brachiocephalic branches may act as an entry and result in a patent false lumen in the aortic arch. However, the effect of brachiocephalic branch re-entry concomitant with A-AAD remains unknown.Methods and Results:Eighty-five patients with A-AAD who underwent ascending aortic replacement in which both preoperative and postoperative multiple-detector computed tomography (MDCT) scans could be evaluated were retrospectively studied. The presence of a patent false lumen in at least one of the brachiocephalic branches on preoperative MDCT was defined as brachiocephalic branch re-entry, and 41 patients (48%) had this. Postoperatively, 47 of 85 (55%) patients had a patent false lumen in the aortic arch. False lumen remained patent after operation in 34 out of the 41 (83%) patients with brachiocephalic branch re-entry, as compared to that in 13 of the 44 (30%) patients without such re-entry (P<0.001). Brachiocephalic branch re-entry was a significant risk factor for a late increase in the aortic arch diameter greater than 10 mm (P=0.047). Brachiocephalic branch re-entry in patients with A-AAD is related to a patent false lumen in the aortic arch early after ascending aortic replacement and is a risk factor for late aortic arch enlargement.

Levels and determinants of pesticide exposure in re-entry workers in vineyards: results of the PESTEXPO study.

PubMed

Baldi, Isabelle; Lebailly, P; Bouvier, G; Rondeau, V; Kientz-Bouchart, V; Canal-Raffin, M; Garrigou, A

2014-07-01

Physical contact with branches, leaves, fruit or vegetables in previously treated crops is responsible for the transfer of pesticides to the worker's skin in agricultural tasks such as harvesting, pruning, thinning, cutting or sorting. Few studies have documented workers' exposure during re-entry in vineyards. In the PESTEXPO study, we described levels of exposure and analyzed their determinants during re-entry and harvesting in vineyards in the Bordeaux area, France. Between 2002 and 2007, volunteers performing re-entry tasks (N=46 days) or harvesting (N=48 days) after dithiocarbamate or folpet treatment were observed. Detailed information on the tasks was collected and dermal contamination was assessed using patches placed on the skin and hand-washing at the end of each working phase. Daily median contamination was 1 967.7 μl of mixture during re-entry (90(e) percentile: 5 045.3 μl) and 18.7 μl during harvesting (90(e) percentile: 911.4 μl). The type of task was the parameter found to be the most strongly associated with contamination. For re-entry, the highest contaminations were observed during raising of wires and cutting of branches. During the harvest, the contamination was maximal for grape-picking. The delay since the last treatment and the rate of active ingredient per hectare played a role, together with other factors such as meteorological factors, crop and farm characteristics, gloves and clothes. Our results underline the necessity to take into account exposures during re-entry and harvest when considering pesticide exposure, both for epidemiological research and preventive action. Copyright © 2014 Elsevier Inc. All rights reserved.

Potential predictors of susceptibility to occupational stress in Japanese novice nurses - a pilot study.

PubMed

Okita, Shinobu; Daitoku, Satoshi; Abe, Masaharu; Arimura, Emi; Setoyama, Hitoshi; Koriyama, Chihaya; Ushikai, Miharu; Kawaguchi, Hiroaki; Horiuchi, Masahisa

2017-04-04

Occupational stress is a known factor behind employee resignations; thus, early identification of individuals prone to such stress is important. Accordingly, in this pilot study we evaluated potential predictors of susceptibility to occupational stress in Japanese novice nurses. Forty-two female novice nurses at Kagoshima University Hospital were recruited for the study population. Each underwent physical health and urinary examinations, and completed a lifestyle questionnaire at the time of job entry. Each also completed a Brief Job Stress Questionnaire (BJSQ), related to mental health status, at job entry and 5 months post-entry. Psychological stress, somatic symptoms, and combined BJSQ scores were determined for each time point. All three stress condition scores had significantly decreased at 5 months post-entry, suggesting occupational stress. Systolic blood pressure (r = -0.324, p < 0.05) and urinary sodium (r = -0.313, p < 0.05) were significantly negatively correlated with combined BJSQ score at 5 months post-entry. Post-entry stress condition scores were significantly low in subjects reporting substantial 1-year body weight change (≤ ± 3 kg) and short times between dinner and bedtimes (≤2 h), though baseline stress condition scores were not. Urinary sodium concentration, 1-year body weight change, and pre-sleep evening meals were then targeted for multivariate analysis, and confirmed as independent explanatory variables for post-entry stress condition scores. One-year body weight change, times between dinner and bedtimes, and urinary sodium concentration are promising potential predictors of susceptibility to occupational stress, and should be further investigated in future research. ISRCTN ISRCTN17516023. Retrospectively registered 7 December 2016.

Step test performance and risk of stress fractures among female army trainees.

PubMed

Cowan, David N; Bedno, Sheryl A; Urban, Nadia; Lee, Dara S; Niebuhr, David W

2012-06-01

Stress fractures and other musculoskeletal injuries are major sources of morbidity among female military trainees. Several risk factors have been postulated, particularly pre-existing fitness, usually assessed with post-entry run time for ≥ 1.0 mile. Physical fitness is not formally evaluated prior to Army entry. If a valid and simple test that identified women at increased risk of stress fracture were available and could be applied prior to entry, it would facilitate cost-benefit studies of deferral or interventions. These analyses were undertaken to determine if a 5-minute step test conducted before entry identified women at increased risk. A prospective study was conducted of weight-qualified women entering the Army in 2005-2006, with analyses completed in 2011. At the pre-entry examination, information was collected on age, BMI, smoking, race, and activity level. Everyone took the step test. All outpatient medical encounters were captured, and stress fractures and other musculoskeletal injuries identified. Women with stress fractures and those with other musculoskeletal injuries were evaluated separately. 1568 women were included in the study; 109 developed stress fractures and 803 other musculoskeletal injury. Women who failed the step test had a 76% higher stress fracture incidence and a 35% higher incidence of other musculoskeletal injuries. There was effect modification between age and test failure for stress fracture. A step test that can be administered before military entry identifies women with increased incidence of stress fracture and other musculoskeletal injury. This test could be used pre-entry to defer or target high-risk recruits for tailored fitness training before or after military entrance. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.

The risk of stanford type-A aortic dissection with different tear size and location: a numerical study.

PubMed

Shi, Yue; Zhu, Minjia; Chang, Yu; Qiao, Huanyu; Liu, Yongmin

2016-12-28

This study is to investigate the influence of hemodynamics on Stanford type-A aortic dissection with different tear size and location, to provide some support for the relationships between the risks (rupture, reverse tearing and further tearing) and tear size and location for clinical treatment. Four numerical models of Stanford type-A aortic dissection were established, with different size and location of the tears. The ratio of the area between the entry and re-entry tears(RA) is various within the model; while, the size and the location of the re-entry in the distal descending aorta are fixed. In model A11 and A21, the entry tears are located near the ascending aorta. The RA in these models are 1 and 2, respectively; In the model B11 and B21, the entry tears are located near the proximal descending aorta and the RA in these models are again assigned to 1 and 2, respectively. Then hemodynamics in these models was solved with numerically and the flow patterns and loading distributions were investigated. The flow velocity of the true lumen in model A21, B21 is lower than that in A11, B11, respectively; the time-averaged wall shear stress (TAWSS) of the false lumen in model A21 and B21 is higher, and for ascending aorta false lumen, A11, A21 are higher than B11, B21, respectively. False lumen intimal wall pressure of A11, A21 are always higher than the true lumen ones. The variation of the RA can significantly affect the dynamics of blood within the aortic dissection. When the entry tear size is larger than the re-entry tear ones, the false lumen, proximal descending aorta and the wall near re-entry tear are prone to cracking. Entry tear location can significantly alter the hemodynamics of aortic dissection as well. When entry tear location is closer to proximal ascending aorta, false lumen continues to expand and compress the true lumen resulting in the true lumen reduction. For proximal ascending aorta, high pressure in false lumen predicts a higher risk of reverse tear.

A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel.

PubMed

Pourshaikhian, Majid; Abolghasem Gorji, Hassan; Aryankhesal, Aidin; Khorasani-Zavareh, Davood; Barati, Ahmad

2016-03-01

In spite of the high prevalence and consequences of much workplace violence against emergency medical services personnel, this phenomenon has been given insufficient attention. A systematic review can aid the development of guidelines to reduce violence. The research question addressed by this paper is, "What are the characteristics and findings of studies on workplace violence against emergency medical services personnel"? A systematic literature review was conducted using online databases (PubMed, Scopus, Google Scholar, and Magiran) with the help of experienced librarians. Inclusion criteria comprised studies in the English or Persian language and researcher's access to the full text. There was no limit to the entry of the study design. Exclusion criteria included lack of access to the full text of the article, studies published in unreliable journals or conferences, and studies in which the results were shared with other medical or relief groups and there was no possibility of breaking down the results. A "Data extraction form" was designed by the researchers based on the goals of the study that included the title and author(s), study method (type, place of study, sample size, sampling method, and data collection/analysis tool), printing location, information related to the frequency of types of violence, characteristics of victims /perpetrators, and related factors. The papers reviewed utilized a variety of locations and environments, methods, and instrument samplings. The majority of the studies were performed using the quantitative method. No intervention study was found. Most studies focused on the prevalence of violence, and their results indicated that exposure to violence was high. The results are presented in six major themes. Workplace violence and injuries incurred from it are extensive throughout the world. The important causes of violence include the shortage of training programs dealing with violence, lack of violence management protocols, and delays in response times. Therefore, afterthought and resolve are more crucial than ever. Workplace violence reduction strategies and suggestions for future studies are also discussed.

Protein tyrosine phosphatase-1B (PTP1B) helps regulate EGF-induced stimulation of S-phase entry in human corneal endothelial cells

PubMed Central

Ishino, Yutaka; Zhu, Cheng; Harris, Deshea L.

2008-01-01

Purpose Human corneal endothelial cells (HCEC), particularly from older donors, only proliferate weakly in response to EGF. The protein tyrosine phosphatase, PTP1B, is known to negatively regulate EGF-induced signaling in several cell types by dephosphorylating the epidermal growth factor receptor (EGFR). The current studies were conducted to determine whether PTP1B plays a role in regulating cell cycle entry in HCEC in response to EGF stimulation. Methods Donor corneas were obtained from the National Disease Research Interchange and accepted for study based on established exclusion criteria. PTP1B was localized in the endothelium of ex vivo corneas and in cultured cells by immunocytochemistry. Western blot analysis verified PTP1B protein expression in HCEC and then compared the relative expression of EGFR and PTP1B in HCEC from young (<3 years old) and older donors (>60 years old). The effect of inhibiting the activity of PTP1B on S-phase entry was tested by comparing time-dependent BrdU incorporation in subconfluent HCEC incubated in the presence or absence of the PTP1B inhibitor, CinnGEL 2Me, before EGF stimulation. Results PTP1B was localized in a punctate pattern mainly within the cytoplasm of HCEC in ex vivo corneas and cultured cells. Western blots revealed the presence of three PTP1B-positive bands in HCEC and the control. Further western blot analysis showed no significant age-related difference in expression of EGFR (p=0.444>0.05); however, PTP1B expression was significantly higher in HCEC from older donors (p=0.024<0.05). Pre-incubation of HCEC with the PTP1B inhibitor significantly increased (p=0.019<0.05) the number of BrdU positive cells by 48 h after EGF stimulation. Conclusions Both immunolocalization and western blot studies confirmed that PTP1B is expressed in HCEC. Staining patterns strongly suggest that at least a subset of PTP1B is localized to the cytoplasm and most likely to the endoplasmic reticulum, the known site of EGFR/PTP1B interaction following EGF stimulation. PTP1B expression, but not EGFR expression, was elevated in HCEC from older donors, suggesting that the reduced proliferative activity of these cells in response to EGF is due, at least in part, to increased PTP1B activity. The fact that inhibition of PTP1B increased the relative number of cells entering S-phase strongly suggests that PTP1B helps negatively regulate EGF-stimulated cell cycle entry in HCEC. These results also suggest that it may be possible to increase the proliferative activity of HCEC, particularly in cells from older donors, by inhibiting the activity of this important protein tyrosine phosphatase. PMID:18253097

A Method for Semi-quantitative Assessment of Exposure to Pesticides of Applicators and Re-entry Workers: An Application in Three Farming Systems in Ethiopia.

PubMed

Negatu, Beyene; Vermeulen, Roel; Mekonnen, Yalemtshay; Kromhout, Hans

2016-07-01

To develop an inexpensive and easily adaptable semi-quantitative exposure assessment method to characterize exposure to pesticide in applicators and re-entry farmers and farm workers in Ethiopia. Two specific semi-quantitative exposure algorithms for pesticides applicators and re-entry workers were developed and applied to 601 farm workers employed in 3 distinctly different farming systems [small-scale irrigated, large-scale greenhouses (LSGH), and large-scale open (LSO)] in Ethiopia. The algorithm for applicators was based on exposure-modifying factors including application methods, farm layout (open or closed), pesticide mixing conditions, cleaning of spraying equipment, intensity of pesticide application per day, utilization of personal protective equipment (PPE), personal hygienic behavior, annual frequency of application, and duration of employment at the farm. The algorithm for re-entry work was based on an expert-based re-entry exposure intensity score, utilization of PPE, personal hygienic behavior, annual frequency of re-entry work, and duration of employment at the farm. The algorithms allowed estimation of daily, annual and cumulative lifetime exposure for applicators, and re-entry workers by farming system, by gender, and by age group. For all metrics, highest exposures occurred in LSGH for both applicators and female re-entry workers. For male re-entry workers, highest cumulative exposure occurred in LSO farms. Female re-entry workers appeared to be higher exposed on a daily or annual basis than male re-entry workers, but their cumulative exposures were similar due to the fact that on average males had longer tenure. Factors related to intensity of exposure (like application method and farm layout) were indicated as the main driving factors for estimated potential exposure. Use of personal protection, hygienic behavior, and duration of employment in surveyed farm workers contributed less to the contrast in exposure estimates. This study indicated that farmers' and farm workers' exposure to pesticides can be inexpensively characterized, ranked, and classified. Our method could be extended to assess exposure to specific active ingredients provided that detailed information on pesticides used is available. The resulting exposure estimates will consequently be used in occupational epidemiology studies in Ethiopia and other similar countries with few resources. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Impact of selective posterior rhizotomy on fine motor skills. Long-term results using a validated evaluative measure.

PubMed

Mittal, Sandeep; Farmer, Jean-Pierre; Al-Atassi, Borhan; Montpetit, Kathleen; Gervais, Nathalie; Poulin, Chantal; Cantin, Marie-André; Benaroch, Thierry E

2002-03-01

Suprasegmental effects following selective posterior rhizotomy have been frequently reported. However, few studies have used validated functional outcome measures to report the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term impact of lumbosacral dorsal rhizotomy on fine motor skills. The study population comprised children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively, at 6 months and 1 year postoperatively. Quantitative standardized assessments of upper extremity function were obtained using the fine motor skills section of the Peabody Developmental Motor Scales (PDMS) test. Of 70 patients who met the entry criteria for the study, 45 and 25 completed the 3- and 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in grasping, hand use, eye-hand coordination, and manual dexterity at 1 year after SPR. More importantly, all improvements were maintained at 3 and 5 years following SPR. This study supports that significant improvements in upper extremity fine motor function using the PDMS evaluative measure are present after SPR and that these suprasegmental benefits are durable. Copyright 2002 S. Karger AG, Basel

Clinical and serologic factors associated with lupus pleuritis.

PubMed

Mittoo, Shikha; Gelber, Allan C; Hitchon, Carol A; Silverman, Earl D; Pope, Janet E; Fortin, Paul R; Pineau, Christian; Smith, C Douglas; Arbillaga, Hector; Gladman, Dafna D; Urowitz, Murray B; Zummer, Michel; Clarke, Ann E; Bernatsky, Sasha; Hudson, Marie; Tucker, Lori B; Petty, Ross E; Peschken, Christine A

2010-04-01

Pleuritis is a common manifestation and independent predictor of mortality in systemic lupus erythematosus (SLE). We examined the prevalence of pleuritis and factors associated with pleuritis in a multicenter Canadian SLE cohort. We studied consecutive adults satisfying the American College of Rheumatology (ACR) classification criteria for SLE who had a completed Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) score, at least 1 evaluable extractable nuclear antigen assay, and either a SLE Disease Activity Index (SLEDAI) or a SLE Activity Measure score. Pleuritis was defined as having pleuritis by satisfying the ACR criteria or the SLEDAI. Factors related to pleuritis were examined using univariate and multivariate logistic regression. In our cohort of 876 patients, 91% were women, 65% Caucasian, mean age (+/- SD) was 46.8 +/- 13.5 years, and disease duration at study entry was 12.1 +/- 9.9 years; the prevalence of pleuritis was 34% (n = 296). Notably, greater disease duration (p = 0.002), higher SDI score (p

Ten-year incidence of dementia in a rural elderly US community population: the MoVIES Project.

PubMed

Ganguli, M; Dodge, H H; Chen, P; Belle, S; DeKosky, S T

2000-03-14

To determine incidence rates by age, sex, and education of overall dementia and probable/ possible AD in a largely rural community. Ten-year prospective study of a randomly selected community sample aged 65+; biennial cognitive screening followed by standardized clinical evaluation. Incidence rates were estimated for overall dementia (Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., revised, criteria and Clinical Dementia Rating [CDR]) and for probable/possible AD (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria). The cohort consisted of 1,298 individuals free of dementia at study entry. Among these, 199 incident (new) cases of overall (all-cause) dementia with CDR stage > or = 0.5, including 110 with CDR > or = 1, were detected during follow-up. Among the incident cases, 153 (76.9%) had probable/ possible AD. Age-specific incidence rates are reported for all dementia and for probable/possible AD, by sex and CDR stage. Among all-cause dementias with CDR = 0.5, controlling for age and education, men had a higher incidence rate than women. In the same group, those with less than high school education had significantly higher incidence rates than those with more education. Rates did not vary significantly by sex or education for probable/possible AD or for dementia with CDR > or = 1. Incidence rates of all dementias and of AD increased with age; men and those with lesser education had higher rates of possible/incipient dementia (CDR = 0.5) in this community. Potential explanations for these sex and education effects are discussed.

Prior Work and Educational Experience Are Not Associated With Successful Completion of a Master's-Level, Distance Education Midwifery Program.

PubMed

Niemczyk, Nancy A; Cutts, Alison; Perlman, Dana B

2018-03-01

In order to increase and diversify the midwifery workforce, admissions criteria for midwifery education programs must not contain unnecessary barriers to entry. Once accepted, students need to successfully complete the program. Many admissions criteria commonly used in midwifery education programs in the United States are not evidence based and could be unnecessary barriers to education. The primary objective of this study was to identify factors known during the admission process that were related to successful completion or failure to complete a midwifery program educating both student nurse-midwives (SNMs) and student midwives (SMs); a secondary objective was to quantify reasons for program noncompletion. This master's-level, distance education program educates a diverse group of both SNMs and SMs. A pilot, retrospective cohort study examined all students matriculating at the program from fall 2012 on and scheduled to graduate by summer 2016 (N = 58). Demographic information, admissions information, academic records, and advising notes were reviewed. Reasons for noncompletion were identified, and characteristics were compared between students who did and did not complete the program. Program completion was not significantly associated with students' status as nurses prior to admission, labor and delivery nursing experience, length of nursing experience, nursing degree held, presence of children at home, working while in school, or undergraduate grade point average. Being a nurse, years of nursing experience, type of nursing degree, or labor and delivery nursing experience were not associated with completion of this midwifery program. © 2018 by the American College of Nurse-Midwives.

Comparison of interbody fusion approaches for disabling low back pain.

PubMed

Hacker, R J

1997-03-15

This is a study comparing two groups of patients surgically treated for disabling low back pain. One group was treated with lumbar anteroposterior fusion (360 degrees fusion), the other with posterior lumbar interbody fusion and an interbody fixation device. To determine which approach provided the best and most cost-effective outcome using similar patient selection criteria. Others have shown that certain patients with disabling low back pain benefit from lumbar fusion. Although rarely reported, the costs of different surgical treatments appear to vary significantly, whereas the patient outcome may vary little. Since 1991, 75 patients have been treated Starting in 1993, posterior lumbar interbody fusion BAK was offered to patients as an alternative to 360 degrees fusion. The treating surgeon reviewed the cases. The interbody fixation device used (BAK; Spine-Tech, Inc., Minneapolis, MN) was part of a Food and Drug Administration study. Patient selection criteria included examination, response to conservative therapy, imaging, psychological profile, and discography. North American Spine Society outcome questionnaires, BAK investigation data radiographs, chart entries, billing records and patient interviews were the basis for assessment. Age, sex compensable injury history and history of previous surgery were similar. Operative time; blood loss, hospitalization time, and total costs were significantly different. There was a quicker return to work and closure of workers compensation claims for the posterior lumbar interbody fusion-BAK group. Patient satisfaction was comparable at last follow-up. Posterior lumbar interbody fusion-BAK achieves equal patient satisfaction but fiscally surpasses the 360 degrees fusion approach. Today's environment of regulated medical practice requires the surgeon to consider cost effectiveness when performing fusion for low back pain.

Midwives and the Computerization of Perinatal Data Entry: The Theory of Beneficial Engagement.

PubMed

Craswell, Alison; Moxham, Lorna; Broadbent, Marc

2016-10-01

Theory building in nursing and midwifery both to explain and inform practice is important to advance these professions via provision of a theoretical foundation. This research explored the process of perinatal data entry undertaken by midwives to explore the impact of the movement from paper to computer collection of data. Use of grounded theory methodology enabled theory building, leading to a theoretical understanding of the phenomenon and development of the Theory of Beneficial Engagement grounded in the data. Methods involved in-depth semistructured interviews with 15 users of perinatal data systems. Participants were recruited from 12 different healthcare locations and were utilizing three different electronic systems for data entry. The research question that guided the study focused on examining the influences of using the computer for perinatal data entry. Findings indicated that qualities particular to some midwives denoted engagement with perinatal data entry, suggesting a strong desire to enter complete, timely, and accurate data. The Theory of Beneficial Engagement provides a model of user engagement with systems for perinatal data entry consistent with other theories of engagement. The theory developed describes this phenomenon in a simple, elegant manner that can be applied to other areas where mandatory data entry is undertaken.

Entry, Descent, and Landing Guidance and Control Approaches to Satisfy Mars Human Mission Landing Criteria

NASA Technical Reports Server (NTRS)

Dwyer Cianciolo, Alicia; Powell, Richard W.

2017-01-01

Precision landing on Mars is a challenge. All Mars lander missions prior to the 2012 Mars Science Laboratory (MSL) had landing location uncertainty ellipses on the order of hundreds of kilometers. Sending humans to the surface of Mars will likely require multiple landers delivered in close proximity, which will in turn require orders of magnitude improvement in landing accuracy. MSL was the first Mars mission to use an Apollo-derived bank angle guidance to reduce the size of the landing ellipse. It utilized commanded bank angle magnitude to control total range and bank angle reversals to control cross range. A shortcoming of this bank angle guidance is that the open loop phase of flight created by use of bank reversals increases targeting errors. This paper presents a comparison of entry, descent and landing performance for a vehicle with a low lift-to-drag ratio using both bank angle control and an alternative guidance called Direct Force Control (DFC). DFC eliminates the open loop flight errors by directly controlling two forces independently, lift and side force. This permits independent control of down range and cross range. Performance results, evaluated using the Program to Optimize Simulated Trajectories (POST2), including propellant use and landing accuracy, are presented.

Intellectual property rights and challenges for development of affordable human papillomavirus, rotavirus and pneumococcal vaccines: Patent landscaping and perspectives of developing country vaccine manufacturers.

PubMed

Chandrasekharan, Subhashini; Amin, Tahir; Kim, Joyce; Furrer, Eliane; Matterson, Anna-Carin; Schwalbe, Nina; Nguyen, Aurélia

2015-11-17

The success of Gavi, the Vaccine Alliance depends on the vaccine markets providing appropriate, affordable vaccines at sufficient and reliable quantities. Gavi's current supplier base for new and underutilized vaccines, such as the human papillomavirus (HPV), rotavirus, and the pneumococcal conjugate vaccine is very small. There is growing concern that following globalization of laws on intellectual property rights (IPRs) through trade agreements, IPRs are impeding new manufacturers from entering the market with competing vaccines. This article examines the extent to which IPRs, specifically patents, can create such obstacles, in particular for developing country vaccine manufacturers (DCVMs). Through building patent landscapes in Brazil, China, and India and interviews with manufacturers and experts in the field, we found intense patenting activity for the HPV and pneumococcal vaccines that could potentially delay the entry of new manufacturers. Increased transparency around patenting of vaccine technologies, stricter patentability criteria suited for local development needs and strengthening of IPRs management capabilities where relevant, may help reduce impediments to market entry for new manufacturers and ensure a competitive supplier base for quality vaccines at sustainably low prices. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparison of cryoablation with 3D mapping versus conventional mapping for the treatment of atrioventricular re-entrant tachycardia and right-sided paraseptal accessory pathways.

PubMed

Russo, Mario S; Drago, Fabrizio; Silvetti, Massimo S; Righi, Daniela; Di Mambro, Corrado; Placidi, Silvia; Prosperi, Monica; Ciani, Michele; Naso Onofrio, Maria T; Cannatà, Vittorio

2016-06-01

Aim Transcatheter cryoablation is a well-established technique for the treatment of atrioventricular nodal re-entry tachycardia and atrioventricular re-entry tachycardia in children. Fluoroscopy or three-dimensional mapping systems can be used to perform the ablation procedure. The aim of this study was to compare the success rate of cryoablation procedures for the treatment of right septal accessory pathways and atrioventricular nodal re-entry circuits in children using conventional or three-dimensional mapping and to evaluate whether three-dimensional mapping was associated with reduced patient radiation dose compared with traditional mapping. In 2013, 81 children underwent transcatheter cryoablation at our institution, using conventional mapping in 41 children - 32 atrioventricular nodal re-entry tachycardia and nine atrioventricular re-entry tachycardia - and three-dimensional mapping in 40 children - 24 atrioventricular nodal re-entry tachycardia and 16 atrioventricular re-entry tachycardia. Using conventional mapping, the overall success rate was 78.1 and 66.7% in patients with atrioventricular nodal re-entry tachycardia or atrioventricular re-entry tachycardia, respectively. Using three-dimensional mapping, the overall success rate was 91.6 and 75%, respectively (p=ns). The use of three-dimensional mapping was associated with a reduction in cumulative air kerma and cumulative air kerma-area product of 76.4 and 67.3%, respectively (p<0.05). The use of three-dimensional mapping compared with the conventional fluoroscopy-guided method for cryoablation of right septal accessory pathways and atrioventricular nodal re-entry circuits in children was associated with a significant reduction in patient radiation dose without an increase in success rate.

Multiple Cationic Amphiphiles Induce a Niemann-Pick C Phenotype and Inhibit Ebola Virus Entry and Infection

PubMed Central

Shoemaker, Charles J.; Schornberg, Kathryn L.; Delos, Sue E.; Scully, Corinne; Pajouhesh, Hassan; Olinger, Gene G.; Johansen, Lisa M.; White, Judith M.

2013-01-01

Ebola virus (EBOV) is an enveloped RNA virus that causes hemorrhagic fever in humans and non-human primates. Infection requires internalization from the cell surface and trafficking to a late endocytic compartment, where viral fusion occurs, providing a conduit for the viral genome to enter the cytoplasm and initiate replication. In a concurrent study, we identified clomiphene as a potent inhibitor of EBOV entry. Here, we screened eleven inhibitors that target the same biosynthetic pathway as clomiphene. From this screen we identified six compounds, including U18666A, that block EBOV infection (IC50 1.6 to 8.0 µM) at a late stage of entry. Intriguingly, all six are cationic amphiphiles that share additional chemical features. U18666A induces phenotypes, including cholesterol accumulation in endosomes, associated with defects in Niemann–Pick C1 protein (NPC1), a late endosomal and lysosomal protein required for EBOV entry. We tested and found that all six EBOV entry inhibitors from our screen induced cholesterol accumulation. We further showed that higher concentrations of cationic amphiphiles are required to inhibit EBOV entry into cells that overexpress NPC1 than parental cells, supporting the contention that they inhibit EBOV entry in an NPC1-dependent manner. A previously reported inhibitor, compound 3.47, inhibits EBOV entry by blocking binding of the EBOV glycoprotein to NPC1. None of the cationic amphiphiles tested had this effect. Hence, multiple cationic amphiphiles (including several FDA approved agents) inhibit EBOV entry in an NPC1-dependent fashion, but by a mechanism distinct from that of compound 3.47. Our findings suggest that there are minimally two ways of perturbing NPC1-dependent pathways that can block EBOV entry, increasing the attractiveness of NPC1 as an anti-filoviral therapeutic target. PMID:23441171

Communications Blackout Predictions for Atmospheric Entry of Mars Science Laboratory

NASA Technical Reports Server (NTRS)

Morabito, David D.; Edquist, Karl

2005-01-01

The Mars Science Laboratory (MSL) is expected to be a long-range, long-duration science laboratory rover on the Martian surface. MSL will provide a significant milestone that paves the way for future landed missions to Mars. NASA is studying options to launch MSL as early as 2009. MSL will be the first mission to demonstrate the new technology of 'smart landers', which include precision landing and hazard avoidance in order to -land at scientifically interesting sites that would otherwise be unreachable. There are three elements to the spacecraft; carrier (cruise stage), entry vehicle, and rover. The rover will have an X-band direct-to-Earth (DTE) link as well as a UHF proximity link. There is also a possibility of an X-band proximity link. Given the importance of collecting critical event telemetry data during atmospheric entry, it is important to understand the ability of a signal link to be maintained, especially during the period near peak convective heating. The received telemetry during entry (or played back later) will allow for the performance of the Entry-Descent-Landing technologies to be assessed. These technologies include guided entry for precision landing, hazard avoidance, a new sky-crane landing system and powered descent. MSL will undergo an entry profile that may result in a potential communications blackout caused by ionized plasma for short periods near peak heating. The vehicle will use UHF and possibly X-band during the entry phase. The purpose of this report is to quantify or bound the likelihood of any such blackout at UHF frequencies (401 MHz) and X-band frequencies (8.4 GHz). Two entry trajectory scenarios were evaluated: a stressful entry trajectory to quantify an upper-bound for any possible blackout period, and a nominal likely trajectory to quantify likelihood of blackout for such cases.

Source Distributions of Substorm Ions Observed in the Near-Earth Magnetotail

NASA Technical Reports Server (NTRS)

Ashour-Abdalla, M.; El-Alaoui, M.; Peroomian, V.; Walker, R. J.; Raeder, J.; Frank, L. A.; Paterson, W. R.

1999-01-01

This study employs Geotail plasma observations and numerical modeling to determine sources of the ions observed in the near-Earth magnetotail near midnight during a substorm. The growth phase has the low-latitude boundary layer as its most important source of ions at Geotail, but during the expansion phase the plasma mantle is dominant. The mantle distribution shows evidence of two distinct entry mechanisms: entry through a high latitude reconnection region resulting in an accelerated component, and entry through open field lines traditionally identified with the mantle source. The two entry mechanisms are separated in time, with the high-latitude reconnection region disappearing prior to substorm onset.

Boronic acid-modified lipid nanocapsules: a novel platform for the highly efficient inhibition of hepatitis C viral entry

NASA Astrophysics Data System (ADS)

Khanal, Manakamana; Barras, Alexandre; Vausselin, Thibaut; Fénéant, Lucie; Boukherroub, Rabah; Siriwardena, Aloysius; Dubuisson, Jean; Szunerits, Sabine

2015-01-01

The search for viral entry inhibitors that selectively target viral envelope glycoproteins has attracted increasing interest in recent years. Amongst the handful of molecules reported to show activity as hepatitis C virus (HCV) entry inhibitors are a variety of glycan-binding proteins including the lectins, cyanovirin-N (CV-N) and griffithsin. We recently demonstrated that boronic acid-modified nanoparticles are able to reduce HCV entry through a similar mechanism to that of lectins. A major obstacle to any further development of these nanostructures as viral entry inhibitors is their only moderate maximal inhibition potential. In the present study, we report that lipid nanocapsules (LNCs), surface-functionalized with amphiphilic boronic acid (BA) through their post-insertion into the semi-rigid shell of the LNCs, are indeed far superior as HCV entry inhibitors when compared with previously reported nanostructures. These 2nd generation particles (BA-LNCs) are shown to prevent HCV infection in the micromolar range (IC50 = 5.4 μM of BA moieties), whereas the corresponding BA monomers show no significant effects even at the highest analyzed concentration (20 μM). The new BA-LNCs are the most promising boronolectin-based HCV entry inhibitors reported to date and are thus observed to show great promise in the development of a pseudolectin-based therapeutic agent.The search for viral entry inhibitors that selectively target viral envelope glycoproteins has attracted increasing interest in recent years. Amongst the handful of molecules reported to show activity as hepatitis C virus (HCV) entry inhibitors are a variety of glycan-binding proteins including the lectins, cyanovirin-N (CV-N) and griffithsin. We recently demonstrated that boronic acid-modified nanoparticles are able to reduce HCV entry through a similar mechanism to that of lectins. A major obstacle to any further development of these nanostructures as viral entry inhibitors is their only moderate maximal inhibition potential. In the present study, we report that lipid nanocapsules (LNCs), surface-functionalized with amphiphilic boronic acid (BA) through their post-insertion into the semi-rigid shell of the LNCs, are indeed far superior as HCV entry inhibitors when compared with previously reported nanostructures. These 2nd generation particles (BA-LNCs) are shown to prevent HCV infection in the micromolar range (IC50 = 5.4 μM of BA moieties), whereas the corresponding BA monomers show no significant effects even at the highest analyzed concentration (20 μM). The new BA-LNCs are the most promising boronolectin-based HCV entry inhibitors reported to date and are thus observed to show great promise in the development of a pseudolectin-based therapeutic agent. Electronic supplementary information (ESI) available. See DOI: 10.1039/c4nr03875d

Use of a Re-entry Device in Left Subclavian Occlusion: Case Series.

PubMed

Thomas, Wiliam Rhodri; Chick, Christopher; Goyal, Nimit

2018-01-01

To describe the use of a re-entry catheter in the endovascular treatment of left subclavian stenosis. We present three patients where initial attempts at re-vascularisation using standard techniques were unsuccessful. An OUTBACK catheter was employed to facilitate re-entry in these patients. True lumen re-entry was achieved in all patients, leading to successful treatment of all stenoses. There was a lack of filling of the left vertebral artery post-angioplasty in one patient; this was not clinically significant. The case series presented is encouraging for the use of a re-entry catheter in the treatment of subclavian occlusion. In our limited experience this has proved to be a safe technique for use in patients who fail re-vascularisation by standard methods; a larger study is required to confirm this.

Overview of the Mars Sample Return Earth Entry Vehicle

NASA Technical Reports Server (NTRS)

Dillman, Robert; Corliss, James

2008-01-01

NASA's Mars Sample Return (MSR) project will bring Mars surface and atmosphere samples back to Earth for detailed examination. Langley Research Center's MSR Earth Entry Vehicle (EEV) is a core part of the mission, protecting the sample container during atmospheric entry, descent, and landing. Planetary protection requirements demand a higher reliability from the EEV than for any previous planetary entry vehicle. An overview of the EEV design and preliminary analysis is presented, with a follow-on discussion of recommended future design trade studies to be performed over the next several years in support of an MSR launch in 2018 or 2020. Planned topics include vehicle size for impact protection of a range of sample container sizes, outer mold line changes to achieve surface sterilization during re-entry, micrometeoroid protection, aerodynamic stability, thermal protection, and structural materials selection.

A focus on extracellular Ca2+ entry into skeletal muscle

PubMed Central

Cho, Chung-Hyun; Woo, Jin Seok; Perez, Claudio F; Lee, Eun Hui

2017-01-01

The main task of skeletal muscle is contraction and relaxation for body movement and posture maintenance. During contraction and relaxation, Ca2+ in the cytosol has a critical role in activating and deactivating a series of contractile proteins. In skeletal muscle, the cytosolic Ca2+ level is mainly determined by Ca2+ movements between the cytosol and the sarcoplasmic reticulum. The importance of Ca2+ entry from extracellular spaces to the cytosol has gained significant attention over the past decade. Store-operated Ca2+ entry with a low amplitude and relatively slow kinetics is a main extracellular Ca2+ entryway into skeletal muscle. Herein, recent studies on extracellular Ca2+ entry into skeletal muscle are reviewed along with descriptions of the proteins that are related to extracellular Ca2+ entry and their influences on skeletal muscle function and disease. PMID:28912570

Atlas instrumentation guided by the medial edge of the posterior arch: An anatomic and radiologic study.

PubMed

Al-Habib, Amro F; Al-Rabie, Abdulkarim; Aleissa, Sami; Albakr, Abdulrahman; Abobotain, Abdulaziz

2017-01-01

This was an interventional human cadaver study and radiological study. Atlas instrumentation is frequently involved in fusion procedures involving the craniocervical junction area. Identification of the entry point at the center of atlas lateral mass (ALM) is challenging because of its rounded posterior surface and the surrounding venous plexus. This report examines using the medial edge of atlas posterior arch (MEC1) as a fixed and reliable anatomic reference to guide the entry point of ALM screws. Fifty, normal, cervical spine computed tomography studies were reviewed. ALM screw trajectories were planned at one point along MEC1 and another point 2 mm lateral to MEC1. Free-hand ALM instrumentation was performed in ten fresh human cadavers using the 2 mm entry point, with a sagittal trajectory parallel to atlas inferior arch (IAC1); three-dimensional imaging was then performed to confirm instrumentation accuracy. The average ALM diameter was 12.35 mm. Inserting a screw using the entry point 2 mm lateral to MEC1 was closer to ALM midpoint than using the entry point along MEC1 ( P < 0.0001). Twenty ALM screws were successfully inserted in the ten cadavers. No encroachments into the spinal canal or foramen transversarium occurred. However, two screws were superiorly directed and violated the occipitocervical joint; they were not parallel to IAC1. MEC1 provides a fixed and reliable landmark for ALM instrumentation. An entry point 2 mm point lateral to MEC1 is close to ALM midpoint. IAC1 also provides a guide for the sagittal trajectory. Attention to anatomic landmarks may help reduce complications associated with atlas instrumentation but should be verified in future clinical studies.

76 FR 47148 - Application(s) for Duty-Free Entry of Scientific Instruments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... work in microbiology and pathology, to study biological materials in order to identify bacterial or viral pathogens with clinical significance in veterinary medicine. Justification for Duty-Free Entry: No...

A cooperative study of gate entry designs: Welbeck Colliery (UK) and Jim Walter Resources (USA)

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

Hendon, G.; Carr, F.; Lewis, A.

1995-11-01

Longwall developments in the UK have historically consisted of single entry gate roads. Adjacent developments were separated from existing pales by large barrier pillars (designed of sufficient width to get away from the longwall abutments of the previous panel) or by small barriers driven in the shadow, or de-stressed zone, of the previous panel. Some 2nd panel tailgates were also driven skin to skin leaving no coal barrier between the newly driven entry and the heavily supported existing gateroad. With the development and wide acceptance of fully bolted entries and the pressure to reduce production costs, alternatives to single entrymore » drivage, particularly yield pillar developments, were examined. Through the Rock Mechanics Branch of british Coal, a cooperative study was begun with Jim Walter Resources, Inc., USA, (JWR) to look at the yield pillar alternative in detail. This study was to determine the feasibility of utilizing yield pillars in the UK and to determine, through monitoring, the possibility of reducing stable pillar widths at JWR. The study has included extensive monitoring of the yield-stable-yield pillar system at JWR No. 7 Mine and an underground trial of a two entry yield pillar test area at Welbeck Colliery in the UK. This paper describes results from the JWR study and the subsequent results of the first advancing yield pillar development in the UK at Welbeck Colliery.« less

Comparisons of musculoskeletal complaints and data entry between a sitting and a sit-stand workstation paradigm.

PubMed

Husemann, Britta; Von Mach, Carolin Yvonne; Borsotto, Daniel; Zepf, Kirsten Isabel; Scharnbacher, Jutta

2009-06-01

Seated working positions are often regarded as a cause for discomfort in the musculoskeletal system. Performing work in different working positions--that is, alternating between sitting and standing (sit-stand workstation paradigm)--could help reduce physical complaints. The questions were whether performing office work partly in a standing position leads to reduced complaints and whether standing would change the efficiency of data entry office work. We investigated the effect of a sit-stand workstation paradigmd during experimental data entry office work on physical and psychological complaints and data entry efficiency by conducting a randomized controlled trial with 60 male participants ages 18 to 35 years. In this experiment, musculoskeletal complaints were reduced by a sit-stand workstation paradigm. A trend could be identified indicating a small but nonsignificant loss of efficiency in data entry while standing. A sit-stand workstation paradigm reduces musculoskeletal complaints without considerably affecting data entry efficiency under the presented study conditions (young male participants, short duration, fixed and controlled sit-stand workstation paradigm, simulated experimental working condition). According to the present data, implementing a sit-stand workstation paradigm can be an effective workplace health intervention to reduce musculoskeletal complaints. This experiment encourages further studies on the effectiveness of a sit-stand workstation paradigm. Experimental research and field studies that prove the reduction of complaints when introducing a sit-stand workstation paradigm in the workplace could be the basis for evidence-based recommendations regarding such interventions.

Predicting risk of entry into foster care from early childhood experiences: A survival analysis using LONGSCAN data.

PubMed

English, Diana J; Thompson, Richard; White, Catherine Roller

2015-07-01

This study examined whether a multi-domain model of maltreatment informed by an ecological framework-including factors related to the child, caregiver, family, neighborhood, and dimensions of maltreatment experience-predicted entry into foster care between the ages of 4 and 18 among children with no prior foster care experience. To determine which factors predict entry into foster care, secondary data analyses were conducted utilizing a sub-sample from LONGSCAN (Longitudinal Studies of Child Abuse and Neglect) of 942 children and their primary caregivers. Results demonstrate that there are important predictors for entry into out-of-home placement across multiple ecological domains. Characteristics related to child, caregiver, and family characteristics, and neighborhood context, as well as dimensions of maltreatment (particularly emotional maltreatment), predicted risk of placement in out-of-home care. Implications for child welfare practice are discussed. This examination of the effects of multiple ecological domains adds to our understanding of children's risk of removal and entry into out-of-home placement. Copyright © 2015 Elsevier Ltd. All rights reserved.

Productive Entry of Foot-and-Mouth Disease Virus via Macropinocytosis Independent of Phosphatidylinositol 3-Kinase

PubMed Central

Han, Shi-Chong; Guo, Hui-Chen; Sun, Shi-Qi; Jin, Ye; Wei, Yan-Quan; Feng, Xia; Yao, Xue-Ping; Cao, Sui-Zhong; Xiang Liu, Ding; Liu, Xiang-Tao

2016-01-01

Virus entry is an attractive target for therapeutic intervention. Here, using a combination of electron microscopy, immunofluorescence assay, siRNA interference, specific pharmacological inhibitors, and dominant negative mutation, we demonstrated that the entry of foot-and-mouth disease virus (FMDV) triggered a substantial amount of plasma membrane ruffling. We also found that the internalization of FMDV induced a robust increase in fluid-phase uptake, and virions internalized within macropinosomes colocalized with phase uptake marker dextran. During this stage, the Rac1-Pak1 signaling pathway was activated. After specific inhibition on actin, Na+/H+ exchanger, receptor tyrosine kinase, Rac1, Pak1, myosin II, and protein kinase C, the entry and infection of FMDV significantly decreased. However, inhibition of phosphatidylinositol 3-kinase (PI3K) did not reduce FMDV internalization but increased the viral entry and infection to a certain extent, implying that FMDV entry did not require PI3K activity. Results showed that internalization of FMDV exhibited the main hallmarks of macropinocytosis. Moreover, intracellular trafficking of FMDV involves EEA1/Rab5-positive vesicles. The present study demonstrated macropinocytosis as another endocytic pathway apart from the clathrin-mediated pathway. The findings greatly expand our understanding of the molecular mechanisms of FMDV entry into cells, as well as provide potential insights into the entry mechanisms of other picornaviruses. PMID:26757826

Structure-activity relationships of 3-O-β-chacotriosyl oleanic acid derivatives as entry inhibitors for highly pathogenic H5N1 influenza virus.

PubMed

Li, Sumei; Jia, Xiuhua; Shen, Xintian; Wei, Zhuwen; Jiang, Zhiyan; Liao, Yixian; Guo, Yiming; Zheng, Xiaojun; Zhong, Guohua; Song, Gaopeng

2017-08-15

Highly pathogenic H5N1 virus (H5N1) entry is a key target for the development of novel anti-influenza agents with new mechanisms of action. In our continuing efforts to identify novel potential anti-H5N1 entry inhibitors, a series of 3-O-β-chacotriosyl oleanolic acid analogs have been designed, synthesized and evaluated as H5N1 entry inhibitors based on two small molecule inhibitors 1 and 2 previously discovered by us. The anti-H5N1 entry activities were determined based on HA/HIV and VSVG/HIV entry assays. Compound 15 displayed the most promising anti-H5N1 entry activities with average IC 50 values of 4.05μM and good selective index (22.9). Detailed structure-activity relationships (SARs) studies suggested that either the introduction of an additional oxo group to position 11 at OA or alteration of the C-3 configuration of OA from 3β- to 3α-forms can significantly enhance the selective index while maintaining their antiviral activities in vitro. Molecular simulation analysis confirmed that the compounds exert their inhibitory activity through binding tightly to hemagglutinin (HA2) protein near the fusion peptide and prevent virus entry. Copyright © 2017 Elsevier Ltd. All rights reserved.

Schizoaffective disorder: a review of current research themes and pharmacological management.

PubMed

Kantrowitz, Joshua T; Citrome, Leslie

2011-04-01

Despite a clear recognition of the existence of patients with co-morbid psychotic and mood symptoms, many studies conclude that schizoaffective disorder as a distinct diagnosis does not exist. Regardless of one's opinion on schizoaffective disorder, psychiatrists remain dependent on phenomenological descriptions for diagnosing psychiatric disorders, and these phenomenological criteria are also used for clinical trial entry. On the other hand, many psychiatrists prescribe for specific target symptoms and do not always rigidly follow diagnostic systems and, moreover, there have been very few trials that have specifically studied schizoaffective disorder. Despite recent intriguing work in epidemiology, genetics, neurocognition and electrophysiology, the diagnosis of schizoaffective disorder remains controversial. Taken together, these studies suggest that even if schizoaffective disorder exists as a separate diagnosis, it may not be useful clinically due to considerable variation in the general use of this term. It is possible that diagnostic criteria in the future will include genetic, imaging and electrophysiological components, and that this will allow for better differentiation of disease states among the heterogeneous pool of patients currently believed to have schizophrenia, schizoaffective disorder or bipolar disorder. Although it is likely that most, if not all, antipsychotics are effective for schizoaffective disorder, given recent regulatory approval of a specific antipsychotic agent for the acute treatment of schizoaffective disorder, greater attention is now being focused on the entity of schizoaffective disorder and potential treatment decisions. However, based on the limited extant evidence, it is not yet possible to make definitive treatment recommendations for schizoaffective disorder. Additional clinical trials that include other antipsychotics, mood stabilizers and antidepressants are desirable and necessary before clear and comprehensive evidence-based treatment recommendations can be made.

Clinical case review: a method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia.

PubMed

Puumalainen, Taneli; Quiambao, Beatriz; Abucejo-Ladesma, Erma; Lupisan, Socorro; Heiskanen-Kosma, Tarja; Ruutu, Petri; Lucero, Marilla G; Nohynek, Hanna; Simoes, Eric A F; Riley, Ian

2008-07-21

The World Health Organization's (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. A group of paediatricians conducted a retrospective review of clinical and laboratory data including C-reactive protein concentration and chest radiograph findings among Filipino children hospitalised in the Bohol Regional Hospital who were enrolled in a pneumococcal vaccine efficacy study and had an episode of respiratory disease fulfilling the WHO case definition for clinical pneumonia. Our aim was to evaluate which disease entities the WHO definition actually captures and what is the probable aetiology of respiratory infections among these episodes diagnosed in this population. Among the 12,194 children enrolled to the vaccine study we recorded 1,195 disease episodes leading to hospitalisation which fulfilled the WHO criteria for pneumonia. In total, 34% of these episodes showed radiographic evidence of pneumonia and 11% were classified as definitive or probable bacterial pneumonia. Over 95% of episodes of WHO-defined severe pneumonia (with chest indrawing) had an acute lower respiratory infection as final diagnosis whereas 34% of those with non-severe clinical pneumonia had gastroenteritis or other non-respiratory infection as main cause of hospitalisation. The WHO definition for severe pneumonia shows high specificity for acute lower respiratory infection and provides a tool to compare the total burden of lower respiratory infections in different settings. ISRCTN62323832.

Literatura Chicana. A Comprehensive Bibliography (1980-June, 1984). Working Bibliography Series No. 1.

ERIC Educational Resources Information Center

Trujillo, Roberto G.; And Others

The 197-item bibliography on Chicano literature published from 1980 through June 1984 is presented in 10 sections: poetry (77 entries), novel (25 entries), short fiction (13 entries), theatre (7 entries), literary criticism (16 entries), anthology (24 entries), unpublished dissertations (13 entries), bibliographies and encyclopedia (6 entries),…

Predicting Intentional Communication in Preverbal Preschoolers with Autism Spectrum Disorder.

PubMed

Sandbank, Micheal; Woynaroski, Tiffany; Watson, Linda R; Gardner, Elizabeth; Keçeli Kaysili, Bahar; Yoder, Paul

2017-06-01

Intentional communication has previously been identified as a value-added predictor of expressive language in preverbal preschoolers with autism spectrum disorder. In the present study, we sought to identify value-added predictors of intentional communication. Of five theoretically-motivated putative predictors of intentional communication measured early in the study (at study entry and 4 months after), three had significant zero-order correlations with later intentional communication (12 months after study entry) and were thus added to a linear model that predicted later intentional communication scores controlling for initial intentional communication scores at study entry. After controlling for initial intentional communication, early motor imitation was the only predictor that accounted for a significant amount of variance in children's later intentional communication.

Entry, Descent, and Landing Technology Concept Trade Study for Increasing Payload Mass to the Surface of Mars

NASA Technical Reports Server (NTRS)

Cruz, Juan R.; Cianciolo, Alicia D.; Powell, Richard W.; Simonsen, Lisa C.; Tolson, Robert H.

2005-01-01

A trade study was conducted that compared various entry, descent, and landing technologies and concepts for placing an 1,800 kg payload on the surface of Mars. The purpose of this trade study was to provide data, and make recommendations, that could be used in making decisions regarding which new technologies and concepts should be pursued. Five concepts were investigated, each using a different combination of new technologies: 1) a Baseline concept using the least new technologies, 2) Aerocapture and Entry from Orbit, 3) Inflatable Aeroshell, 4) Mid L/D Aeroshell-A (high ballistic coefficient), and 5) Mid L/D Aeroshell-B (low ballistic coefficient). All concepts were optimized to minimize entry mass subject to a common set of key requirements. These key requirements were: A) landing a payload mass of 1,800 kg, B) landing at an altitude 2.5 km above the MOLA areoid, C) landing with a descent rate of 2.5 m/s, and D) using a single launch vehicle available within the NASA Expendable Launch Vehicle Contract without resorting to in-space assembly. Additional constraints were implemented, some common to all concepts and others specific to the new technologies used. Among the findings of this study are the following observations. Concepts using blunt-body aeroshells (1, 2, and 3 above) had entry masses between 4,028 kg and 4,123 kg. Concepts using mid L/D aeroshells (4 and 5 above) were significantly heavier with entry masses of 5,292 kg (concept 4) and 4,812 kg (concept 5). This increased weight was mainly due to the aeroshell. Based on a comparison of the concepts it was recommended that: 1) re-qualified and/or improved TPS materials be developed, 2) large subsonic parachutes be qualified. Aerocapture was identified as a promising concept, but system issues beyond the scope of this study need to be investigated. Inflatable aeroshells were identified as a promising new technology, but they require additional technology maturation work. For the class of missions investigated in this trade study, mid L/D aeroshells were not competitive on an entry mass basis as compared to blunt-body aeroshells.

Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial.

PubMed

Oddis, Chester V; Reed, Ann M; Aggarwal, Rohit; Rider, Lisa G; Ascherman, Dana P; Levesque, Marc C; Barohn, Richard J; Feldman, Brian M; Harris-Love, Michael O; Koontz, Diane C; Fertig, Noreen; Kelley, Stephanie S; Pryber, Sherrie L; Miller, Frederick W; Rockette, Howard E

2013-02-01

To assess the safety and efficacy of rituximab in a randomized, double-blind, placebo-phase trial in adult and pediatric myositis patients. Adults with refractory polymyositis (PM) and adults and children with refractory dermatomyositis (DM) were enrolled. Entry criteria included muscle weakness and ≥2 additional abnormal values on core set measures (CSMs) for adults. Juvenile DM patients required ≥3 abnormal CSMs, with or without muscle weakness. Patients were randomized to receive either rituximab early or rituximab late, and glucocorticoid or immunosuppressive therapy was allowed at study entry. The primary end point compared the time to achieve the International Myositis Assessment and Clinical Studies Group preliminary definition of improvement (DOI) between the 2 groups. The secondary end points were the time to achieve ≥20% improvement in muscle strength and the proportions of patients in the early and late rituximab groups achieving the DOI at week 8. Among 200 randomized patients (76 with PM, 76 with DM, and 48 with juvenile DM), 195 showed no difference in the time to achieving the DOI between the rituximab late (n = 102) and rituximab early (n = 93) groups (P = 0.74 by log rank test), with a median time to achieving a DOI of 20.2 weeks and 20.0 weeks, respectively. The secondary end points also did not significantly differ between the 2 treatment groups. However, 161 (83%) of the randomized patients met the DOI, and individual CSMs improved in both groups throughout the 44-week trial. Although there were no significant differences in the 2 treatment arms for the primary and secondary end points, 83% of adult and juvenile myositis patients with refractory disease met the DOI. The role of B cell-depleting therapies in myositis warrants further study, with consideration for a different trial design. Copyright © 2013 by the American College of Rheumatology.

Multicenter Phase II Trial of Temsirolimus and Bevacizumab in Pancreatic Neuroendocrine Tumors

PubMed Central

Hobday, Timothy J.; Qin, Rui; Reidy-Lagunes, Diane; Moore, Malcolm J.; Strosberg, Jonathan; Kaubisch, Andreas; Shah, Manisha; Kindler, Hedy Lee; Lenz, Heinz-Josef; Chen, Helen; Erlichman, Charles

2015-01-01

Purpose There are few effective therapies for pancreatic neuroendocrine tumors (PNETs). Recent placebo-controlled phase III trials of the mammalian target of rapamycin (mTOR) inhibitor everolimus and the vascular endothelial growth factor (VEGF)/platelet-derived growth factor receptor inhibitor sunitinib have noted improved progression-free survival (PFS). Preclinical studies have suggested enhanced antitumor effects with combined mTOR and VEGF pathway–targeted therapy. We conducted a clinical trial to evaluate combination therapy against these targets in PNETs. Patients and Methods We conducted a two-stage single-arm phase II trial of the mTOR inhibitor temsirolimus 25 mg intravenously (IV) once per week and the VEGF-A monoclonal antibody bevacizumab 10 mg/kg IV once every 2 weeks in patients with well or moderately differentiated PNETs and progressive disease by RECIST within 7 months of study entry. Coprimary end points were tumor response rate and 6-month PFS. Results A total of 58 patients were enrolled, and 56 patients were eligible for response assessment. Confirmed response rate (RR) was 41% (23 of 56 patients). PFS at 6 months was 79% (44 of 56). Median PFS was 13.2 months (95% CI, 11.2 to 16.6). Median overall survival was 34 months (95% CI, 27.1 to not reached). For evaluable patients, the most common grade 3 to 4 adverse events attributed to therapy were hypertension (21%), fatigue (16%), lymphopenia (14%), and hyperglycemia (14%). Conclusion The combination of temsirolimus and bevacizumab had substantial activity and reasonable tolerability in a multicenter phase II trial, with RR of 41%, well in excess of single targeted agents in patients with progressive PNETs. Six-month PFS was a notable 79% in a population of patients with disease progression by RECIST criteria within 7 months of study entry. On the basis of this trial, continued evaluation of combination mTOR and VEGF pathway inhibitors is warranted. PMID:25488966

Ethylglucuronide in hair is a top predictor of impaired driving recidivism, alcohol dependence, and a key marker of the highest BAC interlock tests.

PubMed

Marques, Paul R; Tippetts, A Scott; Yegles, Michel

2014-01-01

This study focuses on the predictive and comparative significance of ethyl glucuronide measured in head hair (hEtG) for estimating risks associated with alcohol-impaired driving offenders. Earlier work compared different alcohol biomarkers for estimating rates of failed blood alcohol concentration (BAC) tests logged during 8 months of interlock participation. These analyses evaluate the comparative performance of several alcohol markers including hEtG and other markers, past driver records, and psychometric assessment predictors for the detection of 4 criteria: new driving under the influence (DUI) recidivism, alcohol dependence, and interlock record variables including fail rates and maximal interlock BACs logged. Drivers charged with alcohol impairment (DUI) in Alberta, Canada (n = 534; 64% first offenders, 36% multiple offenders) installed ignition interlock devices and consented to participate in research to evaluate blood-, hair-, and urine-derived alcohol biomarkers; sit for interviews; take psychometric assessments; and permit analyses of driving records and interlock log files. Subject variables included demographics, alcohol dependence at program entry, preprogram prior DUI convictions, postenrollment new DUI convictions, self-reported drinking assessments, morning and overall rates of failed interlock BAC tests, and maximal interlock BAC readings. Recidivism, dependence, high BAC, and combined fail rates were set as criteria; other variables were set as predictors. Area under the receiver operating characteristics (ROC) curve (A') estimates of sensitivity and specificity were calculated. Additional analyses were conducted on baseline hEtG levels. Driver performance and drinking indicators were evaluated against the standard hEtG cutoff for excessive drinking at (30 pg/mg) and a higher criterion of 50 pg/mg. HEtG splits were evaluated with the Mann-Whitney rank statistic. HEtG emerged as a top overall predictor for discriminating new recidivism events that occur after interlock installation, for entry alcohol dependence, and for the highest interlock BACs recorded. Together, hEtG and phosphatidylethanol (PEth) were the top predictors of all criterion measures. By contrast, the hair-derived alcohol biomarkers hEtG and hFAEE (fatty acid ethyl esters) were poorer than other alcohol biomarkers as detectors of interlock BAC test fail rates. This study showed that hEtG, an objective alternative to often unreliable self-reported past representation of drinking levels, yields crucial insight into driver alcohol-related risks early in an interlock program and is a top predictor of new recidivist events. Together with PEth, these markers would be excellent anchors in a panel for detecting alcohol consumption.

The NASA Goddard Space Flight Center Virtual Science Fair

NASA Technical Reports Server (NTRS)

Bolognese, Jeff; Walden, Harvey; Obenschain, Arthur F. (Technical Monitor)

2002-01-01

This report describes the development of the NASA Goddard Space Flight Center Virtual Science Fair, including its history and outgrowth from the traditional regional science fairs supported by NASA. The results of the 1999 Virtual Science Fair pilot program, the mechanics of running the 2000 Virtual Science Fair and its results, and comments and suggestions for future Virtual Science Fairs are provided. The appendices to the report include the original proposal for this project, the judging criteria, the user's guide and the judge's guide to the Virtual Science Fair Web site, the Fair publicity brochure and the Fair award designs, judges' and students' responses to survey questions about the Virtual Science Fair, and lists of student entries to both the 1999 and 2000 Fairs.

Hypersonic vehicle control law development using H(infinity) and micron-synthesis

NASA Technical Reports Server (NTRS)

Gregory, Irene M.; Mcminn, John D.; Shaughnessy, John D.; Chowdhry, Rajiv S.

1993-01-01

Hypersonic vehicle control law development using H(infinity) and mu-synthesis is discussed. Airbreathing SSTO vehicles has a mutli-faceted mission that includes orbital operations, as well as re-entry and descent culminating in horizontal landing. However, the most challenging part of the operations is the ascent to orbit. The airbreathing propulsion requires lengthy atmospheric flight that may last as long as 30 minutes and take the vehicle half way around the globe. The vehicles's ascent is characterized by tight payload to orbit margins which translate into minimum fuel orbit as the performance criteria. Issues discussed include: SSTO airbreathing vehicle issues; control system performance requirements; robust control law framework; H(infinity) controller frequency analysis; and mu controller frequency analysis.

Description of a user-oriented geographic information system - The resource analysis program

NASA Technical Reports Server (NTRS)

Tilmann, S. E.; Mokma, D. L.

1980-01-01

This paper describes the Resource Analysis Program, an applied geographic information system. Several applications are presented which utilized soil, and other natural resource data, to develop integrated maps and data analyses. These applications demonstrate the methods of analysis and the philosophy of approach used in the mapping system. The applications are evaluated in reference to four major needs of a functional mapping system: data capture, data libraries, data analysis, and mapping and data display. These four criteria are then used to describe an effort to develop the next generation of applied mapping systems. This approach uses inexpensive microcomputers for field applications and should prove to be a viable entry point for users heretofore unable or unwilling to venture into applied computer mapping.

Entry, Descent and Landing Systems Analysis: Exploration Class Simulation Overview and Results

NASA Technical Reports Server (NTRS)

DwyerCianciolo, Alicia M.; Davis, Jody L.; Shidner, Jeremy D.; Powell, Richard W.

2010-01-01

NASA senior management commissioned the Entry, Descent and Landing Systems Analysis (EDL-SA) Study in 2008 to identify and roadmap the Entry, Descent and Landing (EDL) technology investments that the agency needed to make in order to successfully land large payloads at Mars for both robotic and exploration or human-scale missions. The year one exploration class mission activity considered technologies capable of delivering a 40-mt payload. This paper provides an overview of the exploration class mission study, including technologies considered, models developed and initial simulation results from the EDL-SA year one effort.

Involvement of Clathrin-Mediated Endocytosis in Human Immunodeficiency Virus Type 1 Entry

PubMed Central

Daecke, Jessica; Fackler, Oliver T.; Dittmar, Matthias T.; Kräusslich, Hans-Georg

2005-01-01

Productive entry of human immunodeficiency virus (HIV) is believed to occur by direct fusion at the plasma membrane. Endocytic uptake of HIV particles has been observed in several studies but is considered to be nonproductive, leading to virus degradation in the lysosome. We show here that endocytosis contributes significantly to productive HIV entry in HeLa cells by using trans dominant-negative mutants of dynamin and Eps15. Inducible expression of a dominant-negative mutant of dynamin in a CD4-positive HeLa cell line reduced HIV infection by 40 to 80%. This effect was independent of the infectious dose and was observed for three different isolates. Analysis of reverse transcription products by real-time PCR and of virus entry by delivery of a virion-associated Vpr-β-lactamase fusion protein revealed a similar reduction, indicating that the block occurred at the entry stage. A strong reduction of HIV entry was also observed upon transient transfection of a different trans dominant-negative variant of dynamin, and this reduction correlated with the relative inhibition of transferrin endocytosis. Expression of a dominant-negative variant of Eps15, which is specific for clathrin-dependent endocytosis, reduced HIV entry in HeLa cells by ca 95%, confirming the role of endocytosis for productive infection. In contrast, no effect was observed for a dominant-negative variant of caveolin. We conclude that dynamin-dependent, clathrin-mediated endocytosis can lead to productive entry of HIV in HeLa cells, suggesting this pathway as an alternative route of virus entry. PMID:15650184

Serum 25-Hydroxyvitamin D Levels and Stress Fractures in Military Personnel: A Systematic Review and Meta-analysis.

PubMed

Dao, Dyda; Sodhi, Sukhmani; Tabasinejad, Rasam; Peterson, Devin; Ayeni, Olufemi R; Bhandari, Mohit; Farrokhyar, Forough

2015-08-01

Low serum 25-hydroxyvitamin D (25(OH)D) levels have been associated with stress fractures in various physically active populations such as the military. To examine the association between serum 25(OH)D levels and stress fractures in the military. Systematic review and meta-analysis. Relevant studies were identified through searching multiple databases and manually screening reference lists. Two reviewers independently selected the included studies by applying the eligibility criteria to the title, abstract, and/or full text of the articles yielded in the search. Two reviewers also independently conducted the methodological quality assessment and data extraction. A random-effects model was used to calculate the mean difference (MD) with 95% CI in serum 25(OH)D levels between stress fracture cases and controls. Nine observational studies on lower extremity stress fractures were eligible, and 1 was excluded due to inadequate data. A total of 2634 military personnel (age, 18-30 years; 44% male) with 761 cases (16% male) and 1873 controls (61% male) from 8 studies were included in the analysis. Three of the 8 studies measured serum 25(OH)D levels at the time of stress fracture diagnosis, and the 5 remaining studies measured serum 25(OH)D levels at the time of entry into basic training. The mean serum 25(OH)D level was lower in stress fracture cases than in controls at the time of entry into basic training (MD, -2.63 ng/mL; 95% CI, -5.80 to 0.54; P = .10; I(2) = 65%) and at the time of stress fracture diagnosis (MD, -2.26 ng/mL; 95% CI, -3.89 to -0.63; P = .007; I(2) = 42%). Despite the inherent limitations of the included studies, the study results suggest some association between low serum 25(OH)D levels and lower extremity stress fractures in military personnel. Given the rigorous training of military personnel, implementing strategies to ensure sufficient 25(OH)D levels may be beneficial for reducing the risk of stress fractures. © 2014 The Author(s).

Study of the Effectiveness of OCR for Decentralized Data Capture and Conversion. Final Report.

ERIC Educational Resources Information Center

Liston, David M.; And Others

The ERIC network conversion to an OCR (Optical Character Recognition) mode of data entry was studied to analyze the potential effectiveness of OCR data entry for future EPC/s (Editorial Processing Centers). Study results are also applicable to any other system involving decentralized bibliographic data capture and conversion functions. The report…

Pioneer Jupiter orbiter probe mission 1980, probe description

NASA Technical Reports Server (NTRS)

Defrees, R. E.

1974-01-01

The adaptation of the Saturn-Uranus Atmospheric Entry Probe (SUAEP) to a Jupiter entry probe is summarized. This report is extracted from a comprehensive study of Jovian missions, atmospheric model definitions and probe subsystem alternatives.

Characterizing Functional Domains for TIM-Mediated Enveloped Virus Entry

PubMed Central

Moller-Tank, Sven; Albritton, Lorraine M.; Rennert, Paul D.

2014-01-01

ABSTRACT T-cell immunoglobulin and mucin domain 1 (TIM-1) and other TIM family members were recently identified as phosphatidylserine (PtdSer)-mediated virus entry-enhancing receptors (PVEERs). These proteins enhance entry of Ebola virus (EBOV) and other viruses by binding PtdSer on the viral envelope, concentrating virus on the cell surface, and promoting subsequent internalization. The PtdSer-binding activity of the immunoglobulin-like variable (IgV) domain is essential for both virus binding and internalization by TIM-1. However, TIM-3, whose IgV domain also binds PtdSer, does not effectively enhance virus entry, indicating that other domains of TIM proteins are functionally important. Here, we investigate the domains supporting enhancement of enveloped virus entry, thereby defining the features necessary for a functional PVEER. Using a variety of chimeras and deletion mutants, we found that in addition to a functional PtdSer-binding domain PVEERs require a stalk domain of sufficient length, containing sequences that promote an extended structure. Neither the cytoplasmic nor the transmembrane domain of TIM-1 is essential for enhancing virus entry, provided the protein is still plasma membrane bound. Based on these defined characteristics, we generated a mimic lacking TIM sequences and composed of annexin V, the mucin-like domain of α-dystroglycan, and a glycophosphatidylinositol anchor that functioned as a PVEER to enhance transduction of virions displaying Ebola, Chikungunya, Ross River, or Sindbis virus glycoproteins. This identification of the key features necessary for PtdSer-mediated enhancement of virus entry provides a basis for more effective recognition of unknown PVEERs. IMPORTANCE T-cell immunoglobulin and mucin domain 1 (TIM-1) and other TIM family members are recently identified phosphatidylserine (PtdSer)-mediated virus entry-enhancing receptors (PVEERs). These proteins enhance virus entry by binding the phospholipid, PtdSer, present on the viral membrane. While it is known that the PtdSer binding is essential for the PVEER function of TIM-1, TIM-3 shares this binding activity but does not enhance virus entry. No comprehensive studies have been done to characterize the other domains of TIM-1. In this study, using a variety of chimeric proteins and deletion mutants, we define the features necessary for a functional PVEER. With these features in mind, we generated a TIM-1 mimic using functionally similar domains from other proteins. This mimic, like TIM-1, effectively enhanced transduction. These studies provide insight into the key features necessary for PVEERs and will allow for more effective identification of unknown PVEERs. PMID:24696470

Dynamics of Chikungunya Virus Cell Entry Unraveled by Single-Virus Tracking in Living Cells.

PubMed

Hoornweg, Tabitha E; van Duijl-Richter, Mareike K S; Ayala Nuñez, Nilda V; Albulescu, Irina C; van Hemert, Martijn J; Smit, Jolanda M

2016-05-01

Chikungunya virus (CHIKV) is a rapidly emerging mosquito-borne human pathogen causing major outbreaks in Africa, Asia, and the Americas. The cell entry pathway hijacked by CHIKV to infect a cell has been studied previously using inhibitory compounds. There has been some debate on the mechanism by which CHIKV enters the cell: several studies suggest that CHIKV enters via clathrin-mediated endocytosis, while others show that it enters independently of clathrin. Here we applied live-cell microscopy and monitored the cell entry behavior of single CHIKV particles in living cells transfected with fluorescent marker proteins. This approach allowed us to obtain detailed insight into the dynamic events that occur during CHIKV entry. We observed that almost all particles fused within 20 min after addition to the cells. Of the particles that fused, the vast majority first colocalized with clathrin. The average time from initial colocalization with clathrin to the moment of membrane fusion was 1.7 min, highlighting the rapidity of the cell entry process of CHIKV. Furthermore, these results show that the virus spends a relatively long time searching for a receptor. Membrane fusion was observed predominantly from within Rab5-positive endosomes and often occurred within 40 s after delivery to endosomes. Furthermore, we confirmed that a valine at position 226 of the E1 protein enhances the cholesterol-dependent membrane fusion properties of CHIKV. To conclude, our work confirms that CHIKV enters cells via clathrin-mediated endocytosis and shows that fusion occurs from within acidic early endosomes. Since its reemergence in 2004, chikungunya virus (CHIKV) has spread rapidly around the world, leading to millions of infections. CHIKV often causes chikungunya fever, a self-limiting febrile illness with severe arthralgia. Currently, no vaccine or specific antiviral treatment against CHIKV is available. A potential antiviral strategy is to interfere with the cell entry process of the virus. However, conflicting results with regard to the cell entry pathway used by CHIKV have been published. Here we applied a novel technology to visualize the entry behavior of single CHIKV particles in living cells. Our results show that CHIKV cell entry is extremely rapid and occurs via clathrin-mediated endocytosis. Membrane fusion from within acidic early endosomes is observed. Furthermore, the membrane fusion capacity of CHIKV is strongly promoted by cholesterol in the target membrane. Taking these findings together, this study provides detailed insight into the cell entry process of CHIKV. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Mission Sizing and Trade Studies for Low Ballistic Coefficient Entry Systems to Venus

NASA Technical Reports Server (NTRS)

Dutta, Soumyo; Smith, Brandon; Prabhu, Dinesh; Venkatapathy, Ethiraj

2012-01-01

The U.S and the U.S.S.R. have sent seventeen successful atmospheric entry missions to Venus. Past missions to Venus have utilized rigid aeroshell systems for entry. This rigid aeroshell paradigm sets performance limitations since the size of the entry vehicle is constrained by the fairing diameter of the launch vehicle. This has limited ballistic coefficients (beta) to well above 100 kg/m2 for the entry vehicles. In order to maximize the science payload and minimize the Thermal Protection System (TPS) mass, these missions have entered at very steep entry flight path angles (gamma). Due to Venus thick atmosphere and the steep-gamma, high- conditions, these entry vehicles have been exposed to very high heat flux, very high pressures and extreme decelerations (upwards of 100 g's). Deployable aeroshells avoid the launch vehicle fairing diameter constraint by expanding to a larger diameter after the launch. Due to the potentially larger wetted area, deployable aeroshells achieve lower ballistic coefficients (well below 100 kg/m2), and if they are flown at shallower flight path angles, the entry vehicle can access trajectories with far lower decelerations (50-60 g's), peak heat fluxes (400 W/cm2) and peak pressures. The structural and TPS mass of the shallow-gamma, low-beta deployables are lower than their steep-gamma, high-beta rigid aeroshell counterparts at larger diameters, contributing to lower areal densities and potentially higher payload mass fractions. For example, at large diameters, deployables may attain aeroshell areal densities of 10 kg/m2 as opposed to 50 kg/m2 for rigid aeroshells. However, the low-beta, shallow-gamma paradigm also raises issues, such as the possibility of skip-out during entry. The shallow-gamma could also increase the landing footprint of the vehicle. Furthermore, the deployable entry systems may be flexible, so there could be fluid-structure interaction, especially in the high altitude, low-density regimes. The need for precision in guidance, navigation and control during entry also has to be better understood. This paper investigates some of the challenges facing the design of a shallow-gamma, low-beta entry system.

Analytic Development of a Reference Profile for the First Entry in a Skip Atmospheric Entry

NASA Technical Reports Server (NTRS)

Garcia-Llama, Eduardo

2010-01-01

This note shows that a feasible reference drag profile for the first entry portion of a skip entry can be generated as a polynomial expression of the velocity. The coefficients of that polynomial are found through the resolution of a system composed of m + 1 equations, where m is the degree of the drag polynomial. It has been shown that a minimum of five equations (m = 4) are required to establish the range and the initial and final conditions on velocity and flight path angle. It has been shown that at least one constraint on the trajectory can be imposed through the addition of one extra equation in the system, which must be accompanied by the increase in the degree of the drag polynomial. In order to simplify the resolution of the system of equations, the drag was considered as being a probability density function of the velocity, with the velocity as a distribution function of the drag. Combining this notion with the introduction of empirically derived constants, it has been shown that the system of equations required to generate the drag profile can be successfully reduced to a system of linear algebraic equations. For completeness, the resulting drag profiles have been flown using the feedback linearization method of differential geometric control as a guidance law with the error dynamics of a second order homogeneous equation in the form of a damped oscillator. Satisfactory results were achieved when the gains in the error dynamics were changed at a certain point along the trajectory that is dependent on the velocity and the curvature of the drag as a function of the velocity. Future work should study the capacity to update the drag profile in flight when dispersions are introduced. Also, future studies should attempt to link the first entry, as presented and controlled in this note, with a more standard control concept for the second entry, such as the Apollo entry guidance, to try to assess the overall skip entry performance. A guidance law that includes an integral feedback term, as is the case in the actual Space Shuttle entry guidance and as is proposed in Ref 29, could be tried in future studies to assess whether its use results in an improvement of the tracking performance, and to evaluate the design needs when determining the control gains.

Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder.

PubMed

Pinto, Anthony; Liebowitz, Michael R; Foa, Edna B; Simpson, H Blair

2011-08-01

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. Copyright © 2011 Elsevier Ltd. All rights reserved.

Obsessive Compulsive Personality Disorder as a Predictor of Exposure and Ritual Prevention Outcome for Obsessive Compulsive Disorder

PubMed Central

Pinto, Anthony; Liebowitz, Michael R.; Foa, Edna B.; Simpson, H. Blair

2011-01-01

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. PMID:21600563

Mechanism of lymphocytic choriomeningitis virus entry into cells.

PubMed

Borrow, P; Oldstone, M B

1994-01-01

The path that the arenavirus lymphocytic choriomeningitis virus (LCMV) uses to enter rodent fibroblastic cell lines was dissected by infectivity and inhibition studies and immunoelectron microscopy. Lysosomotropic weak bases (chloroquine and ammonium chloride) and carboxylic ionophores (monensin and nigericin) inhibited virus entry, assessed as virus nucleoprotein expression at early times post-infection, indicating that the entry process involved a pH-dependent fusion step in intracellular vesicles. That entry occurred in vesicles rather than by direct fusion of virions with the plasma membrane was confirmed by immunoelectron microscopy. The vesicles involved were large (150-300 nm diameter), smooth-walled, and not associated with clathrin. Unlike classical phagocytosis, virus uptake in these vesicles was a microfilament-independent process, as it was not blocked by cytochalasins. LCMV entry into rodent fibroblast cell lines thus involves viropexis in large smooth-walled vesicles, followed by a pH-dependent fusion event inside the cell.

Entry trajectory, entry environment, and analysis of spacecraft motion for the RAM C-3 flight experiment

NASA Technical Reports Server (NTRS)

Weaver, W. L.; Bowen, J. T.

1972-01-01

The RAM C-3 flight experiment was launched to study the problem of radiofrequency blackout at an entry velocity of 24,300 ft/sec. The flight is described, and data for the entry trajectory and environment, which include the effects of actual temperature measured the day of launch, are presented. An analysis of entry spacecraft motions was performed. This analysis included the determination of wind angles from measured accelerations and estimates of wind angles at high altitudes from gyro-measured rotation rates. The maximum wind angles were found to be less than 5 deg to the point of pitch-roll resonance where the total wind angle increased to 8.5 deg and the roll rate started decreasing. A plausible cause for the decrease in roll rate was shown to be a combination of trim angle and an offset center of gravity.

Use of acoustics to deter bark beetles from entering tree material.

PubMed

Aflitto, Nicholas C; Hofstetter, Richard W

2014-12-01

Acoustic technology is a potential tool to protect wood materials and eventually live trees from colonization by bark beetles. Bark beetles such as the southern pine beetle Dendroctonus frontalis, western pine beetle D. brevicomis and pine engraver Ips pini (Coleoptera: Curculionidae) use chemical and acoustic cues to communicate and to locate potential mates and host trees. In this study, the efficacy of sound treatments on D. frontalis, D. brevicomis and I. pini entry into tree materials was tested. Acoustic treatments significantly influenced whether beetles entered pine logs in the laboratory. Playback of artificial sounds reduced D. brevicomis entry into logs, and playback of stress call sounds reduced D. frontalis entry into logs. Sound treatments had no effect on I. pini entry into logs. The reduction in bark beetle entry into logs using particular acoustic treatments indicates that sound could be used as a viable management tool. © 2013 Society of Chemical Industry.

The state-of-the-art port of entry workshop

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

Godfrey, B.

1995-05-01

The increased demand for freight movements through international ports of entry and the signing of the North American Free Trade Agreement (NAFTA) have increased freight traffic at border ports of entry. The State-of-the-Art Port of Entry Workshop initiated a dialogue among technologists and stakeholders to explore the potential uses of technology at border crossings and to set development priorities. International ports of entry are both information and labor intensive, and there are many promising technologies that could be used to provide timely information and optimize inspection resources. Participants universally held that integration of technologies and operations is critical to improvingmore » port services. A series of Next Steps was developed to address stakeholder issues and national priorities, such as the National Transportation Policy and National Drug Policy. This report documents the views of the various stakeholders and technologists present at the workshop and outlines future directions of study.« less

Bovine parvovirus uses clathrin-mediated endocytosis for cell entry.

PubMed

Dudleenamjil, Enkhmart; Lin, Chin-Yo; Dredge, Devin; Murray, Byron K; Robison, Richard A; Johnson, F Brent

2010-12-01

Entry events of bovine parvovirus (BPV) were studied. Transmission electron micrographs of infected cells showed virus particles in cytoplasmic vesicles. Chemical inhibitors that block certain aspects of the cellular machinery were employed to assess viral dependency upon those cellular processes. Chlorpromazine, ammonium chloride, chloroquine and bafilamicin A1 were used to inhibit acidification of endosomes and clathrin-associated endocytosis. Nystatin was used as an inhibitor of the caveolae pathway. Cytochalasin D and ML-7 were used to inhibit actin and myosin functions, respectively. Nocodazole and colchicine were employed to inhibit microtubule activity. Virus entry was assessed by measuring viral transcription using real-time PCR, synthesis of capsid protein and assembly of infectious progeny virus in the presence of inhibitor blockage. The results indicated that BPV entry into embryonic bovine trachael cells utilizes endocytosis in clathrin-coated vesicles, is dependent upon acidification, and appears to be associated with actin and microtubule dependency. Evidence for viral entry through caveolae was not obtained. These findings provide a fuller understanding of the early cell-entry events of the replication cycle for members of the genus Bocavirus.

NTCP and Beyond: Opening the Door to Unveil Hepatitis B Virus Entry

PubMed Central

Watashi, Koichi; Urban, Stephan; Li, Wenhui; Wakita, Takaji

2014-01-01

Chronic hepatitis B virus (HBV) infection, affecting approximately 240 million people worldwide, is a major public health problem that elevates the risk of developing liver cirrhosis and hepatocellular carcinoma. Given that current anti-HBV drugs are limited to interferon-based regimens and nucleos(t)ide analogs, the development of new anti-HBV agents is urgently needed. The viral entry process is generally an attractive target implicated in antiviral strategies. Using primary cells from humans and Tupaia belangeri, as well as HepaRG cells, important determinants of viral entry have been achieved. Recently, sodium taurocholate cotransporting polypeptide (NTCP) was identified as an HBV entry receptor and enabled the establishment of a susceptible cell line that can efficiently support HBV infection. This finding will allow a deeper understanding of the requirements for efficient HBV infection, including the elucidation of the molecular entry mechanism. In addition, pharmacological studies suggest that NTCP is able to serve as a therapeutic target. This article summarizes our current knowledge on the mechanisms of HBV entry and the role of NTCP in this process. PMID:24557582

NTCP and beyond: opening the door to unveil hepatitis B virus entry.

PubMed

Watashi, Koichi; Urban, Stephan; Li, Wenhui; Wakita, Takaji

2014-02-19

Chronic hepatitis B virus (HBV) infection, affecting approximately 240 million people worldwide, is a major public health problem that elevates the risk of developing liver cirrhosis and hepatocellular carcinoma. Given that current anti-HBV drugs are limited to interferon-based regimens and nucleos(t)ide analogs, the development of new anti-HBV agents is urgently needed. The viral entry process is generally an attractive target implicated in antiviral strategies. Using primary cells from humans and Tupaia belangeri, as well as HepaRG cells, important determinants of viral entry have been achieved. Recently, sodium taurocholate cotransporting polypeptide (NTCP) was identified as an HBV entry receptor and enabled the establishment of a susceptible cell line that can efficiently support HBV infection. This finding will allow a deeper understanding of the requirements for efficient HBV infection, including the elucidation of the molecular entry mechanism. In addition, pharmacological studies suggest that NTCP is able to serve as a therapeutic target. This article summarizes our current knowledge on the mechanisms of HBV entry and the role of NTCP in this process.

JAE: A Jupiter Atmospheric Entry Probe Heating Code

NASA Technical Reports Server (NTRS)

Wercinski, Paul F.; Tauber, Michael E.; Yang, Lily

1997-01-01

The strong gravitational attraction of Jupiter on probes approaching the planet results in very high atmospheric entry velocities. The values relative to the rotating atmosphere can vary from about 47 to 60 km/sec, depending on the latitude of the entry. Therefore, the peak heating rates and heat shield mass fractions exceed those for any other atmospheric entries. For example, the Galileo probe's heat shield mass fraction was 50%, of which 45% was devoted to the forebody. Although the Galileo probe's mission was very successful, many more scientific questions about the Jovian atmosphere remain to be answered and additional probe missions are being planned. Recent developments in microelectronics have raised the possibility of building smaller and less expensive probes than Galileo. Therefore, it was desirable to develop a code that could quickly compute the forebody entry heating environments when performing parametric probe sizing studies. The Jupiter Atmospheric Entry (JAE) code was developed to meet this requirement. The body geometry consists of a blunt-nosed conical shape of arbitrary nose and base radius and cone angles up to about 65 deg at zero angle of attack.

Ebola virus requires phosphatidylinositol (3,5) bisphosphate production for efficient viral entry.

PubMed

Qiu, Shirley; Leung, Anders; Bo, Yuxia; Kozak, Robert A; Anand, Sai Priya; Warkentin, Corina; Salambanga, Fabiola D R; Cui, Jennifer; Kobinger, Gary; Kobasa, Darwyn; Côté, Marceline

2018-01-01

For entry, Ebola virus (EBOV) requires the interaction of its viral glycoprotein with the cellular protein Niemann-Pick C1 (NPC1) which resides in late endosomes and lysosomes. How EBOV is trafficked and delivered to NPC1 and whether this is positively regulated during entry remain unclear. Here, we show that the PIKfyve-ArPIKfyve-Sac3 cellular complex, which is involved in the metabolism of phosphatidylinositol (3,5) bisphosphate (PtdIns(3,5)P 2 ), is critical for EBOV infection. Although the expression of all subunits of the complex was required for efficient entry, PIKfyve kinase activity was specifically critical for entry by all pathogenic filoviruses. Inhibition of PIKfyve prevented colocalization of EBOV with NPC1 and led to virus accumulation in intracellular vesicles with characteristics of early endosomes. Importantly, genetically-encoded phosphoinositide probes revealed an increase in PtdIns(3,5)P 2 -positive vesicles in cells during EBOV entry. Taken together, our studies suggest that EBOV requires PtdIns(3,5)P 2 production in cells to promote efficient delivery to NPC1. Copyright © 2017 Elsevier Inc. All rights reserved.

Sparse subspace clustering for data with missing entries and high-rank matrix completion.

PubMed

Fan, Jicong; Chow, Tommy W S

2017-09-01

Many methods have recently been proposed for subspace clustering, but they are often unable to handle incomplete data because of missing entries. Using matrix completion methods to recover missing entries is a common way to solve the problem. Conventional matrix completion methods require that the matrix should be of low-rank intrinsically, but most matrices are of high-rank or even full-rank in practice, especially when the number of subspaces is large. In this paper, a new method called Sparse Representation with Missing Entries and Matrix Completion is proposed to solve the problems of incomplete-data subspace clustering and high-rank matrix completion. The proposed algorithm alternately computes the matrix of sparse representation coefficients and recovers the missing entries of a data matrix. The proposed algorithm recovers missing entries through minimizing the representation coefficients, representation errors, and matrix rank. Thorough experimental study and comparative analysis based on synthetic data and natural images were conducted. The presented results demonstrate that the proposed algorithm is more effective in subspace clustering and matrix completion compared with other existing methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Factors affecting length of stay in teaching hospitals of a middle-income country

PubMed Central

Khosravizadeh, Omid; Vatankhah, Soudabeh; Bastani, Peivand; Kalhor, Rohollah; Alirezaei, Samira; Doosty, Farzane

2016-01-01

Introduction The length of stay (LOS) in hospitals is a widely used and important criteria for evaluating hospital performance. The aim of this study was to determine factors affecting LOS in teaching hospitals of Qazvin Providence. Methods In this cross-sectional study, patients’ health records were randomly selected from archives in teaching hospitals of Qazvin in 2013. Data were collected through a data entry form and were analyzed using Kolmogorov–Smirnov, Kruskal–Wallis, and Mann–Whitney U tests at the significant level of 0.05. Results The mean of hospital LOS was 5.45 ± 6.14 days. Age, employment, marital status, history of previous admission, patient condition at discharge, method of payment, and type of treatment had an impact on LOS (p<0.05). Other factors, including gender, place of residence, and type of admission, did not affect LOS. Conclusion Because hospitals consume a perceptible part of resources in a health system, controlled and optimized use of its resources help to save a lot. Therefore, this study showed many clinical and nonclinical factors affect LOS in evaluating these factors, which may reduce inappropriate hospital stays and decrease costs. PMID:27957301

Interprofessional education in primary health care for entry level students--A systematic literature review.

PubMed

Kent, Fiona; Keating, Jennifer L

2015-12-01

This systematic review investigated student learning and patient outcomes associated with interprofessional education in outpatient, primary care clinics. Medline, Cinahl and Embase databases were searched to March 2014. A mixed method evaluation framework was applied to investigate the participants, interventions and effects on student learning and patient outcomes. 26 studies met the inclusion criteria; 13 were quantitative, predominately pre-post-survey design, 6 qualitative and 7 mixed methods design. Studies most commonly investigated student volunteers from medicine, nursing and allied health working in interprofessional clinics that were established to address gaps in community health care. Students appeared to learn teamwork skills and increase their knowledge of the roles of other disciplines. We found no convincing evidence that participation results in changes in attitudes towards other disciplines compared to single discipline education. We also found insufficient evidence to estimate the effectiveness of patient care delivered by interprofessional student teams in this setting compared to single discipline or no care. Given the logistical challenges associated with coordinating clinic attendance for interprofessional teams, high quality studies are needed to assess the effects of clinics on student learning and patient health outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Port of Davisville utilization study : phase II.

DOT National Transportation Integrated Search

2011-02-01

This project investigated the feasibility of expanding the Port of Davisville (Quonset Point, RI) to serve : as a port of entry and departure for international container shipments. As an international port of entry : (departure), the Port of Davisvil...