Improved techniques for thermomechanical testing in support of deformation modeling

NASA Technical Reports Server (NTRS)

Castelli, Michael G.; Ellis, John R.

1992-01-01

The feasibility of generating precise thermomechanical deformation data to support constitutive model development was investigated. Here, the requirement is for experimental data that is free from anomalies caused by less than ideal equipment and procedures. A series of exploratory tests conducted on Hastelloy X showed that generally accepted techniques for strain controlled tests were lacking in at least three areas. Specifically, problems were encountered with specimen stability, thermal strain compensation, and temperature/mechanical strain phasing. The source of these difficulties was identified and improved thermomechanical testing techniques to correct them were developed. These goals were achieved by developing improved procedures for measuring and controlling thermal gradients and by designing a specimen specifically for thermomechanical testing. In addition, innovative control strategies were developed to correctly proportion and phase the thermal and mechanical components of strain. Subsequently, the improved techniques were used to generate deformation data for Hastelloy X over the temperature range, 200 to 1000 C.

Surgical Outcome of Intermittent Exotropia With Improvement in Control Grade Subsequent to Part-time Preoperative Occlusion Therapy.

PubMed

Bang, Seung Pil; Lee, Dong Cheol; Lee, Se Youp

2018-01-01

To evaluate the effect of improvement in the control grade of intermittent exotropia using part-time occlusion therapy on the final postoperative outcome. Control of intermittent exotropia was graded as good, fair, or poor in 89 consecutive patients with intermittent exotropia during their first visit. The patients were reevaluated after part-time preoperative occlusion therapy and divided into two groups (improvement and no improvement) according to whether they showed improvement in control grade. The surgical success rate was compared retrospectively between the two groups. The mean angle of deviation on the first visit was 27.61 ± 5.40 prism diopters (PD) at distance and 29.82 ± 5.28 PD at near. There were significant improvements in the angles of deviation for distance (26.17 ± 5.09 PD) and near (27.26 ± 5.56 PD) after part-time occlusion (both P < .001). The 49 patients who had a significantly improved control grade had a significantly better surgical success rate (77.6%) than the 40 patients who did not (50%; P = .007). Part-time occlusion therapy improves the control grade of intermittent exotropia, leading to a better likelihood of successful surgery and a reduction of the angles of deviation for distance and near. [J Pediatr Ophthalmol Strabismus. 2018;55(1):59-64.]. Copyright 2017, SLACK Incorporated.

Genetic control of chromosome behaviour: Implications in evolution, crop improvement, and human biology

USDA-ARS?s Scientific Manuscript database

Chromosomes and chromosome pairing are pivotal to all biological sciences. The study of chromosomes helps unravel several aspects of an organism. Although the foundation of genetics occurred with the formulation of the laws of heredity in 1865, long before the discovery of chromosomes, their subsequ...

Increased gamma band power during movement planning coincides with motor memory retrieval.

PubMed

Thürer, Benjamin; Stockinger, Christian; Focke, Anne; Putze, Felix; Schultz, Tanja; Stein, Thorsten

2016-01-15

The retrieval of motor memory requires a previous memory encoding and subsequent consolidation of the specific motor memory. Previous work showed that motor memory seems to rely on different memory components (e.g., implicit, explicit). However, it is still unknown if explicit components contribute to the retrieval of motor memories formed by dynamic adaptation tasks and which neural correlates are linked to memory retrieval. We investigated the lower and higher gamma bands of subjects' electroencephalography during encoding and retrieval of a dynamic adaptation task. A total of 24 subjects were randomly assigned to a treatment and control group. Both groups adapted to a force field A on day 1 and were re-exposed to the same force field A on day 3 of the experiment. On day 2, treatment group learned an interfering force field B whereas control group had a day rest. Kinematic analyses showed that control group improved their initial motor performance from day 1 to day 3 but treatment group did not. This behavioral result coincided with an increased higher gamma band power in the electrodes over prefrontal areas on the initial trials of day 3 for control but not treatment group. Intriguingly, this effect vanished with the subsequent re-adaptation on day 3. We suggest that improved re-test performance in a dynamic motor adaptation task is contributed by explicit memory and that gamma bands in the electrodes over the prefrontal cortex are linked to these explicit components. Furthermore, we suggest that the contribution of explicit memory vanishes with the subsequent re-adaptation while task automaticity increases. Copyright © 2015 Elsevier Inc. All rights reserved.

Brain-computer interfaces in neurological rehabilitation.

PubMed

Daly, Janis J; Wolpaw, Jonathan R

2008-11-01

Recent advances in analysis of brain signals, training patients to control these signals, and improved computing capabilities have enabled people with severe motor disabilities to use their brain signals for communication and control of objects in their environment, thereby bypassing their impaired neuromuscular system. Non-invasive, electroencephalogram (EEG)-based brain-computer interface (BCI) technologies can be used to control a computer cursor or a limb orthosis, for word processing and accessing the internet, and for other functions such as environmental control or entertainment. By re-establishing some independence, BCI technologies can substantially improve the lives of people with devastating neurological disorders such as advanced amyotrophic lateral sclerosis. BCI technology might also restore more effective motor control to people after stroke or other traumatic brain disorders by helping to guide activity-dependent brain plasticity by use of EEG brain signals to indicate to the patient the current state of brain activity and to enable the user to subsequently lower abnormal activity. Alternatively, by use of brain signals to supplement impaired muscle control, BCIs might increase the efficacy of a rehabilitation protocol and thus improve muscle control for the patient.

The effects of elemental diet and subsequent food reintroduction on rheumatoid arthritis.

PubMed

Kavanaghi, R; Workman, E; Nash, P; Smith, M; Hazleman, B L; Hunter, J O

1995-03-01

The role of diet in rheumatoid arthritis (RA) remains controversial and there have been no controlled studies on the use of elemental diet in the treatment of RA. Elemental diet is an hypoallergenic protein-free artificial diet consisting of essential amino acids, glucose, trace elements and vitamins. This study was carried out to assess the role of elemental diet and subsequent food reintroduction in RA. Elemental diet (E028) (and a small number of foods) was given to 24 patients with definite RA in order to induce a remission and then foods were gradually introduced. Where a food was suspected of causing symptoms it was removed from the diet. Twenty-three control patients supplemented their usual diet with E028. After the elemental diet there was a statistically significant improvement in the diet group in grip strength (P = 0.008) and Ritchie score (P = 0.006) but not in ESR, CRP, thermographic joint score or functional score. The diet group lost more weight than the control group and this correlated with the improvement in grip strength. This improvement was not present following food reintroduction. As the improvements took place in more subjective disease parameters and because of the difficulties in adequately blinding studies of diet in arthritis, a placebo effect must be considered. There was a high default rate, only 38% of those patients originally enrolled completed the study. In conclusion, this study shows that elemental diet can cause an improvement in a number of disease parameters in RA but this is not sustained by an individualized diet. It also illustrates some of the difficulties involved in the study of diet in arthritis.

Acute aerobic exercise hastens emotional recovery from a subsequent stressor.

PubMed

Bernstein, Emily E; McNally, Richard J

2017-06-01

Despite findings that regular exercise is broadly associated with emotional well-being, more basic research is needed to deepen our understanding of the exercise and emotion connection. This paper examines how acute aerobic exercise in particular influences subjective emotional recovery from a subsequent stressor. Potential mediators and moderators, including level of physical fitness, attentional control, and perseverative negative thinking were explored. All of the participants (n = 95) completed 3 laboratory visits, each including 1 of 3 activities (i.e., cycling, resting, stretching), tests of working memory and attentional control, and an experimental stressor. Self-reported rumination after the stressor and the experience of positive and negative emotions throughout the study were recorded. In this within-subjects paradigm, as expected, higher rumination in response to the stressor predicted more persistent negative emotion afterward; this effect was attenuated only by prior acute aerobic exercise, in this case, cycling, both 5 min and 15 min poststressor. This effect was unrelated to physical fitness or cognitive performance. Physical fitness level did predict greater attentional control and the capacity to update working memory. Acute aerobic exercise may facilitate subjective emotional recovery from a subsequent stressor and improve emotional flexibility. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Improvement of water resistance and dimensional stability of wood through titanium dioxide coating

Treesearch

Qingfeng Sun; Haipeng Yu; Yixing Liu; Jian Li; Yun Lu; John F. Hunt

2010-01-01

Moisture absorption and dimensional distortion are the major drawbacks of wood utilization as building material. In this study, poplar wood coated with a thin layer of titanium dioxide (TiO2) was prepared by the cosolvent-controlled hydrothermal method. Subsequently, its moisture absorption and dimensional stability were examined. Scanning...

CHANGES IN FLIGHT TRAINEE PERFORMANCE FOLLOWING SYNTHETIC HELICOPTER FLIGHT TRAINING.

ERIC Educational Resources Information Center

CARO, PAUL W., JR.; ISLEY, ROBERT N.

A STUDY WAS CONDUCTED AT THE U.S. ARMY PRIMARY HELICOPTER SCHOOL, FORT WOLTERS, TEXAS, TO DETERMINE WHETHER THE USE OF A HELICOPTER TRAINING DEVICE WOULD IMPROVE STUDENT PERFORMANCE DURING SUBSEQUENT HELICOPTER CONTACT FLIGHT TRAINING. SUBJECTS WERE TWO EXPERIMENTAL GROUPS AND TWO CONTROL GROUPS OF WARRANT OFFICER CANDIDATES ENROLLED FOR A…

Enhancing sludge biodegradability and volatile fatty acid production by tetrakis hydroxymethyl phosphonium sulfate pretreatment.

PubMed

Wu, Qing-Lian; Guo, Wan-Qian; Bao, Xian; Yin, Ren-Li; Feng, Xiao-Chi; Zheng, He-Shan; Luo, Hai-Chao; Ren, Nan-Qi

2017-09-01

A new pretreatment method based on tetrakis hydroxymethyl phosphonium sulfate (THPS) biocide was tried to enhance sludge disintegration, and improved sludge biodegradability and subsequent volatile fatty acid (VFA) production. Sludge activity decreased to less than 10% after 2 days pretreatment using 20mg/g-TSS THPS, which also obviously destroyed EPS and cell membrane, and dissolved more biodegradable substances (48.8%) than raw sludge (19.7%). Moreover, 20mg/g-TSS THPS pretreatment shortened fermentation time to 4days and improved VFA production to 2778mg COD/L (4.35 times than that in control). Therein, the sum of n-butyric, n-valeric and iso-valeric acids unexpectedly accounted for 60.5% of total VFA (only 20.1% of that in control). The more high molecular weight VFAs (C4-C5) than low molecular VFAs (C2-C3) resulted from THPS pretreatment benefited to subsequent medium-chain volatile acids (C6-C12) generation to realize the separation and recovery of organic carbon more efficiently. Copyright © 2017. Published by Elsevier Ltd.

A neural-network approach to robotic control

NASA Technical Reports Server (NTRS)

Graham, D. P. W.; Deleuterio, G. M. T.

1993-01-01

An artificial neural-network paradigm for the control of robotic systems is presented. The approach is based on the Cerebellar Model Articulation Controller created by James Albus and incorporates several extensions. First, recognizing the essential structure of multibody equations of motion, two parallel modules are used that directly reflect the dynamical characteristics of multibody systems. Second, the architecture of the proposed network is imbued with a self-organizational capability which improves efficiency and accuracy. Also, the networks can be arranged in hierarchical fashion with each subsequent network providing finer and finer resolution.

Individual perception of recovery is related to subsequent sprint performance.

PubMed

Cook, Christian J; Beaven, Chris Martyn

2013-07-01

Training recovery is vital for adaptation and performance, and to avoid cumulative fatigue and symptoms associated with overtraining. The use of cold-water immersion (CWI) as a recovery strategy is common; however, the physiological and biochemical rationale behind its use remains unclear. This study aimed to assess the relationship between body temperature responses to water immersion and individual perception of recovery, with subsequent exercise performance. Twelve male rugby players participated in a 3-week cross-over trial where an intense 60 min conditioning session was followed immediately by 15 min of either 14°C CWI, 30°C warm-water immersion (WWI) or passive control (CON) recovery intervention. Postexercise body temperatures and subjective ratings of the recovery intervention were recorded and subsequently related to performance in a 5×40 m repeated sprint protocol undertaken 24 h later. CWI induced large reductions in core body temperature postimmersion (effect size (ES) range 1.05-3.21) and improved subsequent sprint performance compared to WWI (ES 1.04±0.84) and CON (ES 1.44±0.84). Both the degree of temperature decrease at 60 min postimmersion (r=0.6948; p=0.0121) and the subjective rating of the recovery intervention (r=0.5886; p=0.0441) were related to subsequent sprint performance. A very strong linear correlation was observed when these two factors were integrated (r=0.7743; p=0.0031). A combination of physiological and psychological indices provides an improved indication of subsequent performance and suggests an important role of individual perception in enhancing training recovery.

Psychological and support interventions to reduce levels of stress, anxiety or depression on women’s subsequent pregnancy with a history of miscarriage: an empty systematic review

PubMed Central

Meaney, Sarah; McNamara, Karen; O'Donoghue, Keelin

2017-01-01

Objective The aim of this systematic review was to assess the effect of interventions to reduce stress in pregnant women with a history of miscarriage. Design A systematic review of randomised controlled trials (RCTs). Data source A total of 13 medical, psychological and social electronic databases were searched from January 1995 to April 2016 including PUBMED, CENTRAL, Web of Science and EMBASE. Eligibility criteria This review focused on women in their subsequent pregnancy following miscarriage. All published RCTs which assessed the effect of non-medical interventions such as counselling or support interventions on psychological and mental health outcomes such as stress, anxiety or depression when compared with a control group were included. Stress, anxiety or depression had to be measured at least preintervention and postintervention. Results This systematic review found no RCT which met our initial inclusion criteria. Of the 4140 titles screened, 17 RCTs were identified. All of them were excluded. One RCT, which implemented a caring-based intervention, included pregnant women in their subsequent pregnancy; however, miscarriage was analysed as a composite variable among other pregnancy losses such as stillbirth and neonatal death. Levels of perceived stress were measured by four RCTs. Different types of non-medical interventions, time of follow-up and small sample sizes were found. Conclusion Cohort studies and RCTs in non-pregnant women suggest that support and psychological interventions may improve pregnant women’s psychological well-being after miscarriage. This improvement may reduce adverse pregnancy-related outcomes in subsequent pregnancies. However, this review found no RCTs which met our criteria. There is a need for targeted RCTs that can provide reliable and conclusive results to determine effective interventions for this vulnerable group. PMID:28882928

Pasireotide therapy in a rare and unusual case of plurihormonal pituitary macroadenoma

PubMed Central

Rajendran, Rajesh; Naik, Sarita; Sandeman, Derek D; Nasruddin, Azraai B

2013-01-01

Summary We report the use of pasireotide in a rare and unusual case of pituitary macroadenoma co-secreting GH, prolactin and ACTH. A 62-year-old Caucasian man presented with impotence. Clinically, he appeared acromegalic and subsequent investigations confirmed GH excess and hyperprolactinaemia. Magnetic resonance imaging (MRI) of pituitary revealed a large pituitary macroadenoma. He underwent trans-sphenoidal surgery and histology confirmed an adenoma with immunohistochemistry positive for ACTH, GH and prolactin. Acromegaly was not cured following surgery and inadequately controlled despite subsequent octreotide therapy. He underwent further debulking pituitary surgery, following which IGF1 levels improved but still high. This time adenoma cells showed immunohistochemistry positivity for ACTH only, following which subsequent investigations confirmed intermittent hypercortisolaemia compatible with pituitary Cushing's disease. We recommended radiotherapy, but in view of the pluripotential nature of the tumour, we proceeded with a trial of s.c. pasireotide therapy on the basis that it may control both his acromegaly and Cushing's disease. After 3 months of pasireotide therapy, his mean GH and IGF1 levels improved significantly, with improvement in his symptoms but intermittent hypercortisolaemia persists. His glycaemic control deteriorated requiring addition of new anti-diabetic medication. MRI imaging showed loss of contrast uptake within the tumour following pasireotide therapy but no change in size. We conclude that our patient has had a partial response to pasireotide therapy. Long-term follow-up studies are needed to establish its safety and efficacy in patients with acromegaly and/or Cushing's disease. Learning points Plurihormonal pituitary adenomas are rare and unusual.Patients with pituitary adenomas co-secreting ACTH and GH are more likely to present with acromegaly because GH excess can mask hypercortisolaemia.Pasireotide holds potential where conventional somatostatin analogues are not effective in acromegaly due to higher affinity for somatostatin receptor subtypes 1, 2, 3 and 5.Significant deterioration in glycaemic control remains a concern in the use of pasireotide.Currently, long-term safety and efficacy of pasireotide in patients with acromegaly and/or Cushing's disease are not fully clear. PMID:24616766

The effects of platelet lysate on maturation, fertilization and embryo development of NMRI mouse oocytes at germinal vesicle stage.

PubMed

Pazoki, Hassan; Eimani, Hussein; Farokhi, Farah; Shahverdi, Abdol-Hossein; Tahaei, Leila Sadat

2016-04-01

Improving in vitro maturation could increase the rate of pregnancy from oocytes matured in vitro. Consequently, patients will be prevented from using gonadotropin with its related side effects. In this study, the maturation medium was enriched by platelet lysate (PL), then maturation and subsequent developments were monitored. Oocytes at germinal vesicle stage with cumulus cells (cumulus-oocyte complex) and without cumulus cells (denuded oocytes) were obtained from mature female mice. The maturation medium was enriched by 5 and 10 % PL and 5 % PL + 5 % fetal bovine serum (FBS) as experimental groups; the control groups' media consisted of 5 and 10 % FBS. After 18 h, the matured oocytes were collected and, after fertilization, subsequent development was monitored. The rates of maturation, fertilization and 2-cell embryo development for the denuded oocyte groups in experimental media 5 % PL and 5 % PL + 5 % FBS were significantly higher than those of the control groups ( P < 0.05), while the results for the cumulus-oocyte complex groups were similar between the experimental groups and control groups. The results of this study indicated that platelet lysate could improve the maturation rate in the absence of granulosa cells compared to media with FBS. This extract also had positive effects on fertilization and embryo development.

Evaluation of the Use of a Virtual Patient on Student Competence and Confidence in Performing Simulated Clinic Visits.

PubMed

Taglieri, Catherine A; Crosby, Steven J; Zimmerman, Kristin; Schneider, Tulip; Patel, Dhiren K

2017-06-01

Objective. To assess the effect of incorporating virtual patient activities in a pharmacy skills lab on student competence and confidence when conducting real-time comprehensive clinic visits with mock patients. Methods. Students were randomly assigned to a control or intervention group. The control group completed the clinic visit prior to completing virtual patient activities. The intervention group completed the virtual patient activities prior to the clinic visit. Student proficiency was evaluated in the mock lab. All students completed additional exercises with the virtual patient and were subsequently assessed. Student impressions were assessed via a pre- and post-experience survey. Results. Student performance conducting clinic visits was higher in the intervention group compared to the control group. Overall student performance continued to improve in the subsequent module. There was no change in student confidence from pre- to post-experience. Student rating of the ease of use and realistic simulation of the virtual patient increased; however, student rating of the helpfulness of the virtual patient decreased. Despite student rating of the helpfulness of the virtual patient program, student performance improved. Conclusion. Virtual patient activities enhanced student performance during mock clinic visits. Students felt the virtual patient realistically simulated a real patient. Virtual patients may provide additional learning opportunities for students.

Rotorcraft flying qualities improvement using advanced control

NASA Technical Reports Server (NTRS)

Walker, D.; Postlethwaite, I.; Howitt, J.; Foster, N.

1993-01-01

We report on recent experience gained when a multivariable helicopter flight control law was tested on the Large Motion Simulator (LMS) at DRA Bedford. This was part of a study into the application of multivariable control theory to the design of full-authority flight control systems for high-performance helicopters. In this paper, we present some of the results that were obtained during the piloted simulation trial and from subsequent off-line simulation and analysis. The performance provided by the control law led to level 1 handling quality ratings for almost all of the mission task elements assessed, both during the real-time and off-line analysis.

Luteal start vaginal micronized progesterone improves pregnancy success in women with recurrent pregnancy loss.

PubMed

Stephenson, Mary D; McQueen, Dana; Winter, Michelle; Kliman, Harvey J

2017-03-01

To assess the effectiveness of luteal start vaginal micronized P in a recurrent pregnancy loss (RPL) cohort. Observational cohort study using prospectively collected data. Not applicable. Women seen between 2004 and 2012 with a history of two or more unexplained pregnancy losses <10 weeks in size; endometrial biopsy (EB) performed 9-11 days after LH surge; and one or more subsequent pregnancy(ies). Women were excluded if concomitant findings, such as endometritis, maturation delay, or glandular-stromal dyssynchrony, were identified on EB. Vaginal micronized P was prescribed at a dose of 100-200 mg every 12 hours starting 3 days after LH surge (luteal start) if glandular epithelial nuclear cyclin E (nCyclinE) expression was elevated (>20%) in endometrial glands or empirically despite normal nCyclinE (≤20%). Women with normal nCyclinE (≤20%) who did not receive P were used as controls. Pregnancy success was an ongoing pregnancy >10 weeks in size. One hundred sixteen women met the inclusion criteria, of whom 51% (n = 59) had elevated nCyclinE and 49% (n = 57) had normal nCyclinE. Pregnancy success in the 59 women with elevated nCyclinE significantly improved after intervention: 6% (16/255) in prior pregnancies versus 69% (57/83) in subsequent pregnancies. Pregnancy success in subsequent pregnancies was higher in women prescribed vaginal micronized P compared with controls: 68% (86/126) versus 51% (19/37); odds ratio = 2.1 (95% confidence interval, 1.0-4.4). In this study, we found that the use of luteal start vaginal micronized P was associated with improved pregnancy success in a strictly defined cohort of women with RPL. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Effects of pretesting implicit self-determined motivation on behavioral engagement: evidence for the mere measurement effect at the implicit level.

PubMed

Keatley, David A; Clarke, David D; Ferguson, Eamonn; Hagger, Martin S

2014-01-01

Research into individuals' intended behavior and performance has traditionally adopted explicitly measured, self-report constructs, and outcomes. More recently, research has shown that completing explicit self-report measures of constructs may effect subsequent behavior, termed the "mere measurement" effect. The aim of the present experiment was to investigate whether implicit measures of motivation showed a similar mere measurement effect on subsequent behavior. It may be the case that measuring the implicit systems affects subsequent implicit interventions (e.g., priming), observable on subsequent behavior. Priming manipulations were also given to participants in order to investigate the interaction between measurement and priming of motivation. Initially, a 2 [implicit association test (IAT: present vs. absent) ×2 (Prime: autonomous vs. absent) and a 2 (IAT: present vs. absent) × 2 (Prime: controlled vs. absent)] between participants designs were conducted, these were them combined into a 2 (IAT: present vs. absent) ×3 (Prime: autonomous vs. controlled vs. absent) between participants design, with attempts at a novel task taken as the outcome measure. Implicit measure completion significantly decreased behavioral engagement. Priming autonomous motivation significantly facilitated, and controlled motivation significantly inhibited performance. Finally, there was a significant implicit measurement × priming interaction, such that priming autonomous motivation only improved performance in the absence of the implicit measure. Overall, this research provides an insight into the effects of implicit measurement and priming of motivation and the combined effect of completing both tasks on behavior.

Teenagers: fertility control behavior and attitudes before and after abortion, childbearing or negative pregnancy test.

PubMed

Evans, J R; Selstad, G; Welcher, W H

1976-01-01

Following abortion or delivery, teenagers' knowledge and use of effective contraception improved markedly; but those who had negative pregnancy tests continued to take risks--and to get pregnant--subsequently. Most sexually active teenagers were poorly educated on the facts of reproduction, and began to have intercourse before seeking contraception.

EEG-tomographic studies with LORETA on vigilance differences between narcolepsy patients and controls and subsequent double-blind, placebo-controlled studies with modafinil.

PubMed

Saletu, M; Anderer, P; Saletu-Zyhlarz, G M; Mandl, M; Arnold, O; Zeitlhofer, J; Saletu, B

2004-11-01

The aim of the present study was to identify brain regions associated with vigilance in untreated and modafinil-treated narcoleptic patients by means of low-resolution brain electromagnetic tomography (LORETA). 16 drug-free narcoleptics and 16 normal controls were included in the baseline investigation. Subsequently patients participated in a double-blind, placebo-controlled crossover study receiving a three-week fixed titration of modafinil (200, 300, 400 mg) and placebo. Measurements comprised LORETA, the Multiple Sleep Latency Test (MSLT) and the Epworth Sleepiness Scale (ESS) obtained before and after three weeks' therapy. Statistical overall analysis by means of the omnibus significance test demonstrated significant inter-group differences in the resting (R-EEG), but not in the vigilance-controlled recordings (V-EEG). Subsequent univariate analysis revealed a decrease in alpha-2 and beta 1-3 power in prefrontal, temporal and parietal cortices, with the right hemisphere slightly more involved in this vigilance decrement. Modafinil 400 mg/d as compared with placebo induced changes opposite to the aforementioned baseline differences (key-lock principle) with a preponderance in the left hemisphere. This increase in vigilance resulted in an improvement in the MSLT and the ESS. LORETA provided evidence of a functional deterioration of the fronto-temporo-parietal network of the right-hemispheric vigilance system in narcolepsy and a therapeutic effect of modafinil on the left hemisphere, which is less affected by the disease.

Dying scenarios improve recall as much as survival scenarios.

PubMed

Burns, Daniel J; Hart, Joshua; Kramer, Melanie E

2014-01-01

Merely contemplating one's death improves retention for entirely unrelated material learned subsequently. This "dying to remember" effect seems conceptually related to the survival processing effect, whereby processing items for their relevance to being stranded in the grasslands leads to recall superior to that of other deep processing control conditions. The present experiments directly compared survival processing scenarios with "death processing" scenarios. Results showed that when the survival and dying scenarios are closely matched on key dimensions, and possible congruency effects are controlled, the dying and survival scenarios produced equivalently high recall levels. We conclude that the available evidence (cf. Bell, Roer, & Buchner, 2013; Klein, 2012), while not definitive, is consistent with the possibility of overlapping mechanisms.

High-power femtosecond pulses without a modelocked laser

PubMed Central

Fu, Walter; Wright, Logan G.; Wise, Frank W.

2017-01-01

We demonstrate a fiber system which amplifies and compresses pulses from a gain-switched diode. A Mamyshev regenerator shortens the pulses and improves their coherence, enabling subsequent amplification by parabolic pre-shaping. As a result, we are able to control nonlinear effects and generate nearly transform-limited, 140-fs pulses with 13-MW peak power—an order-of-magnitude improvement over previous gain-switched diode sources. Seeding with a gain-switched diode results in random fluctuations of 2% in the pulse energy, which future work using known techniques may ameliorate. Further development may allow such systems to compete directly with sources based on modelocked oscillators in some applications while enjoying unparalleled robustness and repetition rate control. PMID:29214187

Changes in psychosocial and physical working conditions and psychotropic medication in ageing public sector employees: a record-linkage follow-up study.

PubMed

Kouvonen, Anne; Mänty, Minna; Lallukka, Tea; Pietiläinen, Olli; Lahelma, Eero; Rahkonen, Ossi

2017-07-12

To investigate whether changes in psychosocial and physical working conditions are associated with subsequent psychotropic medication in ageing employees. Data were from the Helsinki Health Study, a cohort study of Finnish municipal employees, aged 40-60 years at phase 1 (2000-2002). Changes in psychosocial and physical working conditions were measured between phase 1 and phase 2 (2007). Survey data were longitudinally linked to data on prescribed, reimbursed psychotropic medication purchases (Anatomical Therapeutic Chemical) obtained from the registers of the Social Insurance Institution of Finland between the phase 2 survey and December 2013 (N=3587; 80% women). Outcomes were any psychotropic medication; antidepressants (N06A); anxiolytics (N05B); and sedatives and hypnotics (N05C). Cox regression analyses were performed. During the follow-up, 28% of the participants were prescribed psychotropic medication. Repeated exposures to low job control, high job demands and high physical work load were associated with an increased risk of subsequent antidepressant and anxiolytic medication. Increased and repeated exposure to high physical work load, increased job control and repeated high job demands were associated with subsequent sedative and hypnotic medication. Age and sex-adjusted HR varied from 1.18 to 1.66. Improvement in job control was associated with a lower risk of anxiolytic, but with a higher risk of sedatives and hypnotic medication. Decreased physical work load was associated with a lower risk of antidepressant and anxiolytic medications. Improvement in working conditions could lower the risk of mental ill-health indicated by psychotropic medication. © 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.

Electronic Alerts, Comparative Practitioner Metrics, and Education Improves Thromboprophylaxis and Reduces Thrombosis.

PubMed

Woller, Scott C; Stevens, Scott M; Evans, R Scott; Wray, Daniel G; Christensen, John C; Aston, Valerie T; Wayne, Matthew H; Lloyd, James F; Wilson, Emily L; Elliott, C Gregory

2016-10-01

Venous thromboembolism chemoprophylaxis remains underutilized in hospitalized medical patients at high risk for venous thromboembolism. We assessed the effect of a health care quality-improvement initiative comprised of a targeted electronic alert, comparative practitioner metrics, and practitioner-specific continuing medical education on the rate of appropriate venous thromboembolism chemoprophylaxis provided to medical inpatients at high risk for venous thromboembolism. We performed a multicenter prospective observational cohort study in an urban Utah hospital system. All medical patients admitted to 1 of 2 participating hospitals from April 1, 2010 to December 31, 2012 were eligible. Patients were members of the "control" (April 1, 2010 to December 31, 2010), "intervention" (January 1, 2011 to December 31, 2011), or "subsequent year" (January 1, 2012 to December 31, 2012) group. The primary outcome was the rate of appropriate chemoprophylaxis among patients at high risk for venous thromboembolism. Secondary outcomes included rates of symptomatic venous thromboembolism, major bleeding, all-cause mortality, heparin-induced thrombocytopenia, physician satisfaction, and alert fatigue. The rate of appropriate chemoprophylaxis among patients at high risk for venous thromboembolism increased (66.1% control period vs 81.0% intervention period vs 88.1% subsequent year; P <.001 for each comparison). A significant reduction of 90-day symptomatic venous thromboembolism accompanied the quality initiative (9.3% control period, 9.7% intervention period, 6.7% subsequent year; P = .009); 30-day venous thromboembolism rates also significantly decreased. A multifaceted intervention was associated with increased appropriate venous thromboembolism chemoprophylaxis among medical inpatients at high risk for venous thromboembolism and reduced symptomatic venous thromboembolism. The effect of the intervention was sustained. Copyright © 2016 Elsevier Inc. All rights reserved.

Automatic Information Processing and High Performance Skills: Individual Differences and Mechanisms of Performance Improvement in Search-Detection and Complex Task

DTIC Science & Technology

1992-09-01

abilities is fit along with the autoregressive process. Initially, the influences on search performance of within-group age and sex were included as control...Results: PerformanceLAbility Structure Measurement Model: Ability Structure The correlations between all the ability measures, age, and sex are...subsequent analyses for young adults. Age and sex were included as control variables. There was an age range of 15 years; this range is sufficiently large that

Test Rig for Active Turbine Blade Tip Clearance Control Concepts: An Update

NASA Technical Reports Server (NTRS)

Taylor, Shawn; Steinetz, Bruce; Oswald, Jay; DeCastro, Jonathan; Melcher, Kevin

2006-01-01

The objective is to develop and demonstrate a fast-acting active clearance control system to improve turbine engine performance, reduce emissions, and increase service life. System studies have shown the benefits of reducing blade tip clearances in modern turbine engines. Minimizing blade tip clearances throughout the engine will contribute materially to meeting NASA's Ultra-Efficient Engine Technology (UEET) turbine engine project goals. NASA GRC is examining two candidate approaches including rub-avoidance and regeneration which are explained in subsequent slides.

Employing quality control and feedback to the EQ-5D-5L valuation protocol to improve the quality of data collection.

PubMed

Purba, Fredrick Dermawan; Hunfeld, Joke A M; Iskandarsyah, Aulia; Fitriana, Titi Sahidah; Sadarjoen, Sawitri S; Passchier, Jan; Busschbach, Jan J V

2017-05-01

In valuing health states using generic questionnaires such as EQ-5D, there are unrevealed issues with the quality of the data collection. The aims were to describe the problems encountered during valuation and to evaluate a quality control report and subsequent retraining of interviewers in improving this valuation. Data from the first 266 respondents in an EQ-5D-5L valuation study were used. Interviewers were trained and answered questions regarding problems during these initial interviews. Thematic analysis was used, and individual feedback was provided. After completion of 98 interviews, a first quantitative quality control (QC) report was generated, followed by a 1-day retraining program. Subsequently individual feedback was also given on the basis of follow-up QCs. The Wilcoxon signed-rank test was used to assess improvements based on 7 indicators of quality as identified in the first QC and the QC conducted after a further 168 interviews. Interviewers encountered problems in recruiting respondents. Solutions provided were: optimization of the time of interview, the use of broader networks and the use of different scripts to explain the project's goals to respondents. For problems in interviewing process, solutions applied were: developing the technical and personal skills of the interviewers and stimulating the respondents' thought processes. There were also technical problems related to hardware, software and internet connections. There was an improvement in all 7 indicators of quality after the second QC. Training before and during a study, and individual feedback on the basis of a quantitative QC, can increase the validity of values obtained from generic questionnaires.

Assimilation of total lightning data using the three-dimensional variational method at convection-allowing resolution

NASA Astrophysics Data System (ADS)

Zhang, Rong; Zhang, Yijun; Xu, Liangtao; Zheng, Dong; Yao, Wen

2017-08-01

A large number of observational analyses have shown that lightning data can be used to indicate areas of deep convection. It is important to assimilate observed lightning data into numerical models, so that more small-scale information can be incorporated to improve the quality of the initial condition and the subsequent forecasts. In this study, the empirical relationship between flash rate, water vapor mixing ratio, and graupel mixing ratio was used to adjust the model relative humidity, which was then assimilated by using the three-dimensional variational data assimilation system of the Weather Research and Forecasting model in cycling mode at 10-min intervals. To find the appropriate assimilation time-window length that yielded significant improvement in both the initial conditions and subsequent forecasts, four experiments with different assimilation time-window lengths were conducted for a squall line case that occurred on 10 July 2007 in North China. It was found that 60 min was the appropriate assimilation time-window length for this case, and longer assimilation window length was unnecessary since no further improvement was present. Forecasts of 1-h accumulated precipitation during the assimilation period and the subsequent 3-h accumulated precipitation were significantly improved compared with the control experiment without lightning data assimilation. The simulated reflectivity was optimal after 30 min of the forecast, it remained optimal during the following 42 min, and the positive effect from lightning data assimilation began to diminish after 72 min of the forecast. Overall, the improvement from lightning data assimilation can be maintained for about 3 h.

The consequences of resistance training for movement control in older adults.

PubMed

Barry, Benjamin K; Carson, Richard G

2004-07-01

Older adults who undertake resistance training are typically seeking to maintain or increase their muscular strength with the goal of preserving or improving their functional capabilities. The extent to which resistance training adaptations lead to improved performance on tasks of everyday living is not particularly well understood. Indeed, studies examining changes in functional task performance experienced by older adults following periods of resistance training have produced equivocal findings. A clear understanding of the principles governing the transfer of resistance training adaptations is therefore critical in seeking to optimize the prescription of training regimes that have as their aim the maintenance and improvement of functional movement capacities in older adults. The degenerative processes that occur in the aging motor system are likely to influence heavily any adaptations to resistance training and the subsequent transfer to functional task performance. The resulting characteristics of motor behavior, such as the substantial decline in the rate of force development and the decreased steadiness of force production, may entail that specialized resistance training strategies are necessary to maximize the benefits for older adults. In this review, we summarize the alterations in the neuromuscular system that are responsible for the declines in strength, power, and force control, and the subsequent deterioration in the everyday movement capabilities of older adults. We examine the literature concerning the neural adaptations that older adults experience in response to resistance training, and consider the readiness with which these adaptations will improve the functional movement capabilities of older adults.

Adaptive control schemes for improving dynamic performance of efficiency-optimized induction motor drives.

PubMed

Kumar, Navneet; Raj Chelliah, Thanga; Srivastava, S P

2015-07-01

Model Based Control (MBC) is one of the energy optimal controllers used in vector-controlled Induction Motor (IM) for controlling the excitation of motor in accordance with torque and speed. MBC offers energy conservation especially at part-load operation, but it creates ripples in torque and speed during load transition, leading to poor dynamic performance of the drive. This study investigates the opportunity for improving dynamic performance of a three-phase IM operating with MBC and proposes three control schemes: (i) MBC with a low pass filter (ii) torque producing current (iqs) injection in the output of speed controller (iii) Variable Structure Speed Controller (VSSC). The pre and post operation of MBC during load transition is also analyzed. The dynamic performance of a 1-hp, three-phase squirrel-cage IM with mine-hoist load diagram is tested. Test results are provided for the conventional field-oriented (constant flux) control and MBC (adjustable excitation) with proposed schemes. The effectiveness of proposed schemes is also illustrated for parametric variations. The test results and subsequent analysis confer that the motor dynamics improves significantly with all three proposed schemes in terms of overshoot/undershoot peak amplitude of torque and DC link power in addition to energy saving during load transitions. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

The Effect of Prior Task Success on Older Adults' Memory Performance: Examining the Influence of Different Types of Task Success.

PubMed

Geraci, Lisa; Hughes, Matthew L; Miller, Tyler M; De Forrest, Ross L

2016-01-01

Negative aging stereotypes can lead older adults to perform poorly on memory tests. Yet, memory performance can be improved if older adults have a single successful experience on a cognitive test prior to participating in a memory experiment (Geraci & Miller, 2013, Psychology and Aging, 28, 340-345). The current study examined the effects of different types of prior task experience on subsequent memory performance. Before participating in a verbal free recall experiment, older adults in Experiment 1 successfully completed either a verbal or a visual cognitive task or no task. In Experiment 2, they successfully completed either a motor task or no task before participating in the free recall experiment. Results from Experiment 1 showed that relative to control (no prior task), participants who had prior success, either on a verbal or a visual task, had better subsequent recall performance. Experiment 2 showed that prior success on a motor task, however, did not lead to a later memory advantage relative to control. These findings demonstrate that older adults' memory can be improved by a successful prior task experience so long as that experience is in a cognitive domain.

Ventral striatum and the evaluation of memory retrieval strategies.

PubMed

Badre, David; Lebrecht, Sophie; Pagliaccio, David; Long, Nicole M; Scimeca, Jason M

2014-09-01

Adaptive memory retrieval requires mechanisms of cognitive control that facilitate the recovery of goal-relevant information. Frontoparietal systems are known to support control of memory retrieval. However, the mechanisms by which the brain acquires, evaluates, and adapts retrieval strategies remain unknown. Here, we provide evidence that ventral striatal activation tracks the success of a retrieval strategy and correlates with subsequent reliance on that strategy. Human participants were scanned with fMRI while performing a lexical decision task. A rule was provided that indicated the likely semantic category of a target word given the category of a preceding prime. Reliance on the rule improved decision-making, as estimated within a drift diffusion framework. Ventral striatal activation tracked the benefit that relying on the rule had on decision-making. Moreover, activation in ventral striatum correlated with a participant's subsequent reliance on the rule. Taken together, these results support a role for ventral striatum in learning and evaluating declarative retrieval strategies.

Domains of unprofessional behavior during medical school associated with future disciplinary action by a state medical board.

PubMed

Teherani, Arianne; Hodgson, Carol S; Banach, Mary; Papadakis, Maxine A

2005-10-01

In a previous study, we showed that unprofessional behavior in medical school was associated with subsequent disciplinary action. This study expands on that work by identifying the domains of unprofessional behavior that are most problematic. In this retrospective case-control study, negative comments were extracted from student files for 68 case (disciplined) and 196 matched control (nondisciplined) physicians. Comments were analyzed qualitatively and subsequently quantified. The relationship between domains of behavior and disciplinary action was established through chi-square tests and multivariate analysis of variance. Three domains of unprofessional behavior emerged that were related significantly to later disciplinary outcome: (1) poor reliability and responsibility, (2) lack of self-improvement and adaptability, and (3) poor initiative and motivation. Three critical domains of professionalism associated with future disciplinary action have been defined. These findings could lead to focused remediation strategies and policy decisions.

Data-based control of a multi-step forming process

NASA Astrophysics Data System (ADS)

Schulte, R.; Frey, P.; Hildenbrand, P.; Vogel, M.; Betz, C.; Lechner, M.; Merklein, M.

2017-09-01

The fourth industrial revolution represents a new stage in the organization and management of the entire value chain. However, concerning the field of forming technology, the fourth industrial revolution has only arrived gradually until now. In order to make a valuable contribution to the digital factory the controlling of a multistage forming process was investigated. Within the framework of the investigation, an abstracted and transferable model is used to outline which data have to be collected, how an interface between the different forming machines can be designed tangible and which control tasks must be fulfilled. The goal of this investigation was to control the subsequent process step based on the data recorded in the first step. The investigated process chain links various metal forming processes, which are typical elements of a multi-step forming process. Data recorded in the first step of the process chain is analyzed and processed for an improved process control of the subsequent process. On the basis of the gained scientific knowledge, it is possible to make forming operations more robust and at the same time more flexible, and thus create the fundament for linking various production processes in an efficient way.

Self-esteem treatment in anxiety: A randomized controlled crossover trial of Eye Movement Desensitization and Reprocessing (EMDR) versus Competitive Memory Training (COMET) in patients with anxiety disorders.

PubMed

Staring, A B P; van den Berg, D P G; Cath, D C; Schoorl, M; Engelhard, I M; Korrelboom, C W

2016-07-01

Little is known about treating low self-esteem in anxiety disorders. This study evaluated two treatments targeting different mechanisms: (1) Eye Movement Desensitization and Reprocessing (EMDR), which aims to desensitize negative memory representations that are proposed to maintain low self-esteem; and (2) Competitive Memory Training (COMET), which aims to activate positive representations for enhancing self-esteem. A Randomized Controlled Trial (RCT) was used with a crossover design. Group 1 received six sessions EMDR first and then six sessions COMET; group 2 vice versa. Assessments were made at baseline (T0), end of first treatment (T1), and end of second treatment (T2). Main outcome was self-esteem. We included 47 patients and performed Linear Mixed Models. COMET showed more improvements in self-esteem than EMDR: effect-sizes 1.25 versus 0.46 post-treatment. Unexpectedly, when EMDR was given first, subsequent effects of COMET were significantly reduced in comparison to COMET as the first intervention. For EMDR, sequence made no difference. Reductions in anxiety and depression were mediated by better self-esteem. COMET was associated with significantly greater improvements in self-esteem than EMDR in patients with anxiety disorders. EMDR treatment reduced the effectiveness of subsequent COMET. Improved self-esteem mediated reductions in anxiety and depression symptoms. Copyright © 2016 Elsevier Ltd. All rights reserved.

LIBER8 design and methods: an integrative intervention for loss of control eating among African American and White adolescent girls.

PubMed

Mazzeo, Suzanne E; Kelly, Nichole R; Stern, Marilyn; Palmberg, Allison A; Belgrave, Faye Z; Tanofsky-Kraff, Marian; Latzer, Yael; Bulik, Cynthia M

2013-01-01

Loss of control (LOC) eating affects a significant number of adolescents of all racial and ethnic backgrounds and is associated with numerous psychosocial problems, including depression, anxiety, low self-esteem, body dissatisfaction, and weight concerns. However, empirically validated, culturally sensitive treatments for adolescents with these disordered eating behaviors are not available. This pilot project involved designing a developmentally and culturally appropriate treatment for LOC eating for adolescent girls. We intend to conduct multiple focus groups with adolescent girls who engage in LOC eating, and their primary caregivers. Data from these groups will inform the subsequent creation of a manualized treatment protocol. We will then evaluate the efficacy of this intervention (LIBER8-Linking Individuals Being Emotionally Real) to reduce LOC eating. This intervention will integrate components of dialectical behavior therapy, such as mindfulness and distress tolerance skills training, and cognitive-behavioral therapy. We will also integrate text-messaging, a key adolescent communication strategy, as a means of self-monitoring. Participants meeting study criteria will be offered participation in this 12-week randomized controlled trial comparing LIBER8 to a weight management control condition (2BFit). We hypothesize that this intervention will serve to reduce LOC eating, as well as improve psychosocial functioning as evidenced by decreased depression, anxiety, eating disorder cognitions, emotional eating, impulsivity, and improved quality of life. The feasibility and acceptability of this intervention will be extensively evaluated with the explicit intent of informing a subsequent larger randomized controlled trial. Copyright © 2012 Elsevier Inc. All rights reserved.

LIBER8 Design and Methods: An Integrative Intervention for Loss of Control Eating among African American and White Adolescent Girls

PubMed Central

Mazzeo, Suzanne E.; Kelly, Nichole R.; Stern, Marilyn; Palmberg, Allison A.; Belgrave, Faye Z.; Tanofsky-Kraff, Marian; Latzer, Yael; Bulik, Cynthia M.

2013-01-01

Loss of control (LOC) eating affects a significant number of adolescents of all racial and ethnic backgrounds and is associated with numerous psychosocial problems, including depression, anxiety, low self-esteem, body dissatisfaction, and weight concerns. However, empirically validated, culturally sensitive treatments for adolescents with these disordered eating behaviors are not available. This pilot project involved designing a developmentally and culturally appropriate treatment for LOC eating for adolescent girls. We intend to conduct multiple focus groups with adolescent girls who engage in LOC eating, and their primary caregivers. Data from these groups will inform the subsequent creation of a manualized treatment protocol. We will then evaluate the efficacy of this intervention (LIBER8—Linking Individuals Being Emotionally Real) to reduce LOC eating. This intervention will integrate components of dialectical behavior therapy, such as mindfulness and distress tolerance skills training, and cognitive-behavioral therapy. We will also integrate text-messaging, a key adolescent communication strategy, as a means of self-monitoring. Participants meeting study criteria will be offered participation in this 12-week randomized controlled trial comparing LIBER8 to a weight management control condition (2BFit). We hypothesize that this intervention will serve to reduce LOC eating, as well as improve psychosocial functioning as evidenced by decreased depression, anxiety, eating disorder cognitions, emotional eating, impulsivity, and improved quality of life. The feasibility and acceptability of this intervention will be extensively evaluated with the explicit intent of informing a subsequent larger randomized controlled trial. PMID:23142669

High Current Density, Long Life Cathodes for High Power RF Sources

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

Ives, Robert Lawrence; Collins, George; Falce, Lou

2014-01-22

This program was tasked with improving the quality and expanding applications for Controlled Porosity Reservoir (CPR) cathodes. Calabazas Creek Research, Inc. (CCR) initially developed CPR cathodes on a DOE-funded SBIR program to improve cathodes for magnetron injection guns. Subsequent funding was received from the Defense Advanced Research Projects Agency. The program developed design requirements for implementation of the technology into high current density cathodes for high frequency applications. During Phase I of this program, CCR was awarded the prestigious 2011 R&D100 award for this technology. Subsequently, the technology was presented at numerous technical conferences. A patent was issued for themore » technology in 2009. These cathodes are now marketed by Semicon Associates, Inc. in Lexington, KY. They are the world’s largest producer of cathodes for vacuum electron devices. During this program, CCR teamed with Semicon Associates, Inc. and Ron Witherspoon, Inc. to improve the fabrication processes and expand applications for the cathodes. Specific fabrications issues included the quality of the wire winding that provides the basic structure and the sintering to bond the wires into a robust, cohesive structure. The program also developed improved techniques for integrating the resulting material into cathodes for electron guns.« less

[Nanotechnology, nanomedicine and nanopharmacology].

PubMed

Fernández, Pedro Lorenzo

2007-01-01

Based on Nanotechnology methods, Nanomedicine and Nanotecnology will obtain significant advances in areas such as Diagnostic, Regenerative Medicine and pharmacological Therapeutics. With nanotechnology-based drug delivery systems,important improvement on pharmacokinetics of drugs will take place, due to increased solubility, protection against decrease in drug effects due to excessive metabolism and subsequent increase of bioavailability. Improvement on pharmacodynamic parameters will occur also due to increased drug concentration in target tissues. Also the use of Nanotechnology in the modern pharmacology will serve for a more accurate control of doses, which will decrease significantly drug toxicity.

Age and gender differences in conviction and crash occurrence subsequent to being directed to Iowa's driver improvement program.

PubMed

Zhang, Wei; Gkritza, Konstantina; Keren, Nir; Nambisan, Shashi

2011-10-01

This paper investigates potential gender and age differences in conviction and crash occurrence subsequent to being directed to attend Iowa's Driver Improvement Program (DIP). Binary logit models were developed to investigate the factors that influence conviction occurrence after DIP by gender and age. Because of the low crash occurrence subsequent to DIP, association rules were applied to investigate the factors that influence crash occurrence subsequent to DIP, in lieu of econometric models. There were statistical significant differences by driver gender, age, and conviction history in the likelihood of subsequent convictions. However, this paper found no association between DIP outcome, crash history, and crash occurrence. Evaluating the differences in conviction and crash occurrence subsequent to DIP between female and male drivers, and among different age groups can lead to improvements of the effectiveness of DIPs and help to identify low-cost intervention measures, customized based on drivers' gender and age, for improving driving behaviors. Copyright © 2011 National Safety Council and Elsevier Ltd. All rights reserved.

Olivocochlear Efferent Control in Sound Localization and Experience-Dependent Learning

PubMed Central

Irving, Samuel; Moore, David R.; Liberman, M. Charles; Sumner, Christian J.

2012-01-01

Efferent auditory pathways have been implicated in sound localization and its plasticity. We examined the role of the olivocochlear system (OC) in horizontal sound localization by the ferret and in localization learning following unilateral earplugging. Under anesthesia, adult ferrets underwent olivocochlear bundle section at the floor of the fourth ventricle, either at the midline or laterally (left). Lesioned and control animals were trained to localize 1 s and 40ms amplitude-roved broadband noise stimuli from one of 12 loudspeakers. Neither type of lesion affected normal localization accuracy. All ferrets then received a left earplug and were tested and trained over 10 d. The plug profoundly disrupted localization. Ferrets in the control and lateral lesion groups improved significantly during subsequent training on the 1 s stimulus. No improvement (learning) occurred in the midline lesion group. Markedly poorer performance and failure to learn was observed with the 40 ms stimulus in all groups. Plug removal resulted in a rapid resumption of normal localization in all animals. Insertion of a subsequent plug in the right ear produced similar results to left earplugging. Learning in the lateral lesion group was independent of the side of the lesion relative to the earplug. Lesions in all reported cases were verified histologically. The results suggest the OC system is not needed for accurate localization, but that it is involved in relearning localization during unilateral conductive hearing loss. PMID:21325517

Predictors of smoking cessation in Taiwan: using the theory of planned behavior.

PubMed

Tseng, Yu-Fang; Wang, Kuei-Lan; Lin, Ching-Yun; Lin, Yi-Ting; Pan, Hui-Chen; Chang, Chai-Jan

2018-03-01

This study aimed to explore the factors predicting the intention to quit smoking and the subsequent behavior 6 months later using the theory of planned behavior (TPB). Data were obtained from 145 smokers who attended a smoking cessation clinic in a community hospital. All participants completed a questionnaire which included demographic information, TPB-based items, perceived susceptibility and previous attempts to quit. The actual quitting behavior was obtained by follow-up phone calls 6 months later. The TPB constructs explained 34% of the variance in intention to quit smoking. By adding perceived susceptibility, the explained variance was significantly improved to 40%. The most important predictors were perceived behavior control and perceived susceptibility, followed by attitude. Subjective norm did not contribute to the prediction of intention. Attitude and perceived behavior control contributed to the prediction of actual quitting behavior, but intention, subjective norm and perceived susceptibility did not. Our findings support that the TPB is generally a useful framework to predict the intention to quit smoking in Taiwan. The inclusion of perceived susceptibility improved the prediction of intention. With regards to successfully quitting, attitude and perceived behavior control played more crucial roles than other TPB constructs. Smoking cessation promotion initiatives focusing on reinforcing cessation belief, enhancing a smoker's perception of their capability to quit smoking, and persuading smokers that they can overcome cessation barriers to cessation could make subsequent interventions more effective.

Exotropia in children with high hyperopia

PubMed Central

Kassem, Iris S; Rubin, Steven E; Kodsi, Sylvia R

2012-01-01

Purpose To describe the clinical characteristics, treatment, and subsequent clinical course of children with exotropia and high hyperopia. Methods The medical records of 26 patients seen between 1990 and 2009 who had an exotropia and ≥4.00 D of hyperopia were retrospectively reviewed. We analyzed the clinical characteristics, treatments and subsequent alignment outcomes. Results A total of 26 patients between the ages of 2.5 months and 9 years were included. Of these, 15 had associated medical conditions or developmental delay. Of 22 patients with measured visual acuities, 19 had amblyopia (10 unilateral, 9 bilateral). None of the patients demonstrated fine stereoacuity. Twenty-three exotropic children were treated with spectacles; 15 were fully corrected, 10 of whose exotropia improved; 8 received partial correction of their hyperopia, 3 of whose exotropia improved. Six patients who presented with large, poorly controlled exotropia and did not improve with spectacle correction required strabismus surgery. Conclusions Children with high hyperopia and exotropia are likely to have developmental delay or other systemic diseases, amblyopia, and poor stereopsis. Treatment of high hyperopia in exotropic children with their full cycloplegic refraction can result in excellent alignment. PMID:23084380

Integrated cockpit design for the Army helicopter improvement program

NASA Technical Reports Server (NTRS)

Drennen, T.; Bowen, B.

1984-01-01

The main Army Helicopter Improvement Program (AHIP) mission is to navigate precisely, locate targets accurately, communicate their position to other battlefield elements, and to designate them for laser guided weapons. The onboard navigation and mast-mounted sight (MMS) avionics enable accurate tracking of current aircraft position and subsequent target location. The AHIP crewstation development was based on extensive mission/task analysis, function allocation, total system design, and test and verification. The avionics requirements to meet the mission was limited by the existing aircraft structural and performance characteristics and resultant space, weight, and power restrictions. These limitations and night operations requirement led to the use of night vision goggles. The combination of these requirements and limitations dictated an integrated control/display approach using multifunction displays and controls.

Pro-region engineering for improved yeast display and secretion of brain derived neurotrophic factor.

PubMed

Burns, Michael L; Malott, Thomas M; Metcalf, Kevin J; Puguh, Arthya; Chan, Jonah R; Shusta, Eric V

2016-03-01

Brain derived neurotrophic factor (BDNF) is a promising therapeutic candidate for a variety of neurological diseases. However, it is difficult to produce as a recombinant protein. In its native mammalian context, BDNF is first produced as a pro-protein with subsequent proteolytic removal of the pro-region to yield mature BDNF protein. Therefore, in an attempt to improve yeast as a host for heterologous BDNF production, the BDNF pro-region was first evaluated for its effects on BDNF surface display and secretion. Addition of the wild-type pro-region to yeast BDNF production constructs improved BDNF folding both as a surface-displayed and secreted protein in terms of binding its natural receptors TrkB and p75, but titers remained low. Looking to further enhance the chaperone-like functions provided by the pro-region, two rounds of directed evolution were performed, yielding mutated pro-regions that further improved the display and secretion properties of BDNF. Subsequent optimization of the protease recognition site was used to control whether the produced protein was in pro- or mature BDNF forms. Taken together, we have demonstrated an effective strategy for improving BDNF compatibility with yeast protein engineering and secretion platforms. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Safe teleoperation based on flexible intraoperative planning for robot-assisted laser microsurgery.

PubMed

Mattos, Leonardo S; Caldwell, Darwin G

2012-01-01

This paper describes a new intraoperative planning system created to improve precision and safety in teleoperated laser microsurgeries. It addresses major safety issues related to real-time control of a surgical laser during teleoperated procedures, which are related to the reliability and robustness of the telecommunication channels. Here, a safe solution is presented, consisting in a new planning system architecture that maintains the flexibility and benefits of real-time teleoperation and keeps the surgeon in control of all surgical actions. The developed system is based on our virtual scalpel system for robot-assisted laser microsurgery, and allows the intuitive use of stylus to create surgical plans directly over live video of the surgical field. In this case, surgical plans are defined as graphic objects overlaid on the live video, which can be easily modified or replaced as needed, and which are transmitted to the main surgical system controller for subsequent safe execution. In the process of improving safety, this new planning system also resulted in improved laser aiming precision and improved capability for higher quality laser procedures, both due to the new surgical plan execution module, which allows very fast and precise laser aiming control. Experimental results presented herein show that, in addition to the safety improvements, the new planning system resulted in a 48% improvement in laser aiming precision when compared to the previous virtual scalpel system.

Improving Urban African Americans’ Blood Pressure Control through Multi-level Interventions in the Achieving Blood Pressure Control Together (ACT) Study: A Randomized Clinical Trial

PubMed Central

Ephraim, Patti L.; Hill-Briggs, Felicia; Roter, Debra; Bone, Lee; Wolff, Jennifer; Lewis-Boyer, LaPricia; Levine, David; Aboumatar, Hanan; Cooper, Lisa A; Fitzpatrick, Stephanie; Gudzune, Kimberly; Albert, Michael; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary; Fagan, Peter; Ramamurthi, Hema; Ameling, Jessica; Charlston, Jeanne; Sam, Tanyka; Carson, Kathryn A.; Wang, Nae-Yuh; Crews, Deidra; Greer, Raquel; Sneed, Valerie; Flynn, Sarah J.; DePasquale, Nicole; Boulware, L. Ebony

2014-01-01

Background Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients’ management of a variety of chronic illnesses. However, studies of multilevel interventions designed specifically to improve urban African American patients’ blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. Methods/Design We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients’ improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients’ blood pressure control at 12 months. Discussion Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients’ hypertension control. PMID:24956323

Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study: a randomized clinical trial.

PubMed

Ephraim, Patti L; Hill-Briggs, Felicia; Roter, Debra L; Bone, Lee R; Wolff, Jennifer L; Lewis-Boyer, LaPricia; Levine, David M; Aboumatar, Hanan J; Cooper, Lisa A; Fitzpatrick, Stephanie J; Gudzune, Kimberly A; Albert, Michael C; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary J; Fagan, Peter J; Ramamurthi, Hema C; Ameling, Jessica M; Charlston, Jeanne; Sam, Tanyka S; Carson, Kathryn A; Wang, Nae-Yuh; Crews, Deidra C; Greer, Raquel C; Sneed, Valerie; Flynn, Sarah J; DePasquale, Nicole; Boulware, L Ebony

2014-07-01

Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12months. Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control. Copyright © 2014 Elsevier Inc. All rights reserved.

A diabetes scorecard does not improve HbA(1c), blood pressure, lipids, aspirin usage, exercise and diabetes knowledge over 9 months: a randomized controlled trial.

PubMed

Irwig, M S; Sood, P; Ni, D; Amass, T; Khurana, P S; Jayanthi, V V; Wang, L; Adler, S M

2012-09-01

To test (1) whether a diabetes scorecard can improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage and exercise; (2) if the scorecard will motivate and/or educate patients to improve their scores for subsequent visits; and (3) whether the scorecard will improve rates of clinical inertia. Five physicians enrolled 103 patients ≥ 40 years old with uncontrolled Type 2 diabetes [HbA(1c) ≥ 64 mmol/mol (8.0%)] to randomly receive either a diabetes scorecard or not during four clinical visits over a 9-month period. The population was predominantly urban with a disproportionately higher percentage of black people than the general population. Our scorecard assigned points to six clinical variables, with a perfect total score of 100 points corresponding to meeting all targets. The primary outcomes were total scores and HbA(1c) in the scorecard and control groups at 9 months. There were no significant differences between the control and scorecard groups at visits 1 and 4 in total score, HbA(1c) , blood pressure, LDL cholesterol, aspirin usage, exercise or knowledge about diabetic targets. By visit 4 both the control and scorecard groups had statistically significant improvements with their mean total score (9 and 7 points, respectively), HbA(1c) [-9 mmol/mol (-0.8%) and -15 mmol/mol (-1.4%), respectively] and aspirin usage (33% increase and 16% increase, respectively). Rates of clinical inertia were low throughout the study. A diabetes scorecard did not improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage, exercise or diabetic knowledge in an urban population with uncontrolled Type 2 diabetes. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

Mechanisms of Behavior Change in Alcoholics Anonymous: Does AA lead to better alcohol use outcomes by reducing depression symptoms?

PubMed Central

Kelly, John F.; Stout, Robert L.; Magill, Molly; Tonigan, J. Scott; Pagano, Maria E.

2009-01-01

Rationale Indices of negative affect, such as depression, have been implicated in stress-induced pathways to alcohol relapse. Empirically-supported continuing care resources, such as Alcoholics Anonymous (AA), emphasize reducing negative affect to reduce relapse risk, but little research has been conducted to examine putative affective mechanisms of AA’s effects. Method Using lagged, controlled, hierarchical linear modeling and mediational analyses this study investigated whether AA participation mobilized changes in depression symptoms and whether such changes explained subsequent reductions in alcohol use. Alcohol dependent adults (N = 1,706), receiving treatment as part of a clinical trial, were assessed at intake, 3, 6, 9, 12, and 15 months. Results Findings revealed elevated levels of depression compared to the general population, which decreased during treatment and then remained stable over follow-up. Greater AA attendance was associated with better subsequent alcohol use outcomes and decreased depression. Greater depression was associated with heavier and more frequent drinking. Lagged, mediation analyses revealed that the effects of AA on alcohol use was partially mediated by reductions in depression symptoms. However, this salutary effect on depression itself appeared to be explained by AA’s proximal effect on reducing concurrent drinking. Conclusions AA attendance was both concurrently and predictively associated with improved alcohol outcomes. Although AA attendance was additionally associated with subsequent improvements in depression, it did not predict such improvements over and above concurrent alcohol use. AA appears to lead both to improvements in alcohol use and psychological and emotional well-being, which, in turn, may reinforce further abstinence and recovery-related change. PMID:20102345

Insulin oedema and treatment-induced neuropathy occurring in a 20-year-old patient with Type 1 diabetes commenced on an insulin pump.

PubMed

Rothacker, K M; Kaye, J

2014-01-01

Oedema may occur following initiation or intensification of insulin therapy in patients with Type 1 and Type 2 diabetes. Mild oedema is thought to be not uncommon, but under-reported, whilst generalized oedema with involvement of serous cavities has rarely been described. Multiple pathogenic mechanisms have been proposed, including insulin-induced sodium and water retention. Patients at greater risk for insulin oedema include those with poor glycaemic control. Dramatic improvement in glycaemic control is also associated with sensory and autonomic neuropathy. We describe a case of generalized oedema occurring in a 20-year-old, low body weight patient with Type 1 diabetes with poor glycaemic control 3 days following commencement of an insulin pump; blood sugars had dramatically improved with this treatment. Alternative causes for oedema were excluded. Oedema slowly improved with insulin dose reduction with higher blood sugar targets plus frusemide treatment. Subsequent to oedema resolution, the patient unfortunately developed generalized neuropathic pain, thought to be another manifestation of rapid improvement in glycaemic control. Caution should be taken when a patient with diabetes that is poorly controlled has an escalation in therapy that may dramatically improve their blood sugar levels; this includes the initiation of an insulin pump. Clinicians and patients should be aware of the potential risk of insulin oedema, treatment-induced neuropathy and worsening of diabetic retinopathy in the setting of rapid improvement in glycaemic control. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

76 FR 68366 - Airworthiness Directives; The Boeing Company Model 777-200 and -300 Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-04

...-induced currents and subsequent damage to composite structures, hydraulic tubes, and actuator control... and could subsequently damage composite structures, hydraulic tubes, and actuator control electronics... subsequent damage to composite structures, hydraulic tubes, and actuator control electronics. In the event of...

When instructions fail. The effects of stimulus control training on brain injury survivors' attending and reporting during hearing screenings.

PubMed

Schlund, M W

2000-10-01

Bedside hearing screenings are routinely conducted by speech and language pathologists for brain injury survivors during rehabilitation. Cognitive deficits resulting from brain injury, however, may interfere with obtaining estimates of auditory thresholds. Poor comprehension or attention deficits often compromise patient abilities to follow procedural instructions. This article describes the effects of jointly applying behavioral methods and psychophysical methods to improve two severely brain-injured survivors' attending and reporting on auditory test stimuli presentation. Treatment consisted of stimulus control training that involved differentially reinforcing responding in the presence and absence of an auditory test tone. Subsequent hearing screenings were conducted with novel auditory test tones and a common titration procedure. Results showed that prior stimulus control training improved attending and reporting such that hearing screenings were conducted and estimates of auditory thresholds were obtained.

Reverse ego-depletion: Acts of self-control can improve subsequent performance in Indian cultural contexts.

PubMed

Savani, Krishna; Job, Veronika

2017-10-01

The strength model of self-control has been predominantly tested with people from Western cultures. The present research asks whether the phenomenon of ego-depletion generalizes to a culture emphasizing the virtues of exerting mental self-control in everyday life. A pilot study found that whereas Americans tended to believe that exerting willpower on mental tasks is depleting, Indians tended to believe that exerting willpower is energizing. Using dual task ego-depletion paradigms, Studies 1a, 1b, and 1c found reverse ego-depletion among Indian participants, such that participants exhibited better mental self-control on a subsequent task after initially working on strenuous rather than nonstrenuous cognitive tasks. Studies 2 and 3 found that Westerners exhibited the ego-depletion effect whereas Indians exhibited the reverse ego-depletion effect on the same set of tasks. Study 4 documented the causal effect of lay beliefs about whether exerting willpower is depleting versus energizing on reverse ego-depletion with both Indian and Western participants. Together, these studies reveal the underlying basis of the ego-depletion phenomenon in culturally shaped lay theories about willpower. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A parallel adaptive quantum genetic algorithm for the controllability of arbitrary networks.

PubMed

Li, Yuhong; Gong, Guanghong; Li, Ni

2018-01-01

In this paper, we propose a novel algorithm-parallel adaptive quantum genetic algorithm-which can rapidly determine the minimum control nodes of arbitrary networks with both control nodes and state nodes. The corresponding network can be fully controlled with the obtained control scheme. We transformed the network controllability issue into a combinational optimization problem based on the Popov-Belevitch-Hautus rank condition. A set of canonical networks and a list of real-world networks were experimented. Comparison results demonstrated that the algorithm was more ideal to optimize the controllability of networks, especially those larger-size networks. We demonstrated subsequently that there were links between the optimal control nodes and some network statistical characteristics. The proposed algorithm provides an effective approach to improve the controllability optimization of large networks or even extra-large networks with hundreds of thousands nodes.

Study on real-time force feedback for a master-slave interventional surgical robotic system.

PubMed

Guo, Shuxiang; Wang, Yuan; Xiao, Nan; Li, Youxiang; Jiang, Yuhua

2018-04-13

In robot-assisted catheterization, haptic feedback is important, but is currently lacking. In addition, conventional interventional surgical robotic systems typically employ a master-slave architecture with an open-loop force feedback, which results in inaccurate control. We develop herein a novel real-time master-slave (RTMS) interventional surgical robotic system with a closed-loop force feedback that allows a surgeon to sense the true force during remote operation, provide adequate haptic feedback, and improve control accuracy in robot-assisted catheterization. As part of this system, we also design a unique master control handle that measures the true force felt by a surgeon, providing the basis for the closed-loop control of the entire system. We use theoretical and empirical methods to demonstrate that the proposed RTMS system provides a surgeon (using the master control handle) with a more accurate and realistic force sensation, which subsequently improves the precision of the master-slave manipulation. The experimental results show a substantial increase in the control accuracy of the force feedback and an increase in operational efficiency during surgery.

Worrying about the Future: An Episodic Specificity Induction Impacts Problem Solving, Reappraisal, and Well-Being

PubMed Central

Jing, Helen G.; Madore, Kevin P.; Schacter, Daniel L.

2015-01-01

Previous research has demonstrated that an episodic specificity induction – brief training in recollecting details of a recent experience – enhances performance on various subsequent tasks thought to draw upon episodic memory processes. Existing work has also shown that mental simulation can be beneficial for emotion regulation and coping with stressors. Here we focus on understanding how episodic detail can affect problem solving, reappraisal, and psychological well-being regarding worrisome future events. In Experiment 1, an episodic specificity induction significantly improved participants’ performance on a subsequent means-end problem solving task (i.e., more relevant steps) and an episodic reappraisal task (i.e., more episodic details) involving personally worrisome future events compared with a control induction not focused on episodic specificity. Imagining constructive behaviors with increased episodic detail via the specificity induction was also related to significantly larger decreases in anxiety, perceived likelihood of a bad outcome, and perceived difficulty to cope with a bad outcome, as well as larger increases in perceived likelihood of a good outcome and indicated use of active coping behaviors compared with the control. In Experiment 2, we extended these findings using a more stringent control induction, and found preliminary evidence that the specificity induction was related to an increase in positive affect and decrease in negative affect compared with the control. Our findings support the idea that episodic memory processes are involved in means-end problem solving and episodic reappraisal, and that increasing the episodic specificity of imagining constructive behaviors regarding worrisome events may be related to improved psychological well-being. PMID:26820166

Essential fatty acid supplementation during lactation is required to maximize the subsequent reproductive performance of the modern sow.

PubMed

Rosero, David S; Boyd, R Dean; McCulley, Mark; Odle, Jack; van Heugten, Eric

2016-05-01

This study was conducted to investigate the effects of supplemental essential fatty acids (EFA) on sow reproductive efficiency and to estimate the concentrations of EFA required by the lactating sow for maximum subsequent reproduction. Data were collected on 480 sows (PIC Camborough) balanced by parity, with 241 and 239 sows representing Parity 1, and 3-5 (P3+), respectively. Sows were assigned randomly, within parity, to a 3 × 3 factorial arrangement plus a control diet without added lipids. Factors included linoleic (2.1%, 2.7%, and 3.3%) and α-linolenic acid (0.15%, 0.30%, and 0.45%), obtained by adding 4% of different mixtures of canola, corn and flaxseed oils to diets. Diets were corn-soybean meal based with 12% wheat middlings. The benefits of supplemental EFA were more evident for the subsequent reproduction of mature P3+ sows. For these sows, supplemental α-linolenic acid improved the proportion of sows that farrowed relative to sows weaned (linear P=0.080; 82.8, 80.5, and 92.8% for sows fed 0.15%, 0.30%, and 0.45% α-linolenic acid, respectively). In addition, supplemental linoleic acid, fed to Parity 1 and P3+ sows, tended to increase subsequent litter size (linear P=0.074; 13.2, 13.8 and 14.0 total pigs born for 2.1%, 2.7% and 3.3% linoleic acid, respectively). These results demonstrate that a minimum dietary intake of both α-linolenic and linoleic acid is required for the modern lactating sow to achieve a maximum reproductive outcome through multiple mechanisms that include rapid return to estrus, increased maintenance of pregnancy and improved subsequent litter size. Copyright © 2016 Elsevier B.V. All rights reserved.

Adaptive Harmonic Detection Control of Grid Interfaced Solar Photovoltaic Energy System with Power Quality Improvement

NASA Astrophysics Data System (ADS)

Singh, B.; Goel, S.

2015-03-01

This paper presents a grid interfaced solar photovoltaic (SPV) energy system with a novel adaptive harmonic detection control for power quality improvement at ac mains under balanced as well as unbalanced and distorted supply conditions. The SPV energy system is capable of compensation of linear and nonlinear loads with the objectives of load balancing, harmonics elimination, power factor correction and terminal voltage regulation. The proposed control increases the utilization of PV infrastructure and brings down its effective cost due to its other benefits. The adaptive harmonic detection control algorithm is used to detect the fundamental active power component of load currents which are subsequently used for reference source currents estimation. An instantaneous symmetrical component theory is used to obtain instantaneous positive sequence point of common coupling (PCC) voltages which are used to derive inphase and quadrature phase voltage templates. The proposed grid interfaced PV energy system is modelled and simulated in MATLAB Simulink and its performance is verified under various operating conditions.

In vitro test systems supporting the development of improved pest control methods: a case study with chemical mixtures and bivalve biofoulers.

PubMed

Silva, Carlos; Nunes, Bruno; Nogueira, António Ja; Gonçalves, Fernando; Pereira, Joana L

2016-11-01

Using the bivalve macrofouler Corbicula fluminea, the suitability of in vitro testing as a stepping stone towards the improvement of control methods based on chemical mixtures was addressed in this study. In vitro cholinesterase (ChE) activity inhibition following single exposure of C. fluminea tissue to four model chemicals (the organophosphates dimethoate and dichlorvos, copper and sodium dodecyl phosphate [SDS]) was first assessed. Consequently, mixtures of dimethoate with copper and dichlorvos with SDS were tested and modelled; mixtures with ChE revealed synergistic interactions for both chemical pairs. These synergic combinations were subsequently validated in vivo and the increased control potential of these selected combinations was verified, with gains of up to 50% in C. fluminea mortality relative to corresponding single chemical treatments. Such consistency supports the suitability of using time- and cost-effective surrogate testing platforms to assist the development of biofouling control strategies incorporating mixtures.

Improved Hypoxia Modeling for Nutrient Control Decisions in the Gulf of Mexico

NASA Technical Reports Server (NTRS)

Habib, Shahid; Pickering, Ken; Tzortziou, Maria; Maninio, Antonio; Policelli, Fritz; Stehr, Jeff

2011-01-01

The Gulf of Mexico Modeling Framework is a suite of coupled models linking the deposition and transport of sediment and nutrients to subsequent bio-geo chemical processes and the resulting effect on concentrations of dissolved oxygen in the coastal waters of Louisiana and Texas. Here, we examine the potential benefits of using multiple NASA remote sensing data products within this Modeling Framework for increasing the accuracy of the models and their utility for nutrient control decisions in the Gulf of Mexico. Our approach is divided into three components: evaluation and improvement of (a) the precipitation input data (b) atmospheric constituent concentrations in EPA's air quality/deposition model and (c) the calculation of algal biomass, organic carbon and suspended solids within the water quality/eutrophication models of the framework.

Randomized Multilevel Intervention to Improve Outcomes of Residents in Nursing Homes in Need of Improvement

PubMed Central

Rantz, Marilyn J.; Nahm, Helen E.; Zwygart-Stauffacher, Mary; Hicks, Lanis; Mehr, David; Flesner, Marcia; Petroski, Gregory F.; Madsen, Richard W.; Scott-Cawiezell, Jill

2012-01-01

Purpose A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Intervention facilities (n=29) received a two-year multilevel intervention with monthly on-site consultation from expert nurses with graduate education in gerontological nursing. Attention control facilities (n=29) that also needed to improve resident outcomes received monthly information about aging and physical assessment of elders. Design and Methods Randomized clinical trial of nursing homes in need of improving resident outcomes of bladder and bowel incontinence, weight loss, pressure ulcers, and decline in activities of daily living (ADL). It was hypothesized that following the intervention, experimental facilities would have better resident outcomes, higher quality of care, higher staff retention, more organizational attributes of improved working conditions than control facilities, similar staffing and staff mix, and lower total and direct care costs. Results The intervention did improve quality of care (p=0.02); there were improvements in pressure ulcers (p=0.05), weight loss (p=0.05). Staff retention, organizational working conditions, staffing, and staff mix and most costs were not affected by the intervention. Leadership turnover was surprisingly excessive in both intervention and control groups. Implications Some facilities that are in need of improving quality of care and resident outcomes are able to build the organizational capacity to improve while not increasing staffing or costs of care. Improvement requires continuous supportive consultation and leadership willing to involve staff and work together to build the systematic improvements in care delivery needed. PMID:21816681

Changes in salivary testosterone concentrations and subsequent voluntary squat performance following the presentation of short video clips.

PubMed

Cook, Christian J; Crewther, Blair T

2012-01-01

Previous studies have shown that visual images can produce rapid changes in testosterone concentrations. We explored the acute effects of video clips on salivary testosterone and cortisol concentrations and subsequent voluntary squat performance in highly trained male athletes (n=12). Saliva samples were collected on 6 occasions immediately before and 15 min after watching a brief video clip (approximately 4 min in duration) on a computer screen. The watching of a sad, erotic, aggressive, training motivational, humorous or a neutral control clip was randomised. Subjects then performed a squat workout aimed at producing a 3 repetition maximum (3RM) lift. Significant (P<0.001) relative (%) increases in testosterone concentrations were noted with watching the erotic, humorous, aggressive and training videos (versus control and sad), with testosterone decreasing significantly (versus control) after the sad clip. The aggressive video also produced an elevated cortisol response (% change) and more so than the control and humorous videos (P<0.001). A significant (P<0.003) improvement in 3RM performance was noted after the erotic, aggressive and training clips (versus control). A strong within-individual correlation (mean r=0.85) was also noted between the relative changes in testosterone and the 3RM squats across all video sessions (P<0.001). In conclusion, different video clips were associated with different changes in salivary free hormone concentrations and the relative changes in testosterone closely mapped 3RM squat performance in a group of highly trained males. Thus, speculatively, using short video presentations in the pre-workout environment offers an opportunity for understanding the outcomes of hormonal change, athlete behaviour and subsequent voluntary performance. Copyright © 2011 Elsevier Inc. All rights reserved.

Method of freezing living cells and tissues with improved subsequent survival

DOEpatents

Senkan, Selim M.; Hirsch, Gerald P.

1980-01-01

This invention relates to an improved method for freezing red blood cells, ther living cells, or tissues with improved subsequent survival, wherein constant-volume freezing is utilized that results in significantly improved survival compared with constant-pressure freezing; optimization is attainable through the use of different vessel geometries, cooling baths and warming baths, and sample concentrations.

Workplace pedometer interventions for increasing physical activity.

PubMed

Freak-Poli, Rosanne L A; Cumpston, Miranda; Peeters, Anna; Clemes, Stacy A

2013-04-30

The World Health Organization and the World Economic Forum have recommended further research to strengthen current knowledge of workplace health programmes, particularly on effectiveness and using simple instruments. A pedometer is one such simple instrument that can be incorporated in workplace interventions. To assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes. Electronic searches of the Cochrane Central Register of Controlled Trials (671 potential papers), MEDLINE (1001), Embase (965), CINAHL (1262), OSH UPDATE databases (75) and Web of Science (1154) from the earliest record to between 30th January and 6th February 2012 yielded 3248 unique records. Reference lists of articles yielded an additional 34 papers. Contact with individuals and organisations did not produce any further records. We included individual and cluster-randomised controlled trials of workplace health promotion interventions with a pedometer component in employed adults. The primary outcome was physical activity and was part of the eligibility criteria. We considered subsequent health outcomes, including adverse effects, as secondary outcomes. Two review authors undertook the screening of titles and abstracts and the full-text papers independently. Two review authors (RFP and MC) independently completed data extraction and risk of bias assessment. We contacted authors to obtain additional data and clarification. We found four relevant studies providing data for 1809 employees, 60% of whom were allocated to the intervention group. All studies assessed outcomes immediately after the intervention had finished and the intervention duration varied between three to six months. All studies had usual treatment control conditions; however one study's usual treatment was an alternative physical activity programme while the other three had minimally active controls. In general, there was high risk of bias mainly due to lack of blinding, self reported outcome measurement, incomplete outcome data due to attrition, and most of the studies had not published protocols, which increases the likelihood of selective reporting.Three studies compared the pedometer programme to a minimally active control group, but the results for physical activity could not be combined because each study used a different measure of activity. One study observed an increase in physical activity under a pedometer programme, but the other two did not find a significant difference. For secondary outcomes we found improvements in body mass index, waist circumference, fasting plasma glucose, the quality of life mental component and worksite injury associated with the pedometer programmes, but these results were based on limited data from one or two small studies. There were no differences between the pedometer programme and the control group for blood pressure, a number of biochemical outcomes and the quality of life physical component. Sedentary behaviour and disease risk scores were not measured by any of the included studies.One study compared a pedometer programme and an alternative physical activity programme, but baseline imbalances made it difficult to distinguish the true improvements associated with either programme.Overall, there was insufficient evidence to assess the effectiveness of pedometer interventions in the workplace.There is a need for more high quality randomised controlled trials to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes. To improve the quality of the evidence available, future studies should be registered in an online trials register, publish a protocol, allocate time and financial support to reducing attrition, and try to blind personnel (especially those who undertake measurement). To better identify the effects of pedometer interventions, future studies should report a core set of outcomes (total physical activity in METs, total time sitting in hours and minutes, objectively measured cardiovascular disease and type II diabetes risk factors, quality of life and injury), assess outcomes in the long term and undertake subgroup analyses based upon demographic subgroups (e.g. age, gender, educational status). Future studies should also compare different types of active intervention to test specific intervention components (eligibility, duration, step goal, step diary, settings), and settings (occupation, intervention provider). There was limited and low quality data providing insufficient evidence to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes.

Ventral Striatum and the Evaluation of Memory Retrieval Strategies

PubMed Central

Badre, David; Lebrecht, Sophie; Pagliaccio, David; Long, Nicole M.; Scimeca, Jason M.

2015-01-01

Adaptive memory retrieval requires mechanisms of cognitive control that facilitate the recovery of goal-relevant information. Frontoparietal systems are known to support control of memory retrieval. However, the mechanisms by which the brain acquires, evaluates, and adapts retrieval strategies remain unknown. Here, we provide evidence that ventral striatal activation tracks the success of a retrieval strategy and correlates with subsequent reliance on that strategy. Human participants were scanned with fMRI while performing a lexical decision task. A rule was provided that indicated the likely semantic category of a target word given the category of a preceding prime. Reliance on the rule improved decision-making, as estimated within a drift diffusion framework. Ventral striatal activation tracked the benefit that relying on the rule had on decision-making. Moreover, activation in ventral striatum correlated with a participant’s subsequent reliance on the rule. Taken together, these results support a role for ventral striatum in learning and evaluating declarative retrieval strategies. PMID:24564466

[Hygiene and Infection Prevention in Medical Institutions, Kindergartens and Schools - Statutory Basis, Infection Control Practice and Experiences of the Public Health Services].

PubMed

Heudorf, U

2015-07-01

Infection prevention is one of the main tasks of the public health services. The "Protection against infection act" places all medical institutions and facilities for children (kindergartens and schools) under the obligation to assume responsibility and to cooperate. Duties of the institutions are described, and public health services are obliged to perform hygiene control visits.Regarding medical institutions, the guidelines of the German Commission on Hospital Hygiene and Infection Control have to be observed, and the counties were obliged to publish hygiene enactments. Subsequently, good improvements in hygiene management in medical institutions were achieved. In schools, however, severe hygienic problems (i.e. sanitary hygiene, indoor air hygiene) are detected, without any improvement - obviously due to a missing sense of responsibility in the school community. Causes for poor behaviour prevention (hand hygiene, ventilation) and missing situational prevention (i.e. cleaning) are discussed. Without reversion to the obviously needed but nearly forgotten subject school hygiene, obligatory guidelines and the assuming of responsibility, permanent improvements cannot be achieved. © Georg Thieme Verlag KG Stuttgart · New York.

Specific inspiratory muscle warm-up enhances badminton footwork performance.

PubMed

Lin, Hua; Tong, Tom Kwokkeung; Huang, Chuanye; Nie, Jinlei; Lu, Kui; Quach, Binh

2007-12-01

The effects of inspiratory muscle (IM) warm-up on IM function and on the maximum distance covered in a subsequent incremental badminton-footwork test (FWmax) were examined. Ten male badminton players were recruited to perform identical tests in three different trials in a random order. The control trial did not involve an IM warm-up, whereas the placebo and experimental trials did involve an IM warm-up consisting of two sets of 30-breath manoeuvres with an inspiratory pressure-threshold load equivalent to 15% (PLA) and 40% (IMW) maximum inspiratory mouth pressure, respectively. In the IMW trial, IM function was improved with 7.8%+/-4.0% and 6.9%+/-3.5% increases from control found in maximal inspiratory pressure at zero flow (P0) and maximal rate of P0 development (MRPD), respectively (p<0.05). FWmax was enhanced 6.8%+/-3.7%, whereas the slope of the linear relationship of the increase in the rating of perceived breathlessness for every minute (RPB/min) was reduced (p<0.05). Reduction in blood lactate ([La-]b) accumulation was observed when the test duration was identical to that of the control trial (P<0.05). In the PLA trial, no parameter was changed from control. For the changes (Delta) in parameters in IMW (n=10), negative correlations were found between DeltaP0 and DeltaRPB/min (r2=0.58), DeltaMRPD and DeltaRPB/min (r2=0.48), DeltaRPB/min, and DeltaFWmax (r2=0.55), but not between Delta[La-]b accumulation and DeltaFWmax. Such findings suggest that the IM-specific warm-up improved footwork performance in the subsequent maximum incremental badminton-footwork test. The improved footwork was partly attributable to the reduced breathless sensation resulting from the enhanced IM function, whereas the contribution of the concomitant reduction in [La-]b accumulation was relatively minor.

75 FR 43395 - Airworthiness Directives; Aircraft Industries a.s. Model L 23 Super Blanik Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... elevator in place and in jamming of the Pilot's elevator control system, and subsequent loss of elevator... elevator in place and in jamming of the Pilot's elevator control system, and subsequent loss of elevator... retaining the elevator in place and in jamming of the Pilot's elevator control system, and subsequent loss...

Benefit of interpregnancy HIV viral load suppression on subsequent maternal and infant outcomes.

PubMed

Stewart, Robert D; Wells, C Edward; Roberts, Scott W; Rogers, Vanessa L; McElwee, Barbara S; McIntire, Donald D; Sheffield, Jeanne S

2014-09-01

The objective of the study was to determine whether interpregnancy human immunodeficiency virus (HIV) viral load suppression affects outcomes in subsequent pregnancies. This is a retrospective review of all women who delivered 2 consecutive pregnancies while diagnosed with HIV from Jan. 1, 1984, until Jan. 1, 2012. Medical records were reviewed for maternal, infant, and delivery data. Pregnancies were divided into index and subsequent pregnancy and analyzed for outcomes. During the study period, 172 HIV-infected women who delivered 2 pregnancies at our institution were identified. There was no difference in median HIV viral load at presentation or delivery between the index and subsequent pregnancies. During the subsequent pregnancy, more women presented on antiretroviral therapy (ART) and more often remained compliant with ART; however, there was no difference in vertical transmission risk between the pregnancies. Of those with a viral load less than 1000 copies/mL at the end of their index pregnancy (n = 103), 57 (55%) presented for their subsequent pregnancy with a viral load still less than 1000 copies/mL. Those women who maintained the viral load suppression between pregnancies were more likely to present for their subsequent pregnancy on ART, maintained a greater viral load suppression and CD4 counts during the pregnancy, and had fewer vertical transmissions compared with those who presented with higher viral loads in their subsequent pregnancy (0% vs 9%, P = .02). Maintaining an HIV viral load suppression between pregnancies is associated with improved HIV disease status at delivery in subsequent pregnancies. Interpregnancy HIV viral load suppression is associated with less vertical transmission, emphasizing the importance of maintaining HIV disease control between pregnancies. Copyright © 2014 Mosby, Inc. All rights reserved.

Large area silicon sheet by EFG. [furnace growth techniques

NASA Technical Reports Server (NTRS)

1981-01-01

The development of a technique for the production of silicon ribbon is discussed. Extensive characterization of the multiple ribbon Furnace 3A main zone temperature profile was performed and the information used to improve uniformity of heating. Irregularities in the main zone heater were associated with growth difficulties at specific cartridge locations, and growth conditions subsequently improved by profiling the main zone heater. Good growth conditions were established in all three cartridge positions. These improvements allowed multiple growth of three 10 cm wide ribbons to be demonstrated for periods of an hour on several occasions. A gas distribution system for the 10 cm cartridge was introduced and demonstrated to lead to improved ambient control during growth. Growth without and with CO2 showed that quality improvement in 10 cm ribbon grown with cold shoes results from ambient manipulation.

Neural Conflict–Control Mechanisms Improve Memory for Target Stimuli

PubMed Central

Krebs, Ruth M.; Boehler, Carsten N.; De Belder, Maya; Egner, Tobias

2015-01-01

According to conflict-monitoring models, conflict serves as an internal signal for reinforcing top-down attention to task-relevant information. While evidence based on measures of ongoing task performance supports this idea, implications for long-term consequences, that is, memory, have not been tested yet. Here, we evaluated the prediction that conflict-triggered attentional enhancement of target-stimulus processing should be associated with superior subsequent memory for those stimuli. By combining functional magnetic resonance imaging (fMRI) with a novel variant of a face-word Stroop task that employed trial-unique face stimuli as targets, we were able to assess subsequent (incidental) memory for target faces as a function of whether a given face had previously been accompanied by congruent, neutral, or incongruent (conflicting) distracters. In line with our predictions, incongruent distracters not only induced behavioral conflict, but also gave rise to enhanced memory for target faces. Moreover, conflict-triggered neural activity in prefrontal and parietal regions was predictive of subsequent retrieval success, and displayed conflict-enhanced functional coupling with medial-temporal lobe regions. These data provide support for the proposal that conflict evokes enhanced top-down attention to task-relevant stimuli, thereby promoting their encoding into long-term memory. Our findings thus delineate the neural mechanisms of a novel link between cognitive control and memory. PMID:24108799

Increased acylated plasma ghrelin, but improved lipid profiles 24-h after consumption of carob pulp preparation rich in dietary fibre and polyphenols.

PubMed

Gruendel, Sindy; Garcia, Ada L; Otto, Baerbel; Wagner, Karen; Bidlingmaier, Martin; Burget, Lukas; Weickert, Martin O; Dongowski, Gerhard; Speth, Maria; Katz, Norbert; Koebnick, Corinna

2007-12-01

We have recently shown that a polyphenol-rich insoluble dietary fibre preparation from carob pulp (Ceratonia siliqua L; carob fibre) decreased postprandial acylated ghrelin, TAG and NEFA during an acute liquid meal challenge test. However, delayed effects of carob fibre consumption are unknown. Therefore, a randomized controlled crossover study in nineteen healthy volunteers consuming foods with or without 50 g carob fibre was conducted. On the subsequent day (day 2), glucose, TAG, total and acylated ghrelin as well as insulin, NEFA and leptin were assessed at baseline and at timed intervals for 300 min after ingestion of standardized bread. Consumption of carob fibre-enriched foods did not affect fasting concentrations of glucose, TAG, total ghrelin, NEFA, insulin and leptin. Fasting acylated ghrelin was increased on the day subsequent to carob fibre consumption compared with control (P = 0.046). After consumption of the standard bread on day 2, glucose response (P = 0.029) was increased, and TAG (P = 0.033) and NEFA (P < 0.001) responses were decreased compared with control. Postprandial responses of total and acylated ghrelin, insulin and leptin on day 2 were unaffected by carob fibre consumption the previous day. In conclusion, an increase in total and acylated plasma ghrelin accompanied by enhanced lipid metabolism after carob fibre consumption suggests higher lipid utilization and suppressed lipolysis on the day subsequent to carob fibre consumption. However, elevated glucose levels after carob fibre consumption need to be addressed in future studies.

High-Intensity Strength Training Improves Function of Chronically Painful Muscles: Case-Control and RCT Studies

PubMed Central

Andersen, Christoffer H.; Skotte, Jørgen H.; Suetta, Charlotte; Søgaard, Karen; Saltin, Bengt; Sjøgaard, Gisela

2014-01-01

Aim. This study investigates consequences of chronic neck pain on muscle function and the rehabilitating effects of contrasting interventions. Methods. Women with trapezius myalgia (MYA, n = 42) and healthy controls (CON, n = 20) participated in a case-control study. Subsequently MYA were randomized to 10 weeks of specific strength training (SST, n = 18), general fitness training (GFT, n = 16), or a reference group without physical training (REF, n = 8). Participants performed tests of 100 consecutive cycles of 2 s isometric maximal voluntary contractions (MVC) of shoulder elevation followed by 2 s relaxation at baseline and 10-week follow-up. Results. In the case-control study, peak force, rate of force development, and rate of force relaxation as well as EMG amplitude were lower in MYA than CON throughout all 100 MVC. Muscle fiber capillarization was not significantly different between MYA and CON. In the intervention study, SST improved all force parameters significantly more than the two other groups, to levels comparable to that of CON. This was seen along with muscle fiber hypertrophy and increased capillarization. Conclusion. Women with trapezius myalgia have lower strength capacity during repetitive MVC of the trapezius muscle than healthy controls. High-intensity strength training effectively improves strength capacity during repetitive MVC of the painful trapezius muscle. PMID:24707475

Process capability improvement through DMAIC for aluminum alloy wheel machining

NASA Astrophysics Data System (ADS)

Sharma, G. V. S. S.; Rao, P. Srinivasa; Babu, B. Surendra

2017-07-01

This paper first enlists the generic problems of alloy wheel machining and subsequently details on the process improvement of the identified critical-to-quality machining characteristic of A356 aluminum alloy wheel machining process. The causal factors are traced using the Ishikawa diagram and prioritization of corrective actions is done through process failure modes and effects analysis. Process monitoring charts are employed for improving the process capability index of the process, at the industrial benchmark of four sigma level, which is equal to the value of 1.33. The procedure adopted for improving the process capability levels is the define-measure-analyze-improve-control (DMAIC) approach. By following the DMAIC approach, the C p, C pk and C pm showed signs of improvement from an initial value of 0.66, -0.24 and 0.27, to a final value of 4.19, 3.24 and 1.41, respectively.

N and S co-doped porous carbon spheres prepared using L-cysteine as a dual functional agent for high-performance lithium-sulfur batteries.

PubMed

Niu, Shuzhang; Lv, Wei; Zhou, Guangmin; He, Yanbing; Li, Baohua; Yang, Quan-Hong; Kang, Feiyu

2015-12-28

Nitrogen and sulfur co-doped porous carbon spheres (NS-PCSs) were prepared using L-cysteine to control the structure and functionalization during the hydrothermal reaction of glucose and the subsequent activation process. As the sulfur hosts in Li-S batteries, NS-PCSs combine strong physical confinement and surface chemical interaction to improve the affinity of polysulfides to the carbon matrix.

A Cost Estimation Analysis of U.S. Navy Ship Fuel-Savings Techniques and Technologies

DTIC Science & Technology

2009-09-01

readings to the boiler operator. The PLC will provide constant automatic trimming of the excess oxygen based upon real time SGA readings. An SCD...the author): The Aegis Combat System is controlled by an advanced, automatic detect-and-track, multi-function three-dimensional passive...subsequently offloaded. An Online Wash System would reduce these maintenance costs and improve fuel efficiency of these engines by keeping the engines

An Evolutionary Perspective on Basal Insulin in Diabetes Treatment: Role of Insulin Therapy In Diabetes.

PubMed

Rodbard, Helena W

2016-10-01

The availability of human insulin and subsequently insulin analogs that more closely mimic the body's physiology have contributed to increased safety in patients with diabetes and a greater role in patients with T2DM. This greater role is supported by clear evidence that early use of insulin in T2DM results in long-term improvements in glycemic control and beta-cell function compared with oral agents.

Sustained 12 Month Benefit of Phrenic Nerve Stimulation for Central Sleep Apnea.

PubMed

Costanzo, Maria Rosa; Ponikowski, Piotr; Javaheri, Shahrokh; Augostini, Ralph; Goldberg, Lee R; Holcomb, Richard; Kao, Andrew; Khayat, Rami N; Oldenburg, Olaf; Stellbrink, Christoph; Abraham, William T

2018-06-01

Transvenous phrenic nerve stimulation improved sleep metrics and quality of life after 6 months versus control in the remedē System Pivotal Trial. This analysis explored the effectiveness of phrenic nerve stimulation in patients with central sleep apnea after 12 months of therapy. Reproducibility of treatment effect was assessed in the former control group in whom the implanted device was initially inactive for the sixth month and subsequently activated when the randomized control assessments were complete. Patients with moderate-to-severe central sleep apnea implanted with the remedē System were randomized to therapy activation at 1 month (treatment) or after 6 months (control). Sleep indices were assessed from baseline to 12 months in the treatment group and from 6 to 12 months in former controls. In the treatment group, a ≥50% reduction in apnea-hypopnea index occurred in 60% of patients at 6 months (95% confidence interval [CI] 47% to 64%) and 67% (95% CI 53% to 78%) at 12 months. After 6 months of therapy, 55% of former controls (95% CI 43% to 67%) achieved ≥50%reduction in apnea-hypopnea index. Patient Global Assessment was markedly ormoderately improved at 6 and 12 months in 60% of treatment patients.Improvements persisted at 12 months. A serious adverse event within 12 months occurred in 13 patients (9%). Phrenic nerve stimulation produced sustained improvements in sleep indices and quality of life to at least 12 months in patients with central sleep apnea. The similar improvement of former controls after 6 months of active therapy confirms benefits are reproducible and reliable. Copyright © 2018 Respicardia, Inc. Published by Elsevier Inc. All rights reserved.

Effects of previous grazing nutrition and management on feedlot performance of cattle.

PubMed

Drouillard, J S; Kuhl, G L

1999-01-01

Management strategies designed to improve grazing animal performance can influence feedlot performance and carcass traits both positively and negatively. In spite of the economic relevance of potential interactions between grazing and finishing performance, controlled experiments evaluating integrated production systems are limited in number. Effects of grazing treatments can result from, or be overshadowed by, changes in gut fill, thus making it difficult to assign precise costs to different phases of production. Published reports have considered the effects of stocking rate, duration of grazing, forage characteristics, supplementation, and growth-promoting implants on subsequent finishing performance. Improvements in cattle performance attributed to changes in stocking rate generally have been neutral to positive with respect to effects on finishing performance. Comparisons among forages have led to the suggestion that forage species may contribute to differences in gastrointestinal fill of grazing cattle, thereby influencing gain and efficiency during the subsequent finishing phase. Creep-feeding suckling calves generally has increased preweaning performance but has had relatively little influence on performance during the subsequent finishing phase. Grain supplementation of stocker cattle during the grazing period has improved grazing performance, but effects on subsequent feedlot performance have been inconsistent. Potential carryover effects from protein and mineral supplementation also have been inconclusive. Lack of congruence among studies is puzzling but may be the consequence of highly varied production systems, differences in experimental procedures, and changes in gut fill or mass of internal organs. Based on the studies reviewed, the expression or absence of compensatory growth during the finishing phase appears to be related to the nutritional quality of forages utilized in the grazing period, with higher quality forages tending to yield greater compensatory effects. The bulk of evidence with suckling cattle and stocker implants suggests that effects on subsequent finishing performance are minimal. Attention is drawn to the noticeable lack of research pertaining to integrated production systems. A more thorough understanding of the interactions among grazing nutrition and management, finishing performance, and carcass traits is needed to facilitate greater economic exploitation of these relationships.

Improvements to quality of needle coke by controlled carbonized conditions

NASA Astrophysics Data System (ADS)

Liu, Dong; Lou, Bin; Yu, Ran; Chen, Qingtai; Li, Zhiheng; Zhang, Yadong

2018-06-01

In this study, the selected aromatic-rich fraction derived from hydrocracking tail oil was carbonized and further improvement in the quality of resultant coke was achieved by promoting temperature at the solidification stage. In comparison with conventional process carried out isothermally and isobarically, the coupling analysis between formation and subsequent uni-axial orientation of mesophase textures during the controlled process was systematically discussed on the basis of the mutual relevance among mesophase texture evolution, gas evolution rate and solidification rate of intermediates. The results show that on the premise that formation of bulk mesophase, appropriate rate of gas evolution at a right time of solidification contributes to fine produces fine fibrous mesophase aligned uni-axially and less pores. Moreover, the intermediates with solidification index of 2˜6 are suitable for deformation induced by gas evolution.

Continuous cognitive improvement 1 year following successful kidney transplant.

PubMed

Harciarek, Michał; Biedunkiewicz, Bogdan; Lichodziejewska-Niemierko, Monika; Dębska-Ślizień, Alicja; Rutkowski, Bolesław

2011-06-01

Successful kidney transplantation was recently shown to lead to improvement in the cognitive performance of patients on chronic dialysis. To examine whether the early cognitive benefits of transplantation continue to develop over time, along with the patients' ongoing recovery, we addressed these questions in a prospective controlled study of 27 dialyzed patients who subsequently received a kidney transplant, 18 dialyzed patients awaiting kidney transplant, and 30 matched controls without kidney disease. Overall, successful kidney transplant contributed to a statistically significant improvement in performance on tests of motor/psychomotor speed, visual planning, memory, and abstract reasoning tested 1 year later. We also studied whether the cognitive performance of patients maintained on dialysis is stable or declines over time and found that it actually declined over this time even in adequately dialyzed patients. Measures of memory functions were particularly affected. This study indicates that the early beneficial effects of transplantation are not transient and were still evident 1 year following transplantation.

Augmentation of maneuver performance by spanwise blowing

NASA Technical Reports Server (NTRS)

Erickson, G. E.; Campbell, J. F.

1977-01-01

A generalized wind tunnel model was tested to investigate new component concepts utilizing spanwise blowing to provide improved maneuver characteristics for advanced fighter aircraft. Primary emphasis was placed on high angle of attack performance, stability, and control at subsonic speeds. Spanwise blowing on a 44 deg swept trapezoidal wing resulted in leading edge vortex enhancement with subsequent large vortex-induced lift increments and drag polar improvements at the higher angles of attack. Small deflections of a leading edge flap delayed these lift and drag benefits to higher angles of attack. In addition, blowing was more effective at higher Mach numbers. Spanwise blowing in conjunction with a deflected trailing edge flap resulted in lift and drag benefits that exceeded the summation of the effects of each high lift device acting alone. Asymmetric blowing was an effective lateral control device at the higher angles of attack. Spanwise blowing on the wing reduced horizontal tail loading and improved the lateral-directional stability characteristics of a wing-horizontal tail-vertical tail configuration.

Improving Logistics Processes in Industry Using Web Technologies

NASA Astrophysics Data System (ADS)

Jánošík, Ján; Tanuška, Pavol; Václavová, Andrea

2016-12-01

The aim of this paper is to propose the concept of a system that takes advantage of web technologies and integrates them into the management process and management of internal stocks which may relate to external applications and creates the conditions to transform a Computerized Control of Warehouse Stock (CCWS) in the company. The importance of implementing CCWS is in the elimination of the claims caused by the human factor, as well as to allow the processing of information for analytical purposes and their subsequent use to improve internal processes. Using CCWS in the company would also facilitate better use of the potential tools Business Intelligence and Data Mining.

Influencing Pathways to Quality of Life and HbA1c in Patients With Diabetes: A Longitudinal Study That Inform Evidence-Based Practice.

PubMed

Hsu, Hui-Chun; Lee, Yau-Jiunn; Wang, Ruey-Hsia

2018-04-01

Determining possible associated factors and the influencing pathways to hemoglobin A1C (HbA1C) levels and quality of life (QoL) will facilitate the development of effective interventions to improve the physical and psychosocial health of patients with type 2 diabetes mellitus (T2DM). To test a hypothesized model that addressed the pathways among personal characteristics, social support, diabetes distress, and self-care behaviors to HbA1C and QoL. A total of 382 adults with T2DM were recruited. Self-reported questionnaires and medical records were used to collect data regarding personal characteristics, diabetes distress, and social support at baseline. The self-care behaviors characters were collected 6 months later, as well as QoL and HbA1C levels 1 year later. The 12-month QoL directly affected 12-month HbA1C levels. The 6-month self-care behaviors directly affected 12-month QoL, and indirectly affected 12-month HbA1C levels through 12-month QoL. Baseline diabetes distress directly affected 12-month QoL. Moreover, baseline diabetes distress indirectly affected 12-month HbA1C levels through 12-month QoL. Baseline social support directly affected baseline diabetes distress and 6-month self-care behaviors. In addition, baseline social support indirectly affected 12-month QoL through baseline diabetes distress. Baseline social support also indirectly affected 12-month QoL through 6-month self-care behaviors. Enhancing QoL is important to improve HbA1C levels. Enhancing self-care behaviors is essential to improve subsequent HbA1C control and QoL. Reducing diabetes distress is crucial to improve subsequent QoL. Improving social support is suggested a favorable strategy to reduce diabetes distress and enhance subsequent self-care behaviors in patients with T2DM. © 2018 Sigma Theta Tau International.

Review on design and control aspects of ankle rehabilitation robots.

PubMed

Jamwal, Prashant K; Hussain, Shahid; Xie, Sheng Q

2015-03-01

Ankle rehabilitation robots can play an important role in improving outcomes of the rehabilitation treatment by assisting therapists and patients in number of ways. Consequently, few robot designs have been proposed by researchers which fall under either of the two categories, namely, wearable robots or platform-based robots. This paper presents a review of both kinds of ankle robots along with a brief analysis of their design, actuation and control approaches. While reviewing these designs it was observed that most of them are undesirably inspired by industrial robot designs. Taking note of the design concerns of current ankle robots, few improvements in the ankle robot designs have also been suggested. Conventional position control or force control approaches, being used in the existing ankle robots, have been reviewed. Apparently, opportunities of improvement also exist in the actuation as well as control of ankle robots. Subsequently, a discussion on most recent research in the development of novel actuators and advanced controllers based on appropriate physical and cognitive human-robot interaction has also been included in this review. Implications for Rehabilitation Ankle joint functions are restricted/impaired as a consequence of stroke or injury during sports or otherwise. Robots can help in reinstating functions faster and can also work as tool for recording rehabilitation data useful for further analysis. Evolution of ankle robots with respect to their design and control aspects has been discussed in the present paper and a novel design with futuristic control approach has been proposed.

Wheat seed weight and quality differ temporally in sensitivity to warm or cool conditions during seed development and maturation

PubMed Central

Nasehzadeh, M

2017-01-01

Abstract Background and aims Short periods of extreme temperature may affect wheat (Triticum aestivum) seed weight, but also quality. Temporal sensitivity to extreme temperature during seed development and maturation was investigated. Methods Plants of ‘Tybalt’ grown at ambient temperature were moved to growth cabinets at 29/20°C or 34/20°C (2010), or 15/10°C or 34/20°C (2011), for successive 7-d periods from 7 DAA (days after anthesis) onwards, and also 7–65 DAA in 2011. Seed samples were harvested serially and moisture content, weight, ability to germinate, subsequent longevity in air-dry storage and bread-making quality were determined. Key Results High temperature (34/20°C) reduced final seed weight, with greatest temporal sensitivity at 7–14 or 14–21 DAA. Several aspects of bread-making quality were also most sensitive to high temperature then, but whereas protein quality decreased protein and sulphur concentrations improved. Early exposure to high temperature provided earlier development of ability to germinate and tolerate desiccation, but had little effect on maximum germination capacity. All treatments at 15/10°C resulted in ability to germinate declining between 58 and 65 DAA. Early exposure to high temperature hastened improvement in seed storage longevity, but the subsequent decline in late maturation preceded that in the control. Long (7–65 DAA) exposure to 15/10°C disrupted the development of seed longevity, with no improvement after seed filling ended. Longevity improved during maturation drying in other treatments. Early (7–14 DAA) exposure to high temperature reduced and low temperature increased subsequent longevity at harvest maturity, whereas late (35 or 42–49 DAA) exposure to high temperature increased and low temperature reduced it. Conclusions Temporal sensitivity to extreme temperature was detected. It varied considerably amongst the contrasting seed variables investigated. Subsequent seed longevity at harvest maturity responded negatively to temperature early in development, but positively later in development and throughout maturation. PMID:28637252

Gait Balance Disorder by Thalamic Infarction with the Disorder of Interstitial Nucleus of Cajal

PubMed Central

Kurosu, A.; Hayashi, Y.; Wada, K.; Nagaoka, M.

2011-01-01

The interstitial nucleus of Cajal (INC) is thought to play an important role in torsional/vertical eye position and head posture, and disorders of the INC induce abnormal ocular movements and head tilt. Our patients with ocular tilt reactions simultaneously also had disturbances in ambulatory balance, yet no reports address the loss of balance control induced by disorders of the INC. We examined the ambulatory disturbances induced by INC lesion. We experienced three patients with ocular movement disorders and abnormal head tilt due to thalamic infarction. We performed ophthalmic examinations on and checked the balance of them. With funduscopy, abnormal cycloduction was seen in the unaffected side and normal cycloduction was observed in the affected side. Nevertheless, Hess charts showed distortions in the visual image of both eyes. They all had disorders of balance control. We tried to treat them using the Bobath approach for improving their ambulatory balance. With subsequent improvements in balance control it was possible for them to take short walks, but it was difficult to make any improvements in their ocular movement. The INC is related to balance control of ambulation and disorders of the INC induce ambulatory disturbances. Cycloduction was only observed in the unaffected side, but Hess charts showed distortions of the visual image in both eyes. Ambulation was briefly improved, but diplopia persisted in these patients. PMID:21769260

The effect of a health communication campaign on compliance with mass drug administration for schistosomiasis control in western Kenya--the SCORE project.

PubMed

Omedo, Martin; Ogutu, Michael; Awiti, Alphonce; Musuva, Rosemary; Muchiri, Geoffrey; Montgomery, Susan P; Secor, W Evan; Mwinzi, Pauline

2014-11-01

Compliance with mass drug administration (MDA) can be affected by rumors and mistrust about the drug. Communication campaigns are an effective way to influence attitudes and health behaviors in diverse public health contexts, but there is very little documentation about experiences using health communications in schistosomiasis control programs. A qualitative study was conducted with community health workers (CHWs) as informants to explore the effect of a health communication campaign on their experiences during subsequent praziquantel MDA for schistosomiasis. Discussions were audio-recorded, transcribed verbatim, translated into English where applicable, and analyzed thematically using ATLAS.ti software. According to the CHWs, exposure to mass media messages improved awareness of the MDA, which in turn, led to better treatment compliance. Our findings suggest that communication campaigns influence health behaviors and create awareness of schistosomiasis control interventions, which may ultimately improve praziquantel MDA. © The American Society of Tropical Medicine and Hygiene.

A brief randomized controlled intervention targeting parents improves grades during middle school.

PubMed

Destin, Mesmin; Svoboda, Ryan C

2017-04-01

Despite a growing number of brief, psychosocial interventions that improve academic achievement, little research investigates how to leverage parents during such efforts. We designed and tested a randomized controlled intervention targeting parents to influence important discussions about the future and responses to academic difficulty experienced by their adolescent during eighth grade in the United States. We recruited experienced parents to convey the main messages of the intervention in a parent panel format. As expected, current parents who were randomly assigned to observe the parent panel subsequently planned to talk with their adolescents sooner about future opportunities and to respond more positively to experiences of academic difficulty than parents who were randomly assigned to a control group. The intervention also led to a significant increase in student grades, which was mediated by parents' responses to academic difficulty. We suggest an increase in experimental research that utilizes parents to influence student achievement. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

STOVL Hot Gas Ingestion control technology

NASA Technical Reports Server (NTRS)

Amuedo, K. C.; Williams, B. R.; Flood, J. D.; Johns, A. L.

1991-01-01

A comprehensive wind tunnel test program was conducted to evaluate control of Hot Gas Ingestion (HGI) on a 9.2 percent scale model of the McDonnell Aircraft Company model 279-3C advanced Short Takeoff and Vertical Landing (STOVL) configuration. The test was conducted in the NASA-Lewis Research Center 9 ft by 15 ft Low Speed Wind Tunnel during the summer of 1987. Initial tests defined baseline HGI levels as determined by engine face temperature rise and temperature distortion. Subsequent testing was conducted to evaluate HGI control parametrically using Lift Improvement Devices (LIDs), forward nozzle splay angle, a combination of LIDs and forward nozzle splay angle, and main inlet blocking. The results from this test program demonstrate that HGI can be effectively controlled and that HGI is not a barrier to STOVL aircraft development.

Selection and parameterization of cortical neurons for neuroprosthetic control.

PubMed

Wahnoun, Remy; He, Jiping; Helms Tillery, Stephen I

2006-06-01

When designing neuroprosthetic interfaces for motor function, it is crucial to have a system that can extract reliable information from available neural signals and produce an output suitable for real life applications. Systems designed to date have relied on establishing a relationship between neural discharge patterns in motor cortical areas and limb movement, an approach not suitable for patients who require such implants but who are unable to provide proper motor behavior to initially tune the system. We describe here a method that allows rapid tuning of a population vector-based system for neural control without arm movements. We trained highly motivated primates to observe a 3D center-out task as the computer played it very slowly. Based on only 10-12 s of neuronal activity observed in M1 and PMd, we generated an initial mapping between neural activity and device motion that the animal could successfully use for neuroprosthetic control. Subsequent tunings of the parameters led to improvements in control, but the initial selection of neurons and estimated preferred direction for those cells remained stable throughout the remainder of the day. Using this system, we have observed that the contribution of individual neurons to the overall control of the system is very heterogeneous. We thus derived a novel measure of unit quality and an indexing scheme that allowed us to rate each neuron's contribution to the overall control. In offline tests, we found that fewer than half of the units made positive contributions to the performance. We tested this experimentally by having the animals control the neuroprosthetic system using only the 20 best neurons. We found that performance in this case was better than when the entire set of available neurons was used. Based on these results, we believe that, with careful task design, it is feasible to parameterize control systems without any overt behaviors and that subsequent control system design will be enhanced with cautious unit selection. These improvements can lead to systems demanding lower bandwidth and computational power, and will pave the way for more feasible clinical systems.

The efficacy of a continuous quality improvement (CQI) method in a radiological department. Comparison with non-CQI control material.

PubMed

Laurila, J; Standertskjöld-Nordenstam, C G; Suramo, I; Tolppanen, E M; Tervonen, O; Korhola, O; Brommels, M

2001-01-01

To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00-22:00 and a radiographer was moved from the morning shift to 15:00-22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

Beyond Line of Sight (BLOS) Command and Control (C2) Capability to Improve Disaster Response and Recovery

DTIC Science & Technology

2013-09-01

on the possible threat of an electromagnetic pulse (EMP) and its potential consequences following the destructive “ derecho ” that hit Washington, DC...in 2012.19 Spanish for the word “straight,” a derecho is a term used to describe a widespread, long- lived, straight-line windstorm that is...emergency communications system and raised concern for future response. Both Hurricane Katrina and the Washington, DC, area derecho have subsequently

Sea buckthorn decreases and delays insulin response and improves glycaemic profile following a sucrose-containing berry meal: a randomised, controlled, crossover study of Danish sea buckthorn and strawberries in overweight and obese male subjects.

PubMed

Mortensen, Maria Wichmann; Spagner, Camilla; Cuparencu, Cătălina; Astrup, Arne; Raben, Anne; Dragsted, Lars Ove

2017-10-11

Berries and mixed berry products exert acute effects on postprandial glycaemia and insulinemia, but very few berries have been studied, and primarily in normal weight subjects. Sea buckthorn and strawberry are compositionally widely different berries and may likely produce different responses. The effects of strawberry and sea buckthorn on postprandial glycaemia and insulinemia were examined in overweight or obese male subjects. Subjective appetite sensations and ad libitum intake were also examined. The study was conducted as a randomised, controlled, single-blinded, three-way crossover study. Eighteen subjects were studied in three 2-h meal tests followed by a subsequent ad libitum meal. Test meals contained added sucrose and either sea buckthorn, strawberry or no berries with added fructose (control). Blood samples were collected at t = 0, 30, 45, 60, 90 and 120 min. Subjective appetite sensations were recorded at t = 0, 15, 30, 45, 60, 90, 120, and 140 min and subsequent ad libitum intake was recorded. Statistical differences in all continuous measures were evaluated based on the existence of a meal or a time-meal interaction by repeated measures linear model analyses or by differences in AUC by linear mixed models. None of the berries affected postprandial glucose. However, sea buckthorn improved glycaemic profile (44.7%, p < 0.01) compared to control. Sea buckthorn also resulted in a decrease in plasma insulin concentration at 30 min (39.6%, p < 0.01) and at 45 min (16.5%, p < 0.05) compared to control and the maximal increase in plasma insulin was lower following sea buckthorn compared with control (23.6%, p < 0.01). Strawberry did not affect postprandial insulin concentrations compared to control. No differences between control and each of the two berries were observed for any of the appetite parameters, except for desire for something sweet, which was increased following the sea buckthorn meal compared to control. There was no effect on postprandial glucose response to a sugar challenge given together with purees of strawberry or sea buckthorn. Sea buckthorn decreased and delayed the insulin response and improved glycaemic profile compared with control. Strawberry had no such effects. No important differences were seen for the appetite measures. Sea buckthorn might be useful as a culinary tool for lowering meal insulin response.

Measuring Complexity and Predictability of Time Series with Flexible Multiscale Entropy for Sensor Networks

PubMed Central

Zhou, Renjie; Yang, Chen; Wan, Jian; Zhang, Wei; Guan, Bo; Xiong, Naixue

2017-01-01

Measurement of time series complexity and predictability is sometimes the cornerstone for proposing solutions to topology and congestion control problems in sensor networks. As a method of measuring time series complexity and predictability, multiscale entropy (MSE) has been widely applied in many fields. However, sample entropy, which is the fundamental component of MSE, measures the similarity of two subsequences of a time series with either zero or one, but without in-between values, which causes sudden changes of entropy values even if the time series embraces small changes. This problem becomes especially severe when the length of time series is getting short. For solving such the problem, we propose flexible multiscale entropy (FMSE), which introduces a novel similarity function measuring the similarity of two subsequences with full-range values from zero to one, and thus increases the reliability and stability of measuring time series complexity. The proposed method is evaluated on both synthetic and real time series, including white noise, 1/f noise and real vibration signals. The evaluation results demonstrate that FMSE has a significant improvement in reliability and stability of measuring complexity of time series, especially when the length of time series is short, compared to MSE and composite multiscale entropy (CMSE). The proposed method FMSE is capable of improving the performance of time series analysis based topology and traffic congestion control techniques. PMID:28383496

Measuring Complexity and Predictability of Time Series with Flexible Multiscale Entropy for Sensor Networks.

PubMed

Zhou, Renjie; Yang, Chen; Wan, Jian; Zhang, Wei; Guan, Bo; Xiong, Naixue

2017-04-06

Measurement of time series complexity and predictability is sometimes the cornerstone for proposing solutions to topology and congestion control problems in sensor networks. As a method of measuring time series complexity and predictability, multiscale entropy (MSE) has been widely applied in many fields. However, sample entropy, which is the fundamental component of MSE, measures the similarity of two subsequences of a time series with either zero or one, but without in-between values, which causes sudden changes of entropy values even if the time series embraces small changes. This problem becomes especially severe when the length of time series is getting short. For solving such the problem, we propose flexible multiscale entropy (FMSE), which introduces a novel similarity function measuring the similarity of two subsequences with full-range values from zero to one, and thus increases the reliability and stability of measuring time series complexity. The proposed method is evaluated on both synthetic and real time series, including white noise, 1/f noise and real vibration signals. The evaluation results demonstrate that FMSE has a significant improvement in reliability and stability of measuring complexity of time series, especially when the length of time series is short, compared to MSE and composite multiscale entropy (CMSE). The proposed method FMSE is capable of improving the performance of time series analysis based topology and traffic congestion control techniques.

Objective visual assessment of antiangiogenic treatment for wet age-related macular degeneration.

PubMed

Baseler, Heidi A; Gouws, André; Crossland, Michael D; Leung, Carmen; Tufail, Adnan; Rubin, Gary S; Morland, Antony B

2011-10-01

To assess cortical responses in patients undergoing antiangiogenic treatment for wet age-related macular degeneration (AMD) using functional magnetic resonance imaging (fMRI) as an objective, fixation-independent measure of topographic visual function. A patient with bilateral neovascular AMD was scanned using fMRI before and at regular intervals while undergoing treatment with intravitreal antiangiogenic injections (ranibizumab). Blood oxygenation level-dependent signals were measured in the brain while the patient viewed a stimulus consisting of a full-field flickering (6 Hz) white light alternating with a uniform gray background (18 s on and 18 s off). Topographic distribution and magnitude of activation in visual cortex were compared longitudinally throughout the treatment period (<1 year) and with control patients not currently undergoing treatment. Clinical behavioral tests were also administered, including visual acuity, microperimetry, and reading skills. The area of visual cortex activated increased significantly after the first treatment to include more posterior cortex that normally receives inputs from lesioned parts of the retina. Subsequent treatments yielded no significant further increase in activation area. Behavioral measures all generally showed an improvement with treatment but did not always parallel one another. The untreated control patient showed a consistent lack of significant response in the cortex representing retinal lesions. Retinal treatments may not only improve vision but also result in a concomitant improvement in fixation stability. Current clinical behavioral measures (e.g., acuity and perimetry) are largely dependent on fixation stability and therefore cannot separate improvements of visual function from fixation improvements. fMRI, which provides an objective and sensitive measure of visual function independent of fixation, reveals a significant increase in visual cortical responses in patients with wet AMD after treatment with antiangiogenic injections. Despite recent evidence that visual cortex degenerates subsequent to retinal lesions, our results indicate that it can remain responsive as its inputs are restored.

Guidelines for Risk-Based Changeover of Biopharma Multi-Product Facilities.

PubMed

Lynch, Rob; Barabani, David; Bellorado, Kathy; Canisius, Peter; Heathcote, Doug; Johnson, Alan; Wyman, Ned; Parry, Derek Willison

2018-01-01

In multi-product biopharma facilities, the protection from product contamination due to the manufacture of multiple products simultaneously is paramount to assure product quality. To that end, the use of traditional changeover methods (elastomer change-out, full sampling, etc.) have been widely used within the industry and have been accepted by regulatory agencies. However, with the endorsement of Quality Risk Management (1), the use of risk-based approaches may be applied to assess and continuously improve established changeover processes. All processes, including changeover, can be improved with investment (money/resources), parallel activities, equipment design improvements, and standardization. However, processes can also be improved by eliminating waste. For product changeover, waste is any activity not needed for the new process or that does not provide added assurance of the quality of the subsequent product. The application of a risk-based approach to changeover aligns with the principles of Quality Risk Management. Through the use of risk assessments, the appropriate changeover controls can be identified and controlled to assure product quality is maintained. Likewise, the use of risk assessments and risk-based approaches may be used to improve operational efficiency, reduce waste, and permit concurrent manufacturing of products. © PDA, Inc. 2018.

Monosodium glutamate delivered in a protein-rich soup improves subsequent energy compensation.

PubMed

Masic, Una; Yeomans, Martin R

2014-01-01

Previous research suggests that monosodium glutamate (MSG) may have a biphasic effect on appetite, increasing appetite within a meal with its flavour-enhancing effect, but enhancing subsequent satiety due to its proposed role as a predictor of protein content. The present study explored this by assessing the impact of a 450 g soup preload differing in MSG concentration (1 % MSG added (MSG+) or no MSG (MSG-)) and nutrient content (low-energy control or high-energy carbohydrate or high-energy protein) on rated appetite and ad libitum intake of a test meal in thirty-five low-restraint male volunteers using a within-participant design. Protein-rich preloads significantly reduced intake at the test meal and resulted in more accurate energy compensation than did carbohydrate-rich preloads. This energy compensation was stronger in the MSG+ protein conditions when compared with MSG+ carbohydrate conditions. No clear differences in rated appetite were seen in MSG or the macronutrient conditions alone during preload ingestion or 45 min after intake. Overall, these findings indicate that MSG may act to further improve energy compensation when provided in a protein-rich context.

Preventing alcohol and drug exposed births in Washington state: intervention findings from three parent-child assistance program sites.

PubMed

Grant, Therese M; Ernst, Cara C; Streissguth, Ann; Stark, Kenneth

2005-01-01

Home visitation interventions show promise for helping at-risk mothers, yet few programs have been developed and evaluated specifically for alcohol and drug-abusing pregnant women. This study examines outcomes among 216 women enrolled in the Washington State Parent-Child Assistance Program, a three-year intervention program for women who abuse alcohol and drugs during an index pregnancy. Pretest-posttest comparison was made across three sites: the original demonstration (1991-1995), and the Seattle and Tacoma replications (1996-2003). In the original demonstration, the client group performed significantly better than controls. Compared to the original demonstration, outcomes at replication sites were maintained (for regular use of contraception and use of reliable method; and number of subsequent deliveries), or improved (for alcohol/drug treatment completed; alcohol/ drug abstinence; subsequent delivery unexposed to alcohol/drugs). Improved outcomes at replication sites are not attributable to enrolling lower-risk women. Public policies and programs initiated over the study period may have had a positive effect on outcomes. Study findings suggest that this community-based intervention model is effective over time and across venues.

Simulation of talking faces in the human brain improves auditory speech recognition

PubMed Central

von Kriegstein, Katharina; Dogan, Özgür; Grüter, Martina; Giraud, Anne-Lise; Kell, Christian A.; Grüter, Thomas; Kleinschmidt, Andreas; Kiebel, Stefan J.

2008-01-01

Human face-to-face communication is essentially audiovisual. Typically, people talk to us face-to-face, providing concurrent auditory and visual input. Understanding someone is easier when there is visual input, because visual cues like mouth and tongue movements provide complementary information about speech content. Here, we hypothesized that, even in the absence of visual input, the brain optimizes both auditory-only speech and speaker recognition by harvesting speaker-specific predictions and constraints from distinct visual face-processing areas. To test this hypothesis, we performed behavioral and neuroimaging experiments in two groups: subjects with a face recognition deficit (prosopagnosia) and matched controls. The results show that observing a specific person talking for 2 min improves subsequent auditory-only speech and speaker recognition for this person. In both prosopagnosics and controls, behavioral improvement in auditory-only speech recognition was based on an area typically involved in face-movement processing. Improvement in speaker recognition was only present in controls and was based on an area involved in face-identity processing. These findings challenge current unisensory models of speech processing, because they show that, in auditory-only speech, the brain exploits previously encoded audiovisual correlations to optimize communication. We suggest that this optimization is based on speaker-specific audiovisual internal models, which are used to simulate a talking face. PMID:18436648

Implementation of an Inpatient Pediatric Sepsis Identification Pathway.

PubMed

Bradshaw, Chanda; Goodman, Ilyssa; Rosenberg, Rebecca; Bandera, Christopher; Fierman, Arthur; Rudy, Bret

2016-03-01

Early identification and treatment of severe sepsis and septic shock improves outcomes. We sought to identify and evaluate children with possible sepsis on a pediatric medical/surgical unit through successful implementation of a sepsis identification pathway. The sepsis identification pathway, a vital sign screen and subsequent physician evaluation, was implemented in October 2013. Quality improvement interventions were used to improve physician and nursing adherence with the pathway. We reviewed charts of patients with positive screens on a monthly basis to assess for nursing recognition/physician notification, physician evaluation for sepsis, and subsequent physician diagnosis of sepsis and severe sepsis/septic shock. Adherence data were analyzed on a run chart and statistical process control p-chart. Nursing and physician pathway adherence of >80% was achieved over a 6-month period and sustained for the following 6 months. The direction of improvements met standard criteria for special causes. Over a 1-year period, there were 963 admissions to the unit. Positive screens occurred in 161 (16.7%) of these admissions and 38 (23.5%) of these had a physician diagnosis of sepsis, severe sepsis, or septic shock. One patient with neutropenia and septic shock had a negative sepsis screen due to lack of initial fever. Using quality improvement methodology, we successfully implemented a sepsis identification pathway on our pediatric unit. The pathway provided a standardized process to identify and evaluate children with possible sepsis requiring timely evaluation and treatment. Copyright © 2016 by the American Academy of Pediatrics.

Controlled activation of retrotransposition for plant breeding.

PubMed

Paszkowski, Jerzy

2015-04-01

Plant genomes consist to a large extent of transposable elements (TEs), predominantly retrotransposons. Their accumulation through periodic transposition bursts has shaped the structure and regulatory organization of plant genomes, often contributing to phenotypic traits. Transposon-generated phenotypes selected by humans during plant domestication have been maintained under strict selection during subsequent plant breeding. Our knowledge of the epigenetic, environmental, and developmental regulation of TE activity has advanced considerably in recent years. Here I will consider TEs as an attractive endogenous source of genetic variation that can be liberated in a controlled fashion and thus offer novel phenotypic diversity to be selected for crop improvement. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Strength Model of Self-Control in Sport and Exercise Psychology

PubMed Central

Englert, Chris

2016-01-01

The strength model of self-control assumes that all acts of self-control (e.g., emotion regulation, persistence) are empowered by a single global metaphorical strength that has limited capacity. This strength can become temporarily depleted after a primary self-control act, which, in turn, can impair performance in subsequent acts of self-control. Recently, the assumptions of the strength model of self-control also have been adopted and tested in the field of sport and exercise psychology. The present review paper aims to give an overview of recent developments in self-control research based on the strength model of self-control. Furthermore, recent research on interventions on how to improve and revitalize self-control strength will be presented. Finally, the strength model of self-control has been criticized lately, as well as expanded in scope, so the present paper will also discuss alternative explanations of why previous acts of self-control can lead to impaired performance in sport and exercise. PMID:26973590

Eldecalcitol improves chair-rising time in postmenopausal osteoporotic women treated with bisphosphonates

PubMed Central

Iwamoto, Jun; Sato, Yoshihiro

2014-01-01

An open-label randomized controlled trial was conducted to clarify the effect of eldecalcitol (ED) on body balance and muscle power in postmenopausal osteoporotic women treated with bisphosphonates. A total of 106 postmenopausal women with osteoporosis (mean age 70.8 years) were randomly divided into two groups (n=53 in each group): a bisphosphonate group (control group) and a bisphosphonate plus ED group (ED group). Biochemical markers, unipedal standing time (body balance), and five-repetition chair-rising time (muscle power) were evaluated. The duration of the study was 6 months. Ninety-six women who completed the trial were included in the subsequent analyses. At baseline, the age, body mass index, bone mass indices, bone turnover markers, unipedal standing time, and chair-rising time did not differ significantly between the two groups. During the 6-month treatment period, bone turnover markers decreased significantly from the baseline values similarly in the two groups. Although no significant improvement in the unipedal standing time was seen in the ED group, compared with the control group, the chair-rising time decreased significantly in the ED group compared with the control group. The present study showed that ED improved the chair-rising time in terms of muscle power in postmenopausal osteoporotic women treated with bisphosphonates. PMID:24476669

Analysis of residual symptoms after treatment in benign paroxysmal positional vertigo using questionnaire.

PubMed

Lee, No Hee; Kwon, Hee Jun; Ban, Jae Ho

2009-08-01

Canalith repositioning procedure (CRP) provides rapid and long-lasting relief of symptoms in most patients with benign paroxysmal positional vertigo. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, even after the disappearance of nystagmus and vertigo. The purpose of this study was to assess the residual symptoms after CRP in patients with benign paroxysmal positional vertigo using the Dizziness Handicap Inventory (DHI) in a questionnaire format. Controlled, prospective study. CRP was performed in 135 patients until nystagmus and vertigo disappeared. Patients were asked to complete the questionnaire before and 5 to 7 days after treatment. A control group of 135 normal volunteers was selected and cross-matched according to the age and sex of the patient group. The data were compared for the pre-CRP, post-CRP, and control groups. There was a significant improvement in the DHI scores when comparing the pre- and post-CRP groups (P=0.000), although six items showed incomplete improvement. Subsequent comparison of DHI scores between the control group and the post-CRP group still showed a difference in some items so that the improvement was incomplete. Even after successful CRPs, Dizziness Handicap Inventory scores indicated that residual subjective symptoms may remain. Thus, additional follow-up and management are important for these patients.

Impact of primary care depression intervention on employment and workplace conflict outcomes: is value added?

PubMed

Smith, Jeffrey L; Rost, Kathryn M; Nutting, Paul A; Libby, Anne M; Elliott, Carl E; Pyne, Jeffrey M

2002-03-01

Depression causes significant functional impairment in sufferers and often leads to adverse employment outcomes for working individuals. Recovery from depression has been associated with better employment outcomes at one year. The study s goals were to assess a primary care depression intervention s impact on subsequent employment and workplace conflict outcomes in employed patients with depression. In 1996-1997, the study enrolled 262 employed patients with depression from twelve primary care practices located across ten U.S. states; 219 (84%) of the patients were followed at one year. Intent-to-treat analyses assessing intervention effects on subsequent employment and workplace conflict were conducted using logistic regression models controlling for individual clinical and sociodemographic characteristics, job classification and local employment conditions. To meet criteria for subsequent employment, persons working full-time at baseline had to report they were working full-time at follow-up and persons working part-time at baseline had to report working part-/full-time at follow-up. Workplace conflict was measured by asking patients employed at follow-up whether, in the past year, they had arguments or other difficulties with people at work . Findings showed that 92.1% of intervention patients met criteria for subsequent employment at one year, versus 82.0% of usual care patients (c2=4.42, p=.04). Intervention patients were less likely than usual care patients to report workplace conflict in the year following baseline (8.1% vs. 18.9%, respectively; c2=4.11; p=.04). The intervention s effect on subsequent employment was not mediated by its effect on workplace conflict. The intervention significantly improved employment outcomes and reduced workplace conflict in depressed, employed persons at one year. Economic implications for employers related to reduced turnover costs, for workers related to retained earnings, and for governments related to reduced unemployment expenditures and increased tax receipts may be considerable. Although similar primary care depression interventions have been shown to produce comparable effects on subsequent employment at one year, replications in larger samples of depressed, employed patients in different economic climates may be necessary to increase the generalizability and precision of estimates. Primary care interventions that enhance depression treatment and improve clinical outcomes can contribute meaningful added value to society by improving employment and workplace outcomes. Federal/state governments may realize economic benefits from reduced unemployment expenditures and increased tax receipts should primary care depression interventions that improve employment outcomes be broadly disseminated. Policy initiatives to increase the dissemination of such interventions may be an innovative approach for improving labor force participation by depressed individuals. Formal cost-benefit analyses are needed to explore whether economic benefits to societal stakeholders from these and other labor outcomes equal or exceed the incremental costs of disseminating similar primary care interventions nationally. Researchers in other nations may wish to consider investigating the impact primary care depression interventions might have on employment and workplace outcomes in their countries.

Serotonin 2C receptor antagonist improves fear discrimination and subsequent safety signal recall

PubMed Central

Foilb, Allison R.; Christianson, John P.

2015-01-01

The capacity to discriminate between safety and danger is fundamental for survival, but is disrupted in individuals with posttraumatic stress disorder (PTSD). Acute stressors cause a release of serotonin (5-HT) in the forebrain, which is one mechanism for enhanced fear and anxiety; these effects are mediated by the 5-HT2C receptor. Using a fear discrimination paradigm where a danger signal conditioned stimulus (CS+) coterminates with a mild footshock and a safety signal (CS-) indicates the absence of shock, we demonstrate that danger/safety discrimination and fear inhibition develops over the course of 4 daily conditioning sessions. Systemic administration of the 5-HT2C receptor antagonist SB 242084 (0.25 or 1.0 mg/kg) prior to conditioning reduced behavioral freezing during conditioning, improved learning and subsequent inhibition of fear by the safety signal. Discrimination was apparent in the first recall test, and discrimination during training was evident after 3 days of conditioning versus 5 days in the vehicle treated controls. These results suggest a novel therapeutic use for 5-HT2C receptor antagonists to improve learning under stressful circumstances. Potential anatomical loci for 5-HT2C receptor modulation of fear discrimination learning and cognitive performance enhancement are discussed. PMID:26344640

Neural conflict-control mechanisms improve memory for target stimuli.

PubMed

Krebs, Ruth M; Boehler, Carsten N; De Belder, Maya; Egner, Tobias

2015-03-01

According to conflict-monitoring models, conflict serves as an internal signal for reinforcing top-down attention to task-relevant information. While evidence based on measures of ongoing task performance supports this idea, implications for long-term consequences, that is, memory, have not been tested yet. Here, we evaluated the prediction that conflict-triggered attentional enhancement of target-stimulus processing should be associated with superior subsequent memory for those stimuli. By combining functional magnetic resonance imaging (fMRI) with a novel variant of a face-word Stroop task that employed trial-unique face stimuli as targets, we were able to assess subsequent (incidental) memory for target faces as a function of whether a given face had previously been accompanied by congruent, neutral, or incongruent (conflicting) distracters. In line with our predictions, incongruent distracters not only induced behavioral conflict, but also gave rise to enhanced memory for target faces. Moreover, conflict-triggered neural activity in prefrontal and parietal regions was predictive of subsequent retrieval success, and displayed conflict-enhanced functional coupling with medial-temporal lobe regions. These data provide support for the proposal that conflict evokes enhanced top-down attention to task-relevant stimuli, thereby promoting their encoding into long-term memory. Our findings thus delineate the neural mechanisms of a novel link between cognitive control and memory. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Contribution of reactive and proactive control to children's working memory performance: Insight from item recall durations in response sequence planning.

PubMed

Chevalier, Nicolas; James, Tiffany D; Wiebe, Sandra A; Nelson, Jennifer Mize; Espy, Kimberly Andrews

2014-07-01

The present study addressed whether developmental improvement in working memory span task performance relies upon a growing ability to proactively plan response sequences during childhood. Two hundred thirteen children completed a working memory span task in which they used a touchscreen to reproduce orally presented sequences of animal names. Children were assessed longitudinally at 7 time points between 3 and 10 years of age. Twenty-one young adults also completed the same task. Proactive response sequence planning was assessed by comparing recall durations for the 1st item (preparatory interval) and subsequent items. At preschool age, the preparatory interval was generally shorter than subsequent item recall durations, whereas it was systematically longer during elementary school and in adults. Although children mostly approached the task reactively at preschool, they proactively planned response sequences with increasing efficiency from age 7 on, like adults. These findings clarify the nature of the changes in executive control that support working memory performance with age. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial

PubMed Central

Feldman, Jonathan M.; Matte, Lynne; Interian, Alejandro; Lehrer, Paul M.; Lu, Shou-En; Scheckner, Bari; Steinberg, Dara M.; Oken, Tanya; Kotay, Anu; Sinha, Sumita; Shim, Chang

2016-01-01

Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improvements in PD severity were mediated by anxiety sensitivity in CBPT and by depression in MRT, although earlier levels of these mediators did not predict subsequent improvements. Attrition was high (40%) in both groups, albeit comparable to CBT studies targeting anxiety in Latinos. Additional strategies are needed to improve retention in this high-risk population. Both CBPT and MRT may be efficacious interventions for comorbid asthma-PD, and CBPT may offer additional benefits for improving medication adherence. PMID:27668723

Participatory women's groups and counselling through home visits to improve child growth in rural eastern India: protocol for a cluster randomised controlled trial.

PubMed

Nair, Nirmala; Tripathy, Prasanta; Sachdev, Harshpal S; Bhattacharyya, Sanghita; Gope, Rajkumar; Gagrai, Sumitra; Rath, Shibanand; Rath, Suchitra; Sinha, Rajesh; Roy, Swati Sarbani; Shewale, Suhas; Singh, Vijay; Srivastava, Aradhana; Pradhan, Hemanta; Costello, Anthony; Copas, Andrew; Skordis-Worrall, Jolene; Haghparast-Bidgoli, Hassan; Saville, Naomi; Prost, Audrey

2015-04-15

Child stunting (low height-for-age) is a marker of chronic undernutrition and predicts children's subsequent physical and cognitive development. Around one third of the world's stunted children live in India. Our study aims to assess the impact, cost-effectiveness, and scalability of a community intervention with a government-proposed community-based worker to improve growth in children under two in rural India. The study is a cluster randomised controlled trial in two rural districts of Jharkhand and Odisha (eastern India). The intervention tested involves a community-based worker carrying out two activities: (a) one home visit to all pregnant women in the third trimester, followed by subsequent monthly home visits to all infants aged 0-24 months to support appropriate feeding, infection control, and care-giving; (b) a monthly women's group meeting using participatory learning and action to catalyse individual and community action for maternal and child health and nutrition. Both intervention and control clusters also receive an intervention to strengthen Village Health Sanitation and Nutrition Committees. The unit of randomisation is a purposively selected cluster of approximately 1000 population. A total of 120 geographical clusters covering an estimated population of 121,531 were randomised to two trial arms: 60 clusters in the intervention arm receive home visits, group meetings, and support to Village Health Sanitation and Nutrition Committees; 60 clusters in the control arm receive support to Committees only. The study participants are pregnant women identified in the third trimester of pregnancy and their children (n = 2520). Mothers and their children are followed up at seven time points: during pregnancy, within 72 hours of delivery, and at 3, 6, 9, 12 and 18 months after birth. The trial's primary outcome is children's mean length-for-age Z scores at 18 months. Secondary outcomes include wasting and underweight at all time points, birth weight, growth velocity, feeding, infection control, and care-giving practices. Additional qualitative and quantitative data are collected for process and economic evaluations. This trial will contribute to evidence on effective strategies to improve children's growth in India. ISRCTN register 51505201 ; Clinical Trials Registry of India number 2014/06/004664.

Comparison of extended colectomy and limited resection in patients with Lynch syndrome.

PubMed

Natarajan, Nagendra; Watson, Patrice; Silva-Lopez, Edibaldo; Lynch, Henry T

2010-01-01

The purpose of the study was to determine the advantages and disadvantages of prophylactic/extended colectomy (subtotal colectomy) in patients with Lynch syndrome who manifest colorectal cancer. A retrospective cohort using Creighton University's hereditary cancer database was used to identify cases and controls. Cases are patients who underwent subtotal colectomy, either with no colorectal cancer diagnosis (prophylactic) or at diagnosis of first colorectal cancer; controls for these 2 types of cases were, respectively, patients who underwent no colon surgery or those having limited resection at time of diagnosis of first colorectal cancer. The Kaplan-Meier and proportional hazard regression models from the Statistical Analysis Software program was used to calculate the difference in survival, time to subsequent colorectal cancer, and subsequent abdominal surgery between cases and controls. The event-free survival of our study did not reach 50%, so we used the event-free survival at 5 years as our parameter to compare the 2 groups. The event-free survival for subsequent colorectal cancer, subsequent abdominal surgery, and death was 94%, 84%, and 93%, respectively, for cases and 74%, 63%, and 88%, respectively, for controls. Times to subsequent colorectal cancer and subsequent abdominal surgery were significantly shorter in the control group (P < .006 and P < .04, respectively). No significant difference was identified with respect to survival time between the cases and controls. Even though no survival benefit was identified between the cases and controls the increased incidence of metachronous colorectal cancer and increased abdominal surgeries among controls warrant the recommendation of subtotal colectomy in patients with Lynch syndrome.

Electrodialysis operation with buffer solution

DOEpatents

Hryn, John N [Naperville, IL; Daniels, Edward J [Orland Park, IL; Krumdick, Greg K [Crete, IL

2009-12-15

A new method for improving the efficiency of electrodialysis (ED) cells and stacks, in particular those used in chemical synthesis. The process entails adding a buffer solution to the stack for subsequent depletion in the stack during electrolysis. The buffer solution is regenerated continuously after depletion. This buffer process serves to control the hydrogen ion or hydroxide ion concentration so as to protect the active sites of electrodialysis membranes. The process enables electrodialysis processing options for products that are sensitive to pH changes.

A real-time simulation evaluation of an advanced detection. Isolation and accommodation algorithm for sensor failures in turbine engines

NASA Technical Reports Server (NTRS)

Merrill, W. C.; Delaat, J. C.

1986-01-01

An advanced sensor failure detection, isolation, and accommodation (ADIA) algorithm has been developed for use with an aircraft turbofan engine control system. In a previous paper the authors described the ADIA algorithm and its real-time implementation. Subsequent improvements made to the algorithm and implementation are discussed, and the results of an evaluation presented. The evaluation used a real-time, hybrid computer simulation of an F100 turbofan engine.

Active Flow Separation Control of a Stator Vane Using Surface Injection in a Multistage Compressor Experiment

NASA Technical Reports Server (NTRS)

Culley, Dennis E.; Bright, Michelle M.; Prahst, Patricia S.; Strazisar, Anthony J.

2003-01-01

Micro-flow control actuation embedded in a stator vane was used to successfully control separation and improve near stall performance in a multistage compressor rig at NASA Glenn. Using specially designed stator vanes configured with internal actuation to deliver pulsating air through slots along the suction surface, a research study was performed to identify performance benefits using this microflow control approach. Pressure profiles and unsteady pressure measurements along the blade surface and at the shroud provided a dynamic look at the compressor during microflow air injection. These pressure measurements lead to a tracking algorithm to identify the onset of separation. The testing included steady air injection at various slot locations along the vane. The research also examined the benefit of pulsed injection and actively controlled air injection along the stator vane. Two types of actuation schemes were studied, including an embedded actuator for on-blade control. Successful application of an online detection and flow control scheme will be discussed. Testing showed dramatic performance benefit for flow reattachment and subsequent improvement in diffusion through the use of pulsed controlled injection. The paper will discuss the experimental setup, the blade configurations, and preliminary CFD results which guided the slot location along the blade. The paper will also show the pressure profiles and unsteady pressure measurements used to track flow control enhancement, and will conclude with the tracking algorithm for adjusting the control.

A multi-component cognitive behavioural intervention for the treatment of fear of falling after hip fracture (FIT-HIP): protocol of a randomised controlled trial.

PubMed

Scheffers-Barnhoorn, Maaike N; van Haastregt, Jolanda C M; Schols, Jos M G A; Kempen, Gertrudis I J M; van Balen, Romke; Visschedijk, Jan H M; van den Hout, Wilbert B; Dumas, Eve M; Achterberg, Wilco P; van Eijk, Monica

2017-03-20

Hip fracture is a common injury in the geriatric population. Despite surgical repair and subsequent rehabilitation programmes, functional recovery is often limited, particularly in individuals with multi-morbidity. This leads to high care dependency and subsequent use of healthcare services. Fear of falling has a negative influence on recovery after hip fracture, due to avoidance of activity and subsequent restriction in mobility. Although fear of falling is highly prevalent after hip fracture, no structured treatment programme is currently available. This trial will evaluate whether targeted treatment of fear of falling in geriatric rehabilitation after hip fracture using a multi-component cognitive behavioural intervention (FIT-HIP), is feasible and (cost) effective in reducing fear of falling and associated activity restriction and thereby improves physical functioning. This multicentre cluster randomised controlled trial will be conducted among older patients with hip fracture and fear of falling who are admitted to a multidisciplinary inpatient geriatric rehabilitation programme in eleven post-acute geriatric rehabilitation units. Fifteen participants will be recruited from each site. Recruitment sites will be allocated by computer randomisation to either the control group, receiving usual care, or to the intervention group receiving the FIT-HIP intervention in addition to usual care. The FIT-HIP intervention is conducted by physiotherapists and will be embedded in usual care. It consists of various elements of cognitive behavioural therapy, including guided exposure to feared activities (that are avoided by the participants). Participants and outcome assessors are blinded to group allocation. Follow-up measurements will be performed at 3 and 6 months after discharge from geriatric rehabilitation. (Cost)-effectiveness and feasibility of the intervention will be evaluated. Primary outcome measures are fear of falling and mobility. Targeted treatment of fear of falling may improve recovery and physical and social functioning after hip fracture, thereby offering benefits for patients and reducing healthcare costs. Results of this study will provide insight into whether fear of falling is modifiable in the (geriatric) rehabilitation after hip fracture and whether the intervention is feasible. Netherlands Trial Register: NTR 5695 .

Elevating glucose and insulin secretion by carbohydrate formulation diets in late lactation to improve post-weaning fertility in primiparous sows.

PubMed

Chen, T Y; Lines, D; Dickson, C; Go, C; Kirkwood, R N; Langendijk, P

2016-10-01

Primiparous (P1) sows commonly lose excessive body reserves to meet energy requirements for maintenance and milk production during lactation, and consequently, post-weaning reproductive performance may be compromised. The present studies determined whether ad libitum feeding a glucogenic carbohydrate diet (CHO) during late lactation could stimulate insulin and glucose secretion (experiment 1) and improve subsequent litter size (experiment 2). For experiment 1, 15 P1 sows, and for experiment 2, 99 P1 sows (198.5 ± 2.7 kg) were allocated randomly according to suckled litter size (≥10 piglets), either to a CHO diet (14.3 MJ DE/kg, 19.8% crude protein) or a standard lactation diet (control; 14.2 DE MJ/kg, 19.5% crude protein) at 8 days before weaning. The CHO diet aimed to provide glucogenic content (extruded wheat, dextrose and sugar) as energy sources instead of fat sources without changing total dietary energy. Pre-prandial plasma glucose and insulin concentrations were not influenced by treatments. However, post-prandial plasma glucose and insulin concentrations and their peaks were both higher (p < .05) compared to the control treatment. Body weight loss during lactation was relatively low at 3%-4% for both treatments and did not differ between control and CHO treatments (-7.6 ± 1.6 vs -5.4 ± 1.2 kg; p > .05). Second litter size was not influenced by diet (p > .05), but the weaning-to-mating interval was shorter in CHO sows (p < .05). This study demonstrates that providing an enriched CHO diet in late lactation did influence post-weaning follicle growth but did not improve subsequent litter size. This may be due to the primiparous sows in this study not experiencing severe negative energy balance and there was no second litter syndrome in this farm which limited the ability of diet to improve sow fertility. © 2016 Blackwell Verlag GmbH.

The Association of Health Literacy with Adherence and Outcomes in Moderate-Severe Asthma

PubMed Central

Apter, Andrea J.; Wan, Fei; Reisine, Susan; Bender, Bruce; Rand, Cynthia; Bogen, Daniel K.; Bennett, Ian M.; Bryant-Stephens, Tyra; Roy, Jason; Gonzalez, Rodalyn; Priolo, Chantel; Have, Thomas Ten; Morales, Knashawn H.

2013-01-01

Background Low health literacy is associated with poor outcomes in asthma and other diseases but the mechanisms governing this relationship are not well-defined. Objective To assess whether literacy is related to subsequent asthma self-management, measured as adherence to inhaled steroids, and asthma outcomes. Methods In a prospective longitudinal cohort study, numeric (Asthma Numeracy Questionnaire (ANQ)) and print literacy (Short Test of Functional Health Literacy in Adults (S-TOFHLA)) were assessed at baseline in adults with moderate or severe asthma for their impact on subsequent electronically monitored adherence and asthma outcomes (asthma control, asthma-related quality of life, and FEV1) over 26 weeks, using mixed-effects linear regression models. Results 284 adults participated: 48±14 years, 71% female, 70% African American, 6% Latino, mean FEV1 66% ± 19%, 86 (30%) with hospitalizations and 148 (52%) with ED visits for asthma in the prior year. Mean ANQ score (range 0–4) was 2.3 ± 1.2; mean S-TOFHLA score 31 ± 8 (range 0–36). In unadjusted analyses numeric and print literacy were associated with better adherence (p=0.01, p=0.08), asthma control (p=0.005, p <0.001), and quality of life (p<0.001, p<0.001). After controlling for age, sex, and race/ethnicity, the associations diminished and only quality of life (numeric: p=0.03, print p=0.006) and asthma control (print p=0.005) remained significantly associated with literacy. Race/ethnicity, income, and educational attainment were correlated (p<0.001). Conclusion While the relationship between literacy and health is complex, interventions which account for and address the literacy needs of patients may improve asthma outcomes. Clinical Implications/Key Summary In adults with moderate or severe asthma, higher health literacy scores were associated with better subsequent quality of life and asthma control. PMID:23591273

Event Segmentation Improves Event Memory up to One Month Later

ERIC Educational Resources Information Center

Flores, Shaney; Bailey, Heather R.; Eisenberg, Michelle L.; Zacks, Jeffrey M.

2017-01-01

When people observe everyday activity, they spontaneously parse it into discrete meaningful events. Individuals who segment activity in a more normative fashion show better subsequent memory for the events. If segmenting events effectively leads to better memory, does asking people to attend to segmentation improve subsequent memory? To answer…

Dispersible shortened boron nitride nanotubes with improved molecule-loading capacity.

PubMed

Zhi, Chunyi; Hanagata, Nobutaka; Bando, Yoshio; Golberg, Dmitri

2011-09-05

The oxidation process of boron nitride nanotubes was thoroughly investigated, and a slow oxidation characteristic was clearly revealed. Subsequently, the controllable oxidation process was utilized to break the sturdy structure of the boron nitride nanotubes to fabricate shortened nanotubes. The shortened boron nitride nanotubes were found to possess good solubility in water and many organic solvents. Further experiments demonstrated remarkably improved molecule-loading capacity of the shortened boron nitride nanotubes. These dispersible shortened boron nitride nanotubes might have the potential to be developed as effective delivery systems for various molecules, which may find applications in bio-related fields. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Stress Testing of an Artificial Pancreas System With Pizza and Exercise Leads to Improvements in the System's Fuzzy Logic Controller.

PubMed

Mauseth, Richard; Lord, Sandra M; Hirsch, Irl B; Kircher, Robert C; Matheson, Don P; Greenbaum, Carla J

2015-09-14

Under controlled conditions, the Dose Safety artificial pancreas (AP) system controller, which utilizes "fuzzy logic" (FL) methodology to calculate and deliver appropriate insulin dosages based on changes in blood glucose, successfully managed glycemic excursions. The aim of this study was to show whether stressing the system with pizza (high carbohydrate/high fat) meals and exercise would reveal deficits in the performance of the Dose Safety FL controller (FLC) and lead to improvements in the dosing matrix. Ten subjects with type 1 diabetes (T1D) were enrolled and participated in 30 studies (17 meal, 13 exercise) using 2 versions of the FLC. After conducting 13 studies with the first version (FLC v2.0), interim results were evaluated and the FLC insulin-dosing matrix was modified to create a new controller version (FLC v2.1) that was validated through regression testing using v2.0 CGM datasets prior to its use in clinical studies. The subsequent 17 studies were performed using FLC v2.1. Use of FLC v2.1 vs FLC v2.0 in the pizza meal tests showed improvements in mean blood glucose (205 mg/dL vs 232 mg/dL, P = .04). FLC v2.1 versus FLC v2.0 in exercise tests showed improvements in mean blood glucose (146 mg/dL vs 201 mg/dL, P = .004), percentage time spent >180 mg/dL (19.3% vs 46.7%, P = .001), and percentage time spent 70-180 mg/dL (80.0% vs 53.3%, P = .002). Stress testing the AP system revealed deficits in the FLC performance, which led to adjustments to the dosing matrix followed by improved FLC performance when retested. © 2015 Diabetes Technology Society.

Premalignant gastric lesions in patients with gastric mucosa-associated lymphoid tissue lymphoma and metachronous gastric adenocarcinoma: a case-control study.

PubMed

Capelle, Lisette G; den Hoed, Caroline M; de Vries, Annemarie C; Biermann, Katharina; Casparie, Mariel K; Meijer, Gerrit A; Kuipers, Ernst J

2012-01-01

Patients with gastric mucosa-associated lymphoid tissue lymphoma or diffuse large B-cell lymphoma have an increased risk of developing gastric carcinoma (GC). Identifying patients at high GC risk may lead to improved survival and prognosis. The aim of this case-control study was to evaluate whether premalignant gastric lesions are more prevalent and severe in gastric lymphoma (GL) patients with a subsequent diagnosis of GC than in those without GC. Patients with a first GL diagnosis from 1991-2008 were identified in the Dutch histopathology registry (PALGA). Cases were patients with a diagnosis of GL and a subsequent diagnosis of GC. Controls were patients with a diagnosis of GL without GC development. In total, eight cases (mean follow-up 5.5 years) and 31 controls (mean follow-up 5.3 years) were included (mean age 60 years). At lymphoma diagnosis, six (75%) cases were diagnosed with premalignant lesions, whereas in the control group, 21 (68%) had histological evidence for premalignant lesions (P=0.69). At GC diagnosis, five (63%) cases showed intestinal metaplasia in the surrounding gastric mucosa. In 22 (71%) controls premalignant lesions were present at the end of follow-up (P=0.47). No differences were demonstrated in the prevalence of premalignant lesions of cases and controls at GL diagnosis or the end of follow-up. As the prevalence of premalignant lesions is substantial in both the groups of patients, careful endoscopic surveillance of GL patients is warranted not only for recurrence of lymphoma, but also for progression to adenocarcinoma.

Artificial Bone and Teeth through Controlled Ice Growth in Colloidal Suspensions

NASA Astrophysics Data System (ADS)

Tomsia, Antoni P.; Saiz, Eduardo; Deville, Sylvain

2007-06-01

The formation of regular patterns is a common feature of many solidification processes involving cast materials. We describe here how regular patterns can be obtained in porous alumina and hydroxyapatite (HAP) by controlling the freezing of ceramic slurries followed by subsequent ice sublimation and sintering, leading to multilayered porous ceramic structures with homogeneous and well-defined architecture. These porous materials can be infiltrated with a second phase of choice to yield biomimetic nacre-like composites with improved mechanical properties, which could be used for artificial bone and teeth applications. Proper control of the solidification patterns provides powerful means of control over the final functional properties. We discuss the relationships between the experimental results, ice growth fundamentals, the physics of ice and the interaction between inert particles and the solidification front during directional freezing.

Artificial Bone and Teeth through Controlled Ice Growth in Colloidal Suspensions

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

Tomsia, Antoni P.; Saiz, Eduardo; Deville, Sylvain

2007-06-14

The formation of regular patterns is a common feature of many solidification processes involving cast materials. We describe here how regular patterns can be obtained in porous alumina and hydroxyapatite (HAP) by controlling the freezing of ceramic slurries followed by subsequent ice sublimation and sintering, leading to multilayered porous ceramic structures with homogeneous and well-defined architecture. These porous materials can be infiltrated with a second phase of choice to yield biomimetic nacre-like composites with improved mechanical properties, which could be used for artificial bone and teeth applications. Proper control of the solidification patterns provides powerful means of control over themore » final functional properties. We discuss the relationships between the experimental results, ice growth fundamentals, the physics of ice and the interaction between inert particles and the solidification front during directional freezing.« less

Effect of Rosa damascene aromatherapy on sleep quality in cardiac patients: a randomized controlled trial.

PubMed

Hajibagheri, Ali; Babaii, Atye; Adib-Hajbaghery, Mohsen

2014-08-01

Sleep disorders are common among patients hospitalized in coronary care unit (CCU). This study aimed to investigate the effect of Rosa damascene aromatherapy on sleep quality of patients hospitalized in CCU. In this randomized controlled trial, 60 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups. Patients in the control group received routine care. In the experimental group, patients received routine care and Rosa damascene aromatherapy for three subsequent nights. In the both groups the sleep quality was assessed using the Pittsburgh Sleep Quality Index. After the study, the mean scores of five domains of Pittsburg Sleep Quality Index as well as the mean of total score of the index in the experimental group were significantly lower than the control group. Rosa damascene aromatherapy can significantly improve the sleep quality of patients hospitalized in CCUs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Transactive Control of Commercial Building HVAC Systems

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

Corbin, Charles D.; Makhmalbaf, Atefe; Huang, Sen

This document details the development and testing of market-based transactive controls for building heating, ventilating and air conditioning (HVAC) systems. These controls are intended to serve the purposes of reducing electricity use through conservation, reducing peak building electric demand, and providing demand flexibility to assist with power system operations. This report is the summary of the first year of work conducted under Phase 1 of the Clean Energy and Transactive Campus Project. The methods and techniques described here were first investigated in simulation, and then subsequently deployed to a physical testbed on the Pacific Northwest National Laboratory (PNNL) campus formore » validation. In this report, we describe the models and control algorithms we have developed, testing of the control algorithms in simulation, and deployment to a physical testbed. Results from physical experiments support previous simulation findings, and provide insights for further improvement.« less

CONGESTIVE HEART FAILURE ASSOCIATED WITH PREGNANCY IN OKAPI (OKAPIA JOHNSTONI).

PubMed

Warren, Joshua D; Aitken-Palmer, Copper; Weldon, Alan D; Flanagan, Joseph P; Howard, Lauren L; Garner, Michael M; Citino, Scott B

2017-03-01

Acute signs associated with cardiovascular disease occurred in three pregnant okapi ( Okapia johnstoni ) during early to midgestation and progressed to congestive heart failure. Congestive heart failure was diagnosed antemortem using echocardiography and plasma cardiac troponin levels. Clinical signs included decreased activity, hyporexia, tachypnea, dyspnea, flared nostrils, and productive coughing with copious amounts of foamy nasal discharge. Parenteral and oral treatment with furosemide, enalapril, and spironolactone controlled clinical signs in the three okapi allowing each to carry out one pregnancy to term. Two okapi carried the first pregnancy to term after showing signs, while one okapi aborted the first calf and gave birth to a healthy calf in a subsequent pregnancy. Subsequent pregnancy in one okapi ended with abortion and associated dystocia and endometritis. Following parturition, clinical signs associated with heart failure resolved in all three individuals; serial echocardiography in two individuals showed improvement in fractional shortening and left atrial size and all three okapi showed markedly decreased pleural effusion and resolution of pulmonary edema. However, subsequent pregnancies in all three okapi induced respiratory distress and recurrence of congestive heart failure; one okapi died from congestive heart failure associated with subsequent pregnancy. This case series describes the clinical presentation and pathologic findings of congestive heart failure during pregnancy in adult okapi.

The impact of postpartum cervical tear on the occurrence of preterm birth in subsequent pregnancy.

PubMed

Zafran, Noah; Gerszman, Eden; Garmi, Gali; Zuaretz-Easton, Sivan; Salim, Raed

2017-08-01

To examine the occurrence of subsequent preterm birth (PTB) among women who experienced a cervical tear during prior delivery. A retrospective study conducted at a single teaching hospital on data from January 1994 to March 2014. The study group included all women who had a cervical tear detected at uterine and cervical examination, performed due to early postpartum hemorrhage. The control group consisted of women who delivered vaginally, experienced an early postpartum hemorrhage, and had an intact cervix at uterine and cervical examination. The control group was matched for maternal age and ethnicity at a ratio of 1:2. Women who had a cervical tear but then did not have a subsequent delivery, or had multiple fetal gestations or cervical cerclage at subsequent pregnancies were excluded. Primary outcome was spontaneous PTB rate (<37 weeks) in the subsequent pregnancy. Secondary outcomes included any PTBs in other subsequent pregnancies. Overall, 389 women were included. Of all cases of cervical tear, 129 were identified eligible and included in the final analysis. The control group included 260 women with an intact cervix. No significant differences were found between the study and control groups in the incidence of spontaneous PTB in the immediate subsequent pregnancy [1.6% (2/129) vs. 3.8% (10/260), respectively, p = 0.35]. The incidence of any spontaneous PTBs in all subsequent pregnancies did not differ also [4.7% (6/129) vs. 7.3% (19/260), respectively, p = 0.31]. Cervical tear detected after delivery does not increase the risk of spontaneous PTB in subsequent pregnancies.

Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes.

PubMed

Tieu, Joanna; Shepherd, Emily; Middleton, Philippa; Crowther, Caroline A

2017-08-24

Gestational diabetes mellitus (GDM) is associated with adverse health outcomes for mothers and their infants both perinatally and long term. Women with a history of GDM are at risk of recurrence in subsequent pregnancies and may benefit from intervention in the interconception period to improve maternal and infant health outcomes. To assess the effects of interconception care for women with a history of GDM on maternal and infant health outcomes. We searched Cochrane Pregnancy and Childbirth's Trials Register (7 April 2017) and reference lists of retrieved studies. Randomised controlled trials, including quasi-randomised controlled trials and cluster-randomised trials evaluating any protocol of interconception care with standard care or other forms of interconception care for women with a history of GDM on maternal and infant health outcomes. Two review authors independently assessed study eligibility. In future updates of this review, at least two review authors will extract data and assess the risk of bias of included studies; the quality of the evidence will be assessed using the GRADE approach. No eligible published trials were identified. We identified a completed randomised controlled trial that was designed to evaluate the effects of a diet and exercise intervention compared with standard care in women with a history of GDM, however to date, it has only published results on women who were pregnant at randomisation (and not women in the interconception period). We also identified an ongoing trial, in obese women with a history of GDM planning a subsequent pregnancy, which is assessing the effects of an intensive lifestyle intervention, supported with liraglutide treatment, compared with usual care. We also identified a trial that was designed to evaluate the effects of a weight loss and exercise intervention compared with lifestyle education also in obese women with a history of GDM planning a subsequent pregnancy, however it has not yet been published. These trials will be re-considered for inclusion in the next review update. The role of interconception care for women with a history of GDM remains unclear. Randomised controlled trials are required evaluating different forms and protocols of interconception care for these women on perinatal and long-term maternal and infant health outcomes, acceptability of such interventions and cost-effectiveness.

Further education improves cognitive reserve and triggers improvement in selective cognitive functions in older adults: The Tasmanian Healthy Brain Project.

PubMed

Thow, Megan E; Summers, Mathew J; Saunders, Nichole L; Summers, Jeffery J; Ritchie, Karen; Vickers, James C

2018-01-01

The strong link between early-life education and subsequent reduced risk of dementia suggests that education in later life could enhance cognitive function and may reduce age-related cognitive decline and protect against dementia. Episodic memory, working memory, executive function, and language processing performances were assessed annually over 4 years in 359 healthy older adults who attended university for a minimum of 12 months (intervention) and were compared against 100 healthy adult controls. Multiple group latent growth curve modeling revealed a significant improvement in language processing capacity over time in the intervention group. No changes were detected for episodic memory, working memory, or executive function. These results suggest that complex mental stimulation resulting from late-life further education results in improved crystallized knowledge but no changes to fluid cognitive functions.

Wavelength dependent recovery of UV-mediated damage: Tying up the loose ends of optical based powdery mildew management.

PubMed

Suthaparan, Aruppillai; Pathak, Ranjana; Solhaug, Knut Asbjørn; Gislerød, Hans Ragnar

2018-01-01

Controlled environment chamber experiments at Petri dish level were conducted to examine the wavelength and dose dependent efficacy of ultraviolet (UV) radiation, the recovery action potential of optical radiation applied concomitantly/subsequently to effective UV treatment, and the lapse time between UV treatment and subsequent exposure to recovery wavelength on germination efficiency of Oidium neolycopersici conidia. Conidia of eight- to nine-day-old colonies were dusted on water agar surface in Petri dishes and exposed to UV treatments (without lid). Immediately after UV treatments, Petri dishes were sealed and incubated in darkness or differing optical environments generated using seven different radiation sources (range 290nm to 780nm). Twenty-four hours after UV treatment, fifty conidia from each sample were assessed for germination. Compared to non-UV controls, <10% of the conidia germinated after 30s of exposure to 254nm or 283nm UV and subsequent dark incubation. Conidia germination was almost negligible if the exposure duration increased to 4min. Germination was about 60% with broad spectrum UV after 1min of exposure, and about 35% after 2 to 4min of exposure. There was no reduction of conidia germination with the exposure of ≤4min with 310nm. With the tested wavelength and dose ranges, germination recovery was effective in the 350nm to 500nm range. Germination efficiency of conidia treated with effective UV was significantly higher (>73%) if incubated subsequently in the 350nm to 500nm range (germination recovery). Furthermore, germination recovery depends on the characteristics of UV treatment (wavelength, and duration of exposure) and the lapse time between UV treatment and subsequent exposure to optical radiation in the recovery range. The findings of this study provide key criteria for wavelength selection, combination and application time in the optical radiation range, enabling improved design of optical based management strategies against powdery mildews. Copyright © 2017 Elsevier B.V. All rights reserved.

Improving everyday memory performance after acquired brain injury: An RCT on recollection and working memory training.

PubMed

Richter, Kim Merle; Mödden, Claudia; Eling, Paul; Hildebrandt, Helmut

2018-04-26

To show the effectiveness of a combined recognition and working memory training on everyday memory performance in patients suffering from organic memory disorders. In this double-blind, randomized controlled Study 36 patients with organic memory impairments, mainly attributable to stroke, were assigned to either the experimental or the active control group. In the experimental group a working memory training was combined with a recollection training based on the repetition-lag procedure. Patients in the active control group received the memory therapy usually provided in the rehabilitation center. Both groups received nine hours of therapy. Prior (T0) and subsequent (T1) to the therapy, patients were evaluated on an everyday memory test (EMT) as well as on a neuropsychological test battery. Based on factor analysis of the neuropsychological test scores at T0 we calculated composite scores for working memory, verbal learning and word fluency. After treatment, the intervention group showed a significantly greater improvement for WM performance compared with the active control group. More importantly, performance on the EMT also improved significantly in patients receiving the recollection and working memory training compared with patients with standard memory training. Our results show that combining working memory and recollection training significantly improves performance on everyday memory tasks, demonstrating far transfer effects. The present study argues in favor of a process-based approach for treating memory impairments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Physician control of needle and syringe during aspiration-injection procedures with the new reciprocating syringe.

PubMed

Sibbitt, Wilmer; Sibbitt, Randy R; Michael, Adrian A; Fu, Druce I; Draeger, Hilda T; Twining, Jon M; Bankhurst, Arthur D

2006-04-01

To evaluate physician control of needle and syringe during aspiration-injection syringe procedures by comparing the new reciprocating procedure syringe to a traditional conventional syringe. Twenty-six physicians were tested for their individual ability to control the reciprocating and conventional syringes in typical aspiration-injection procedures using a novel quantitative needle-based displacement procedure model. Subsequently, the physicians performed 48 clinical aspiration-injection (arthrocentesis) procedures on 32 subjects randomized to the reciprocating or conventional syringes. Clinical outcomes included procedure time, patient pain, and operator satisfaction. Multivariate modeling methods were used to determine the experimental variables in the syringe control model most predictive of clinical outcome measures. In the model system, the reciprocating syringe significantly improved physician control of the syringe and needle, with a 66% reduction in unintended forward penetration (p < 0.001) and a 68% reduction in unintended retraction (p < 0.001). In clinical arthrocentesis, improvements were also noted: 30% reduction in procedure time (p < 0.03), 57% reduction in patient pain (p < 0.001), and a 79% increase in physician satisfaction (p < 0.001). The variables in the experimental system--unintended forward penetration, unintended retraction, and operator satisfaction--independently predicted the outcomes of procedure time, patient pain, and physician satisfaction in the clinical study (p < or = 0.001). The reciprocating syringe reduces procedure time and patient pain and improves operator satisfaction with the procedure syringe. The reciprocating syringe improves physician performance in both the validated quantitative needle-based displacement model and in real aspiration-injection syringe procedures, including arthrocentesis.

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

Education differentials by race and ethnicity in the diagnosis and management of hypercholesterolemia: a national sample of U.S. adults (NHANES 1999-2002).

PubMed

Merkin, Sharon Stein; Karlamangla, Arun; Crimmins, Eileen; Charette, Susan L; Hayward, Mark; Kim, Jung Ki; Koretz, Brandon; Seeman, Teresa

2009-01-01

To examine education differentials in screening, awareness, treatment and control of hypercholesterolemia overall and in 3 race/ethnic groups. We analyzed data for a nationally representative sample of 8,429 men and women ages 20 to 85 years, self-reported as white, black, Mexican American, or other race/ethnicity, who participated in the National Health and Nutrition Examination Survey from 1999-2002. Participants with < high school education were 2.5 times less likely than participants with > or = high school education to have been screened for hypercholesterolemia, after adjusting for age and gender (odds ratio: 0.4, 95 % confidence interval: 0.3-0.5, and similar across race/ethnic group). Multivariable models for awareness, treatment and control showed no significant trends associated with education after adjusting for age, gender, race and comorbidities. Higher education significantly increased the odds of being screened for hypercholesterolemia overall and within each race/ethnic group. Education differentials were strongest for hypercholesterolemia screening, and weak or no longer apparent for subsequent steps of awareness, treatment and control. Focusing public health policy on increasing screening for individuals with low education might greatly improve their chances of preventing or mitigating morbidity related to hypercholesterolemia and subsequent cardiovascular disease.

Debriefing decreases mental workload in surgical crisis: A randomized controlled trial.

PubMed

Boet, Sylvain; Sharma, Bharat; Pigford, Ashlee-Ann; Hladkowicz, Emily; Rittenhouse, Neil; Grantcharov, Teodor

2017-05-01

Mental workload is the amount of mental effort involved in performing a particular task. Crisis situations may increase mental workload, which can subsequently negatively impact operative performance and patient safety. This study aims to measure the impact of learning through debriefing and a systematic approach to crisis on trainees' mental workload in a simulated surgical crisis. Twenty junior surgical residents participated in a high-fidelity, simulated, postoperative crisis in a surgical ward environment (pretest). Participants were randomized to either an instructor-led debriefing, including performance feedback (intervention; n = 10) or no debriefing (control; n = 10). Subjects then immediately managed a second simulated crisis (post-test). Mental workload was assessed in real time during the scenarios using a previously validated, wireless, vibrotactile device. Mental workload was represented by subject response times to the vibrations, which were recorded and analyzed using the Mann-Whitney U test. Participants in the debriefing arm had a significantly reduced median response time in milliseconds (post-test minus pretest -695, quartile range -2,136 to -297) compared to participants in the control arm (42, -1,191 to 763), (between-arm difference P = .049). Debriefing after simulated surgical crisis situations may improve performance by decreasing trainee's mental workload during a subsequent simulated surgical crisis. Copyright © 2016 Elsevier Inc. All rights reserved.

Modification of hemiplegic compensatory gait pattern by symmetry-based motion controller of HAL.

PubMed

Kawamoto, Hiroaki; Kadone, Hideki; Sakurai, Takeru; Sankai, Yoshiyuki

2015-01-01

As one of several characteristics of hemiplegic patients after stroke, compensatory gait caused by affected limb is often seen. The purpose of this research is to apply a symmetry-based controller of a wearable type lower limb robot, Hybrid Assistive Limb (HAL) to hemiplegic patients with compensatory gait, and to investigate improvement of gait symmetry. The controller is designed respectively for swing phase and support phase according to characteristics of hemiplegic gait pattern. The controller during swing phase stores the motion of the unaffected limb and then provides motion support on the affected limb during the subsequent swing using the stored pattern to realize symmetric gait based on spontaneous limb swing. Moreover, the controller during support phase provides motion to extend hip and knee joints to support wearer's body. Clinical tests were conducted in order to assess the modification of gait symmetry. Our case study involved participation of one chronic stroke patient who performs abnormally-compensatory gait for both of the affected and unaffected limbs. As a result, the patient's gait symmetry was improved by providing motion support during the swing phase on the affected side and motion constraint during the support phase on the unaffected side. The study showed promising basis for the effectiveness of the controller for the future clinical study.

Safe household water treatment and storage using ceramic drip filters: a randomised controlled trial in Bolivia.

PubMed

Clasen, T; Brown, J; Suntura, O; Collin, S

2004-01-01

A randomised controlled field trial was conducted to evaluate the effectiveness of ceramic drip filters to improve the microbiological quality of drinking water in a low-income community in rural Bolivia. In four rounds of water sampling over five months, 100% of the samples were free of thermotolerant (faecal) coliforms (TTC) compared to an arithmetic mean TTC count of 1517, 406, 167 and 245 among control households which continued to use their customary sources of drinking water. The filter systems produced water that consistently met WHO drinking-water standards despite levels of turbidity that presented a challenge to other low-cost POU treatment methods. The filter systems also demonstrated an ability to maintain the high quality of the treated water against subsequent re-contamination in the home.

Effects of high-protein vs. high- fat snacks on appetite control, satiety, and eating initiation in healthy women.

PubMed

Ortinau, Laura C; Hoertel, Heather A; Douglas, Steve M; Leidy, Heather J

2014-09-29

The purpose of this study was to determine whether a high-protein afternoon yogurt snack improves appetite control, satiety, and reduces subsequent food intake compared to other commonly-consumed, energy dense, high-fat snacks. Twenty, healthy women (age: 27 ± 2 y; BMI: 23.4 ± 0.7 kg/m2) completed the randomized crossover design study which included 3, 8-h testing days comparing the following 160 kcal afternoon snacks: high-protein yogurt (14 g protein/25 g CHO/0 g fat); high-fat crackers (0 g protein/19 g CHO/9 g fat); and high-fat chocolate (2 g protein/19 g CHO/9 g fat). Participants were acclimated to each snack for 3 consecutive days. On day 4, the participants consumed a standardized breakfast and lunch; the respective snack was consumed 3-h post-lunch. Perceived hunger and fullness were assessed throughout the afternoon until dinner was voluntarily requested. An ad libitum dinner was then provided. The consumption of the yogurt snack led to greater reductions in afternoon hunger vs. chocolate (p < 0.01). No differences in afternoon fullness were detected. The yogurt snack also delayed eating initiation by approximately 30 min compared to the chocolate snack (p < 0.01) and approximately 20 min vs. crackers (p = 0.07). The yogurt snack led to approximately 100 fewer kcals consumed at dinner vs. the crackers (p = 0.08) and chocolate (p < 0.05). No other differences were detected. These data suggest that, when compared to high-fat snacks, eating less energy dense, high-protein snacks like yogurt improves appetite control, satiety, and reduces subsequent food intake in healthy women.

The Health Of Patients' Eyes (HOPE) Glaucoma study. The effectiveness of a 'glaucoma personal record' for newly diagnosed glaucoma patients: study protocol for a randomised controlled trial.

PubMed

Forbes, Marina; Fairlamb, Helen; Jonker, Leon

2015-08-07

Glaucoma involves progressive optic nerve fibre loss, subsequently leading to irreversible and disabling visual field defects. In Europe, the prevalence of glaucoma is approximately 2.2 % of all people aged over 40 years; this equates to 12 million people. Glaucoma patients require regular lifelong follow-up, contributing to a large financial and resource burden for the National Health Service (NHS) in the UK. This study aims to determine whether providing newly diagnosed glaucoma patients with a personalised client-held eye health summary ('glaucoma personal record'), improves patients' knowledge of their glaucoma condition. A potential long-term benefit could be improved self-management and henceforth a slower rate of deterioration. HOPE Glaucoma is a 3-year, prospective, parallel-group, pragmatic, single-centred, randomised controlled trial. An anticipated 122 adults, newly diagnosed with glaucoma (including ocular hypertension, suspected glaucoma and/or chronic open-angle glaucoma) will be recruited from a nurse-led ophthalmology outpatient clinic at a medium-sized NHS Trust. Participants will be randomly allocated to receive standard clinical care (control arm) or standard care plus a glaucoma personal record, detailing the current state of their condition (interventional arm). Participant assessments are designed to test whether provision of a glaucoma personal record 1) improves patient knowledge of glaucoma and 2) contributes to improvements in clinical outcomes, i.e. delay of visual field loss. The primary outcome measure is better client knowledge of glaucoma at the 9-12 month follow-up visit. Secondary outcome measures include the rate of visual field loss and patient-reported outcome measures on visual function (National Eye Institute VFQ - 25) measured at baseline, 9-12 months, 24 months and 36 months. Estimating a 20 % drop-out rate, the study will have 90 % power to detect a mean two-point difference in glaucoma knowledge score between groups at 5 % significance - based on two-sided Mann-Whitney U test. If a glaucoma personal record is found to significantly improve glaucoma patients' knowledge of their condition, this intervention could potentially provide a low-cost, straightforward tool to educate and engage glaucoma patients. Subsequently, this could have the potential to increase patient self-management and therefore allow glaucoma patients to prolong their sight functionality for longer. ISRCTN41306818 , registered on 22 August 2013.

Low-Cost Detection of Thin Film Stress during Fabrication

NASA Technical Reports Server (NTRS)

Nabors, Sammy A.

2015-01-01

NASA's Marshall Space Flight Center has developed a simple, cost-effective optical method for thin film stress measurements during growth and/or subsequent annealing processes. Stress arising in thin film fabrication presents production challenges for electronic devices, sensors, and optical coatings; it can lead to substrate distortion and deformation, impacting the performance of thin film products. NASA's technique measures in-situ stress using a simple, noncontact fiber optic probe in the thin film vacuum deposition chamber. This enables real-time monitoring of stress during the fabrication process and allows for efficient control of deposition process parameters. By modifying process parameters in real time during fabrication, thin film stress can be optimized or controlled, improving thin film product performance.

Positioning growth of NPB crystalline nanowires on the PTCDA nanocrystal template.

PubMed

Wang, Hong; Lin, Haiping; Fan, Xing; Ostendorp, Stefan; Wang, Yandong; Huang, Lizhen; Jiang, Lin; Li, Youyong; Wilde, Gerhard; Fuchs, Harald; Wang, Wenchong; Chi, Lifeng

2018-05-31

Non-planar organic molecules often form amorphous films via vapor phase deposition on surfaces. In this study, we demonstrate for the first time that direct crystalline growth of non-planar NPB is possible when the orientation of initially deposited molecules on a PTCDA nanocrystal template is controlled to make it analogous to the structure of the molecular crystal. The crystalline NPB nanowires can be further positioned by controlling the site-selective growth of PTCDA nanocrystal templates at pre-determined locations. Short channel bottom contact OFET array with the NPB nanowires directly grown on electrodes were subsequently fabricated. The hole mobility of NPB nanowires is improved by 40-fold in comparison to that of the amorphous films.

Improvement of maneuver aerodynamics by spanwise blowing

NASA Technical Reports Server (NTRS)

Erickson, G. E.; Campbell, J. F.

1977-01-01

Spanwise blowing was used to test a generalized wind-tunnel model to investigate component concepts in order to provide improved maneuver characteristics for advanced fighter aircraft. Primary emphasis was placed on performance, stability, and control at high angles of attack and subsonic speeds. Test data were obtained in the Langley high speed 7 by 10 foot tunnel at free stream Mach numbers up to 0.50 for a range of model angles of attack, jet momentum coefficients, and leading and trailing edge flap deflection angles. Spanwise blowing on a 44 deg swept trapezoidal wing resulted in leading edge vortex enhancement with subsequent large vortex induced lift increments and drag polar improvements at the higher angles of attack. Small deflections of a leading edge flap delayed these lift and drag benefits to higher angles of attack. In addition, blowing was more effective at higher Mach numbers. Spanwise blowing in conjunction with a deflected trailing edge flap resulted in lift and drag benefits that exceeded the summation of the effects of each high lift device acting alone. Asymmetric blowing was an effective lateral control device at the higher angles of attack.

Effect of electronically delivered prescriptions on compliance and pharmacy wait time among emergency department patients.

PubMed

Fernando, Tasha J; Nguyen, Duy D; Baraff, Larry J

2012-01-01

The primary objectives were to assess whether electronically delivered prescriptions lead to reduced pharmacy wait time, improved patient satisfaction, and improved compliance with prescriptions. Secondary objectives included determining other reasons for noncompliance and if there was an association between prescription noncompliance and subsequent physician and emergency department (ED) visits. In this prospective study, patients discharged from the Ronald Reagan UCLA Medical Center ED with prescriptions for nonnarcotic medications were randomized to a control group who were discharged with standard written prescriptions or an intervention group who had their prescriptions electronically delivered to the pharmacy of their choice. All study participants were contacted 7 to 31 days after ED discharge for a structured telephone interview. Of the 454 patients enrolled, follow-up was successful for 224 patients (52.4%). Twenty-eight patients did not fill their prescriptions (12.5% noncompliance rate). The top three reasons patients stated for not picking up their medications were perceiving their prescription as unnecessary (n = 11), medication affordability (n = 5), and lack of time (n = 4). There was no difference in primary prescription noncompliance between the two study groups (p = 0.58). However, electronically delivered prescriptions significantly reduced the median pharmacy wait time, from 15 to 0 minutes (p = 0.001), and improved patient satisfaction at the pharmacy (p = 0.034). Neither subsequent physician nor ED visits were increased by primary prescription noncompliance. Electronically delivered prescriptions significantly minimized pharmacy wait time and improved patient satisfaction at the pharmacy, but did not improve primary compliance with prescriptions. © 2011 by the Society for Academic Emergency Medicine.

Retrieval practice enhances the accessibility but not the quality of memory.

PubMed

Sutterer, David W; Awh, Edward

2016-06-01

Numerous studies have demonstrated that retrieval from long-term memory (LTM) can enhance subsequent memory performance, a phenomenon labeled the retrieval practice effect. However, the almost exclusive reliance on categorical stimuli in this literature leaves open a basic question about the nature of this improvement in memory performance. It has not yet been determined whether retrieval practice improves the probability of successful memory retrieval or the quality of the retrieved representation. To answer this question, we conducted three experiments using a mixture modeling approach (Zhang & Luck, 2008) that provides a measure of both the probability of recall and the quality of the recalled memories. Subjects attempted to memorize the color of 400 unique shapes. After every 10 images were presented, subjects either recalled the last 10 colors (the retrieval practice condition) by clicking on a color wheel with each shape as a retrieval cue or they participated in a control condition that involved no further presentations (Experiment 1) or restudy of the 10 shape/color associations (Experiments 2 and 3). Performance in a subsequent delayed recall test revealed a robust retrieval practice effect. Subjects recalled a significantly higher proportion of items that they had previously retrieved relative to items that were untested or that they had restudied. Interestingly, retrieval practice did not elicit any improvement in the precision of the retrieved memories. The same empirical pattern also was observed following delays of greater than 24 hours. Thus, retrieval practice increases the probability of successful memory retrieval but does not improve memory quality.

A Robust Inner and Outer Loop Control Method for Trajectory Tracking of a Quadrotor

PubMed Central

Xia, Dunzhu; Cheng, Limei; Yao, Yanhong

2017-01-01

In order to achieve the complicated trajectory tracking of quadrotor, a geometric inner and outer loop control scheme is presented. The outer loop generates the desired rotation matrix for the inner loop. To improve the response speed and robustness, a geometric SMC controller is designed for the inner loop. The outer loop is also designed via sliding mode control (SMC). By Lyapunov theory and cascade theory, the closed-loop system stability is guaranteed. Next, the tracking performance is validated by tracking three representative trajectories. Then, the robustness of the proposed control method is illustrated by trajectory tracking in presence of model uncertainty and disturbances. Subsequently, experiments are carried out to verify the method. In the experiment, ultra wideband (UWB) is used for indoor positioning. Extended Kalman Filter (EKF) is used for fusing inertial measurement unit (IMU) and UWB measurements. The experimental results show the feasibility of the designed controller in practice. The comparative experiments with PD and PD loop demonstrate the robustness of the proposed control method. PMID:28925984

The influence of focused-attention meditation states on the cognitive control of sequence learning.

PubMed

Chan, Russell W; Immink, Maarten A; Lushington, Kurt

2017-10-01

Cognitive control processes influence how motor sequence information is utilised and represented. Since cognitive control processes are shared amongst goal-oriented tasks, motor sequence learning and performance might be influenced by preceding cognitive tasks such as focused-attention meditation (FAM). Prior to a serial reaction time task (SRTT), participants completed either a single-session of FAM, a single-session of FAM followed by delay (FAM+) or no meditation (CONTROL). Relative to CONTROL, FAM benefitted performance in early, random-ordered blocks. However, across subsequent sequence learning blocks, FAM+ supported the highest levels of performance improvement resulting in superior performance at the end of the SRTT. Performance following FAM+ demonstrated greater reliance on embedded sequence structures than FAM. These findings illustrate that increased top-down control immediately after FAM biases the implementation of stimulus-based planning. Introduction of a delay following FAM relaxes top-down control allowing for implementation of response-based planning resulting in sequence learning benefits. Copyright © 2017 Elsevier Inc. All rights reserved.

Straight Talk About Birth Control: A Contraceptive Education Protocol for Home Care.

PubMed

Schoenberg, Leslie

Home healthcare providers play a critical role in the prevention of unintended pregnancies by providing evidence-based contraception education during home visits. This article describes an innovative and comprehensive contraception protocol that was developed for Nurse-Family Partnership to improve contraception education for home healthcare patients. The protocol focused on increasing uptake of long-acting reversible contraception (LARC) for high-risk prenatal and postpartum home healthcare patients. The protocol was designed to reduce early subsequent pregnancies and thereby improve outcomes for mothers and their infants. An evidence-based translation project was designed and piloted in three California counties. The protocol consisted of a contraception education module for nurses and a patient education toolkit. The toolkit included an interactive patient education workbook emphasizing LARC methods for nurses to complete with their patients along with other teaching tools. The project was evaluated using pre- and posttest surveys that measured changes in nurses' knowledge, attitudes, and practice before, after, and 2 months after implementation. Outcomes revealed the following statistically significant results: (a) nurses' knowledge doubled at the first posttest and persisted at 2 months, (b) nurses' attitudes improved on two of the three measures, and (c) there was a 17.7% increase in the frequency of LARC birth control education 2 months after implementation. An evidence-based contraception protocol can promote acceptance of LARC methods and improve home healthcare clinician comfort with and frequency of birth control education.

Improved leukemia-free survival after postconsolidation immunotherapy with histamine dihydrochloride and interleukin-2 in acute myeloid leukemia: results of a randomized phase 3 trial.

PubMed

Brune, Mats; Castaigne, Sylvie; Catalano, John; Gehlsen, Kurt; Ho, Anthony D; Hofmann, Wolf-Karsten; Hogge, Donna E; Nilsson, Bo; Or, Reuven; Romero, Ana I; Rowe, Jacob M; Simonsson, Bengt; Spearing, Ruth; Stadtmauer, Edward A; Szer, Jeff; Wallhult, Elisabeth; Hellstrand, Kristoffer

2006-07-01

The primary objective of this phase 3 study was to determine whether postconsolidation immunotherapy with interleukin-2 (IL-2) and histamine dihydrochloride (HDC) improved the leukemia-free survival (LFS) of adult patients with acute myeloid leukemia (AML) in complete remission (CR). Three hundred twenty patients with AML (median age, 57 years; range, 18-84 years) were stratified by CR1 or subsequent CR (CR > 1) and randomly assigned to treatment with HDC/IL-2 or no treatment (control). Treatment comprised 10 21-day cycles with IL-2 (16 400 U/kg) plus HDC (0.5 mg); both compounds were administered by subcutaneous injection twice daily. Study arms were balanced for age, sex, previous treatment, leukemic karyotypes, time from CR to inclusion, and frequency of secondary leukemia. Three years after enrollment of the last patient, treatment with HDC/IL-2 was found to improve LFS over control in the study population (CR1 + CR > 1, n = 320; P < .01, log-rank test). For patients in CR1 (n = 261), treatment significantly improved LFS (P = .01) with 3-year LFS estimates of 40% (HDC/IL-2) compared with 26% (control). Side effects were typically mild to moderate. These results indicate that HDC/IL-2 treatment offers an efficacious and tolerable treatment for patients with AML in remission.

Do pre-existing diabetes social support or depressive symptoms influence the effectiveness of a diabetes management intervention?

PubMed

Rosland, Ann-Marie; Kieffer, Edith; Spencer, Michael; Sinco, Brandy; Palmisano, Gloria; Valerio, Melissa; Nicklett, Emily; Heisler, Michele

2015-11-01

Examine influences of diabetes-specific social support (D-SS) and depressive symptoms on glycemic control over time, among adults randomized to a diabetes self-management education and support (DSME/S) intervention or usual care. Data were from 108 African-American and Latino participants in a 6-month intervention trial. Multivariable linear regression models assessed associations between baseline D-SS from family and friends and depressive symptoms with changes in HbA1c. We then examined whether baseline D-SS or depression moderated intervention-associated effects on HbA1c. Higher baseline D-SS was associated with larger improvements in HbA1c (adjusted ΔHbA1c -0.39% for each +1-point D-SS, p=0.02), independent of intervention-associated HbA1c decreases. Baseline depressive symptoms had no significant association with subsequent HbA1c change. Neither D-SS nor depression moderated intervention-associated effects on HbA1c. Diabetes self-management education and support programs have potential to improve glycemic control for participants starting with varying levels of social support and depressive symptoms. Participants starting with more support for diabetes management from family and friends improved HbA1c significantly more over 6 months than those with less support, independent of additional significant DSME/S intervention-associated HbA1c improvements. Social support from family and friends may improve glycemic control in ways additive to DSME/S. Published by Elsevier Ireland Ltd.

Hand hygiene and the use of personal protective equipment.

PubMed

Wyeth, Jenny

Infection prevention and control nurses (IPCNs) have an extremely wide remit in relation to the facilitation of appropriate infection prevention and control practice within healthcare environments. In order to be effective IPCNs need to be involved at all stages of healthcare service delivery and need to form close working relationships with staff at all levels and in all departments within their organisation. The provision of the necessary facilities within the clinical environment, along with the ongoing training and support of staff are essential prerequisites to changing the behaviour of staff in order to consistently deliver effective hand hygiene and other infection prevention and control practices. Auditing of practice and the investigation of incidents enable the identification of areas of practice requiring improvement, which subsequently informs the continual development of training programmes and initiatives with a view to improving patient and staff safety. IPCNs need to be able to react swiftly to the emergence of new infectious organisms and/or evidence to identify what is required in order to ensure that staff are compliant with anticipated practice to maintain the safety of the patients in their care, themselves and their colleagues.

Six-sigma application in tire-manufacturing company: a case study

NASA Astrophysics Data System (ADS)

Gupta, Vikash; Jain, Rahul; Meena, M. L.; Dangayach, G. S.

2017-09-01

Globalization, advancement of technologies, and increment in the demand of the customer change the way of doing business in the companies. To overcome these barriers, the six-sigma define-measure-analyze-improve-control (DMAIC) method is most popular and useful. This method helps to trim down the wastes and generating the potential ways of improvement in the process as well as service industries. In the current research, the DMAIC method was used for decreasing the process variations of bead splice causing wastage of material. This six-sigma DMAIC research was initiated by problem identification through voice of customer in the define step. The subsequent step constitutes of gathering the specification data of existing tire bead. This step was followed by the analysis and improvement steps, where the six-sigma quality tools such as cause-effect diagram, statistical process control, and substantial analysis of existing system were implemented for root cause identification and reduction in process variation. The process control charts were used for systematic observation and control the process. Utilizing DMAIC methodology, the standard deviation was decreased from 2.17 to 1.69. The process capability index (C p) value was enhanced from 1.65 to 2.95 and the process performance capability index (C pk) value was enhanced from 0.94 to 2.66. A DMAIC methodology was established that can play a key role for reducing defects in the tire-manufacturing process in India.

Camouflage for patients with vitiligo vulgaris improved their quality of life.

PubMed

Tanioka, Miki; Yamamoto, Yosuke; Kato, Mayumi; Miyachi, Yoshiki

2010-03-01

Cosmetic camouflage is important for patients with vitiligo vulgaris. However, few studies have investigated its benefit for vitiligo patients. To analyze the psychological effects on patients with vitiligo vulgaris by camouflage lessons performed in vitiligo clinics in Kyoto University Hospital and Fukui Red Cross Hospital, Dermatological Life Quality Index (DLQI) questionnaires were collected before and 1 month after camouflage lessons. Patients with vitiligo vulgaris, who visited our clinics in 2008 and had never experienced camouflage, were enrolled in this study. They took camouflage lessons and continued subsequent self-camouflage for 1 month. Control patients took no lessons and no camouflage. Camouflage improved the scores of DLQI when compared with those without camouflage (P = 0.005). Camouflage improved DLQI scores from 5.90 to 4.48. In DLQI subcategories, camouflage lessons improved a subcategory of "symptoms and feelings" (P = 0.0037). These data supported the idea that camouflage for patients with vitiligo not only covers the white patches but also improves their quality of life.

The effect of lithium chloride on one-trial passive avoidance learning in rats.

PubMed Central

Johnson, F N

1976-01-01

1 Expression of a one-trial passive avoidance learning response in rats was examined following injections of lithium chloride or sodium chloride before and after initial training and before the first day of testing. Five tests were given at daily intervals, 24 h after training being the time of the first test. 2. Lithium given before the first day of testing impaired response expression on the first and all subsequent days of testing; the rate of extinction was unaffected. 3. Given both before and immediately after initial training, lithium impaired response expression on the first day of testing but slowed down the subsequent rate of extinction, leading eventually to improved performance on the fifth day, as compared with placebo-treated control subjects. 4. The results are interpreted in the light of the hypothesis that lithium impaired the central processing of sensory information. PMID:1252666

Neuropsychological results after gamma knife radiosurgery for mesial temporal lobe epilepsy.

PubMed

Vojtěch, Zdeněk; Krámská, Lenka; Malíková, Hana; Stará, Michaela; Liščák, Roman

2015-01-01

The aim of this study is to summarize our experience with neuropsychological changes after radiosurgical treatment for mesial temporal lobe epilepsy and subsequent surgery due to insufficient seizure control. Between November 1995 and May 1999, 14 patients underwent radiosurgical entorhinoamygdalohippocampectomy with a marginal dose of 18, 20 or 25 Gy to the 50% isodose. 9 of these patients subsequently underwent surgery. We compared Memory Quotients and Intelligence Quotients before and after the interventions. We found a slight, but nonsignificant decline in intelligence and memory quotients one year after GKRS. Two years after radiosurgery there were no significant changes in any of the quotients. After surgery, we found significant increase in Global and Visual MQ, (p<0.05). There were no statistically significant changes in verbal memory and intelligence performance after surgery. Epilepsy surgery after unsuccessful radiosurgery could lead to improvements in cognitive functions in patients with mesial temporal lobe epilepsy.

Combinatorial Motor Training Results in Functional Reorganization of Remaining Motor Cortex after Controlled Cortical Impact in Rats

PubMed Central

Combs, Hannah L.; Jones, Theresa A.; Kozlowski, Dorothy A.

2016-01-01

Abstract Cortical reorganization subsequent to post-stroke motor rehabilitative training (RT) has been extensively examined in animal models and humans. However, similar studies focused on the effects of motor training after traumatic brain injury (TBI) are lacking. We previously reported that after a moderate/severe TBI in adult male rats, functional improvements in forelimb use were accomplished only with a combination of skilled forelimb reach training and aerobic exercise, with or without nonimpaired forelimb constraint. Thus, the current study was designed to examine the relationship between functional motor cortical map reorganization after experimental TBI and the behavioral improvements resulting from this combinatorial rehabilitative regime. Adult male rats were trained to proficiency on a skilled reaching task, received a unilateral controlled cortical impact (CCI) over the forelimb area of the caudal motor cortex (CMC). Three days post-CCI, animals began RT (n = 13) or no rehabilitative training (NoRT) control procedures (n = 13). The RT group participated in daily skilled reach training, voluntary aerobic exercise, and nonimpaired forelimb constraint. This RT regimen significantly improved impaired forelimb reaching success and normalized reaching strategies, consistent with previous findings. RT also enlarged the area of motor cortical wrist representation, derived by intracortical microstimulation, compared to NoRT. These findings indicate that sufficient RT can greatly improve motor function and improve the functional integrity of remaining motor cortex after a moderate/severe CCI. When compared with findings from stroke models, these findings also suggest that more intense RT may be needed to improve motor function and remodel the injured cortex after TBI. PMID:26421759

Combinatorial Motor Training Results in Functional Reorganization of Remaining Motor Cortex after Controlled Cortical Impact in Rats.

PubMed

Combs, Hannah L; Jones, Theresa A; Kozlowski, Dorothy A; Adkins, DeAnna L

2016-04-15

Cortical reorganization subsequent to post-stroke motor rehabilitative training (RT) has been extensively examined in animal models and humans. However, similar studies focused on the effects of motor training after traumatic brain injury (TBI) are lacking. We previously reported that after a moderate/severe TBI in adult male rats, functional improvements in forelimb use were accomplished only with a combination of skilled forelimb reach training and aerobic exercise, with or without nonimpaired forelimb constraint. Thus, the current study was designed to examine the relationship between functional motor cortical map reorganization after experimental TBI and the behavioral improvements resulting from this combinatorial rehabilitative regime. Adult male rats were trained to proficiency on a skilled reaching task, received a unilateral controlled cortical impact (CCI) over the forelimb area of the caudal motor cortex (CMC). Three days post-CCI, animals began RT (n = 13) or no rehabilitative training (NoRT) control procedures (n = 13). The RT group participated in daily skilled reach training, voluntary aerobic exercise, and nonimpaired forelimb constraint. This RT regimen significantly improved impaired forelimb reaching success and normalized reaching strategies, consistent with previous findings. RT also enlarged the area of motor cortical wrist representation, derived by intracortical microstimulation, compared to NoRT. These findings indicate that sufficient RT can greatly improve motor function and improve the functional integrity of remaining motor cortex after a moderate/severe CCI. When compared with findings from stroke models, these findings also suggest that more intense RT may be needed to improve motor function and remodel the injured cortex after TBI.

Rating of perceived exertion during cycling is associated with subsequent running economy in triathletes.

PubMed

Bonacci, Jason; Vleck, Veronica; Saunders, Philo U; Blanch, Peter; Vicenzino, Bill

2013-01-01

To determine which commonly measured variables of cycling intensity are related to subsequent running economy in triathletes. Cross-sectional laboratory study. Running economy was compared between a control run (no preceding cycle) and a run performed after a 45 min high-intensity cycle in eighteen triathletes. Power output, heart rate, rating of perceived exertion (RPE) and blood lactate concentration were monitored throughout the cycle. The relationship between measures of cycle intensity and the change in running economy was evaluated using Pearson's product moment correlation. Changes in running economy were also interpreted using the smallest worthwhile change (>2.4%) and grouped accordingly (i.e. impaired, no change, or improved running economy). Triathletes' RPE at the end of the cycling bout was significantly associated with the change in running economy after cycling (r=0.57, p=0.01). Average RPE of the cycle bout and RPE at the end of the cycling bout were significantly different between groups, with higher RPE scores being related to impairments in running economy (p=0.04 and p=0.02 respectively). RPE during cycling is associated with subsequent running economy in triathletes. RPE is a simple, cost-effective measure that triathletes and their coaches can use in competition and training to control cycling intensity without the need for specialist equipment such as crank systems or blood analysers. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A simple provider-based educational intervention to boost infant immunization rates: a controlled trial.

PubMed

Stille, C J; Christison-Lagay, J; Bernstein, B A; Dworkin, P H

2001-07-01

We sought to determine if a simple educational intervention initiated at the first well-child care visit, with reinforcement at subsequent visits, can improve inner-city infant immunization rates. We conducted a controlled trial involving 315 newborn infants and their primary caregivers in 3 inner-city primary care centers. Child health care providers gave caregivers in the intervention group an interactive graphic card with verbal reinforcement. At later visits, stickers were applied to the card when immunizations were given. Routine information was given to controls. After the trial, age-appropriate immunization rates at 7 months were 58% in each group. Intervention infants had 50% fewer missed opportunities to immunize (p=0.01) but cancelled 77% more appointments (p=0.04) than controls. We conclude that a brief educational intervention at the first well-child care visit did not boost 7-month immunization rates, although it was associated with fewer missed opportunities to immunize.

The associations among prior drinking consequences, subjective evaluations, and subsequent alcohol outcomes.

PubMed

Zaso, Michelle J; Park, Aesoon; Kim, Jueun; Gellis, Les A; Kwon, Hoin; Maisto, Stephen A

2016-05-01

Although the many positive and negative psychosocial consequences of alcohol use are well documented, evidence of the association between prior drinking consequences and subsequent alcohol-related outcomes is mixed. Social learning theory highlights that cognitive appraisals of prior drinking consequences play a crucial intermediate role in the relation of prior drinking consequences with subsequent alcohol-related outcomes. This prospective study was designed to test the mediating effects of subjective evaluations (i.e., perceived valence and controllability) in the association of prior drinking consequences with change in binge drinking and drinking consequences over time. Participants were 171 college students (69% female, 74% White, M age = 18.95 years, SD = 1.35) who completed 2 online surveys, with an average interval of 68 days (SD = 10.22) between assessments. Path analyses of the data did not support mediational effects of perceived valence or controllability of prior drinking consequences on subsequent alcohol-related outcomes. Specifically, greater frequency of negative consequences was associated with lower perceived valence and controllability, and greater frequency of positive consequences was associated with lower perceived controllability of the experienced consequences. However, perceptions of valence and controllability were not in turn associated with subsequent binge drinking and drinking consequences. Instead, greater frequency of positive consequences was directly associated with greater subsequent frequency of binge drinking. Findings highlight the importance of prior positive consequences in the escalation of binge drinking over a short period of time, although this relation may not be accounted for by perceptions of valence and controllability of the prior drinking consequences. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Improvements in closeness, communication, and psychological distress mediate effects of couple therapy for veterans.

PubMed

Doss, Brian D; Mitchell, Alexandra; Georgia, Emily J; Biesen, Judith N; Rowe, Lorelei Simpson

2015-04-01

Empirically based couple therapy results in significant improvements in relationship satisfaction for the average couple; however, further research is needed to identify mediators that lead to change and to ensure that improvements in mediators predict subsequent-not just concurrent-relationship satisfaction. In addition, given that much of the current literature on couple therapy examines outcomes in a research environment, it is important to examine mediators in a treatment-as-usual setting. To address these questions, 161 heterosexual couples (322 individuals) received treatment-as-usual couple therapy at one of two Veteran Administration Medical Centers (M = 5.0 and 13.0 sessions at the two sites) and were assessed before every session. The majority of couples were married (85%) and had been together for a median of 7.8 years (SD = 13). Participants were primarily White, non-Hispanic (69%), African American (21%), and White, Hispanic/Latino (8%). Individuals' own self-reported improvements in communication, emotional closeness, and psychological distress (but not frequency of behaviors targeted in treatment) mediated the effect of treatment on their subsequent relationship satisfaction. When all significant mediators were examined simultaneously, improvements in men's and women's emotional closeness and men's psychological distress independently mediated subsequent relationship satisfaction. In contrast, improvements in earlier relationship satisfaction mediated the effect of treatment only on subsequent psychological distress. This study identifies unique mediators of treatment effects and shows that gains in mechanisms predict subsequent relationship satisfaction. Future investigations should focus on the role of emotional closeness and psychological distress-constructs that have often been neglected-in couple therapy. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Improvement of anticipatory postural adjustments for balance control: effect of a single training session.

PubMed

Kanekar, Neeta; Aruin, Alexander S

2015-04-01

Humans use anticipatory and compensatory postural strategies to maintain and restore balance when perturbed. Inefficient generation and utilization of anticipatory postural adjustments (APAs) is one of the reasons for postural instability. The aim of the study was to investigate the role of training in improvement of APAs and its effect on subsequent control of posture. Thirteen healthy young adults were exposed to predictable external perturbations before and after a single training session consisting of catches of a medicine ball thrown at the shoulder level. 3-D body kinematics, EMG activity of thirteen trunk and lower limb muscles, and ground reaction forces were recorded before and immediately after a single training session. Muscle onsets, EMG integrals, center of pressure (COP), and center of mass (COM) displacements were analyzed during the anticipatory and compensatory phases of postural control. The effect of a single training session was seen as significantly early muscle onsets and larger anticipatory COP displacements. As a result, significantly smaller peak COM displacements were observed after the perturbation indicating greater postural stability. The outcome of this study provides a background for examining the role of training in improvement of APAs and its effect on postural stability in individuals in need. Copyright © 2014 Elsevier Ltd. All rights reserved.

Improving the diagnosis and treatment of osteoporosis using a senior-friendly peer-led community education and mentoring model: a randomized controlled trial

PubMed Central

Kloseck, Marita; Fitzsimmons, Deborah A; Speechley, Mark; Savundranayagam, Marie Y; Crilly, Richard G

2017-01-01

Background This randomized controlled trial (RCT) evaluated a 6-month peer-led community education and mentorship program to improve the diagnosis and management of osteoporosis. Methods Ten seniors (74–90 years of age) were trained to become peer educators and mentors and deliver the intervention. In the subsequent RCT, 105 seniors (mean age =80.5±6.9; 89% female) were randomly assigned to the peer-led education and mentorship program (n=53) or control group (n=52). Knowledge was assessed at baseline and 6 months. Success was defined as discussing osteoporosis risk with their family physician, obtaining a bone mineral density assessment, and returning to review their risk profile and receive advice and/or treatment. Results Knowledge of osteoporosis did not change significantly. There was no difference in knowledge change between the two groups (mean difference =1.3, 95% confidence interval [CI] of difference −0.76 to 3.36). More participants in the intervention group achieved a successful outcome (odds ratio 0.16, 95% CI 0.06–0.42, P<0.001). Conclusion Peer-led education and mentorship can promote positive health behavior in seniors. This model was effective for improving osteoporosis risk assessment, diagnosis, and treatment in a community setting. PMID:28553091

Improving the diagnosis and treatment of osteoporosis using a senior-friendly peer-led community education and mentoring model: a randomized controlled trial.

PubMed

Kloseck, Marita; Fitzsimmons, Deborah A; Speechley, Mark; Savundranayagam, Marie Y; Crilly, Richard G

2017-01-01

This randomized controlled trial (RCT) evaluated a 6-month peer-led community education and mentorship program to improve the diagnosis and management of osteoporosis. Ten seniors (74-90 years of age) were trained to become peer educators and mentors and deliver the intervention. In the subsequent RCT, 105 seniors (mean age =80.5±6.9; 89% female) were randomly assigned to the peer-led education and mentorship program (n=53) or control group (n=52). Knowledge was assessed at baseline and 6 months. Success was defined as discussing osteoporosis risk with their family physician, obtaining a bone mineral density assessment, and returning to review their risk profile and receive advice and/or treatment. Knowledge of osteoporosis did not change significantly. There was no difference in knowledge change between the two groups (mean difference =1.3, 95% confidence interval [CI] of difference -0.76 to 3.36). More participants in the intervention group achieved a successful outcome (odds ratio 0.16, 95% CI 0.06-0.42, P <0.001). Peer-led education and mentorship can promote positive health behavior in seniors. This model was effective for improving osteoporosis risk assessment, diagnosis, and treatment in a community setting.

On the impact of self-clearing on electroactive polymer (EAP) actuators

NASA Astrophysics Data System (ADS)

Ahmed, Saad; Ounaies, Zoubeida; Lanagan, Michael T.

2017-10-01

Electroactive polymer (EAP)-based actuators have large potential for a wide array of applications; however, their practical implementation is still a challenge because of the requirement of high driving voltage, which most often leads to premature defect-driven electrical breakdown. Polymer-based capacitors have the ability to clear defects with partial electrical breakdown and subsequent removal of a localized electrode section near the defect. In this study, this process, which is known as self-clearing, is adopted for EAP technologies. We report a methodical approach to self-clear an EAP, more specifically P(VDF-TrFE-CTFE) terpolymer, to delay premature defect-driven electrical breakdown of the terpolymer actuators at high operating electric fields. Breakdown results show that electrical breakdown strength is improved up to 18% in comparison to a control sample after self-clearing. Furthermore, the electromechanical performance in terms of blocked force and free displacement of P(VDF-TrFE-CTFE) terpolymer-based bending actuators are examined after self-clearing and precleared samples show improved blocked force, free displacement and maximum sustainable electric field compared to control samples. The study demonstrates that controlled self-clearing of EAPs improves the breakdown limit and reliability of the EAP actuators for practical applications without impeding their electromechanical performance.

Enhanced osseointegration of titanium implants in a rat model of osteoporosis using multilayer bone mesenchymal stem cell sheets

PubMed Central

Duan, Yan; Ma, Wei; Li, Dehua; Wang, Tongfei; Liu, Baolin

2017-01-01

The present study aimed to investigate whether bone marrow-derived mesenchymal stem cell (BMSC) sheets combined with titanium implants enhanced implant osseointegration in an ovariectomized (OVX) rat model of osteoporosis. Sprague-Dawley rats were randomly assigned into a test group and control group. Allogenic BMSCs were collected from the rats, cultured and stored via cryopreservation. At 6 months post-ovariectomy, establishment of the OVX model was confirmed by micro-computed tomography (CT) measurements. BMSC sheets were subsequently layered and wrapped over titanium implants for implantation. Unmodified implants served as the control. At 8 weeks post-implantation, samples were observed by micro-CT reconstruction and histomorphometric evaluation. Micro-CT reconstruction identified a marked improvement in the surrounding bone volume following treatment, with data analyses indicating a significant increase in bone volume in the BMSC-implant group compared with the control implant group (P<0.05). In addition, histological staining identified new bone formation and an increased rate of bone-implant contact surrounding the BMSC-implant constructs. These results indicate that the use of BMSC sheets as a novel tissue engineering approach improves the osseointegration of titanium implants in an osteoporosis model. This method may expand the operative indications in patients with osteoporosis and improve the success rate of clinical dental implant treatments. PMID:29250137

Neural mechanisms of attentional control in mindfulness meditation

PubMed Central

Malinowski, Peter

2013-01-01

The scientific interest in meditation and mindfulness practice has recently seen an unprecedented surge. After an initial phase of presenting beneficial effects of mindfulness practice in various domains, research is now seeking to unravel the underlying psychological and neurophysiological mechanisms. Advances in understanding these processes are required for improving and fine-tuning mindfulness-based interventions that target specific conditions such as eating disorders or attention deficit hyperactivity disorders. This review presents a theoretical framework that emphasizes the central role of attentional control mechanisms in the development of mindfulness skills. It discusses the phenomenological level of experience during meditation, the different attentional functions that are involved, and relates these to the brain networks that subserve these functions. On the basis of currently available empirical evidence specific processes as to how attention exerts its positive influence are considered and it is concluded that meditation practice appears to positively impact attentional functions by improving resource allocation processes. As a result, attentional resources are allocated more fully during early processing phases which subsequently enhance further processing. Neural changes resulting from a pure form of mindfulness practice that is central to most mindfulness programs are considered from the perspective that they constitute a useful reference point for future research. Furthermore, possible interrelations between the improvement of attentional control and emotion regulation skills are discussed. PMID:23382709

Neural mechanisms of attentional control in mindfulness meditation.

PubMed

Malinowski, Peter

2013-01-01

The scientific interest in meditation and mindfulness practice has recently seen an unprecedented surge. After an initial phase of presenting beneficial effects of mindfulness practice in various domains, research is now seeking to unravel the underlying psychological and neurophysiological mechanisms. Advances in understanding these processes are required for improving and fine-tuning mindfulness-based interventions that target specific conditions such as eating disorders or attention deficit hyperactivity disorders. This review presents a theoretical framework that emphasizes the central role of attentional control mechanisms in the development of mindfulness skills. It discusses the phenomenological level of experience during meditation, the different attentional functions that are involved, and relates these to the brain networks that subserve these functions. On the basis of currently available empirical evidence specific processes as to how attention exerts its positive influence are considered and it is concluded that meditation practice appears to positively impact attentional functions by improving resource allocation processes. As a result, attentional resources are allocated more fully during early processing phases which subsequently enhance further processing. Neural changes resulting from a pure form of mindfulness practice that is central to most mindfulness programs are considered from the perspective that they constitute a useful reference point for future research. Furthermore, possible interrelations between the improvement of attentional control and emotion regulation skills are discussed.

Improving patient satisfaction with pain management using Six Sigma tools.

PubMed

DuPree, Erin; Martin, Lisa; Anderson, Rebecca; Kathuria, Navneet; Reich, David; Porter, Carol; Chassin, Mark R

2009-07-01

Patient satisfaction as a direct and public measure of quality of care is changing the way hospitals address quality improvement. The feasibility of using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) methodology to improve patient satisfaction as it relates to pain management was evaluated. This project used the DMAIC methodology to improve patients' overall satisfaction with pain management on two inpatient units in an urban academic medical center. Pre- and postintervention patient surveys were conducted. The DMAIC methodology provided a data-driven structure to determine the optimal improvement strategies, as well as a long-term plan for maintaining any improvements. In addition, the Change Acceleration Process (CAP) was used throughout the project's various DMAIC stages to further the work of the team by creating a shared need to meet the objectives of the project. Overall satisfaction with pain management "excellent" ratings increased from 37% to 54%. Both units surpassed the goal of at least 50% of responses in the "excellent" category. Several key drivers of satisfaction with pain management were uncovered in the Analyze phase of the project, and each saw rating increases from the pre-intervention to postintervention surveys. Ongoing monitoring by the hospital inpatient satisfaction survey showed that the pain satisfaction score improved in subsequent quarters as compared with the pre-intervention period. The Six Sigma DMAIC methodology can be used successfully to improve patient satisfaction. The project led to measurable improvements in patient satisfaction with pain management, which have endured past the duration of the Six Sigma project. The Control phase of DMAIC allows the improvements to be incorporated into daily operations.

Effect of sericin supplementation in maturation medium on cumulus cell expansion, oocyte nuclear maturation, and subsequent embryo development in Sanjabi ewes during the breeding season.

PubMed

Aghaz, F; Hajarian, H; Shabankareh, H Karami; Abdolmohammadi, A

2015-12-01

The purpose of this study was to evaluate the effect of sericin with different concentrations (0% [control], 0.1%, 0.5%, 1.0%, and 2.5%) added to the IVM medium on cumulus cell expansion, oocyte nuclear maturation, and subsequent embryo development in Sanjabi ewes during the breeding season. The resumption of meiosis was assessed by the frequency of germinal vesicle breakdown and the first polar body extrusion. After IVF with fresh ram semen, presumptive zygotes were cultured 8 days in potassium simplex optimization medium supplemented by amino acids, and the percentages developing to the two-cell and blastocyst stages were measured as the indicators of early embryonic developmental competence. More cumulus-oocyte complexes matured with 0.5% sericin underwent germinal vesicle breakdown and reached metaphase II stage compared with the control cumulus-oocyte complexes matured without sericin (P ≤ 0.05). The present findings indicated that supplementation with 0.5% sericin during the maturation culture may improve the nuclear maturation and the cumulus cell expansion. Furthermore, the percentage of blastocysts obtained from 0.5% and 0.1% sericin (37.8 ± 1.76% and 34.8 ± 1.09%, respectively) was higher (P ≤ 0.05) than that of the control medium (29.60 ± 1.67%). However, addition of 1% and 2.5% of sericin to the IVM medium oocytes had a negative effect on nuclear maturation and cumulus cell expansion. Furthermore, the percentage of cleavage and blastocyst rate was significantly lower in the 1% and 2.5% sericin groups than in the control group. These findings showed that supplementation of IVM medium with 0.5% sericin may improve the meiotic competence of oocytes and early embryonic development in Sanjabi ewes during the breeding season. Copyright © 2015 Elsevier Inc. All rights reserved.

Enhanced control of electrochemical response in metallic materials in neural stimulation electrode applications

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

Watkins, K.G.; Steen, W.M.; Manna, I.

New means have been investigated for the production of electrode devices (stimulation electrodes) which could be implanted in the human body in order to control pain, activate paralysed limbs or provide electrode arrays for cochlear implants for the deaf or for the relief of tinitus. To achieve this ion implantation and laser materials processing techniques were employed. Ir was ion implanted in Ti-6Al-4V alloy and the surface subsequently enriched in the noble metal by dissolution in sulphuric acid. For laser materials processing techniques, investigation has been carried out on the laser cladding and laser alloying of Ir in Ti wire.more » A particular aim has been the determination of conditions required for the formation of a two phase Ir, Ir-rich, and Ti-rich microstructure which would enable subsequent removal of the non-noble phase to leave a highly porous noble metal with large real surface area and hence improved charge carrying capacity compared with conventional non porous electrodes. Evaluation of the materials produced has been carried out using repetitive cyclic voltammetry, amongst other techniques. For laser alloyed Ir on Ti wire, it has been found that differences in the melting point and density of the materials makes control of the cladding or alloying process difficult. Investigation of laser process parameters for the control of alloying and cladding in this system was carried out and a set of conditions for the successful production of two phase Ir-rich and Ti-rich components in a coating layer with strong metallurgical bonding to the Ti alloy substrate was derived. The laser processed material displays excellent potential for further development in providing stimulation electrodes with the current carrying capacity of Ir but in a form which is malleable and hence capable of formation into smaller electrodes with improved spatial resolution compared with presently employed electrodes.« less

Low-Cost Control System Built Upon Consumer-Based Electronics For Supervisory Control Of A Gas-Operated Heat Pump

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

Wetherington Jr, G Randall; Vineyard, Edward Allan; Mahderekal, Isaac

A preliminary evaluation of the performance of a consumer-based control system was conducted by the Oak Ridge National Laboratory (ORNL) and Southwest Gas as part of a cooperative research and development agreement (CRADA) authorized by the Department of Energy (DOE) (Mahderekal et al. (2013). The goal of the research was to evaluate the low-cost approach as a solution for implementing a supervisory control system for a residential gas-operated heat pump. The design incorporated two consumer-based micro-controllers; the Arduino Mega-2650 and the BeagleBone (white). Ten five-ton heat pump systems were designed, fabricated, and operationally tested in the Las Vega NV region.more » A robust data set was produced that allowed detailed assessment of the reliability and the operational perfromance of the newly developed control system. Experiences gained from the test provided important points of improvement for subsequent evolution of the heat pump technology.« less

Process yield improvements with process control terminal for varian serial ion implanters

NASA Astrophysics Data System (ADS)

Higashi, Harry; Soni, Ameeta; Martinez, Larry; Week, Ken

Implant processes in a modern wafer production fab are extremely complex. There can be several types of misprocessing, i.e. wrong dose or species, double implants and missed implants. Process Control Terminals (PCT) for Varian 350Ds installed at Intel fabs were found to substantially reduce the number of misprocessing steps. This paper describes those misprocessing steps and their subsequent reduction with use of PCTs. Reliable and simple process control with serial process ion implanters has been in increasing demand. A well designed process control terminal greatly increases device yield by monitoring all pertinent implanter functions and enabling process engineering personnel to set up process recipes for simple and accurate system operation. By programming user-selectable interlocks, implant errors are reduced and those that occur are logged for further analysis and prevention. A process control terminal should also be compatible with office personal computers for greater flexibility in system use and data analysis. The impact from the capability of a process control terminal is increased productivity, ergo higher device yield.

Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study.

PubMed

Tuakli-Wosornu, Yetsa A; Terry, Alon; Boachie-Adjei, Kwadwo; Harrison, Julian R; Gribbin, Caitlin K; LaSalle, Elizabeth E; Nguyen, Joseph T; Solomon, Jennifer L; Lutz, Gregory E

2016-01-01

To determine whether single injections of autologous platelet-rich plasma (PRP) into symptomatic degenerative intervertebral disks will improve participant-reported pain and function. Prospective, double-blind, randomized controlled study. Outpatient physiatric spine practice. Adults with chronic (≥6 months), moderate-to-severe lumbar diskogenic pain that was unresponsive to conservative treatment. Participants were randomized to receive intradiskal PRP or contrast agent after provocative diskography. Data on pain, physical function, and participant satisfaction were collected at 1 week, 4 weeks, 8 weeks, 6 months, and 1 year. Participants in the control group who did not improve at 8 weeks were offered the option to receive PRP and subsequently followed. Functional Rating Index (FRI), Numeric Rating Scale (NRS) for pain, the pain and physical function domains of the 36-item Short Form Health Survey, and the modified North American Spine Society (NASS) Outcome Questionnaire were used. Forty-seven participants (29 in the treatment group, 18 in the control group) were analyzed by an independent observer with a 92% follow-up rate. Over 8 weeks of follow-up, there were statistically significant improvements in participants who received intradiskal PRP with regards to pain (NRS Best Pain) (P = .02), function (FRI) (P = .03), and patient satisfaction (NASS Outcome Questionnaire) (P = .01) compared with controls. No adverse events of disk space infection, neurologic injury, or progressive herniation were reported following the injection of PRP. Participants who received intradiskal PRP showed significant improvements in FRI, NRS Best Pain, and NASS patient satisfaction scores over 8 weeks compared with controls. Those who received PRP maintained significant improvements in FRI scores through at least 1 year of follow-up. Although these results are promising, further studies are needed to define the subset of participants most likely to respond to biologic intradiskal treatment and the ideal cellular characteristics of the intradiskal PRP injectate. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Ultrasonic control of ceramic membrane fouling by particles: effect of ultrasonic factors.

PubMed

Chen, Dong; Weavers, Linda K; Walker, Harold W

2006-07-01

Ultrasound at 20 kHz was applied to a cross-flow ultrafiltration system with gamma-alumina membranes in the presence of colloidal silica particles to systematically investigate how ultrasonic factors affect membrane cleaning. Based on imaging of the ultrasonic cavitation region, optimal cleaning occurred when the membrane was outside but close to the cavitation region. Increasing the filtration pressure increased the compressive forces driving cavitation collapse and resulted in fewer cavitation bubbles absorbing and scattering sound waves and increasing sound wave penetration. However, an increased filtration pressure also resulted in greater permeation drag, and subsequently less improvement in permeate flux compared to low filtration pressure. Finally, pulsed ultrasound with short pulse intervals resulted in permeate flux improvement close to that of continuous sonication.

Development of Microalloyed Steels for The Oil and Gas Industry

NASA Astrophysics Data System (ADS)

Henein, H.; Ivey, D. G.; Luo, J.; Wiskel, J. B.

Microalloying, in combination with thermomechanical controlled processing (TMCP), is a cost effective method of producing steels for a wide range of applications where improved mechanical properties, namel y strength, formability and toughness coupled with weldability, are required. This paper reviews the efforts undertaken at the University of Alberta aimed at improving the above mentioned mechanical properties in microalloyed steels used in the transmission of oil and gas (i.e., pipelines). Topics that will be reviewed include the characterization of precipitates, the effect of processing conditions on precipitate evolution, and the effect of pipe forming and subsequent low temperature heat treatment on tensile behaviour and the use of Genetic Algorithm optimization of the laminar cooling system to produce a uniform through thickness microstructure.

16 CFR 801.20 - Acquisitions subsequent to exceeding threshold.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Acquisitions subsequent to exceeding threshold. 801.20 Section 801.20 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.20 Acquisitions subsequent to exceeding...

16 CFR 801.20 - Acquisitions subsequent to exceeding threshold.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Acquisitions subsequent to exceeding threshold. 801.20 Section 801.20 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.20 Acquisitions subsequent to exceeding...

Evaluating the impact of a disease management program for chronic complex conditions at two large northeast health plans using a control group methodology.

PubMed

Schwerner, Henry; Mellody, Timothy; Goldstein, Allan B; Wansink, Daryl; Sullivan, Virginia; Yelenik, Stephan N; Charlton, Warwick; Lloyd, Kelley; Courtemanche, Ted

2006-02-01

The objective of this study was to observe trends in payer expenditures for plan members with one of 14 chronic, complex conditions comparing one group with a disease management program specific to their condition (the intervention group) and the other with no specific disease management program (the control group) for these conditions. The authors used payer claims and membership data to identify members eligible for the program in a 12-month baseline year (October 2001 to September 2002) and a subsequent 12-month program year (October 2002 to September 2003). Two payers were analyzed: one health plan with members primarily in New Jersey (AmeriHealth New Jersey [AHNJ]), where the disease management program was offered, and one affiliated large plan with members primarily in the metro Philadelphia area, where the program was not offered. The claims payment policy for both plans is identical. Intervention and control groups were analyzed for equivalence. The analysis was conducted in both groups over identical time periods. The intervention group showed statistically significant (p < 0.01) differences in total paid claims trend and expenditures when compared to the control group. Intervention group members showed a reduction in expenditures of -8%, while control group members showed an increase of +10% over identical time periods. Subsequent analyses controlling for outliers and product lines served to confirm the overall results. The disease management program is likely responsible for the observed difference between the intervention and control group results. A well-designed, targeted disease management program offered by a motivated, supportive health plan can play an important role in cost improvement strategies for members with complex, chronic conditions.

Stressors, locus of control, and social support as consequences of affective psychological well-being.

PubMed

Daniels, K; Guppy, A

1997-04-01

Tests of the influence of affective psychological well-being on stressors, locus of control, and social support in a 1-month follow-up study of 210 male and 34 female British accountants is reported. There was a marginally significant association between the level of psychological symptoms and subsequent reports of intensity of quantitative workload stressors. A significant interaction between psychological symptoms and a measure of depression-enthusiasm was found to predict subsequent locus of control. The results indicate a differential pattern of associations between aspects of affective well-being and subsequent reports of social support. The results also indicate that initially more frequent stressors are associated with subsequently less intense stressors of the same type. The findings highlight the dynamic and reciprocal nature of the occupational stress process.

Error-enhancing robot therapy to induce motor control improvement in childhood onset primary dystonia.

PubMed

Casellato, Claudia; Pedrocchi, Alessandra; Zorzi, Giovanna; Rizzi, Giorgio; Ferrigno, Giancarlo; Nardocci, Nardo

2012-07-23

Robot-generated deviating forces during multijoint reaching movements have been applied to investigate motor control and to tune neuromotor adaptation. Can the application of force to limbs improve motor learning? In this framework, the response to altered dynamic environments of children affected by primary dystonia has never been studied. As preliminary pilot study, eleven children with primary dystonia and eleven age-matched healthy control subjects were asked to perform upper limb movements, triangle-reaching (three directions) and circle-writing, using a haptic robot interacting with ad-hoc developed task-specific visual interfaces. Three dynamic conditions were provided, null additive external force (A), constant disturbing force (B) and deactivation of the additive external force again (C). The path length for each trial was computed, from the recorded position data and interaction events. The results show that the disturbing force affects significantly the movement outcomes in healthy but not in dystonic subjects, already compromised in the reference condition: the external alteration uncalibrates the healthy sensorimotor system, while the dystonic one is already strongly uncalibrated. The lack of systematic compensation for perturbation effects during B condition is reflected into the absence of after-effects in C condition, which would be the evidence that CNS generates a prediction of the perturbing forces using an internal model of the environment.The most promising finding is that in dystonic population the altered dynamic exposure seems to induce a subsequent improvement, i.e. a beneficial after-effect in terms of optimal path control, compared with the correspondent reference movement outcome. The short-time error-enhancing training in dystonia could represent an effective approach for motor performance improvement, since the exposure to controlled dynamic alterations induces a refining of the existing but strongly imprecise motor scheme and sensorimotor patterns.

A combined teamwork training and work standardisation intervention in operating theatres: controlled interrupted time series study.

PubMed

Morgan, Lauren; Pickering, Sharon P; Hadi, Mohammed; Robertson, Eleanor; New, Steve; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

2015-02-01

Teamwork training and system standardisation have both been proposed to reduce error and harm in surgery. Since the approaches differ markedly, there is potential for synergy between them. Controlled interrupted time series with a 3 month intervention and observation phases before and after. Operating theatres conducting elective orthopaedic surgery in a single hospital system (UK Hospital Trust). Teamwork training based on crew resource management plus training and follow-up support in developing standardised operating procedures. Focus of subsequent standardisation efforts decided by theatre staff. Paired observers watched whole procedures together. We assessed non-technical skills using NOTECHS II, technical performance using glitch rate and compliance with WHO checklist using a simple quality tool. We measured complication and readmission rates and hospital stay using hospital administrative records. Before/after change was compared in the active and control groups using two-way ANOVA and regression models. 1121 patients were operated on before and 1100 after intervention. 44 operations were observed before and 50 afterwards. Non-technical skills (p=0.002) and WHO compliance (p<0.001) improved significantly after the intervention in the active versus the control group. Glitch count improved in both groups and there was no significant effect on clinical outcomes. Combined training in teamwork and system improvement causes marked improvements in team behaviour and WHO performance, but not technical performance or outcome. These findings are consistent with the synergistic hypothesis, but larger controlled studies with a strong implementation strategy are required to test potential outcome effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Error-enhancing robot therapy to induce motor control improvement in childhood onset primary dystonia

PubMed Central

2012-01-01

Background Robot-generated deviating forces during multijoint reaching movements have been applied to investigate motor control and to tune neuromotor adaptation. Can the application of force to limbs improve motor learning? In this framework, the response to altered dynamic environments of children affected by primary dystonia has never been studied. Methods As preliminary pilot study, eleven children with primary dystonia and eleven age-matched healthy control subjects were asked to perform upper limb movements, triangle-reaching (three directions) and circle-writing, using a haptic robot interacting with ad-hoc developed task-specific visual interfaces. Three dynamic conditions were provided, null additive external force (A), constant disturbing force (B) and deactivation of the additive external force again (C). The path length for each trial was computed, from the recorded position data and interaction events. Results The results show that the disturbing force affects significantly the movement outcomes in healthy but not in dystonic subjects, already compromised in the reference condition: the external alteration uncalibrates the healthy sensorimotor system, while the dystonic one is already strongly uncalibrated. The lack of systematic compensation for perturbation effects during B condition is reflected into the absence of after-effects in C condition, which would be the evidence that CNS generates a prediction of the perturbing forces using an internal model of the environment. The most promising finding is that in dystonic population the altered dynamic exposure seems to induce a subsequent improvement, i.e. a beneficial after-effect in terms of optimal path control, compared with the correspondent reference movement outcome. Conclusions The short-time error-enhancing training in dystonia could represent an effective approach for motor performance improvement, since the exposure to controlled dynamic alterations induces a refining of the existing but strongly imprecise motor scheme and sensorimotor patterns. PMID:22824547

Effect of a brief training program based on cognitive behavioral therapy in improving work performance: A randomized controlled trial.

PubMed

Kimura, Risa; Mori, Makiko; Tajima, Miyuki; Somemura, Hironori; Sasaki, Norio; Yamamoto, Megumi; Nakamura, Saki; Okanoya, June; Ito, Yukio; Otsubo, Tempei; Tanaka, Katsutoshi

2015-01-01

Efforts to improve performance in the workplace with respect to positive mental health have increased, and cognitive behavioral therapy (CBT) has recently attracted attention as an intervention measure to this end. Here, we conducted a randomized controlled trial to evaluate the effectiveness of a brief training program on CBT for improving work performance of employees. The participants were employees of an electric company in Japan. The intervention consisted of 1 group session of CBT (120 min) and web-based CBT homework for 1 month. We evaluated employees in both the intervention and control groups at baseline and follow-up after three months. The main outcome was work performance, which was evaluated by a subjective score from 1 to 10. The secondary outcome was self-evaluation of cognitive flexibility. Analyses were conducted based on ITT. In the intervention group, 84 participants attended the group session, with 79 subsequently completing at least 1 instance of online homework. ITT analysis showed that the subjective performance of the intervention group was significantly improved compared with that of the control group (1.47 vs. 0.69, mean difference 0.78 [95% confidence interval {CI}, 0.05 to 1.51], Cohen's d=0.31). The ability to recognize dysfunctional thinking patterns and change them to positive ones significantly improved in the intervention group compared to the control group (0.71 vs. 0.26, mean difference 0.45 [95% CI 0.06 to 0.83], d=0.33). However, after adjustment for baseline scores, no significant difference was observed. The ability to view a situation from multiple perspectives and expand one's repertoire of thought patterns in the intervention group also significantly improved (0.83 vs. 0.35, mean difference 0.48 [95% CI 0.35 to 0.95], d=0.29), but here again, significance was lost after adjusting for baseline scores. Our results suggest that a brief training program that combines a group CBT session with web-based CBT homework improved subjective work performance. In addition, this program might help improve employees' cognitive flexibility.

Improving Sleep for Hospitalized Antepartum Patients: A Non-Randomized Controlled Pilot Study.

PubMed

Lee, Kathryn A; Gay, Caryl L

2017-12-15

To evaluate feasibility and efficacy of a hospital-based protocol for improving sleep in high- risk antepartum patients. Sleep measures were compared during 1 week of hospitalization before and after implementing a Sleep Improvement Protocol for Antepartum Patients (SIP-AP). A non-randomized convenience sample of usual care controls was compared to a subsequent intervention sample after the protocol was implemented. Women were eligible if they spoke English, were medically stable, pregnant for at least 20 weeks, and hospitalized at least 24 hours; 25 pregnant women had sufficient data for analyses (11 controls, 14 intervention). Sleep was assessed in 3 ways: the Pittsburgh Sleep Quality Index was completed after obtaining consent to estimate sleep quality prior to hospital admission; sleep diary completed each hospital day; and General Sleep Disturbance Scale completed at 7 days or prior to hospital discharge. Symptoms that could affect sleep were assessed with the Memorial Symptom Assessment Scale. Both groups recorded similar sleep duration (7 hours) but the intervention group had fewer symptoms and significantly ( P = .015) lower sleep disturbance scores (53.1 ± 14.5) than controls (71.9 ± 18.8). Participant feedback about the intervention was positive, although adherence to components of the intervention protocol was variable. This pilot study provides evidence of the feasibility and preliminary efficacy of the SIP-AP intervention for reducing symptoms and improving sleep of antepartum patients during hospitalization. Further detailed evaluation of specific components of this protocol is warranted, and other types of hospitalized patients may benefit from unit-based modifications to this SIP-AP protocol. © 2017 American Academy of Sleep Medicine

[The 2011 HUS epidemic in Germany. Challenges for disease control: what should be improved?].

PubMed

Krause, G; Frank, C; Gilsdorf, A; Mielke, M; Schaade, L; Stark, K; Burger, R

2013-01-01

From May to July 2011 [corrected] the world's largest outbreak of hemolytic uremic syndrome (HUS) occurred in northern Germany with dramatic consequences for the population, the health care system and the food industry. In the following we examine the detection of the outbreak, epidemic management and related public communication aspects based on scientific publications, media reports as well as own and new data analyses. The subsequent 17 recommendations concern issues such as participation in and implementation of existing and new surveillance systems particularly with respect to physicians, broad application of finely tuned microbiological typing, improved personnel capacity and crisis management structures within the public health service and evidence-based communication by administrations and scientific associations. Outbreaks of similar dimensions can inevitably occur again and result in costs which will far exceed investments needed for early detection and control. This societal balance should be taken into account in spite of limited resources in the public health sector.

Enhancing Risk Detection Among Homeless Youth: A Randomized Clinical Trial of a Promising Pilot Intervention.

PubMed

Bender, Kimberly A; DePrince, Anne; Begun, Stephanie; Hathaway, Jessica; Haffejee, Badiah; Schau, Nicholas

2016-03-02

Homeless youth frequently experience victimization, and youth with histories of trauma often fail to detect danger risks, making them vulnerable to subsequent victimization. The current study describes a pilot test of a skills-based intervention designed to improve risk detection among homeless youth through focusing attention to internal, interpersonal, and environmental cues. Youth aged 18 to 21 years (N = 74) were recruited from a shelter and randomly assigned to receive usual case management services or usual services plus a 3-day manualized risk detection intervention. Pretest and posttest interviews assessed youths' risk detection abilities through vignettes describing risky situations and asking youth to identify risk cues present. Separate 2 (intervention vs. control) × 2 (pretest vs. posttest) mixed ANOVAs found significant interaction effects, as intervention youth significantly improved in overall risk detection compared with control youth. Post hoc subgroup analyses found the intervention had a greater effect for youth without previous experiences of indirect victimization than those with previous indirect victimization experiences. © The Author(s) 2016.

Development of Thin-Walled Magnesium Alloy Extrusions for Improved Crash Performance Based Upon Texture Control

NASA Astrophysics Data System (ADS)

Williams, Bruce W.; Agnew, Sean R.; Klein, Robert W.; McKinley, Jonathan

Recent investigations suggest that it is possible to achieve dramatic modifications to both strength and ductility of magnesium alloys through a combination of alloying, grain refinement, and texture control. The current work explores the possibility of altering the texture in extruded thin-walled magnesium alloy tubes for improved ductility during axial crush in which energy is absorbed through progressive buckling. The texture evolution was predicted using the viscoplastic self-consistent (VPSC) crystal plasticity model, with strain path input from continuum-based finite element simulations of extrusion. A limited diversity of textures can be induced by altering the strain path through the extrusion die design. In some cases, such as for simple bar extrusion, the textures predicted can be connected with simple shape change. In other cases, a subtle influence of strain path involving shear-reverse-shear is predicted. The most promising textures predicted for a variety of strain paths are selected for subsequent experimental study.

Hypothesis: proposals for the management of a neonate at risk of hyperammonaemia due to a urea cycle disorder.

PubMed

Leonard, James Vivian; Ward Platt, Martin Peter; Morris, Andrew Alan Myles

2008-03-01

It is difficult to prevent hyperammonaemia in patients with urea cycle disorders that present in the newborn period. This is true, even if treatment is started prospectively because of an affected relative. We propose several additional measures that could be used in conjunction with conventional therapy to improve the metabolic control. Catabolism could be reduced by delivering the babies by elective caesarean section, by starting intravenous glucose immediately after delivery and, possibly, by using beta-blockers or octreotide and insulin. The effectiveness of sodium benzoate and sodium phenylbutyrate might be increased by giving phenobarbital to the mother before delivery and subsequently to the baby to induce the enzymes for conjugation. We would expect the proposed measures to reduce the risk of hyperammonaemia and to improve the outcome for these patients. They have not, however, previously been used in this context, so families would need to be counselled carefully and controlled studies should be undertaken.

Evolution of Stored-Product Entomology: Protecting the World Food Supply.

PubMed

Hagstrum, David W; Phillips, Thomas W

2017-01-31

Traditional methods of stored-product pest control were initially passed from generation to generation. Ancient literature and archaeology reveal hermetic sealing, burning sulfur, desiccant dusts, and toxic botanicals as early control methods. Whereas traditional nonchemical methods were subsequently replaced by synthetic chemicals, other traditional methods were improved and integrated with key modern pesticides. Modern stored-product integrated pest management (IPM) makes decisions using knowledge of population dynamics and threshold insect densities. IPM programs are now being fine-tuned to meet regulatory and market standards. Better sampling methods and insights from life histories and ecological studies have been used to optimize the timing of pest management. Over the past 100 years, research on stored-product insects has shifted from being largely concentrated within 10 countries to being distributed across 65 countries. Although the components of IPM programs have been well researched, more research is needed on how these components can be combined to improve effectiveness and assure the security of postharvest food as the human population increases.

Total hip arthroplasty of dysplastic hip after previous Chiari pelvic osteotomy.

PubMed

Minoda, Yukihide; Kadowaki, Toru; Kim, Mitsunari

2006-08-01

Many reports have suggested that Chiari pelvic osteotomy would improve the results of acetabular component placement and fixation in subsequent total hip arthroplasty. However, little is known concerning the biomechanical, radiological, and clinical effects of Chiari pelvic osteotomy on subsequent total hip arthroplasty. Ten total hip arthroplasties for developmental dysplasia of the hip after previous Chiari pelvic osteotomy (Chiari group) were compared with 20 total hip arthroplasties for developmental dysplasia of the hip without previous surgery (control group). Preoperative patient demographic data and operative technique were well matched between the groups. The mean duration of follow-up was 3.0 years. Biomechanical, radiological, and clinical evaluations were performed. No acetabular or femoral components exhibited loosening. All patients had good or excellent clinical score according to the Merle d'Aubigne-Postel rating system at the most recent follow-up. Abductor force and joint force were smaller in the Chiari group, although long operative time, more blood loss, and verticalization of joint force were noted in this group. This limited study suggested that Chiari pelvic osteotomy changed the biomechanical features of the hip joint, and that this alteration might have compromised subsequent total hip arthroplasty.

Achieving and maintaining asthma control in an urban pediatric disease management program: the Breathmobile Program.

PubMed

Jones, Craig A; Clement, Loran T; Morphew, Tricia; Kwong, Kenny Yat Choi; Hanley-Lopez, Jean; Lifson, Francene; Opas, Lawrence; Guterman, Jeffrey J

2007-06-01

National guidelines suggest that, with appropriate care, most patients can control their asthma. The probabilities of children achieving and maintaining control with ongoing care are unknown. We sought to evaluate the degree to which children in a lower socioeconomic urban setting achieve and maintain control of asthma with regular participation in a disease management program that provides guideline-based care. Interdisciplinary teams of asthma specialists use mobile clinics to offer ongoing care at schools and county clinics. A guideline-derived construct of asthma control is recorded at each visit. Two thousand one hundred eighty-five enrollees were eligible to evaluate the time to first achieve control, and 1591 patients were eligible to evaluate subsequent control maintenance. Depending on severity, 70% to 87% of patients with persistent asthma achieved control by visit 3, and 89% to 98% achieved control by visit 6. Subsequent control maintenance was highly variable. Thirty-nine percent of patients displayed well-controlled asthma (control at >90% of subsequent visits), whereas 13% displayed difficult-to-control asthma (<50% of subsequent visits). Patients from each baseline severity category were found in each group. Maintenance of control was influenced by physician-estimated compliance with the treatment plan, baseline severity, and the interval between clinic visits. Many children can achieve asthma control with regular visit intervals and guideline-based care; however, long-term control can be highly variable among patients in all severity categories. These findings highlight the need and feasibility for systematically tracking each patient's clinical response to individualize therapy and guide the use of population management strategies.

Evolving Improvements to TRMM Ground Validation Rainfall Estimates

NASA Technical Reports Server (NTRS)

Robinson, M.; Kulie, M. S.; Marks, D. A.; Wolff, D. B.; Ferrier, B. S.; Amitai, E.; Silberstein, D. S.; Fisher, B. L.; Wang, J.; Einaudi, Franco (Technical Monitor)

2000-01-01

The primary function of the TRMM Ground Validation (GV) Program is to create GV rainfall products that provide basic validation of satellite-derived precipitation measurements for select primary sites. Since the successful 1997 launch of the TRMM satellite, GV rainfall estimates have demonstrated systematic improvements directly related to improved radar and rain gauge data, modified science techniques, and software revisions. Improved rainfall estimates have resulted in higher quality GV rainfall products and subsequently, much improved evaluation products for the satellite-based precipitation estimates from TRMM. This presentation will demonstrate how TRMM GV rainfall products created in a semi-automated, operational environment have evolved and improved through successive generations. Monthly rainfall maps and rainfall accumulation statistics for each primary site will be presented for each stage of GV product development. Contributions from individual product modifications involving radar reflectivity (Ze)-rain rate (R) relationship refinements, improvements in rain gauge bulk-adjustment and data quality control processes, and improved radar and gauge data will be discussed. Finally, it will be demonstrated that as GV rainfall products have improved, rainfall estimation comparisons between GV and satellite have converged, lending confidence to the satellite-derived precipitation measurements from TRMM.

Dancing Effects on Preschoolers' Sensorimotor Synchronization, Balance, and Movement Reaction Time.

PubMed

Chatzihidiroglou, Panagiota; Chatzopoulos, Dimitris; Lykesas, Georgios; Doganis, Georgios

2018-06-01

In the present study, we compared an experimental group of preschool children ( n = 22; mean age = 5 years, 8 months) who followed an 8-week dance program with a control group ( n = 20; mean age = 5 years, 5 months) on pre-post measures of sensorimotor synchronization (K-Rhythm Test), balancing on one leg and movement reaction time. Compared with the control participants, the dance group demonstrated significantly better pretest to posttest improvements on sensorimotor synchronization and balance (but not movement reaction time). Considering the importance of sensorimotor synchronization and balance for subsequent child development and performance of daily and sport activities, these results suggest that dancing should be included in early childhood curricula.

The seasonal-cycle climate model

NASA Technical Reports Server (NTRS)

Marx, L.; Randall, D. A.

1981-01-01

The seasonal cycle run which will become the control run for the comparison with runs utilizing codes and parameterizations developed by outside investigators is discussed. The climate model currently exists in two parallel versions: one running on the Amdahl and the other running on the CYBER 203. These two versions are as nearly identical as machine capability and the requirement for high speed performance will allow. Developmental changes are made on the Amdahl/CMS version for ease of testing and rapidity of turnaround. The changes are subsequently incorporated into the CYBER 203 version using vectorization techniques where speed improvement can be realized. The 400 day seasonal cycle run serves as a control run for both medium and long range climate forecasts alsensitivity studies.

Radiation damage in lithium-counterdoped N/P silicon solar cells

NASA Technical Reports Server (NTRS)

Hermann, A. M.; Swartz, C. K.; Brandhorst, H. W., Jr.; Weinberg, I.

1980-01-01

The radiation resistance and low-temperature annealing properties of lithium-counterdoped n(+)-p silicon solar cells are investigated. Cells fabricated from float zone and Czochralski grown silicon were irradiated with 1 MeV electrons and their performance compared to that of 0.35 ohm-cm control cells. The float zone cells demonstrated superior radiation resistance compared to the control cells, while no improvement was noted for the Czochralski grown cells. Annealing kinetics were found to lie between first and second order for relatively short times, and the most likely annealing mechanism was found to be the diffusion of lithium to defects with the subsequent neutralization of defects by combination with lithium. Cells with zero lithium gradients exhibited the best radiation resistance.

Does Winning a Pay-for-Performance Bonus Improve Subsequent Quality Performance? Evidence from the Hospital Quality Incentive Demonstration

PubMed Central

Ryan, Andrew; Sutton, Matthew; Doran, Tim

2014-01-01

Objective To test whether receiving a financial bonus for quality in the Premier Hospital Quality Incentive Demonstration (HQID) stimulated subsequent quality improvement. Data Hospital-level data on process-of-care quality from Hospital Compare for the treatment of acute myocardial infarction (AMI), heart failure, and pneumonia for 260 hospitals participating in the HQID from 2004 to 2006; receipt of quality bonuses in the first 3 years of HQID from the Premier Inc. website; and hospital characteristics from the 2005 American Hospital Association Annual Survey. Study Design Under the HQID, hospitals received a 1 percent bonus on Medicare payments for scoring between the 80th and 90th percentiles on a composite quality measure, and a 2 percent bonus for scoring at the 90th percentile or above. We used a regression discontinuity design to evaluate whether hospitals with quality scores just above these payment thresholds improved more in the subsequent year than hospitals with quality scores just below the thresholds. In alternative specifications, we examined samples of hospitals scoring within 3, 5, and 10 percentage point “bandwidths” of the thresholds. We used a Generalized Linear Model to estimate whether the relationship between quality and lagged quality was discontinuous at the lagged thresholds required for quality bonuses. Principal Findings There were no statistically significant associations between receipt of a bonus and subsequent quality performance, with the exception of the 2 percent bonus for AMI in 2006 using the 5 percentage point bandwidth (0.8 percentage point increase, p < .01), and the 1 percent bonus for pneumonia in 2005 using all bandwidths (3.7 percentage point increase using the 3 percentage point bandwidth, p < .05). Conclusions We found little evidence that hospitals' receipt of quality bonuses was associated with subsequent improvement in performance. This raises questions about whether winning in pay-for-performance programs, such as Hospital Value-Based Purchasing, will lead to subsequent quality improvement. PMID:23909992

Bundled Payments in Total Joint Replacement: Keeping Our Care Affordable and High in Quality.

PubMed

McLawhorn, Alexander S; Buller, Leonard T

2017-09-01

The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control. Early results of bundled payments are promising, but preserving access to care for patients with high comorbidity burdens and those requiring more complex care is a lingering concern. Hospitals, regardless of current participation in bundled payments, should develop care pathways for TJA to maximize efficiency and patient safety.

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency.

PubMed

Jansen, Oliver; Schildhauer, Thomas A; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-12-01

Longitudinal prospective study. Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients' functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients' ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished.

Benefits of a Pharmacology Antimalarial Reference Standard and Proficiency Testing Program Provided by the Worldwide Antimalarial Resistance Network (WWARN)

PubMed Central

Lourens, Chris; Lindegardh, Niklas; Barnes, Karen I.; Guerin, Philippe J.; Sibley, Carol H.; White, Nicholas J.

2014-01-01

Comprehensive assessment of antimalarial drug resistance should include measurements of antimalarial blood or plasma concentrations in clinical trials and in individual assessments of treatment failure so that true resistance can be differentiated from inadequate drug exposure. Pharmacometric modeling is necessary to assess pharmacokinetic-pharmacodynamic relationships in different populations to optimize dosing. To accomplish both effectively and to allow comparison of data from different laboratories, it is essential that drug concentration measurement is accurate. Proficiency testing (PT) of laboratory procedures is necessary for verification of assay results. Within the Worldwide Antimalarial Resistance Network (WWARN), the goal of the quality assurance/quality control (QA/QC) program is to facilitate and sustain high-quality antimalarial assays. The QA/QC program consists of an international PT program for pharmacology laboratories and a reference material (RM) program for the provision of antimalarial drug standards, metabolites, and internal standards for laboratory use. The RM program currently distributes accurately weighed quantities of antimalarial drug standards, metabolites, and internal standards to 44 pharmacology, in vitro, and drug quality testing laboratories. The pharmacology PT program has sent samples to eight laboratories in four rounds of testing. WWARN technical experts have provided advice for correcting identified problems to improve performance of subsequent analysis and ultimately improved the quality of data. Many participants have demonstrated substantial improvements over subsequent rounds of PT. The WWARN QA/QC program has improved the quality and value of antimalarial drug measurement in laboratories globally. It is a model that has potential to be applied to strengthening laboratories more widely and improving the therapeutics of other infectious diseases. PMID:24777099

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency

PubMed Central

Schildhauer, Thomas A.; Meindl, Renate C.; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-01-01

Study Design: Longitudinal prospective study. Objectives: Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Methods: Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients’ functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. Results: During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Conclusions: Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients’ ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished. PMID:29238636

42 CFR 456.234 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Subsequent continued stay review dates. 456.234 Section 456.234 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

Adaptive Neural Tracking Control for Switched High-Order Stochastic Nonlinear Systems.

PubMed

Zhao, Xudong; Wang, Xinyong; Zong, Guangdeng; Zheng, Xiaolong

2017-10-01

This paper deals with adaptive neural tracking control design for a class of switched high-order stochastic nonlinear systems with unknown uncertainties and arbitrary deterministic switching. The considered issues are: 1) completely unknown uncertainties; 2) stochastic disturbances; and 3) high-order nonstrict-feedback system structure. The considered mathematical models can represent many practical systems in the actual engineering. By adopting the approximation ability of neural networks, common stochastic Lyapunov function method together with adding an improved power integrator technique, an adaptive state feedback controller with multiple adaptive laws is systematically designed for the systems. Subsequently, a controller with only two adaptive laws is proposed to solve the problem of over parameterization. Under the designed controllers, all the signals in the closed-loop system are bounded-input bounded-output stable in probability, and the system output can almost surely track the target trajectory within a specified bounded error. Finally, simulation results are presented to show the effectiveness of the proposed approaches.

Control of Nausea and Vomiting in Patients Receiving Anthracycline/Cyclophosphamide Chemotherapy for Breast Cancer.

PubMed

Nawa-Nishigaki, Minako; Kobayashi, Ryo; Suzuki, Akio; Hirose, Chiemi; Matsuoka, Rie; Mori, Ryutaro; Futamura, Manabu; Sugiyama, Tadashi; Yoshida, Kazuhiro; Itoh, Yoshinori

2018-02-01

Chemotherapy-induced nausea and vomiting (CINV) is one of most distressing adverse events during cancer chemotherapy. In breast cancer patients receiving anthracycline and cyclophosphamide (AC) chemotherapy, CINV is poorly controlled. The prevalence of guideline-consistent antiemetic medication and control of CINV were investigated retrospectively in breast cancer patients receiving the first cycle of AC chemotherapy. Risks for CINV were analyzed by the multivariate logistic regression analysis. The effect of olanzapine added to the standard antiemetic medication on the incidence of CINV was subsequently evaluated in separate patients who received the first cycle of AC chemotherapy. Although the guideline-consistent antiemetic medication was performed in all subjects, the control rate of nausea (32%), but not vomiting (78%) was low. Risk analysis indicated that age younger than 55-year-old was a significant factor that reduces the control of both nausea and vomiting. Olanzapine (5 mg/day for 5 days), when added to the standard three-drug antiemetic medication, significantly improved the control of nausea and complete response. CINV was poorly controlled in breast cancer patients receiving AC chemotherapy, in which age younger than 55-year-old was a significant risk for both nausea and vomiting. Olanzapine was effective for improvement of the control of CINV associated with AC chemotherapy. Therefore, care should be taken to prevent CINV in young patients receiving AC chemotherapy by adding olanzapine to the standard three-drug antiemetic medication. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Do Pre-Existing Diabetes Social Support or Depressive Symptoms Influence the Effectiveness of a Diabetes Management Intervention?

PubMed Central

Rosland, Ann-Marie; Kieffer, Edith; Spencer, Michael; Sinco, Brandy; Palmisano, Gloria; Valerio, Melissa; Nicklett, Emily; Heisler, Michele

2015-01-01

Objective Examine influences of diabetes-specific social support (D-SS) and depressive symptoms on glycemic control over time, among adults randomized to a diabetes self-management education and support (DSME/S) intervention or usual care. Methods Data were from 108 African-American and Latino participants in a six-month intervention trial. Multivariable linear regression models assessed associations between baseline D-SS from family and friends and depressive symptoms with changes in HbA1c. We then examined whether baseline D-SS or depression moderated intervention-associated effects on HbA1c. Results Higher baseline D-SS was associated with larger improvements in HbA1c (adjusted ΔHbA1c -0.39% for each +1-point D-SS, p=0.02), independent of intervention-associated HbA1c decreases. Baseline depressive symptoms had no significant association with subsequent HbA1c change. Neither D-SS nor depression moderated intervention-associated effects on HbA1c. Conclusions and Practice Implications Diabetes self-management education and support programs have potential to improve glycemic control for participants starting with varying levels of social support and depressive symptoms. Participants starting with more support for diabetes management from family and friends improved HbA1c significantly more over six months than those with less support, independent of additional significant DSME/S intervention-associated HbA1c improvements. Social support from family and friends may improve glycemic control in ways additive to DSME/S. PMID:26234800

Improved stress tolerance and productivity in transgenic rice plants constitutively expressing the Oryza sativa glutathione synthetase OsGS under paddy field conditions.

PubMed

Park, Seong-Im; Kim, Young-Saeng; Kim, Jin-Ju; Mok, Ji-Eun; Kim, Yul-Ho; Park, Hyang-Mi; Kim, Il-Sup; Yoon, Ho-Sung

2017-08-01

Reactive oxygen species, which increase under various environmental stresses, have deleterious effects on plants. An important antioxidant, glutathione, is used to detoxify reactive oxygen species in plant cells and is mainly produced by two enzymes: gamma-glutamylcysteine synthetase (γ-ECS) and glutathione synthetase (GS). To evaluate the functional roles of the glutathione synthetase gene (OsGS) in rice, we generated four independent transgenic rice plants (TG1-TG4) that overexpressed OsGS under the control of the constitutively expressed OsCc1 promoter. When grown under natural paddy field conditions, the TG rice plants exhibited greater growth development, higher chlorophyll content, and higher GSH/GSSH ratios than control wild-type (WT) rice plants. Subsequently, the TG rice plants enhanced redox homeostasis by preventing hydroperoxide-mediated membrane damage, which improved their adaptation to environmental stresses. As a result, TG rice plants improved rice grain yield and total biomass following increases in panicle number and number of spikelets per panicle, despite differences in climate during the cultivation periods of 2014 and 2015. Overall, our results indicate that OsGS overexpression improved redox homeostasis by enhancing the glutathione pool, which resulted in greater tolerance to environmental stresses in the paddy fields. Copyright © 2017. Published by Elsevier GmbH.

Effectiveness of motor practice in lucid dreams: a comparison with physical and mental practice.

PubMed

Stumbrys, Tadas; Erlacher, Daniel; Schredl, Michael

2016-01-01

Motor practice in lucid dreams is a form of mental rehearsal where the dreamer can consciously rehearse motor skills in the dream state while being physically asleep. A previous pilot study showed that practice in lucid dreams can improve subsequent performance. This study aimed to replicate those findings with a different task (finger-tapping) and compare the effectiveness of lucid dream practice (LDP) not only to physical but also to mental practice (MP) in wakefulness. An online experiment was completed by 68 participants within four groups: LDP group, MP group, physical practice (PP) group and control (no practice) group. Pre-test was accomplished in the evening, post-test in the next morning, while the practice was done during the night. All three practice groups significantly improved their performance from pre-test to post-test, but no significant improvements were observed for the control group. Subjective sleep quality was not affected by night practice. This study thus corroborates the previous findings that practice in lucid dreams is effective in improving performance. Its effects seem to be similar to actual PP and MP in wakefulness. Future studies should establish reliable techniques for lucid dream induction and verify the effects of LDP in sleep laboratory conditions.

Modifying the Sleep Treatment Education Program for Students to include technology use (STEPS-TECH): Intervention effects on objective and subjective sleep outcomes.

PubMed

Barber, Larissa K; Cucalon, Maria S

2017-12-01

University students often have sleep issues that arise from poor sleep hygiene practices and technology use patterns. Yet, technology-related behaviors are often neglected in sleep hygiene education. This study examined whether the Sleep Treatment Education Program for Students-modified to include information regarding managing technology use (STEPS-TECH)-helps improve both subjective and objective sleep outcomes among university students. Results of an experimental study among 78 university students showed improvements in objective indicators of sleep quantity (total sleep time) and sleep quality (less awakenings) during the subsequent week for students in the STEPS-TECH intervention group compared to a control group. Exploratory analyses indicated that effects were driven by improvements in weekend days immediately following the intervention. There were also no intervention effects on subjective sleep quality or quantity outcomes. In terms of self-reported behavioral responses to educational content in the intervention, there were no group differences in sleep hygiene practices or technology use before bedtime. However, the intervention group reported less technology use during sleep periods than the control group. These preliminary findings suggest that STEPS-TECH may be a useful educational tool to help improve objective sleep and reduce technology use during sleep periods among university students. Copyright © 2017 John Wiley & Sons, Ltd.

Simultaneous heavy metals removal and municipal sewage sludge dewaterability improvement in bioleaching processes by various inoculums.

PubMed

Shi, Chaohong; Zhu, Nengwu; Shang, Ru; Kang, Naixin; Wu, Pingxiao

2015-11-01

The heavy metals content and dewaterability of municipal sewage sludge (MSS) are important parameters affecting its subsequent disposal and land application. Six kinds of inoculums were prepared to examine the characteristics of heavy metals removal and MSS dewaterability improvement in bioleaching processes. The results showed that Cu, Zn and Cd bioleaching efficiencies (12 days) were 81-91, 87-93 and 81-89%, respectively, which were significantly higher than those of Fe-S control (P < 0.05) and blank control (P < 0.01). The bioleaching boosted by the prepared inoculums could also significantly enhance MSS dewaterability (P < 0.01). The centrifugal dehydration efficiency of MSS rose from 73.00 to 90.00% at day 12. Microscopic observations and energy dispersive spectrum analysis demonstrated that the dewaterability improvement might be attributed to the changes of sludge structure from flocculent to obvious granular and the formation of secondary minerals mainly consisting of iron, oxygen and sulfur elements. The results above demonstrated that bacterial consortium enriched from acid mine drainage (AMD) was suitable to boost sludge bioleaching for heavy metals removal and dewaterability improvement. It also suggested that the synergy of sulfur/ferrous-oxidizing bacteria (SFOB) enriched from AMD and the cooperation of exogenous and indigenous SFOB significantly promoted bioleaching efficiencies.

Sinonasal inhalation of dornase alfa administered by vibrating aerosol to cystic fibrosis patients: a double-blind placebo-controlled cross-over trial.

PubMed

Mainz, Jochen G; Schien, Claudia; Schiller, Isabella; Schädlich, Katja; Koitschev, Assen; Koitschev, Christiane; Riethmüller, Joachim; Graepler-Mainka, Uta; Wiedemann, Bärbel; Beck, James F

2014-07-01

Chronic rhinosinusitis significantly impairs CF patients' quality of life and overall health. The Pari-Sinus™ device delivers vibrating aerosol effectively to paranasal sinuses. After a small pilot study to assess sinonasal inhalation of dornase alfa and placebo (isotonic saline) on potential sinonasal outcome measures, we present the subsequent prospective double-blind placebo-controlled crossover-trial. 23 CF patients were randomised to inhale either dornase alfa or isotonic saline for 28 days with the Pari-Sinus™ and after 28 days (wash-out) crossed over to the alternative treatment. The primary outcome parameter was primary nasal symptom score in the disease-specific quality of life Sino-Nasal Outcome-Test-20 (SNOT-20: nasal obstruction/sneezing/runny nose/thick nasal discharge/reduced smelling). Primary nasal symptoms improved significantly with dornase alfa compared with no treatment, while small improvements with isotonic saline did not reach significance. SNOT-20 overall scores improved significantly after dornase alfa compared with isotonic saline (p=0.017). Additionally, sinonasal dornase alfa but not isotonic saline significantly improved pulmonary function (FEF75-25: p=0.021). Vibrating sinonasal inhalation of dornase alfa reduces rhinosinusitis symptoms in CF. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Improved military air traffic controller selection methods as measured by subsequent training performance.

PubMed

Carretta, Thomas R; King, Raymond E

2008-01-01

Over the past decade, the U.S. military has conducted several studies to evaluate determinants of enlisted air traffic controller (ATC) performance. Research has focused on validation of the Armed Services Vocational Aptitude Battery (ASVAB) and has shown it to be a good predictor of training performance. Despite this, enlisted ATC training and post-training attrition is higher than desirable, prompting interest in alternate selection methods to augment current procedures. The current study examined the utility of the FAA Air Traffic Selection and Training (AT-SAT) battery for incrementing the predictiveness of the ASVAB versus several enlisted ATC training criteria. Subjects were 448 USAF enlisted ATC students who were administered the ASVAB and FAA AT-SAT subtests and subsequently graduated or were eliminated from apprentice-level training. Training criteria were a dichotomous graduation/elimination training score, average ATC fundamentals course score, and FAA certified tower operator test score. Results confirmed the predictive validity of the ASVAB and showed that one of the AT-SAT subtests resembling a low-fidelity ATC work sample significantly improved prediction of training performance beyond the ASVAB alone. Results suggested training attrition could be reduced by raising the current ASVAB minimum qualifying score. However, this approach may make it difficult to identify sufficient numbers of trainees and lead to adverse impact. Although the AT-SAT ATC work sample subtest showed incremental validity to the ASVAB, its length (95 min) may be problematic in operational testing. Recommendations are made for additional studies to address issues affecting operational implementation.

Multi-phase back contacts for CIS solar cells

DOEpatents

Rockett, A.A.; Yang, L.C.

1995-12-19

Multi-phase, single layer, non-interdiffusing M-Mo back contact metallized films, where M is selected from Cu, Ga, or mixtures thereof, for CIS cells are deposited by a sputtering process on suitable substrates, preferably glass or alumina, to prevent delamination of the CIS from the back contact layer. Typical CIS compositions include CuXSe{sub 2} where X is In or/and Ga. The multi-phase mixture is deposited on the substrate in a manner to provide a columnar microstructure, with micro-vein Cu or/and Ga regions which partially or fully vertically penetrate the entire back contact layer. The CIS semiconductor layer is then deposited by hybrid sputtering and evaporation process. The Cu/Ga-Mo deposition is controlled to produce the single layer two-phase columnar morphology with controllable Cu or Ga vein size less than about 0.01 microns in width. During the subsequent deposition of the CIS layer, the columnar Cu/Ga regions within the molybdenum of the Cu/Ga-Mo back layer tend to partially leach out, and are replaced by columns of CIS. Narrower Cu and/or Ga regions, and those with fewer inner connections between regions, leach out more slowly during the subsequent CIS deposition. This gives a good mechanical and electrical interlock of the CIS layer into the Cu/Ga-Mo back layer. Solar cells employing In-rich CIS semiconductors bonded to the multi-phase columnar microstructure back layer of this invention exhibit vastly improved photo-electrical conversion on the order of 17% greater than Mo alone, improved uniformity of output across the face of the cell, and greater Fill Factor. 15 figs.

Multi-phase back contacts for CIS solar cells

DOEpatents

Rockett, Angus A.; Yang, Li-Chung

1995-01-01

Multi-phase, single layer, non-interdiffusing M-Mo back contact metallized films, where M is selected from Cu, Ga, or mixtures thereof, for CIS cells are deposited by a sputtering process on suitable substrates, preferably glass or alumina, to prevent delamination of the CIS from the back contact layer. Typical CIS compositions include CuXSe.sub.2 where X is In or/and Ga. The multi-phase mixture is deposited on the substrate in a manner to provide a columnar microstructure, with micro-vein Cu or/and Ga regions which partially or fully vertically penetrate the entire back contact layer. The CIS semiconductor layer is then deposited by hybrid sputtering and evaporation process. The Cu/Ga-Mo deposition is controlled to produce the single layer two-phase columnar morphology with controllable Cu or Ga vein size less than about 0.01 microns in width. During the subsequent deposition of the CIS layer, the columnar Cu/Ga regions within the molybdenum of the Cu/Ga-Mo back layer tend to partially leach out, and are replaced by columns of CIS. Narrower Cu and/or Ga regions, and those with fewer inner connections between regions, leach out more slowly during the subsequent CIS deposition. This gives a good mechanical and electrical interlock of the CIS layer into the Cu/Ga-Mo back layer. Solar cells employing In-rich CIS semiconductors bonded to the multi-phase columnar microstructure back layer of this invention exhibit vastly improved photo-electrical conversion on the order of 17% greater than Mo alone, improved uniformity of output across the face of the cell, and greater Fill Factor.

Dapagliflozin: glucuretic action and beyond.

PubMed

Balakumar, Pitchai; Sundram, Karupiah; Dhanaraj, Sokkalingam A

2014-04-01

Diabetes mellitus is a greatly challenging disease of the 21 century, and the mortality rate due to this insidious disease is increasing worldwide in spite of availability of effective oral hypoglycemic agents. Satisfactory management of glycemic control in patients afflicted with type 2 diabetes mellitus (T2DM) remains a major clinical challenge. Identification of potential pharmacological target sites is therefore continuing as an integral part of the diabetic research. The sodium-glucose co-transporter type 2 (SGLT2) expressed in the renal proximal tubule plays an essential role in glucose reabsorption. Pharmacological blockade of SGLT2 prevents glucose reabsorption and subsequently induces the elimination of filtered glucose via urine, the process is known as 'glucuresis'. Dapagliflozin is a selective inhibitor of SGLT2. The US FDA approved dapagliflozin in January 2014 to improve glycemic control along with diet and exercise in adult patients afflicted with T2DM. It has a potential to decrease glycated hemoglobin and to promote weight loss. Although the mechanism of action of dapagliflozin is not directly linked with insulin or insulin sensitivity, reduction of plasma glucose by dapagliflozin via induction of glucosuria could improve muscle insulin sensitivity. Moreover, dapagliflozin could cause diuresis and subsequently fall in blood pressure. In addition to general discussion on the pharmacology of dapagliflozin, we propose in this review the possibilities of dual antidiabetic effect of dapagliflozin and its possible additional beneficial actions in hypertensive-obese-T2DM patients through its indirect blood pressure-lowering action and reduction of body calories and weight. Long-term clinical studies are however needed to clarify this contention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Resveratrol improves prostate fibrosis during progression of urinary dysfunction in chronic prostatitis.

PubMed

He, Yi; Zeng, Hui-Zhi; Yu, Yang; Zhang, Jia-Shu; Duan, Xingping; Zeng, Xiao-Na; Gong, Feng-Tao; Liu, Qi; Yang, Bo

2017-09-01

We investigated whether prostate fibrosis was associated with urinary dysfunction in chronic prostatitis (CP) and whether resveratrol improved urinary dysfunction and the underlying molecular mechanism. Rat model of CP was established via subcutaneous injections of DPT vaccine and subsequently treated with resveratrol. Bladder pressure and volume tests investigated the effect of resveratrol on urinary dysfunction in CP rats. Western blotting and immunohistochemical staining examined the expression level of C-kit/SCF and TGF-β/Wnt/β-catenin. Compared to the control group, the maximum capacity of the bladder, residual urine volume and maximum voiding pressure, the activity of C-kit/SCF and TGF-β/Wnt/β-catenin pathways were increased significantly in the CP group. Resveratrol treatment significantly improved these factors. CP induced significantly prostate fibrosis, which exhibits a close relationship with urinary dysfunction. Resveratrol improved fibrosis, which may be associated with the suppression of C-kit/SCF and TGF-β/Wnt/β-catenin pathway. Copyright © 2017 Elsevier B.V. All rights reserved.

The effectiveness of cognitive-behavioral group therapy training on improving emotional intelligence and general health of adolescents.

PubMed

Aghel Masjedi, M; Taghavizadeh, M; Azadi, N; Hosseinzadeh, F; Koushkestani, A

2015-01-01

Introduction: The aim of the current research was to examine the effectiveness of cognitive-behavioral group therapy (CBT) training on the general health and improve the emotional intelligence of male adolescents in Tehran city. Methodology: The current research is a semi-trial research with pretest-posttest experimental design and two test and control groups, which were carried out in the 2014-2015 academic year. 40 high school male students were chosen via proper sampling approach and they were stochastically classified into test and control team (each team, n = 20). The students were protested via Baron emotional intelligence and GHQ-28 general health questionnaire. Subsequently, the test group was trained in the cognitive-behavioral group therapy for eight sessions and the control group received no interventions. In the end, both groups were post-tested, and the data were investigated by using a multivariate investigation of covariance method and SPSS-20. Findings: The outcomes demonstrated that there were notable distinctions between the experiment and the checking teams after the implementation of the CBT training (P < 0.001) so that the average score of emotional intelligence and general health increased in test group rather than in the check team. Conclusion: The findings indicated that the CBT practice is useful in improving emotional intelligence and general health in adolescent male students. Thus, one can recommend that appropriate therapy training could be designed to improve their emotional intelligence and general health.

The effectiveness of cognitive-behavioral group therapy training on improving emotional intelligence and general health of adolescents

PubMed Central

Aghel Masjedi, M; Taghavizadeh, M; Azadi, N; Hosseinzadeh, F; Koushkestani, A

2015-01-01

Introduction: The aim of the current research was to examine the effectiveness of cognitive-behavioral group therapy (CBT) training on the general health and improve the emotional intelligence of male adolescents in Tehran city. Methodology: The current research is a semi-trial research with pretest-posttest experimental design and two test and control groups, which were carried out in the 2014-2015 academic year. 40 high school male students were chosen via proper sampling approach and they were stochastically classified into test and control team (each team, n = 20). The students were protested via Baron emotional intelligence and GHQ-28 general health questionnaire. Subsequently, the test group was trained in the cognitive-behavioral group therapy for eight sessions and the control group received no interventions. In the end, both groups were post-tested, and the data were investigated by using a multivariate investigation of covariance method and SPSS-20. Findings: The outcomes demonstrated that there were notable distinctions between the experiment and the checking teams after the implementation of the CBT training (P < 0.001) so that the average score of emotional intelligence and general health increased in test group rather than in the check team. Conclusion: The findings indicated that the CBT practice is useful in improving emotional intelligence and general health in adolescent male students. Thus, one can recommend that appropriate therapy training could be designed to improve their emotional intelligence and general health. PMID:28316719

Oral Administration of Faecalibacterium prausnitzii Decreased the Incidence of Severe Diarrhea and Related Mortality Rate and Increased Weight Gain in Preweaned Dairy Heifers.

PubMed

Foditsch, Carla; Pereira, Richard Van Vleck; Ganda, Erika Korzune; Gomez, Marilia Souza; Marques, Eduardo Carvalho; Santin, Thiago; Bicalho, Rodrigo Carvalho

2015-01-01

Probiotics are a promising alternative to improve food animal productivity and health. However, scientific evidence that specific microbes can be used to benefit animal health and performance is limited. The objective of this study was to evaluate the effects of administering a live culture of Faecalibacterium prausnitzii to newborn dairy calves on subsequent growth, health, and fecal microbiome. Initially, a safety trial was conducted using 30 newborn bull calves to assess potential adverse effects of the oral and rectal administration of F. prausnitzii to neonatal calves. No adverse reactions, such as increased body temperature or heart and respiratory rates, were observed after the administration of the treatments. All calves survived the experimental period, and there was no difference in fecal consistency score, attitude, appetite or dehydration between the treatment groups. The rectal route was not an efficient practice while the oral route ensures that the full dose is administered to the treated calves. Subsequently, a randomized field trial was completed in a commercial farm with preweaned calves. A total of 554 Holstein heifers were assigned to one of two treatment groups: treated calves (FPTRT) and non-treated calves (control). Treated calves received two oral doses of F. prausnitzii, one at treatment assignment (1st week) and another one week later. The FPTRT group presented significantly lower incidence of severe diarrhea (3.1%) compared with the control group (6.8%). Treated calves also had lower mortality rate associated with severe diarrhea (1.5%) compared to control calves (4.4%). Furthermore, FPTRT calves gained significantly more weight, 4.4 kg over the preweaning period, than controls calves. The relative abundance of F. prausnitzii in the fecal microbiota was significantly higher in the 3rd and 5th weeks of life of FPTRT calves than of the control calves, as revealed by sequencing of the 16S rRNA gene. Our findings showed that oral administration of F. prausnitzii improves gastrointestinal health and growth of preweaned calves, supporting its use as a potential probiotic.

Application of the balanced scorecard to an academic medical center in Taiwan: the effect of warning systems on improvement of hospital performance.

PubMed

Chen, Hsueh-Fen; Hou, Ying-Hui; Chang, Ray-E

2012-10-01

The balanced scorecard (BSC) is considered to be a useful tool for management in a variety of business environments. The purpose of this article is to utilize the experimental data produced by the incorporation and implementation of the BSC in hospitals and to investigate the effects of the BSC red light tracking warning system on performance improvement. This research was designed to be a retrospective follow-up study. The linear mixed model was applied for correcting the correlated errors. The data used in this study were secondary data collected by repeated measurements taken between 2004 and 2010 by 67 first-line medical departments of a public academic medical center in Taipei, Taiwan. The linear mixed model of analysis was applied for multilevel analysis. Improvements were observed with various time lags, from the subsequent month to three months after red light warning. During follow-up, the red light warning system more effectively improved controllable costs, infection rates, and the medical records completion rate. This further suggests that follow-up management promotes an enhancing and supportive effect to the red light warning. The red light follow-up management of BSC is an effective and efficient tool where improvement depends on ongoing and consistent attention in a continuing effort to better administer medical care and control costs. Copyright © 2012. Published by Elsevier B.V.

Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.

PubMed

Boussi-Gross, Rahav; Golan, Haim; Fishlev, Gregori; Bechor, Yair; Volkov, Olga; Bergan, Jacob; Friedman, Mony; Hoofien, Dan; Shlamkovitch, Nathan; Ben-Jacob, Eshel; Efrati, Shai

2013-01-01

Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments. The trial population included 56 mTBI patients 1-5 years after injury with prolonged post-concussion syndrome (PCS). The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. "Mindstreams" was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements. HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage. ClinicalTrials.gov NCT00715052.

The beneficial effects of treadmill step training on activity-dependent synaptic and cellular plasticity markers after complete spinal cord injury.

PubMed

Ilha, Jocemar; Centenaro, Lígia A; Broetto Cunha, Núbia; de Souza, Daniela F; Jaeger, Mariane; do Nascimento, Patrícia S; Kolling, Janaína; Ben, Juliana; Marcuzzo, Simone; Wyse, Angela T S; Gottfried, Carmem; Achaval, Matilde

2011-06-01

Several studies have shown that treadmill training improves neurological outcomes and promotes plasticity in lumbar spinal cord of spinal animals. The morphological and biochemical mechanisms underlying these phenomena remain unclear. The purpose of this study was to provide evidence of activity-dependent plasticity in spinal cord segment (L5) below a complete spinal cord transection (SCT) at T8-9 in rats in which the lower spinal cord segments have been fully separated from supraspinal control and that subsequently underwent treadmill step training. Five days after SCT, spinal animals started a step-training program on a treadmill with partial body weight support and manual step help. Hindlimb movements were evaluated over time and scored on the basis of the open-field BBB scale and were significantly improved at post-injury weeks 8 and 10 in trained spinal animals. Treadmill training also showed normalization of withdrawal reflex in trained spinal animals, which was significantly different from the untrained animals at post-injury weeks 8 and 10. Additionally, compared to controls, spinal rats had alpha motoneuronal soma size atrophy and reduced synaptophysin protein expression and Na(+), K(+)-ATPase activity in lumbar spinal cord. Step-trained rats had motoneuronal soma size, synaptophysin expression and Na(+), K(+)-ATPase activity similar to control animals. These findings suggest that treadmill step training can promote activity-dependent neural plasticity in lumbar spinal cord, which may lead to neurological improvements without supraspinal descending control after complete spinal cord injury.

Looking beyond the face: a training to improve perceivers' impressions of people with facial paralysis.

PubMed

Bogart, Kathleen R; Tickle-Degnen, Linda

2015-02-01

Healthcare providers and lay people alike tend to form inaccurate first impressions of people with facial movement disorders such as facial paralysis (FP) because of the natural tendency to base impressions on the face. This study tested the effectiveness of the first interpersonal sensitivity training for FP. Undergraduate participants were randomly assigned to one of two training conditions or an untrained control. Education raised awareness about FP symptoms and experiences and instructed participants to form their impressions based on cues from the body and voice rather than the face. Education+feedback added feedback about the correctness of participants' judgments. Subsequently, participants watched 30s video clips of people with FP and rated their extraversion. Participants' bias and accuracy in the two training conditions did not significantly differ, but they were significantly less biased than controls. Training did not improve the more challenging task of accurately detecting individual differences in extraversion. Educating people improves bias, but not accuracy, of impressions of people with FP. Information from the education condition could be delivered in a pamphlet to those likely to interact with this population such as healthcare providers and educators. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cognitive rehabilitation in multiple sclerosis: a randomized controlled trial.

PubMed

Hanssen, K T; Beiske, A G; Landrø, N I; Hofoss, D; Hessen, E

2016-01-01

The evidence base in cognitive rehabilitation in multiple sclerosis (MS) is still sparse. The aim of the study was to investigate the effects of cognitive rehabilitation on cognitive and executive coping, psychological well-being and psychological aspects of health-related quality of life (HRQoL) in patients with MS. One hundred and twenty patients with cognitive complaints, taking part in a 4-week multidisciplinary rehabilitation, were randomized to an intervention group (n = 60) and a control group (n = 60). Both groups underwent neuropsychological assessment with subsequent feedback and took part in general multidisciplinary MS rehabilitation. Additionally, the intervention group participated in cognitive group sessions as well as individual sessions. The main focus was to formulate Goal Attainment Scaling goals for coping with cognitive challenges. For 3 months past rehabilitation, the intervention group received biweekly telephone follow-up, focusing on goal attainment. Executive functioning improved significantly from baseline to four and 7 months in both groups. Improvements in psychological well-being and psychological aspects of HRQoL occurred only in the intervention group. Multicomponent cognitive rehabilitation administered within the context of multidisciplinary rehabilitation can improve psychological well-being and psychological aspects of HRQoL. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of a High-Protein, High-Fiber Beverage Preload on Subjective Appetite Ratings and Subsequent Ad Libitum Energy Intake in Overweight Men and Women: A Randomized, Double-Blind Placebo-Controlled, Crossover Study.

PubMed

Sharafi, Mastaneh; Alamdari, Nima; Wilson, Michael; Leidy, Heather J; Glynn, Erin L

2018-06-01

Dietary protein and fiber have been shown to independently improve subjective measures of appetite control. The aim of this study was to determine the acute effects of a high-protein, high-fiber (HP/HFb) beverage taken as a preload compared with an isocaloric lower-protein, lower-fiber (LP/LFb) placebo beverage on subjective appetite ratings and subsequent energy intake at an ad libitum meal in healthy adults. A total of 50 overweight/obese men and women [ n  = 25 men, 25 women; age 30 ± 2 y; body mass index (BMI) 29.6 ± 0.3 kg/m 2 ] received a 160 kcal HP/HFb beverage containing 17 g protein and 6 g fiber on one occasion and an isocaloric LP/LFb placebo beverage containing 1 g protein and 3 g fiber on another occasion in a randomized, double-blind, crossover design. Thirty min after consumption of the beverage preload, an ad libitum pizza meal was provided to be consumed over a 30-min period. Visual analog scales (VAS) were used to assess subjective appetite ratings throughout the testing period. The Revised Restraint Scale (RRS) was used to classify participants as restrained or unrestrained eaters. HP/HFb led to greater reductions in postprandial desire to eat and hunger compared with LP/LFb (both, P  < 0.05) but did not significantly affect postprandial fullness or prospective food consumption. Subsequent meal energy intake tended to be lower after HP/HFb compared with LP/LFb ( P  = 0.09). A subanalysis showed lower energy intake after HP/HFb in older participants (≥25 y) compared with LP/LFb, which was not observed in the younger participants (<25 y). Compared with LP/LFb, a HP/HFb beverage preload reduced hunger, desire to eat, and tended to reduce subsequent food intake. Dietary restraint and age appear to influence subsequent energy intake and should be taken into account when designing nutrition interventions for weight reduction and/or maintenance. This trial was registered at clinicaltrials.gov as NCT02979717.

A planned care approach and patient registry to improve adherence to clinical guidelines for the diagnosis and management of attention-deficit/hyperactivity disorder.

PubMed

Geltman, Paul L; Fried, Lise E; Arsenault, Lisa N; Knowles, Alice M; Link, David A; Goldstein, Joel N; Perrin, James M; Hacker, Karen A

2015-01-01

Attention-deficit/hyperactivity disorder (ADHD) affects almost 2.4 million US children. Because American Academy of Pediatrics guidelines for ADHD recommend use of standardized diagnostic instruments, regular follow-up and the chronic care model, this pilot project sought to implement and assess an electronic registry of patients with ADHD combined with care coordination by a planned care team. This quality improvement project was structured with 2 intervention and 2 control clinics to facilitate evaluation of the use of a planned care system for management of ADHD. Care teams included a pediatrician, nurse, medical assistant, and care coordinator and tracked patients using an electronic registry with data drawn from the EMR. Clinical work flows were pilot tested to facilitate use of the Vanderbilt scales and their incorporation into the EMR at intervention sites. Outcome measures included 2 recommended clinical follow-ups based on HEDIS measures as well as use of the Vanderbilt rating scales. Initiation phase measure was for follow-up after initiating medication, while the continuation phase measure was for subsequent follow-up during the first year of treatment. Measures were monitored during the project year and then also in the ensuing period of spread of the intervention to other sites. Although the modified HEDIS initiation phase measure for patients newly on medication remained static at approximately 50% throughout the project period, the continuation phase measure showed improvement from 35% at baseline to 45% at the end of the project assessment year, a 29% increase. Follow-up for patients stable on medications also remained unchanged during the project period, but during subsequent spreading of the intervention to nonproject sites, follow-up of these patients improved to over 90%. In adjusted analyses, patients with ADHD at intervention sites were over 2 times more likely than patients at control sites to have had a Vanderbilt score documented in their records. The project achieved modest improvements in the diagnostic and treatment process for patients with ADHD. The use of a planned care system and electronic patient registry shows promise for improving the diagnosis and treatment process for patients with ADHD. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Passivation of InP heterojunction bipolar transistors by strain controlled plasma assisted electron beam evaporated hafnium oxide

NASA Astrophysics Data System (ADS)

Driad, R.; Sah, R. E.; Schmidt, R.; Kirste, L.

2012-01-01

We present structural, stress, and electrical properties of plasma assisted e-beam evaporated hafnium dioxide (HfO2) layers on n-type InP substrates. These layers have subsequently been used for surface passivation of InGaAs/InP heterostructure bipolar transistors either alone or in combination with plasma enhanced chemical vapor deposited SiO2 layers. The use of stacked HfO2/SiO2 results in better interface quality with InGaAs/InP heterostructures, as illustrated by smaller leakage current and improved breakdown voltage. These improvements can be attributed to the reduced defect density and charge trapping at the dielectric-semiconductor interface. The deposition at room temperature makes these films suitable for sensitive devices.

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

78 FR 49227 - Airworthiness Directives; Bombardier, Inc. Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... primary wheels, and cracked rings on the primary wheel shaft, on certain horizontal stabilizer trim..., which may lead to a disconnect of the pitch trim surface and subsequent loss of pitch control, resulting... disconnect of the pitch trim surface and subsequent loss of pitch control. This [Canadian] AD mandates the...

Control and eradication of invasive mammals in Great Britain.

PubMed

Baker, S J

2010-08-01

This paper provides a 'long view' of the eradication and control of invasive mammals by reviewing the management of 24 mammalian species that have been introduced into Great Britain since the Neolithic period and have subsequently established free-living populations in the wild. The approach provides examples of the issues faced when managing populations and examines some of the lessons that can be learned from successes and failures. The species are covered in the order of introduction, with the control/eradication of rabbit (Oryctolagus cuniculus), muskrat (Ondatra zibethicus), coypu (Myocastor coypus) and American mink (Mustela vison) considered in more detail. The species accounts are set within the context of commitments for the control of invasive alien species made by parties to the Convention on Biological Diversity and guidance provided by the International Union for Conservation of Nature and the Council of Europe. These have led to improvements in the process for assessing risks and co-ordinating action. However, despite some notable cases documented here, there have been few successful eradication programmes carried out in Europe. This paper argues that there is a case for building on the improved frameworks that are being developed in the United Kingdom and elsewhere and for being more ambitious with goals for the management of invasive alien species.

A randomised controlled trial of an online theory-based intervention to improve adult Australians' sun-protective behaviours.

PubMed

White, Katherine M; Starfelt, Louise C; Young, Ross McD; Hawkes, Anna L; Cleary, Catherine; Leske, Stuart; Wihardjo, Kylie

2015-03-01

To evaluate the effectiveness of a single-session online theory of planned behaviour (TPB)-based intervention to improve sun-protective attitudes and behaviour among Australian adults. Australian adults (N=534; 38.7% males; Mage=39.3 years) from major cities (80.9%), regional (17.6%) and remote areas (1.5%) were recruited and randomly allocated to an intervention (N=265) and information only group (N=267). The online intervention focused on fostering positive attitudes, perceptions of normative support, and control perceptions for sun protection. Participants completed questionnaires assessing standard TPB measures (attitude, subjective norm, perceived behavioural control, intention, behaviour) and extended TPB constructs of group norm (friends, family), personal norm, and image norm, pre-intervention (Time 1) and one week (Time 2) and one month post-intervention (Time 3). Repeated Measures Multivariate Analysis of Variance tested intervention effects across time. Intervention participants reported more positive attitudes towards sun protection and used sun-protective measures more often in the subsequent month than participants receiving information only. The intervention effects on control perceptions and norms were non-significant. A theory-based online intervention fostering more favourable attitudes towards sun safety can increase sun protection attitudes and self-reported behaviour among Australian adults in the short term. Copyright © 2015 Elsevier Inc. All rights reserved.

Focus is key: Panic-focused interpretations are associated with symptomatic improvement in panic-focused psychodynamic psychotherapy.

PubMed

Keefe, John R; Solomonov, Nili; Derubeis, Robert J; Phillips, Alexander C; Busch, Fredric N; Barber, Jacques P; Chambless, Dianne L; Milrod, Barbara L

2018-04-18

This study examines whether, in panic-focused psychodynamic psychotherapy (PFPP), interpretations of conflicts that underlie anxiety (panic-focused or PF-interpretations) are specifically associated with subsequent panic disorder (PD) symptom improvement, over and above the provision of non-symptom-focused interpretations. Technique use in Sessions 2 and 10 of a 24-session PFPP protocol was assessed for the 65 patients with complete outcome data randomized to PFPP in a two-site trial of psychotherapies for PD. Sessions were rated in 15-min segments for therapists' use of PF-interpretations, non-PF-interpretations, and PF-clarifications. Robust regressions were conducted to examine the relationship between these interventions and symptom change subsequent to the sampled session. Interpersonal problems were examined as a moderator of the relationship of PF-interpretations to symptom change. At Session 10, but not at Session 2, patients who received a higher degree of PF-interpretations experienced greater subsequent improvement in panic symptoms. Non-PF-interpretations were not predictive. Patients with more interpersonal distress benefitted particularly from the use of PF-interpretations at Session 10. By the middle phase of PFPP, panic-focused interpretations may drive subsequent improvements in panic symptoms, especially among patients with higher interpersonal distress. Interpretations of conflict absent a panic focus may not be especially helpful.

Development of dental restorative materials based on visible light-cured multi-methacrylates

NASA Astrophysics Data System (ADS)

Tiba, Amer

The studies described in this dissertation focus on new visible light-curing (VLC) oligomers exhibiting low shrinkage, low water sorption, and improved mechanical properties. A family of multi-methacrylates, based on poly(isopropylidenediphenol) resin (BPA), was synthesized, characterized, and evaluated. The commercial BPA resin is prepared from enzymatic polymerization (oligomerization) of bisphenol A. The BPA resin, having an average of eight phenolic hydroxyl groups per molecule, was treated with propylene carbonate, and the resultant product, i.e., propoxylated BPA (PEBPA) oligomer, was confirmed by Fourier transform infrared spectroscopy (FT-IR) and sp{13}C nuclear magnetic resonance (NMR). The propoxylated BPA was subsequently treated with methacryloyl chloride to produce the multi-methacrylates, identified by FT-IR and NMR. The PEBPA oligomer multimethacrylate: triethylene glycol dimethacrylate (TEGDMA) (50:50/wt:wt) blends were combined with 0.5 wt. % camphoroquinone (CQ) and 1.0 wt. % N,N-dimethylaminoethyl methacrylate (DMAEMA). The control polymers were 2,2-bis(4-(2-hydroxy-3-methacryloyloxypropoxy)phenyl) propane (BisGMA): TEGDMA(50:50/wt:wt) blends having the same levels of CQ/DMAEMA. Differential photocalorimetry (DPC) and differential scanning calorimetry (DSC) showed these multimethacrylate/TEGDMA (neat resin) blends have polymerization characteristics comparable to the BisGMA/TEGDMA controls. These new multifunctional oligomers have lower polymerization shrinkage and lower uptake of water and other liquids, compared to BisGMA based materials. In addition, two experimental oligomers, PEBPA #2 and #3, have higher compressive strength than the BisGMA control. A biocompatibility test of the polymerized multi-methacrylate resins was performed and compared with the conventional BisGMA/TEGDMA resin and blank controls, using cell culture techniques. Human gingival fibroblasts were used for biocompatibility evaluation of these resins. The results revealed that the BPA oligomer (multi-methacrylate) based resin significantly favored the cell growth of the human gingival fibroblasts, compared to the control. An experimental composite was made from EPBPA oligomers (multi-methacrylates). The compressive strength of the experimental EPBPA containing composite was not significantly different than the commercial composite Herculite HXR. SEM photomicrographs revealed more voids in the experimental composites than the commercial composite on both the external surfaces of the prepared specimens and the subsequent fractured surfaces. This is due to the molding technique for specimen preparation and lack of good mechanical mixing for filler incorporation prior to placement of the resin in the mold for subsequent photopolymerization. However, the water sorption for the experimental EPBPA-based composite was significantly lower than the commercial Herculite (HXR) composite. This is most likely related to the hydrophobic nature of the experimental resin. These results suggest that the new type of polyfunctional methacrylate oligomers (PEBPA) have potential application in formulating dental composites as direct esthetic restorative materials with improved properties.

An Innovative Approach to Control Steel Reinforcement Corrosion by Self-Healing.

PubMed

Koleva, Dessi A

2018-02-20

The corrosion of reinforced steel, and subsequent reinforced concrete degradation, is a major concern for infrastructure durability. New materials with specific, tailor-made properties or the establishment of optimum construction regimes are among the many approaches to improving civil structure performance. Ideally, novel materials would carry self-repairing or self-healing capacities, triggered in the event of detrimental influence and/or damage. Controlling or altering a material's behavior at the nano-level would result in traditional materials with radically enhanced properties. Nevertheless, nanotechnology applications are still rare in construction, and would break new ground in engineering practice. An approach to controlling the corrosion-related degradation of reinforced concrete was designed as a synergetic action of electrochemistry, cement chemistry and nanotechnology. This contribution presents the concept of the approach, namely to simultaneously achieve steel corrosion resistance and improved bulk matrix properties. The technical background and challenges for the application of polymeric nanomaterials in the field are briefly outlined in view of this concept, which has the added value of self-healing. The credibility of the approach is discussed with reference to previously reported outcomes, and is illustrated via the results of the steel electrochemical responses and microscopic evaluations of the discussed materials.

An Innovative Approach to Control Steel Reinforcement Corrosion by Self-Healing

PubMed Central

2018-01-01

The corrosion of reinforced steel, and subsequent reinforced concrete degradation, is a major concern for infrastructure durability. New materials with specific, tailor-made properties or the establishment of optimum construction regimes are among the many approaches to improving civil structure performance. Ideally, novel materials would carry self-repairing or self-healing capacities, triggered in the event of detrimental influence and/or damage. Controlling or altering a material’s behavior at the nano-level would result in traditional materials with radically enhanced properties. Nevertheless, nanotechnology applications are still rare in construction, and would break new ground in engineering practice. An approach to controlling the corrosion-related degradation of reinforced concrete was designed as a synergetic action of electrochemistry, cement chemistry and nanotechnology. This contribution presents the concept of the approach, namely to simultaneously achieve steel corrosion resistance and improved bulk matrix properties. The technical background and challenges for the application of polymeric nanomaterials in the field are briefly outlined in view of this concept, which has the added value of self-healing. The credibility of the approach is discussed with reference to previously reported outcomes, and is illustrated via the results of the steel electrochemical responses and microscopic evaluations of the discussed materials. PMID:29461495

When Does Stress Help or Harm? The Effects of Stress Controllability and Subjective Stress Response on Stroop Performance

PubMed Central

Henderson, Roselinde K.; Snyder, Hannah R.; Gupta, Tina; Banich, Marie T.

2012-01-01

The ability to engage in goal-directed behavior despite exposure to stress is critical to resilience. Questions of how stress can impair or improve behavioral functioning are important in diverse settings, from athletic competitions to academic testing. Previous research suggests that controllability is a key factor in the impact of stress on behavior: learning how to control stressors buffers people from the negative effects of stress on subsequent cognitively demanding tasks. In addition, research suggests that the impact of stress on cognitive functioning depends on an individual’s response to stressors: moderate responses to stress can lead to improved performance while extreme (high or low) responses can lead to impaired performance. The present studies tested the hypothesis that (1) learning to behaviorally control stressors leads to improved performance on a test of general executive functioning, the color-word Stroop, and that (2) this improvement emerges specifically for people who report moderate (subjective) responses to stress. Experiment 1: Stroop performance, measured before and after a stress manipulation, was compared across groups of undergraduate participants (n = 109). People who learned to control a noise stressor and received accurate performance feedback demonstrated reduced Stroop interference compared with people exposed to uncontrollable noise stress and feedback indicating an exaggerated rate of failure. In the group who learned behavioral control, those who reported moderate levels of stress showed the greatest reduction in Stroop interference. In contrast, in the group exposed to uncontrollable events, self-reported stress failed to predict performance. Experiment 2: In a second sample (n = 90), we specifically investigated the role of controllability by keeping the rate of failure feedback constant across groups. In the group who learned behavioral control, those who reported moderate levels of stress showed the greatest Stroop improvement. Once again, this pattern was not demonstrated in the group exposed to uncontrollable events. These results suggest that stress controllability and subjective response interact to affect high-level cognitive abilities. Specifically, exposure to moderate, controllable stress benefits performance, but exposure to uncontrollable stress or having a more extreme response to stress tends to harm performance. These findings may provide insights on how to leverage the beneficial effects of stress in a range of settings. PMID:22701442

When does stress help or harm? The effects of stress controllability and subjective stress response on stroop performance.

PubMed

Henderson, Roselinde K; Snyder, Hannah R; Gupta, Tina; Banich, Marie T

2012-01-01

The ability to engage in goal-directed behavior despite exposure to stress is critical to resilience. Questions of how stress can impair or improve behavioral functioning are important in diverse settings, from athletic competitions to academic testing. Previous research suggests that controllability is a key factor in the impact of stress on behavior: learning how to control stressors buffers people from the negative effects of stress on subsequent cognitively demanding tasks. In addition, research suggests that the impact of stress on cognitive functioning depends on an individual's response to stressors: moderate responses to stress can lead to improved performance while extreme (high or low) responses can lead to impaired performance. The present studies tested the hypothesis that (1) learning to behaviorally control stressors leads to improved performance on a test of general executive functioning, the color-word Stroop, and that (2) this improvement emerges specifically for people who report moderate (subjective) responses to stress. Experiment 1: Stroop performance, measured before and after a stress manipulation, was compared across groups of undergraduate participants (n = 109). People who learned to control a noise stressor and received accurate performance feedback demonstrated reduced Stroop interference compared with people exposed to uncontrollable noise stress and feedback indicating an exaggerated rate of failure. In the group who learned behavioral control, those who reported moderate levels of stress showed the greatest reduction in Stroop interference. In contrast, in the group exposed to uncontrollable events, self-reported stress failed to predict performance. Experiment 2: In a second sample (n = 90), we specifically investigated the role of controllability by keeping the rate of failure feedback constant across groups. In the group who learned behavioral control, those who reported moderate levels of stress showed the greatest Stroop improvement. Once again, this pattern was not demonstrated in the group exposed to uncontrollable events. These results suggest that stress controllability and subjective response interact to affect high-level cognitive abilities. Specifically, exposure to moderate, controllable stress benefits performance, but exposure to uncontrollable stress or having a more extreme response to stress tends to harm performance. These findings may provide insights on how to leverage the beneficial effects of stress in a range of settings.

The effect of learning climate on snack consumption and ego depletion among undergraduate students.

PubMed

Magaraggia, Christian; Dimmock, James A; Jackson, Ben

2013-10-01

We explored the effect of controlled and autonomous learning choices on the consumption of a high-energy snack food, and also examined whether snack consumption during a controlled choice learning activity could 'up-regulate' subsequent performance on a self-regulation task. Participants were randomly assigned to a controlled choice learning condition in which food was provided, a controlled choice learning condition in which food was not provided, or an autonomous choice learning condition in which food was provided. Results indicated that the autonomous choice group consumed significantly less snack food than the controlled-choice-and-food group. Participants in the autonomous choice condition also performed better on the subsequent self-regulation task than the controlled-choice-and-food group, even after controlling for the amount of food consumed. Furthermore, within the controlled-choice-and-food condition, there was no association between food consumption and subsequent self-regulation task performance. Discussion focuses on the potential impact of a controlled learning climate on snack food consumption and on the degradation of self-regulation capacities. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Medical school-based teaching kitchen improves HbA1c, blood pressure, and cholesterol for patients with type 2 diabetes: Results from a novel randomized controlled trial.

PubMed

Monlezun, Dominique J; Kasprowicz, Eric; Tosh, Katherine W; Nix, Jenni; Urday, Pedro; Tice, Daphne; Sarris, Leah; Harlan, Timothy S

2015-08-01

A medical school-based teaching kitchen sought to establish proof-of-principle for its hands-on Mediterranean diet (MD)-based cooking and nutrition curriculum for patients with type 2 diabetes (T2D). This pilot randomized controlled trial (RCT) allocated 27 patients with T2D between the control and GCCM arms. Mixed effects linear regression with repeated measures was used to investigate differences from baseline to 6 months. The primary and secondary endpoints were HbA1c -0.3% (-27 mmol/mol) and diastolic blood pressure (DBP) -10 mmHg and a 25% improved responses in dietary habits and attitudes and competencies in healthy nutrition. Compared to the control group, the GCCM group had superior HbA1c reduction (-0.4% vs. -0.3%, p = 0.575) that was not statistically significant. There were significantly greater reductions in the GCCM vs. control group for DBP (-4 vs. 7 mmHg, p=0.037) and total cholesterol (-14 vs. 17 mg/dL, p = 0.044). There was a greater proportion increase though not significant of GCCM subjects compared to controls who mostly believed they could eat correct portions (18% vs. -11%, p = 0.124), and who used nutrition panels to make food choices (34% vs. 0%, p = 0.745). This is the first known RCT demonstrating improved biometrics using a novel MD-based hands on cooking and nutrition curriculum for patients with T2D. These results suggest subsequent clinical trials are warranted on the grounds of documented feasibility and clinical efficacy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Variation in Rising Limb of Colorado River Snowmelt Runoff Hydrograph Controlled by Dust Radiative Forcing in Snow

NASA Astrophysics Data System (ADS)

Painter, Thomas H.; Skiles, S. McKenzie; Deems, Jeffrey S.; Brandt, W. Tyler; Dozier, Jeff

2018-01-01

Common practice and conventional wisdom hold that fluctuations in air temperature control interannual variability in snowmelt and subsequent river runoff. However, recent observations in the Upper Colorado River Basin confirm that net solar radiation and by extension radiative forcing by dust deposited on snow cover exerts the primary forcing on snowmelt. We show that the variation in the shape of the rising limb of the annual hydrograph is controlled by variability in dust radiative forcing and surprisingly is independent of variations in winter and spring air temperatures. These observations suggest that hydroclimatic modeling must be improved to account for aerosol forcings of the water cycle. Anthropogenic climate change will likely reduce total snow accumulations and cause snowmelt runoff to occur earlier. However, dust radiative forcing of snowmelt is likely consuming important adaptive capacity that would allow human and natural systems to be more resilient to changing hydroclimatic conditions.

Accounting for sequential trial effects in the flanker task: conflict adaptation or associative priming?

PubMed

Nieuwenhuis, Sander; Stins, John F; Posthuma, Danielle; Polderman, Tinca J C; Boomsma, Dorret I; de Geus, Eco J

2006-09-01

The conflict-control loop theory proposes that the detection of conflict in information processing triggers an increase in cognitive control, resulting in improved performance on the subsequent trial. This theory seems consistent with the robust finding that conflict susceptibility is reduced following correct trials associated with high conflict: the conflict adaptation effect. However, despite providing favorable conditions for eliciting and detecting conflict-triggered performance adjustments, none of the five experiments reported here provide unequivocal evidence of such adjustments. Instead, the results corroborate and extend earlier findings by demonstrating that the conflict adaptation effect, at least in the flanker task, is only present for a specific subset of trial sequences that is characterized by a response repetition. This pattern of results provides strong evidence that the conflict adaptation effect reflects associative stimulus-response priming instead of conflict-driven adaptations in cognitive control.

Reducing misinformation effects in older adults with cognitive interview mnemonics.

PubMed

Holliday, Robyn E; Humphries, Joyce E; Milne, Rebecca; Memon, Amina; Houlder, Lucy; Lyons, Amy; Bull, Ray

2012-12-01

We examined the effect of a prior Modified Cognitive Interview on young and older adults' recall of a short film of a staged crime and subsequent reporting of misinformation. Participants viewed the film followed the next day by misinformation presented in a postevent summary. They were then interviewed with either a Modified Cognitive Interview or a control interview followed by a recognition memory test. A Modified Cognitive Interview elicited more correct details and improved overall accuracy compared to a control interview in both age groups, although the young adults recollected three times more correct information in a Modified Cognitive Interview than the older adults. In both age groups, correct recollections of person and action details were higher in a Modified Cognitive Interview than a control interview. Importantly, older adults who were interviewed with a Modified Cognitive Interview were not susceptible to misinformation effects. 2013 APA, all rights reserved

Clinical case report of long-term follow-up in type-2 diabetes patient with severe chronic periodontitis and nifedipine-induced gingival overgrowth.

PubMed

Shibukawa, Yoshihiro; Fujinami, Koushu; Yamashita, Shuichiro

2012-01-01

In this case report, we describe the clinical course over a 14-year follow-up in a 47-year-old diabetes patient with severe chronic periodontitis and nifedipine-induced gingival overgrowth. The patient had a history of hypertension for over 5 years and uncontrolled type 2 diabetes. Overgrown gingiva was observed in most of the teeth and was marked in the upper and lower anterior teeth. A probing pocket depth of ≥ 4 mm and bleeding on probing (BOP) were observed in 94 and 90% of sites examined, respectively. At baseline, his hemoglobin A1c (HbA1c) was 8.5%. The patient received periodontal and diabetic treatment simultaneously. Medication was changed from nifedipine chloride to an angiotensin-converting enzyme inhibitor. After initial therapy and subsequent periodontal surgery, gingival overgrowth disappeared and probing depth and BOP showed a significant improvement. No recurrence was observed during supportive periodontal therapy (SPT). The HbA1c level improved from 8.5 to 6.3% after periodontal treatment, subsequently remaining at a good level during SPT over 10 years. This study demonstrated that periodontal treatment, withdrawal of medication and control of diabetes can result in remarkable improvements in type 2 diabetes patients with chronic periodontitis and nifedipine-induced gingival overgrowth. These results suggest that comprehensive periodontal treatment in combination with treatment for diabetes mellitus can exert a positive influence on blood glucose levels and periodontal condition in diabetic patients.

The association between controlled interpersonal affect regulation and resource depletion.

PubMed

Martínez-Íñigo, David; Poerio, Giulia Lara; Totterdell, Peter

2013-07-01

This investigation focuses on what occurs to individuals' self-regulatory resource during controlled Interpersonal Affect Regulation (IAR) which is the process of deliberately influencing the internal feeling states of others. Combining the strength model of self-regulation and the resources conservation model, the investigation tested whether: (1) IAR behaviors are positively related to ego-depletion because goal-directed behaviors demand self-regulatory processes, and (2) the use of affect-improving strategies benefits from a source of resource-recovery because it initiates positive feedback from targets, as proposed from a resource-conservation perspective. To test this, a lab study based on an experimental dual-task paradigm using a sample of pairs of friends in the UK and a longitudinal field study of a sample of healthcare workers in Spain were conducted. The experimental study showed a depleting effect of interpersonal affect-improving IAR on a subsequent self-regulation task. The field study showed that while interpersonal affect-worsening was positively associated with depletion, as indicated by the level of emotional exhaustion, interpersonal affect-improving was only associated with depletion after controlling for the effect of positive feedback from clients. The findings indicate that IAR does have implications for resource depletion, but that social reactions play a role in the outcome. © 2013 The Authors. Applied Psychology: Health and Well-Being © 2013 The International Association of Applied Psychology.

Outcomes of a school-based intervention on rabies prevention among school children in rural Sri Lanka.

PubMed

Kanda, Koji; Obayashi, Yoshi; Jayasinghe, Ananda; Gunawardena, G S P de S; Delpitiya, N Y; Priyadarshani, N G W; Gamage, Chandika D; Arai, Asuna; Tamashiro, Hiko

2015-09-01

In Sri Lanka, one of the major challenges in rabies control is to manage the dog population and subsequently to protect people, especially young children, from dog bites. In 2009, an educational-entertainment campaign called 'Rabies Edutainment 4 Kids' was introduced in the school curricula in rural Sri Lanka to improve practices on rabies prevention and pet care among school children, and to evaluate its effectiveness through pre- and post-tests. The level of rabies knowledge, attitude and practice among the pupils was dependent on their responses to a survey, and scores were significantly improved both among the study and control groups after the intervention. A lecture accompanied by a rabies awareness leaflet was much more effective in improving knowledge than the leaflet alone. The type of intervention and language used was significantly associated with the score increment (p<0.001). The threat of rabies to pupils in Sri Lanka would be reduced if they are given appropriate information on rabies prevention as a part of the school curricula. Close collaboration with local education offices is key to successful implementation of school-based rabies control programmes, which is, in turn, crucial to the eradication of rabies from Sri Lanka. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Intersections of girl child marriage and family planning beliefs and use: qualitative findings from Ethiopia and India.

PubMed

McClendon, Katherine A; McDougal, Lotus; Ayyaluru, Sankari; Belayneh, Yemeserach; Sinha, Anand; Silverman, Jay G; Raj, Anita

2017-10-18

Child marriage and subsequent early first birth is a considerable social, economic and health concern, and a pervasive practice in sub-Saharan Africa and South Asia. This study explores barriers and facilitators to family planning among women and girls, and their marital decision-makers subsequent to receipt of child marriage prevention programmes in Ethiopia and India. In-depth interviews with 128 women and girls who were married as minors or who cancelled or postponed marriage as minors and their marital decision-makers were analysed using content analysis. Respondents identified social norms, including child marriage and pressure to have children, and lack of information as barriers to family planning. Benefits included delayed first birth and increased birth spacing, improved maternal and child health and girls' educational attainment. Respondents associated family planning use with delayed pregnancy and increased educational attainment, particularly in Ethiopia. Child marriage prevention programmes were identified as important sources of family planning information. Ethiopia's school-based programme strengthened access to health workers and contraception more so than India's community-based programme. Findings highlight young wives' vulnerability with regard to reproductive control, and support the need for multi-sector approaches across communities, schools and community health workers to improve family planning among young wives.

Adaptations and mechanisms of human heat acclimation: Applications for competitive athletes and sports.

PubMed

Périard, J D; Racinais, S; Sawka, M N

2015-06-01

Exercise heat acclimation induces physiological adaptations that improve thermoregulation, attenuate physiological strain, reduce the risk of serious heat illness, and improve aerobic performance in warm-hot environments and potentially in temperate environments. The adaptations include improved sweating, improved skin blood flow, lowered body temperatures, reduced cardiovascular strain, improved fluid balance, altered metabolism, and enhanced cellular protection. The magnitudes of adaptations are determined by the intensity, duration, frequency, and number of heat exposures, as well as the environmental conditions (i.e., dry or humid heat). Evidence is emerging that controlled hyperthermia regimens where a target core temperature is maintained, enable more rapid and complete adaptations relative to the traditional constant work rate exercise heat acclimation regimens. Furthermore, inducing heat acclimation outdoors in a natural field setting may provide more specific adaptations based on direct exposure to the exact environmental and exercise conditions to be encountered during competition. This review initially examines the physiological adaptations associated with heat acclimation induction regimens, and subsequently emphasizes their application to competitive athletes and sports. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The association between smoking and subsequent suicide-related outcomes in the National Comorbidity Survey panel sample

PubMed Central

Kessler, Ronald C.; Borges, Guilherme; Sampson, Nancy; Miller, Matthew; Nock, Matthew K.

2009-01-01

Controversy exists about whether the repeatedly-documented associations between smoking and subsequent suicide-related outcomes (SROs; ideation, plans, gestures, and attempts) are due to unmeasured common causes or to causal effects of smoking on SROs. We address this issue by examining associations of smoking with subsequent SROs with and without controls for potential explanatory variables in the National Comorbidity Survey (NCS) panel. The latter consists of 5001 people who participated in both the 199002 NCS and the 2001–03 NCS Follow-up Survey. Explanatory variables include socio-demographics, potential common causes (parental history of mental-substance disorders; other respondent childhood adversities) and potential mediators (respondent history of DSM-III-R mental-substance disorders). Small gross (i.e., without controls) prospective associations are found between history of early-onset nicotine dependence and both subsequent suicide ideation and, among ideators, subsequent suicide plans. None of the baseline smoking measures, though, predicts subsequent suicide gestures or attempts among ideators. The smoking-ideation association largely disappear, but the association of early-onset nicotine dependence with subsequent suicide plans persists (Odds-ratio = 3.0), after adjustment for control variables. However, the latter association is as strong with remitted as active nicotine dependence, arguing against a direct causal effect of nicotine dependence on suicide plans. Decomposition of the control variable effects, furthermore, suggests that these effects are due to common causes more than to mediators. These results refine our understanding of the ways in which smoking is associated with later SROs and for the most part argue against the view that these associations are due to causal effects of smoking. PMID:18645572

Modeling spatial patterns of link-based PM2.5 emissions and subsequent human exposure in a large canadian metropolitan area

NASA Astrophysics Data System (ADS)

Requia, Weeberb J.; Dalumpines, Ron; Adams, Matthew D.; Arain, Altaf; Ferguson, Mark; Koutrakis, Petros

2017-06-01

Understanding the relationship between mobile source emissions and subsequent human exposure is crucial for emissions control. Determining this relationship over space is fundamental to improve the accuracy and precision of public policies. In this study, we evaluated the spatial patterns of link-based PM2.5 emissions and subsequent human exposure in a large Canadian metropolitan area - the Greater Toronto and Hamilton Area (GTHA). This study was performed in three stages. First, we estimated vehicle emissions using transportation models and emission simulators. Then we evaluated human exposure to PM2.5 emissions using the Intake fraction (iF) approach. Finally, we applied geostatistical methods to assess spatial patterns of vehicle emissions and subsequent human exposure based on three prospective goals: i) classification of emissions (Global Moran's I test), ii) level of emission exposure (Getis-Ord General G test), and; iii) location of emissions (Anselin Local Moran's I). Our results showed that passenger vehicles accounted for the highest total amount of PM2.5 emissions, representing 57% emissions from all vehicles. Examining only the emissions from passenger vehicles, on average, each person in the GTHA inhales 2.58 × 10-3 ppm per day. Accounting the emissions from buses and trucks, on average each person inhales 0.12 × 10-3 and 1.91 × 10-3 ppm per day, respectively. For both PM2.5 emissions and human exposure using iF approach, our analysis showed Moran's Index greater than 0 for all vehicle categories, suggesting the presence of significant clusters (p-value <0.01) in the region. Our study indicates that air pollution control policy must be developed for the whole region, because of the spatial distribution of housing and businesses centers and inter-connectivity of transportation networks across the region, where a policy cannot simply be based on a municipal or other boundaries.

The Role of Allergen Exposure and Avoidance in Asthma

PubMed Central

Baxi, Sachin N.; Phipatanakul, Wanda

2010-01-01

Allergy testing and avoidance of allergens plays an important role in asthma control. Increased allergen exposure, in genetically susceptible individuals, can lead to allergic sensitization. Continued allergen exposure can increase the risk of asthma and other allergic diseases. In a patient with persistent asthma, identification of indoor and outdoor allergens and subsequent avoidance can improve symptoms. Often times, a patient will have multiple allergies and the avoidance plan should target all positive allergens. Several studies have shown that successful allergen remediation includes a comprehensive approach including education, cleaning, physical barriers and maintaining these practices. PMID:20568555

Long-term treatment with antioxidants and a program of behavioral enrichment reduces age-dependent impairment in discrimination and reversal learning in beagle dogs.

PubMed

Milgram, Norton W; Head, Elizabeth; Zicker, Steven C; Ikeda-Douglas, Candace; Murphey, Heather; Muggenberg, Bruce A; Siwak, Christina T; Tapp, P Dwight; Lowry, Stephen R; Cotman, Carl W

2004-05-01

The effects of long-term treatment with both antioxidants and a program of behavioral enrichment were studied as part of a longitudinal investigation of cognitive aging in beagle dogs. Baseline performance on a battery of cognitive tests was used to assign 48 aged dogs (9-12 years) into four cognitively equivalent groups, of 12 animals per group: Group CC (control food-control environment), group CE (control food-enriched environment); Group AC (antioxidant fortified food-control environment); Group AE (fortified food-enriched environment). We also tested a group of young dogs fed the control food and a second group fed the fortified food. Both groups of young dogs received a program of behavioral enrichment. To evaluate the effects of the interventions on cognition after 1 year, the dogs were tested on a size discrimination learning task and subsequently on a size discrimination reversal learning task. Both tasks showed age-sensitivity, with old dogs performing more poorly than young dogs. Both tasks were also improved by both the fortified food and the behavioral enrichment. However, in both instances the treatment effects largely reflected improved performance in the combined treatment group. These results suggest that the effectiveness of antioxidants in attenuating age-dependent cognitive decline is dependent on behavioral and environmental experience.

A functional magnetic resonance imaging study mapping the episodic memory encoding network in temporal lobe epilepsy

PubMed Central

Sidhu, Meneka K.; Stretton, Jason; Winston, Gavin P.; Bonelli, Silvia; Centeno, Maria; Vollmar, Christian; Symms, Mark; Thompson, Pamela J.; Koepp, Matthias J.

2013-01-01

Functional magnetic resonance imaging has demonstrated reorganization of memory encoding networks within the temporal lobe in temporal lobe epilepsy, but little is known of the extra-temporal networks in these patients. We investigated the temporal and extra-temporal reorganization of memory encoding networks in refractory temporal lobe epilepsy and the neural correlates of successful subsequent memory formation. We studied 44 patients with unilateral temporal lobe epilepsy and hippocampal sclerosis (24 left) and 26 healthy control subjects. All participants performed a functional magnetic resonance imaging memory encoding paradigm of faces and words with subsequent out-of-scanner recognition assessments. A blocked analysis was used to investigate activations during encoding and neural correlates of subsequent memory were investigated using an event-related analysis. Event-related activations were then correlated with out-of-scanner verbal and visual memory scores. During word encoding, control subjects activated the left prefrontal cortex and left hippocampus whereas patients with left hippocampal sclerosis showed significant additional right temporal and extra-temporal activations. Control subjects displayed subsequent verbal memory effects within left parahippocampal gyrus, left orbitofrontal cortex and fusiform gyrus whereas patients with left hippocampal sclerosis activated only right posterior hippocampus, parahippocampus and fusiform gyrus. Correlational analysis showed that patients with left hippocampal sclerosis with better verbal memory additionally activated left orbitofrontal cortex, anterior cingulate cortex and left posterior hippocampus. During face encoding, control subjects showed right lateralized prefrontal cortex and bilateral hippocampal activations. Patients with right hippocampal sclerosis showed increased temporal activations within the superior temporal gyri bilaterally and no increased extra-temporal areas of activation compared with control subjects. Control subjects showed subsequent visual memory effects within right amygdala, hippocampus, fusiform gyrus and orbitofrontal cortex. Patients with right hippocampal sclerosis showed subsequent visual memory effects within right posterior hippocampus, parahippocampal and fusiform gyri, and predominantly left hemisphere extra-temporal activations within the insula and orbitofrontal cortex. Correlational analysis showed that patients with right hippocampal sclerosis with better visual memory activated the amygdala bilaterally, right anterior parahippocampal gyrus and left insula. Right sided extra-temporal areas of reorganization observed in patients with left hippocampal sclerosis during word encoding and bilateral lateral temporal reorganization in patients with right hippocampal sclerosis during face encoding were not associated with subsequent memory formation. Reorganization within the medial temporal lobe, however, is an efficient process. The orbitofrontal cortex is critical to subsequent memory formation in control subjects and patients. Activations within anterior cingulum and insula correlated with better verbal and visual subsequent memory in patients with left and right hippocampal sclerosis, respectively, representing effective extra-temporal recruitment. PMID:23674488

Improved Hypoxia Modeling for Nutrient Control Decisions in the Gulf of Mexico

NASA Technical Reports Server (NTRS)

Habib, Shaid; Pickering, Ken; Tzortziou, Maria; Maninio, Antonio; Policelli, Fritz

2010-01-01

As required by the Harmful Algal Bloom and Hypoxia Research Control Act of 1998, the Mississippi River/Gulf of Mexico Watershed Nutrient Task Force issued the 2001 Gulf Hypoxia Action Plan (updated in 2008). In response to the Gulf Hypoxia Action Plan of 2001 (updated in 2008), the EPA Gulf of Mexico Hypoxia Modeling and Monitoring Project has established a detailed model for the Mississippi-Attchafalaya River Basin which provides a capability to forecast the multi-source nutrient loading to the Gulf and the subsequent bio-geochemical processes leading to hypoxic conditions and subsequent effects on Gulf habitats and fisheries. The primary purpose of the EPA model is to characterize the impacts of nutrient management actions, or proposed actions on the spatial and temporal characteristics of the Gulf hypoxic zone. The model is expected to play a significant role in determining best practices and improved strategies for incentivizing nutrient reduction strategies, including installation of on-farm structures to reduce sediment and nutrient runoff, use of cover crops and other agricultural practices, restoration of wetlands and riparian buffers, improved waste water treatment and decreased industrial nitrogen emissions. These decisions are currently made in a fragmented way by federal, state, and local agencies, using a variety of small scale models and limited data. During the past three years, EPA has collected an enormous amount of in-situ data to be used in the model. We believe that the use of NASA satellite data products in the model and for long term validation of the model has the potential to significantly increase the accuracy and therefore the utility of the model for the decision making described above. This proposal addresses the Gulf of Mexico Alliance (GOMA) priority issue of reductions in nutrient inputs to coastal ecosystem. It further directly relates to water quality for healthy beaches and shellfish beds and wetland and coastal conservation restoration.

Basic Aspects of Deep Soil Mixing Technology Control

NASA Astrophysics Data System (ADS)

Egorova, Alexandra A.; Rybak, Jarosław; Stefaniuk, Damian; Zajączkowski, Przemysław

2017-10-01

Improving a soil is a process of increasing its physical/mechanical properties without changing its natural structure. Improvement of soil subbase is reached by means of the knitted materials, or other methods when strong connection between soil particles is established. The method of DSM (Deep Soil Mixing) columns has been invented in Japan in 1970s. The main reason of designing cement-soil columns is to improve properties of local soils (such as strength and stiffness) by mixing them with various cementing materials. Cement and calcium are the most commonly used binders. However new research undertaken worldwide proves that apart from these materials, also gypsum or fly ashes can also be successfully implemented. As the Deep Soil Mixing is still being under development, anticipating mechanical properties of columns in particular soils and the usage of cementing materials in formed columns is very difficult and often inappropriate to predict. That is why a research is carried out in order to find out what binders and mixing technology should be used. The paper presents several remarks on the testing procedures related to quality and capacity control of Deep Soil Mixing columns. Soil improvement methods, their advantages and limitations are briefly described. The authors analyse the suitability of selected testing methods on subsequent stages of design and execution of special foundations works. Chosen examples from engineering practice form the basis for recommendations for the control procedures. Presented case studies concerning testing the on capacity field samples and laboratory procedures on various categories of soil-cement samples were picked from R&D and consulting works offered by Wroclaw University of Science and Technology. Special emphasis is paid to climate conditions which may affect the availability of performing and controlling of DSM techniques in polar zones, with a special regard to sample curing.

Effect of integrated pest management on controlling zoonotic cutaneous leishmaniasis in Emamzadeh Agha Ali Abbas (AS) District, Isfahan province, 2006-2009.

PubMed

Nilforoushzadeh, Mohammad Ali; Shirani-Bidabadi, Leila; Saberi, Sedigheh; Hosseini, Seyed Mohsen; Jaffary, Fariba

2014-01-01

Cutaneous leishmaniasis (CL) is still considered as a health problem in the world. Several methods of control in different regions, together with obtaining integrated information on its natural foci, are needed to decrease its prevalence. This study was designed to evaluate the effects of simultaneous interventions on CL control. A standard questionnaire was used to identify patients among pilgrims to Emamzadeh Agha Ali Abbas (Isfahan Province, Iran). Subsequently, three methods of controlling the disease, including, spraying residential buildings with Baygon, baiting with zinc phosphide poisons, changing the vegetative cover of the region, improving the environment, and mounting a mesh on all doors and windows of buildings in residential areas were used. The control measures were then evaluated by comparing the number of pilgrims affected by CL after and before the interventions. While 23 pilgrims (1.4%) were affected with CL before the intervention (pretest), five (0.3%) persons were found to have CL after taking control measures. The Chi-square test did not indicate any significant difference in the relative frequency of CL (P = 0.731). The only scientific method for preventing and controlling zoonotic CL (ZCL) is a combination of the control methods (improving the environment and fighting off the disease districts and vectors) together with changing the vegetative cover of the region. Any measure for controlling this disease must be taken and programmed in accordance with the relevant experts' views, in coordination with the participation of other organizations and the society.

MicroRNA expression in benign breast tissue and risk of subsequent invasive breast cancer.

PubMed

Rohan, Thomas; Ye, Kenny; Wang, Yihong; Glass, Andrew G; Ginsberg, Mindy; Loudig, Olivier

2018-01-01

MicroRNAs are endogenous, small non-coding RNAs that control gene expression by directing their target mRNAs for degradation and/or posttranscriptional repression. Abnormal expression of microRNAs is thought to contribute to the development and progression of cancer. A history of benign breast disease (BBD) is associated with increased risk of subsequent breast cancer. However, no large-scale study has examined the association between microRNA expression in BBD tissue and risk of subsequent invasive breast cancer (IBC). We conducted discovery and validation case-control studies nested in a cohort of 15,395 women diagnosed with BBD in a large health plan between 1971 and 2006 and followed to mid-2015. Cases were women with BBD who developed subsequent IBC; controls were matched 1:1 to cases on age, age at diagnosis of BBD, and duration of plan membership. The discovery stage (316 case-control pairs) entailed use of the Illumina MicroRNA Expression Profiling Assay (in duplicate) to identify breast cancer-associated microRNAs. MicroRNAs identified at this stage were ranked by the strength of the correlation between Illumina array and quantitative PCR results for 15 case-control pairs. The top ranked 14 microRNAs entered the validation stage (165 case-control pairs) which was conducted using quantitative PCR (in triplicate). In both stages, linear regression was used to evaluate the association between the mean expression level of each microRNA (response variable) and case-control status (independent variable); paired t-tests were also used in the validation stage. None of the 14 validation stage microRNAs was associated with breast cancer risk. The results of this study suggest that microRNA expression in benign breast tissue does not influence the risk of subsequent IBC.

MicroRNA expression in benign breast tissue and risk of subsequent invasive breast cancer

PubMed Central

Ye, Kenny; Wang, Yihong; Ginsberg, Mindy; Loudig, Olivier

2018-01-01

MicroRNAs are endogenous, small non-coding RNAs that control gene expression by directing their target mRNAs for degradation and/or posttranscriptional repression. Abnormal expression of microRNAs is thought to contribute to the development and progression of cancer. A history of benign breast disease (BBD) is associated with increased risk of subsequent breast cancer. However, no large-scale study has examined the association between microRNA expression in BBD tissue and risk of subsequent invasive breast cancer (IBC). We conducted discovery and validation case-control studies nested in a cohort of 15,395 women diagnosed with BBD in a large health plan between 1971 and 2006 and followed to mid-2015. Cases were women with BBD who developed subsequent IBC; controls were matched 1:1 to cases on age, age at diagnosis of BBD, and duration of plan membership. The discovery stage (316 case-control pairs) entailed use of the Illumina MicroRNA Expression Profiling Assay (in duplicate) to identify breast cancer-associated microRNAs. MicroRNAs identified at this stage were ranked by the strength of the correlation between Illumina array and quantitative PCR results for 15 case-control pairs. The top ranked 14 microRNAs entered the validation stage (165 case-control pairs) which was conducted using quantitative PCR (in triplicate). In both stages, linear regression was used to evaluate the association between the mean expression level of each microRNA (response variable) and case-control status (independent variable); paired t-tests were also used in the validation stage. None of the 14 validation stage microRNAs was associated with breast cancer risk. The results of this study suggest that microRNA expression in benign breast tissue does not influence the risk of subsequent IBC. PMID:29432432

75 FR 48617 - Airworthiness Directives; Eurocopter Deutschland GmbH (ECD) Model MBB-BK 117 C-2 Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

... separation of dynamic weights, severe vibration, and subsequent loss of control of the helicopter. Actions... in-flight incident in which a dynamic weight broke off the control lever leading to considerable... proposed actions are intended to prevent separation of dynamic weights, severe vibration, and subsequent...

Thin Film Deposition Using Energetic Ions

PubMed Central

Manova, Darina; Gerlach, Jürgen W.; Mändl, Stephan

2010-01-01

One important recent trend in deposition technology is the continuous expansion of available processes towards higher ion assistance with the subsequent beneficial effects to film properties. Nowadays, a multitude of processes, including laser ablation and deposition, vacuum arc deposition, ion assisted deposition, high power impulse magnetron sputtering and plasma immersion ion implantation, are available. However, there are obstacles to overcome in all technologies, including line-of-sight processes, particle contaminations and low growth rates, which lead to ongoing process refinements and development of new methods. Concerning the deposited thin films, control of energetic ion bombardment leads to improved adhesion, reduced substrate temperatures, control of intrinsic stress within the films as well as adjustment of surface texture, phase formation and nanotopography. This review illustrates recent trends for both areas; plasma process and solid state surface processes. PMID:28883323

Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis.

PubMed

Lancaster, Lisa H; de Andrade, Joao A; Zibrak, Joseph D; Padilla, Maria L; Albera, Carlo; Nathan, Steven D; Wijsenbeek, Marlies S; Stauffer, John L; Kirchgaessler, Klaus-Uwe; Costabel, Ulrich

2017-12-31

Pirfenidone is one of two approved therapies for the treatment of idiopathic pulmonary fibrosis (IPF). Randomised controlled clinical trials and subsequent post hoc analyses have demonstrated that pirfenidone reduces lung function decline, decreases mortality and improves progression-free survival. Long-term extension trials, registries and real-world studies have also shown similar treatment effects with pirfenidone. However, for patients with IPF to obtain the maximum benefits of pirfenidone treatment, the potential adverse events (AEs) associated with pirfenidone need to be managed. This review highlights the well-known and established safety profile of pirfenidone based on randomised controlled clinical trials and real-world data. Key strategies for preventing and managing the most common pirfenidone-related AEs are described, with the goal of maximising adherence to pirfenidone with minimal AEs. Copyright ©ERS 2017.

All-optical switch and transistor gated by one stored photon.

PubMed

Chen, Wenlan; Beck, Kristin M; Bücker, Robert; Gullans, Michael; Lukin, Mikhail D; Tanji-Suzuki, Haruka; Vuletić, Vladan

2013-08-16

The realization of an all-optical transistor, in which one "gate" photon controls a "source" light beam, is a long-standing goal in optics. By stopping a light pulse in an atomic ensemble contained inside an optical resonator, we realized a device in which one stored gate photon controls the resonator transmission of subsequently applied source photons. A weak gate pulse induces bimodal transmission distribution, corresponding to zero and one gate photons. One stored gate photon produces fivefold source attenuation and can be retrieved from the atomic ensemble after switching more than one source photon. Without retrieval, one stored gate photon can switch several hundred source photons. With improved storage and retrieval efficiency, our work may enable various new applications, including photonic quantum gates and deterministic multiphoton entanglement.

The pillars of land plants: new insights into stem development.

PubMed

Serrano-Mislata, Antonio; Sablowski, Robert

2018-05-12

In spite of its central importance in evolution, plant architecture and crop improvement, stem development remains poorly understood relative to other plant organs. Here, we summarise current knowledge of stem ontogenesis and its regulation, including insights from new image analysis and biophysical approaches. The stem initiates in the rib zone (RZ) of the shoot apical meristem, under transcriptional control by DELLA and BLH proteins. Links have emerged between these regulators and cell proliferation, patterning and oriented growth in the RZ. During subsequent internode elongation, cell wall properties and mechanics have been analysed in detail, revealing pectin modification as a prominent control point. Recent work has also highlighted signalling to coordinate growth of stem tissues with different mechanical properties. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Stressor controllability modulates fear extinction in humans

PubMed Central

Hartley, Catherine A.; Gorun, Alyson; Reddan, Marianne C.; Ramirez, Franchesca; Phelps, Elizabeth A.

2014-01-01

Traumatic events are proposed to play a role in the development of anxiety disorders, however not all individuals exposed to extreme stress experience a pathological increase in fear. Recent studies in animal models suggest that the degree to which one is able to control an aversive experience is a critical factor determining its behavioral consequences. In this study, we examined whether stressor controllability modulates subsequent conditioned fear expression in humans. Participants were randomly assigned to an escapable stressor condition, a yoked inescapable stressor condition, or a control condition involving no stress exposure. One week later, all participants underwent fear conditioning, fear extinction, and a test of extinction retrieval the following day. Participants exposed to inescapable stress showed impaired fear extinction learning and increased fear expression the following day. In contrast, escapable stress improved fear extinction and prevented the spontaneous recovery of fear. Consistent with the bidirectional controllability effects previously reported in animal models, these results suggest that one's degree of control over aversive experiences may be an important factor influencing the development of psychological resilience or vulnerability in humans. PMID:24333646

Training self-assessment and task-selection skills to foster self-regulated learning: Do trained skills transfer across domains?

PubMed

Raaijmakers, Steven F; Baars, Martine; Paas, Fred; van Merriënboer, Jeroen J G; van Gog, Tamara

2018-01-01

Students' ability to accurately self-assess their performance and select a suitable subsequent learning task in response is imperative for effective self-regulated learning. Video modeling examples have proven effective for training self-assessment and task-selection skills, and-importantly-such training fostered self-regulated learning outcomes. It is unclear, however, whether trained skills would transfer across domains. We investigated whether skills acquired from training with either a specific, algorithmic task-selection rule or a more general heuristic task-selection rule in biology would transfer to self-regulated learning in math. A manipulation check performed after the training confirmed that both algorithmic and heuristic training improved task-selection skills on the biology problems compared with the control condition. However, we found no evidence that students subsequently applied the acquired skills during self-regulated learning in math. Future research should investigate how to support transfer of task-selection skills across domains.

Advanced functionalization of polyhydroxyalkanoate via the UV-initiated thiol-ene click reaction.

PubMed

Tajima, Kenji; Iwamoto, Kosuke; Satoh, Yasuharu; Sakai, Ryosuke; Satoh, Toshifumi; Dairi, Tohru

2016-05-01

Polyhydroxyalkanoates (PHAs) incorporating vinyl-bearing 3-hydroxyalkanoates were prepared in 8.5-12.9 g L(-1) yield. The molar ratios (0-16 mol%) of the vinyl-bearing 3-hydroxyalkanoate derivatives were controlled by the continuous feeding of undecylenate at various concentrations. Subsequently, the PHAs were functionalized by UV-initiated thiol-ene click reaction and chemical modification. (1)H NMR spectra suggested that 3-mercaptopropionic acid and 2-aminoethanethiol were successfully introduced into the vinyl-bearing PHA. Subsequently, chemical modification using fluorescein or a fibronectin active fragment (GRGDS) was attempted. The former yielded a PHA derivative capable of emitting fluorescence under UV irradiation, which was useful for determining the miscibility of PHA in a composite film comprising poly-ʟ-lactic acid (PLLA) and PHA. In the latter case, PHA bearing GRGDS peptides exhibited cell adhesiveness, suggesting that its biocompatibility was improved upon peptide introduction. Taken together, the UV-initiated thiol-ene click reaction was demonstrated to be useful in PHA modification.

Is there a role for organic trace element supplements in transition cow health?

PubMed

Andrieu, S

2008-04-01

Optimal transition cow health is the key to success of the subsequent lactation, and increasing attention has been focused on management and nutritional practices that support it. Physiological stress during the transition period alters the efficiency of the immune system, making the lactating dairy cow more susceptible to infectious diseases, such as mastitis and metritis, with subsequent impairment of reproductive performance. Trace elements have a specific role in free radical control at the cellular level and influence the anti-oxidant/free radical balance. Dietary trace elements must be available for absorption throughout the whole of the digestive process until they reach the final site of absorption in the small intestine. Negative interactions between minerals can occur and, as the intestinal environment lowers the absorption of ionic minerals, chelation technology has been developed to increase mineral bioavailability. Organic trace elements have been used in dairy cow experiments, resulting in significant improvements in udder health, lameness and reproductive performance.

Extracellular polymeric substances govern the development of biofilm and mass transfer of polycyclic aromatic hydrocarbons for improved biodegradation.

PubMed

Zhang, Yinping; Wang, Fang; Zhu, Xiaoshu; Zeng, Jun; Zhao, Qiguo; Jiang, Xin

2015-10-01

The hypothesis that extracellular polymeric substances (EPS) affect the formation of biofilms for subsequent enhanced biodegradation of polycyclic aromatic hydrocarbons was tested. Controlled formation of biofilms on humin particles and biodegradation of phenanthrene and pyrene were performed with bacteria and EPS-extracted bacteria of Micrococcus sp. PHE9 and Mycobacterium sp. NJS-P. Bacteria without EPS extraction developed biofilms on humin, in contrast the EPS-extracted bacteria could not attach to humin particles. In the subsequent biodegradation of phenanthrene and pyrene, the biodegradation rates by biofilms were significantly higher than those of EPS-extracted bacteria. Although, both the biofilms and EPS-extracted bacteria showed increases in EPS contents, only the EPS contents in biofilms displayed significant correlations with the biodegradation efficiencies of phenanthrene and pyrene. It is proposed that the bacterial-produced EPS was a key factor to mediate bacterial attachment to other surfaces and develop biofilms, thereby increasing the bioavailability of poorly soluble PAH for enhanced biodegradation. Copyright © 2015. Published by Elsevier Ltd.

Training self‐assessment and task‐selection skills to foster self‐regulated learning: Do trained skills transfer across domains?

PubMed Central

Baars, Martine; Paas, Fred; van Merriënboer, Jeroen J. G.; van Gog, Tamara

2018-01-01

Summary Students' ability to accurately self‐assess their performance and select a suitable subsequent learning task in response is imperative for effective self‐regulated learning. Video modeling examples have proven effective for training self‐assessment and task‐selection skills, and—importantly—such training fostered self‐regulated learning outcomes. It is unclear, however, whether trained skills would transfer across domains. We investigated whether skills acquired from training with either a specific, algorithmic task‐selection rule or a more general heuristic task‐selection rule in biology would transfer to self‐regulated learning in math. A manipulation check performed after the training confirmed that both algorithmic and heuristic training improved task‐selection skills on the biology problems compared with the control condition. However, we found no evidence that students subsequently applied the acquired skills during self‐regulated learning in math. Future research should investigate how to support transfer of task‐selection skills across domains. PMID:29610547

Sad Kids, Sad Media? Applying Mood Management Theory to Depressed Adolescents’ Use of Media

PubMed Central

Carpentier, Francesca R. Dillman; Brown, Jane D.; Bertocci, Michele; Silk, Jennifer S.; Forbes, Erika E.; Dahl, Ronald E.

2009-01-01

Mood management studies typically have found that adults will select media that enhance positive moods and reduce negative moods. In this study, adolescents diagnosed with major depressive disorder and control adolescents without psychiatric disorders were called on customized cell phones up to 4 times a day and asked about their current mood state and media use for five extended weekends across an 8-week period. Mood effects on subsequent media use, mood during media consumption, and media effects on subsequent mood were examined. Results indicated that adolescents who consumed fun media tended to do so in a way that sustained, rather than enhanced their prior positive mood levels during and after consumption-if they turned to media. Adolescents in more negative moods did not often use media to improve their moods. When they did, boys were more likely than girls to use media that ultimately reduced negative mood levels. Findings are discussed in light of the literature on mood management, adolescence, and depression. PMID:19768135

Novel small interfering RNA-containing solution protecting donor organs in heart transplantation.

PubMed

Zheng, Xiufen; Lian, Dameng; Wong, Arthur; Bygrave, Michael; Ichim, Thomas E; Khoshniat, Mahdieh; Zhang, Xusheng; Sun, Hongtao; De Zordo, Tobias; Lacefield, James C; Garcia, Bertha; Jevnikar, Anthony M; Min, Wei-Ping

2009-09-22

Ischemia/reperfusion injury is a major factor in graft quality and subsequent function in the transplantation setting. We hypothesize that the process of RNA interference may be used to "engineer" a graft to suppress expression of genes associated with inflammation, apoptosis, and complement, which are believed to cause ischemia/reperfusion injury. Such manipulation of pathological gene expression may be performed by treatment of the graft ex vivo with small interfering RNA (siRNA) as part of the preservation procedure. Heart grafts from BALB/c mice were preserved in UW solution (control) or UW solution containing siRNAs targeting tumor necrosis factor-alpha, C3, and Fas genes (siRNA solution) at 4 degrees C for 48 hours and subsequently transplanted into syngeneic recipients. Tumor necrosis factor-alpha, C3, and Fas genes were elevated by ischemia/reperfusion injury after 48 hours of preservation in UW solution. Preservation in siRNA solution knocked down gene expression at the level of messenger RNA and protein in the grafts after transplantation. All grafts preserved in siRNA solution showed strong contraction, whereas grafts preserved in control solution demonstrated no detectable contraction by high-frequency ultrasound scanning. siRNA solution-treated organs exhibited improved histology and diminished neutrophil and lymphocyte infiltration compared with control solution-treated organs. Furthermore, the treated heart grafts retained strong beating up to the end of the observation period (>100 days), whereas all control grafts lost function within 8 days. Incorporation of siRNA into organ storage solution is a feasible and effective method of attenuating ischemia/reperfusion injury, protecting cardiac function, and prolonging graft survival.

Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea

PubMed Central

Billoo, AG; Memon, MA; Khaskheli, SA; Murtaza, G; Iqbal, Khalid; Shekhani, M Saeed; Siddiqi, Ahson Q

2006-01-01

AIM: To assess the efficacy and safety of Saccharomyces boulardii (S. boulardii) in acute watery diarrhoea and its role in reducing the frequency of episodes of diarrhoea in subsequent two months. METHODS: Children from 2 mo to 12 years of age, with acute diarrhoea were selected according to inclusion criteria and randomised in S. boulardii group (treated with ORS, nutritional support and S. boulardii, 250 mg bid) and in control group (treated with ORS and nutritional support only). Active treatment phase was 5 d and each child was followed for two months afterwards. Frequency and consistency of stools as well as safety of drug was assessed on every visit. A comparison of two groups was done in terms of number of diarrhoeal episode in subsequent two months. RESULTS: There were fifty patients in each group. Baseline characteristics such as mean age and the average frequency of stools were comparable in S. boulardii and control group at the time of inclusion in the trial. By d 3 it reduced to 2.7 and 4.2 stools per d respectively and by d 6 it reduced to 1.6 (S. boulardii Group) and 3.3 (control group). The duration of diarrhoea was 3.6 d in S. boulardii group whereas it was 4.8 d in control group (P = 0.001). In the following two months, S. boulardii group had a significantly lower frequency of 0.54 episodes as compared to 1.08 episodes in control group. The drug was well accepted and tolerated. There were no reports of the side effects during treatment period. CONCLUSION: S. boulardii significantly reduces the frequency and duration of acute diarrhoea. The consistency of stool also improves. The drug is well-tolerated. PMID:16874872

Zoledronic acid infusion for lumbar interbody fusion in osteoporosis.

PubMed

Tu, Chao-Wei; Huang, Kuo-Feng; Hsu, Hsien-Ta; Li, Hung-Yu; Yang, Stephen Shei-Dei; Chen, Yi-Chu

2014-11-01

Clinical outcomes of intravenous (IV) infusion of zoledronic acid (ZOL) for lumbar interbody fusion surgery (LIFS) remain unknown. We investigated the efficacy of IV ZOL on clinical outcome and bone fusion after LIFS. We retrospectively analyzed 64 patients with both degenerative lumbar spondylolisthesis and osteoporosis who underwent LIFS from January 2007 to April 2010. All patients were followed up for 2 y. Thirty-two were treated with an IV infusion of ZOL 3 d after surgery and a second injection 1 y later, and the other 32 patients did not receive ZOL. Preoperatively and every 3 mo postoperatively, oswestry disability index questionnaire and visual analog scale (VAS) scores for back and leg were compared. Preoperative and final postoperative follow-up to evaluate for subsequent compression fractures were also performed. Pedicle screw loosening, cage subsidence, and fusion rate were documented 2 y after surgery. At 2-y follow-up, a solid fusion was achieved in 75% of the ZOL group and only 56% of the control group. At final follow up, the incidence of final subsequent vertebral compression fractures (19% of the ZOL group and 51% of the control group, P = 0.006), pedicle screw loosening (18% of the ZOL group and 45% of the control group, P = 0.03), and cage subsidence >2 mm (28% of the ZOL group and only 54% of the control group, P = 0.04) were significantly lower in the ZOL group than in the control group. The ZOL group demonstrated improvement in VAS (for leg pain VAS, 2/10 for the ZOL group and 5/10 for the control group; for back pain VAS, 2/10 for the ZOL group and 6/10 for the control group) and oswestry disability index scores (7/25 for the ZOL group and 16/25 for the control group). ZOL treatment has beneficial effects on instrumented LIFS both radiographic and clinically. Thus, ZOL treatment can be recommended for osteoporosis patients undergoing LIFS. Copyright © 2014 Elsevier Inc. All rights reserved.

Java Tool Framework for Automation of Hardware Commissioning and Maintenance Procedures

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

Ho, J C; Fisher, J M; Gordon, J B

2007-10-02

The National Ignition Facility (NIF) is a 192-beam laser system designed to study high energy density physics. Each beam line contains a variety of line replaceable units (LRUs) that contain optics, stepping motors, sensors and other devices to control and diagnose the laser. During commissioning and subsequent maintenance of the laser, LRUs undergo a qualification process using the Integrated Computer Control System (ICCS) to verify and calibrate the equipment. The commissioning processes are both repetitive and tedious when we use remote manual computer controls, making them ideal candidates for software automation. Maintenance and Commissioning Tool (MCT) software was developed tomore » improve the efficiency of the qualification process. The tools are implemented in Java, leveraging ICCS services and CORBA to communicate with the control devices. The framework provides easy-to-use mechanisms for handling configuration data, task execution, task progress reporting, and generation of commissioning test reports. The tool framework design and application examples will be discussed.« less

Grain Structure Control of Additively Manufactured Metallic Materials

PubMed Central

Faierson, Eric J.

2017-01-01

Grain structure control is challenging for metal additive manufacturing (AM). Grain structure optimization requires the control of grain morphology with grain size refinement, which can improve the mechanical properties of additive manufactured components. This work summarizes methods to promote fine equiaxed grains in both the additive manufacturing process and subsequent heat treatment. Influences of temperature gradient, solidification velocity and alloy composition on grain morphology are discussed. Equiaxed solidification is greatly promoted by introducing a high density of heterogeneous nucleation sites via powder rate control in the direct energy deposition (DED) technique or powder surface treatment for powder-bed techniques. Grain growth/coarsening during post-processing heat treatment can be restricted by presence of nano-scale oxide particles formed in-situ during AM. Grain refinement of martensitic steels can also be achieved by cyclic austenitizing in post-processing heat treatment. Evidently, new alloy powder design is another sustainable method enhancing the capability of AM for high-performance components with desirable microstructures.

Finite-Horizon $H_\\infty $ Consensus for Multiagent Systems With Redundant Channels via An Observer-Type Event-Triggered Scheme.

PubMed

Xu, Wenying; Wang, Zidong; Ho, Daniel W C

2018-05-01

This paper is concerned with the finite-horizon consensus problem for a class of discrete time-varying multiagent systems with external disturbances and missing measurements. To improve the communication reliability, redundant channels are introduced and the corresponding protocol is constructed for the information transmission over redundant channels. An event-triggered scheme is adopted to determine whether the information of agents should be transmitted to their neighbors. Subsequently, an observer-type event-triggered control protocol is proposed based on the latest received neighbors' information. The purpose of the addressed problem is to design a time-varying controller based on the observed information to achieve the consensus performance in a finite horizon. By utilizing a constrained recursive Riccati difference equation approach, some sufficient conditions are obtained to guarantee the consensus performance, and the controller parameters are also designed. Finally, a numerical example is provided to demonstrate the desired reliability of redundant channels and the effectiveness of the event-triggered control protocol.

Development of an assist controller with robot suit HAL for hemiplegic patients using motion data on the unaffected side.

PubMed

Kawamoto, Hiroaki; Kandone, Hideki; Sakurai, Takeru; Ariyasu, Ryohei; Ueno, Yukiko; Eguchi, Kiyoshi; Sankai, Yoshiyuki

2014-01-01

Among several characteristics seen in gait of hemiplegic patients after stroke, symmetry is known to be an indicator of the degree of impairment of walking ability. This paper proposes a control method for a wearable type lower limb motion assist robot to realize spontaneous symmetric gait for these individuals. This control method stores the motion of the unaffected limb during swing and then provides motion support on the affected limb during the subsequent swing using the stored pattern to realize symmetric gait based on spontaneous limb swing. This method is implemented on the robot suit HAL (Hybrid Assistive Limbs). Clinical tests were conducted in order to assess the feasibility of the control method. Our case study involved participation of one chronic stroke patient who was not able to flex his right knee. As a result, the walking support for hemiplegic leg provided by the HAL improved the subject's gait symmetry. The feasibility study showed promising basis for the future clinical study.

Sleep quality predicts positive and negative affect but not vice versa. An electronic diary study in depressed and healthy individuals.

PubMed

Bouwmans, Mara E J; Bos, Elisabeth H; Hoenders, H J Rogier; Oldehinkel, Albertine J; de Jonge, Peter

2017-01-01

The exact nature of the complex relationship between sleep and affect has remained unclear. This study investigated the temporal order of change in sleep and affect in participants with and without depression. 27 depressed patients and 27 pair-matched healthy controls assessed their sleep in the morning and their affect 3 times a day for 30 consecutive days in their natural environment. Daily sleep quality and average positive affect (PA) and negative affect (NA) were used to examine whether changes in sleep quality preceded or followed changes in PA and NA, and whether this was different for patients and healthy controls. Second, presumptive mediating factors were investigated. We hypothesized that fatigue mediated the effect of changes in sleep quality on subsequent PA/NA, and that rumination mediated the effect of changes in PA/NA on subsequent sleep quality. Multilevel models showed that changes in sleep quality predicted changes in PA (B=0.08, p<0.001) and NA (B=-0.06, p<0.001), but not the other way around (PA: B=0.03, p=0.70, NA: B=-0.05, p=0.60). Fatigue was found to be a significant mediator of the relationship between sleep quality and PA (Indirect Effect=0.03, p<0.001), and between sleep quality and NA (Indirect Effect=-0.02, p=0.01). Rumination was not investigated because of non-significant associations between PA/NA and sleep quality. The associations were not different for patients and controls. The analyses were restricted to self-reported sleep quality, and conclusions about causality could not be drawn. Improvements in sleep quality predicted improvements in affect the following day, partly mediated by fatigue. Treatment of sleep symptoms would benefit affect in clinical care and beyond. Copyright © 2016 Elsevier B.V. All rights reserved.

Coherent control of plasma dynamics

NASA Astrophysics Data System (ADS)

He, Zhaohan

2014-10-01

The concept of coherent control - precise measurement or determination of a process through control of the phase of an applied oscillating field - has been applied to numerous systems with great success. Here, we demonstrate the use of coherent control on plasma dynamics in a laser wakefield electron acceleration experiment. A tightly focused femtosecond laser pulse (10 mJ, 35 fs) was used to generate electron beams by plasma wakefield acceleration in the density down ramp. The technique is based on optimization of the electron beam using a deformable mirror adaptive optical system with an iterative evolutionary genetic algorithm. The image of the electrons on a scintillator screen was processed and used in a fitness function as direct feedback for the optimization algorithm. This coherent manipulation of the laser wavefront leads to orders of magnitude improvement to the electron beam properties such as the peak charge and beam divergence. The laser beam optimized to generate the best electron beam was not the one with the ``best'' focal spot. When a particular wavefront of laser light interacts with plasma, it can affect the plasma wave structures and trapping conditions of the electrons in a complex way. For example, Raman forward scattering, envelope self-modulation, relativistic self-focusing, and relativistic self-phase modulation and many other nonlinear interactions modify both the pulse envelope and phase as the pulse propagates, in a way that cannot be easily predicted and that subsequently dictates the formation of plasma waves. The optimal wavefront could be successfully determined via the heuristic search under laser-plasma conditions that were not known a priori. Control and shaping of the electron energy distribution was found to be less effective, but was still possible. Particle-in-cell simulations were performed to show that the mode structure of the laser beam can affect the plasma wave structure and trapping conditions of electrons, which subsequently produces electron beams with a different divergence. The proof-of-principle demonstration of coherent control for plasmas opens new possibilities for future laser-based accelerators and their applications. This study should also enable a significantly improved understanding of the complex dynamics of laser plasma interactions. This work was supported by DARPA under Contract No. N66001-11-1-4208, the NSF under Contract No. 0935197 and MCubed at the University of Michigan.

The Effects of Vaccination and Immunity on Bacterial Infection Dynamics In Vivo

PubMed Central

Coward, Chris; Restif, Olivier; Dybowski, Richard; Grant, Andrew J.; Maskell, Duncan J.; Mastroeni, Pietro

2014-01-01

Salmonella enterica infections are a significant global health issue, and development of vaccines against these bacteria requires an improved understanding of how vaccination affects the growth and spread of the bacteria within the host. We have combined in vivo tracking of molecularly tagged bacterial subpopulations with mathematical modelling to gain a novel insight into how different classes of vaccines and branches of the immune response protect against secondary Salmonella enterica infections of the mouse. We have found that a live Salmonella vaccine significantly reduced bacteraemia during a secondary challenge and restrained inter-organ spread of the bacteria in the systemic organs. Further, fitting mechanistic models to the data indicated that live vaccine immunisation enhanced both the bacterial killing in the very early stages of the infection and bacteriostatic control over the first day post-challenge. T-cell immunity induced by this vaccine is not necessary for the enhanced bacteriostasis but is required for subsequent bactericidal clearance of Salmonella in the blood and tissues. Conversely, a non-living vaccine while able to enhance initial blood clearance and killing of virulent secondary challenge bacteria, was unable to alter the subsequent bacterial growth rate in the systemic organs, did not prevent the resurgence of extensive bacteraemia and failed to control the spread of the bacteria in the body. PMID:25233077

With or without pheromone habituation: possible differences between insect orders?

PubMed

Suckling, David Maxwell; Stringer, Lloyd D; Jiménez-Pérez, Alfredo; Walter, Gimme H; Sullivan, Nicola; El-Sayed, Ashraf M

2018-06-01

Habituation to sex pheromones is one of the key mechanisms in mating disruption, an insect control tactic. Male moths often show reduced sexual response after pre-exposure to female sex pheromone. Mating disruption is relatively rare in insect orders other than Lepidoptera. As a positive control we confirmed habituation in a moth (Epiphyas postvittana) using 24 h pre-exposure to sex pheromone to reduce subsequent activation behaviour. We then tested the impact of pre-exposure to sex or trail pheromone on subsequent behavioural response with insects from three other orders. Similar pre-exposure for 24 h to either sex pheromone [Pseudococcus calceolariae (Homoptera) and apple leaf curling midge Dasineura mali (Diptera), or trail pheromone of Argentine ants (Linepithema humile (Hymenoptera)], followed by behavioural assay in clean air provided no evidence of habituation after pre-exposure in these latter cases. The moths alone were affected by pre-exposure to pheromone. For pests without habituation, sustained attraction to a point source may make lure and kill more economical. Improved knowledge of behavioural processes should lead to better success in pest management and mechanisms should be investigated further to inform studies and practical efforts generally enhancing effectiveness of pheromone-based management. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

The inter-relationship between mood, self-esteem and response styles in adolescent offspring of bipolar parents: an experience sampling study.

PubMed

Pavlickova, Hana; Turnbull, Oliver H; Myin-Germeys, Inez; Bentall, Richard P

2015-02-28

The response styles theory of depression (Nolen-Hoeksema, 1991) proposes three main strategies individuals employ in response to low mood: rumination, active coping (distraction and problem-solving) and risk taking. Although recent research has suggested this theory has utility in understanding the symptoms of bipolar disorder (BD), the role of these processes in conferring vulnerability to the condition is poorly understood. Twenty-three adolescent children of patients with BD and 25 offspring of well parents completed the Experience Sampling Method (ESM; Csikszentmihalyi and Larson, 1987) diary for six days. Longitudinal analyses were carried out to examine inter-relationships between mood, self-esteem and response styles. Increased negative as well as positive mood resulted in greater rumination in both groups. Low self-esteem triggered greater risk-taking at the subsequent time point in the at-risk group, while negative affect instigated increased active coping in the control group. In both groups, engagement in risk-taking improved mood at the subsequent time point, whilst rumination dampened self-esteem. Differential longitudinal associations between mood, self-esteem and response styles between at-risk and control children suggest early psychological vulnerability in the offspring of BD parents, with important indications for early intervention. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Improved tolerance to post-anthesis drought stress by pre-drought priming at vegetative stages in drought-tolerant and -sensitive wheat cultivars.

PubMed

Abid, Muhammad; Tian, Zhongwei; Ata-Ul-Karim, Syed Tahir; Liu, Yang; Cui, Yakun; Zahoor, Rizwan; Jiang, Dong; Dai, Tingbo

2016-09-01

Wheat crop endures a considerable penalty of yield reduction to escape the drought events during post-anthesis period. Drought priming under a pre-drought stress can enhance the crop potential to tolerate the subsequent drought stress by triggering a faster and stronger defense mechanism. Towards these understandings, a set of controlled moderate drought stress at 55-60% field capacity (FC) was developed to prime the plants of two wheat cultivars namely Luhan-7 (drought tolerant) and Yangmai-16 (drought sensitive) during tillering (Feekes 2 stage) and jointing (Feekes 6 stage), respectively. The comparative response of primed and non-primed plants, cultivars and priming stages was evaluated by applying a subsequent severe drought stress at 7 days after anthesis. The results showed that primed plants of both cultivars showed higher potential to tolerate the post-anthesis drought stress through improved leaf water potential, more chlorophyll, and ribulose-1, 5-bisphosphate carboxylase/oxygenase contents, enhanced photosynthesis, better photoprotection and efficient enzymatic antioxidant system leading to less yield reductions. The primed plants of Luhan-7 showed higher capability to adapt the drought stress events than Yangmai-16. The positive effects of drought priming to sustain higher grain yield were pronounced in plants primed at tillering than those primed at jointing. In consequence, upregulated functioning of photosynthetic apparatus and efficient enzymatic antioxidant activities in primed plants indicated their superior potential to alleviate a subsequently occurring drought stress, which contributed to lower yield reductions than non-primed plants. However, genotypic and priming stages differences in response to drought stress also contributed to affect the capability of primed plants to tolerate the post-anthesis drought stress conditions in wheat. Copyright © 2016. Published by Elsevier Masson SAS.

ERP and Behavioral Effects of Physical and Cognitive Training on Working Memory in Aging: A Randomized Controlled Study

PubMed Central

Falkenstein, Michael

2018-01-01

Working memory (WM) performance decreases with age. A promising method to improve WM is physical or cognitive training. The present randomized controlled study is aimed at evaluating the effects of different training methods on WM. A sample of 141 healthy older adults (mean age 70 years) was assigned to one of four groups: physical training, cognitive training, a social control group, and a no-contact control group. The participants trained for four months. Before and after the training, n-back task during an EEG recording was applied. The results show that cognitive training enhanced the target detection rate in the 2-back task. This was corroborated by an increased number of repeated digits in the backward digit-span test but not in other memory tests. The improvement of WM was supported by an increased P3a prior to a correct target and an increased P3b both in nontarget and target trials. No ERP effects in the physical and no-contact control groups were found, while a reduction of P3a and P3b was found in the social control group. Thus, cognitive training enhances frontal and parietal processing related to the maintenance of a stored stimulus for subsequent matching with an upcoming stimulus and increases allocation of cognitive resources. These results indicate that multidomain cognitive training may increase WM capacity and neuronal activity in older age. PMID:29796016

Can Pharmacotherapists be Too Supportive? A Process Study of Active Medication and Placebo in the Treatment of Depression

PubMed Central

Strunk, Daniel R.; Stewart, Michael O.; Hollon, Steven D.; DeRubeis, Robert J.; Fawcett, Jan; Amsterdam, Jay D.; Shelton, Richard C.

2013-01-01

Background This study examined therapist-patient interactions during clinical management with anti-depressant medication and pill-placebo. Methods The sample consisted of 80 patients on active medication and 40 patients in a pill-placebo condition from a randomized controlled trial for moderate to severe depression. Pharmacotherapist-patient interactions were characterized using observer ratings of the therapeutic alliance, pharmacotherapist-offered facilitative conditions, pharmacotherapist adherence to clinical management treatment guidelines, and pharmacotherapist competence. Patients, therapists, and raters were blind to treatment condition and outcome. Results Provision of greater nonspecific support (facilitative conditions) in early sessions predicted less subsequent improvement in depressive symptoms for patients receiving pill-placebo but not those receiving active medications, for which none of the process ratings predicted subsequent change. Early symptom change predicted later alliance and adherence in both conditions and therapist competence in the active condition. Conclusions Higher levels of support in early sessions predict poorer subsequent response among placebo patients. It remains unclear whether patients who are likely to be refractory elicit greater nonspecific support or whether the provision of such support has a deleterious effect in unmedicated patients. Differences in treatment process variables between conditions late in treatment are likely to be largely a consequence of symptom relief produced by active medications. PMID:19891806

Investigation of Patient-Specific Cerebral Aneurysm using Volumetric PIV, CFD, and In Vitro PC-MRI

NASA Astrophysics Data System (ADS)

Brindise, Melissa; Dickerhoff, Ben; Saloner, David; Rayz, Vitaliy; Vlachos, Pavlos

2017-11-01

4D PC-MRI is a modality capable of providing time-resolved velocity fields in cerebral aneurysms in vivo. The MRI-measured velocities and subsequent hemodynamic parameters such as wall shear stress, and oscillatory shear index, can help neurosurgeons decide a course of treatment for a patient, e.g. whether to treat or monitor the aneurysm. However, low spatiotemporal resolution, limited velocity dynamic range, and inherent noise of PC-MRI velocity fields can have a notable effect on subsequent calculations, and should be investigated. In this work, we compare velocity fields obtained with 4D PC-MRI, computational fluid dynamics (CFD) and volumetric particle image velocimetry (PIV), using a patient-specific model of a basilar tip aneurysm. The same in vitro model is used for all three modalities and flow input parameters are controlled. In vivo, PC-MRI data was also acquired for this patient and used for comparison. Specifically, we investigate differences in the resulting velocity fields and biases in subsequent calculations. Further, we explore the effect these errors may have on assessment of the aneurysm progression and seek to develop corrective algorithms and other methodologies that can be used to improve the accuracy of hemodynamic analysis in clinical setting.

Optimizing the "priming" effect: influence of prior exercise intensity and recovery duration on O2 uptake kinetics and severe-intensity exercise tolerance.

PubMed

Bailey, Stephen J; Vanhatalo, Anni; Wilkerson, Daryl P; Dimenna, Fred J; Jones, Andrew M

2009-12-01

It has been suggested that a prior bout of high-intensity exercise has the potential to enhance performance during subsequent high-intensity exercise by accelerating the O(2) uptake (Vo(2)) on-response. However, the optimal combination of prior exercise intensity and subsequent recovery duration required to elicit this effect is presently unclear. Eight male participants, aged 18-24 yr, completed step cycle ergometer exercise tests to 80% of the difference between the preestablished gas exchange threshold and maximal Vo(2) (i.e., 80%Delta) after no prior exercise (control) and after six different combinations of prior exercise intensity and recovery duration: 40%Delta with 3 min (40-3-80), 9 min (40-9-80), and 20 min (40-20-80) of recovery and 70%Delta with 3 min (70-3-80), 9 min (70-9-80), and 20 min (70-20-80) of recovery. Overall Vo(2) kinetics were accelerated relative to control in all conditions except for 40-9-80 and 40-20-80 conditions as a consequence of a reduction in the Vo(2) slow component amplitude; the phase II time constant was not significantly altered with any prior exercise/recovery combination. Exercise tolerance at 80%Delta was improved by 15% and 30% above control in the 70-9-80 and 70-20-80 conditions, respectively, but was impaired by 16% in the 70-3-80 condition. Prior exercise at 40%Delta did not significantly influence exercise tolerance regardless of the recovery duration. These data demonstrate that prior high-intensity exercise ( approximately 70%Delta) can enhance the tolerance to subsequent high-intensity exercise provided that it is coupled with adequate recovery duration (>or=9 min). This combination presumably optimizes the balance between preserving the effects of prior exercise on Vo(2) kinetics and providing sufficient time for muscle homeostasis (e.g., muscle phosphocreatine and H(+) concentrations) to be restored.

Trends and management of wolf-livestock conflicts in Minnesota

USGS Publications Warehouse

Fritts, S.H.; Paul, W.J.; Mech, L.D.; Scott, D.P.

1992-01-01

The nature and extent of wolf-livestock conflicts in Minnesota during 1975-86 was studied as part of a wolf depredation control program. The level of wolf (Canis lupus) depredation on livestock in Minnesota, as determined from the total number of complaints verified annually during 1975-86, showed a slight upward trend but did not increase significantly. A significant portion of the annual variation in verified complaints-perhaps the best index on severity of the depredation problem was explained by variation in severity of the winter before the depredation season (inverse relation). The addition of a time variable did not account for a significant portion of the remaining variation. Verified complaints of depredations averaged 30 per year, affecting an average of 21 farms (0.33% of producers) annually. Conflicts were highly seasonal and involved primarily cattle (mainly calves), sheep, and domestic turkeys. Annual variation in losses of sheep and turkeys was higher than for cattle. In recent years, sheep and turkey losses in two northwestern counties have increased; preventive control may be warranted in those areas. Site-specific trapping and removal of wolves in response to depredations was the primary control method, resulting in captures of 437 wolves in 12 depredation seasons. For the wolf range as a whole, no relation was found between wolf removal and subsequent depredation rates; however, wolf removal seemed to reduce depredations locally at some farms. When adults and yearlings were removed, no subsequent losses occurred in about 55% of instances; removal of young of the year reduced losses in 22%. Removal of breeding wolves did not reduce the incidence of subsequent losses more than removal of nonbreeding adults and yearlings did. The low number of conflicts for 1975-86 was remarkable considering the frequent contact between wolves and livestock. However, an update of complaints for 1987-89 revealed a definite upward trend in depredations (Epilogue). Improvements in farm management practices may reduce the present number of conflicts.

Sexual relationship power and depression among HIV-infected women in Rural Uganda.

PubMed

Hatcher, Abigail M; Tsai, Alexander C; Kumbakumba, Elias; Dworkin, Shari L; Hunt, Peter W; Martin, Jeffrey N; Clark, Gina; Bangsberg, David R; Weiser, Sheri D

2012-01-01

Depression is associated with increased HIV transmission risk, increased morbidity, and higher risk of HIV-related death among HIV-infected women. Low sexual relationship power also contributes to HIV risk, but there is limited understanding of how it relates to mental health among HIV-infected women. Participants were 270 HIV-infected women from the Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of individuals initiating antiretroviral therapy (ART) in Mbarara, Uganda. Our primary predictor was baseline sexual relationship power as measured by the Sexual Relationship Power Scale (SRPS). The primary outcome was depression severity, measured with the Hopkins Symptom Checklist (HSCL), and a secondary outcome was a functional scale for mental health status (MHS). Adjusted models controlled for socio-demographic factors, CD4 count, alcohol and tobacco use, baseline WHO stage 4 disease, social support, and duration of ART. The mean HSCL score was 1.34 and 23.7% of participants had HSCL scores consistent with probable depression (HSCL>1.75). Compared to participants with low SRPS scores, individuals with both moderate (coefficient b = -0.21; 95%CI, -0.36 to -0.07) and high power (b = -0.21; 95%CI, -0.36 to -0.06) reported decreased depressive symptomology. High SRPS scores halved the likelihood of women meeting criteria for probable depression (adjusted odds ratio = 0.44; 95%CI, 0.20 to 0.93). In lagged models, low SRPS predicted subsequent depression severity, but depression did not predict subsequent changes in SPRS. Results were similar for MHS, with lagged models showing SRPS predicts subsequent mental health, but not visa versa. Both Decision-Making Dominance and Relationship Control subscales of SRPS were associated with depression symptom severity. HIV-infected women with high sexual relationship power had lower depression and higher mental health status than women with low power. Interventions to improve equity in decision-making and control within dyadic partnerships are critical to prevent HIV transmission and to optimize mental health of HIV-infected women.

Effects of adrenal sensitivity, stress- and cue-induced craving, and anxiety on subsequent alcohol relapse and treatment outcomes.

PubMed

Sinha, Rajita; Fox, Helen C; Hong, Kwang-Ik Adam; Hansen, Julie; Tuit, Keri; Kreek, Mary Jeanne

2011-09-01

Alcoholism is a chronic, relapsing illness in which stress and alcohol cues contribute significantly to relapse risk. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, increased anxiety, and high alcohol craving have been documented during early alcohol recovery, but their influence on relapse risk has not been well studied. To investigate these responses in treatment-engaged, 1-month-abstinent, recovering alcohol-dependent patients relative to matched controls (study 1) and to assess whether HPA axis function, anxiety, and craving responses are predictive of subsequent alcohol relapse and treatment outcome (study 2). Experimental exposure to stress, alcohol cues, and neutral, relaxing context to provoke alcohol craving, anxiety, and HPA axis responses (corticotropin and cortisol levels and cortisol to corticotropin ratio) and a prospective 90-day follow-up outcome design to assess alcohol relapse and aftercare treatment outcomes. Inpatient treatment in a community mental health center and hospital-based research unit. Treatment-engaged alcohol-dependent individuals and healthy controls. Time to alcohol relapse and to heavy drinking relapse. Significant HPA axis dysregulation, marked by higher basal corticotropin level and lack of stress- and cue-induced corticotropin and cortisol responses, higher anxiety, and greater stress- and cue-induced alcohol craving, was seen in the alcohol-dependent patients vs the control group. Stress- and cue-induced anxiety and stress-induced alcohol craving were associated with fewer days in aftercare alcohol treatment. High provoked alcohol craving to both stress and to cues and greater neutral, relaxed-state cortisol to corticotropin ratio (adrenal sensitivity) were each predictive of shorter time to alcohol relapse. These results identify a significant effect of high adrenal sensitivity, anxiety, and increased stress- and cue-induced alcohol craving on subsequent alcohol relapse and treatment outcomes. Findings suggest that new treatments that decrease adrenal sensitivity, stress- and cue-induced alcohol craving, and anxiety could be beneficial in improving alcohol relapse outcomes.

78 FR 78710 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... attached loads, and subsequent loss of helicopter control. DATES: This AD is effective January 31, 2014... of the boom and attached loads, and subsequent loss of helicopter control. The NPRM was prompted by... the loss of the boom and attached loads. According to EASA, boom P/Ns 44301-500 and 44307-500-1 are of...

Context, not conflict, drives cognitive control.

PubMed

Schlaghecken, Friederike; Martini, Paolo

2012-04-01

Theories of cognitive control generally assume that perceived conflict acts as a signal to engage inhibitory mechanisms that suppress subsequent conflicting information. Crucially, an absence of conflict is not regarded as being a relevant signal for cognitive control. Using a cueing, a priming, and a Simon task, we provide evidence that conflict does not have this unique signal status: Encountering a conflict does not lead to behavioral adjustments on subsequent conflict trials, whereas encountering a nonconflict trial does lead to behavioral adjustments on subsequent nonconflict trials. We propose that this apparent role-reversal can be explained by a mechanism that responds to both the presence and the absence of conflict, down-regulating the visuomotor system following conflict, and up-regulating it following nonconflict.

Effects of dispersed oil on reproduction in the cold water copepod Calanus finmarchicus (Gunnerus)

PubMed Central

Olsen, Anders Johny; Nordtug, Trond; Altin, Dag; Lervik, Morten; Hansen, Bjørn Henrik

2013-01-01

Following a 120-h exposure period to 3 concentrations of oil dispersions (0.022 mg L−1, 1.8 mg L−1, and 16.5 mg L−1, plus controls) generated from a North Sea crude oil and a subsequent 21-d recovery, mortality, and several reproduction endpoints (egg production rates, egg hatching success, and fraction of females participating in reproduction) in Calanus finmarchicus were studied. Concentration-dependent mortality was found during exposure, averaging to 6%, 3%, 15%, and 42% for the controls and 3 exposure levels, respectively. At the start of the recovery period, mean egg production rates of surviving females from the highest concentrations were very low, but reproduction subsequently improved. In a 4-d single female reproduction test starting 13 d postexposure, no significant differences in egg production rates or hatching success were found between reproducing control and exposed copepods. However, a significantly lower portion of the surviving females from the highest exposure participated in egg production. The results indicate that although short-term exposure to oil-polluted water after an oil spill can induce severe mortality and temporarily suspend reproduction, copepods may recover and produce viable offspring soon after exposure. The results might imply that for C. finmarchicus populations, the impact from short-term exposure to an oil spill might be predicted from acute mortality and that delayed effects make only a limited contribution to population decrease. PMID:23661343

Effects of Incorporating Carboxymethyl Chitosan into PMMA Bone Cement Containing Methotrexate

PubMed Central

Liu, Bo-Ming; Li, Ming; Yin, Bao-Sheng; Zou, Ji-Yang; Zhang, Wei-Guo; Wang, Shou-Yu

2015-01-01

Treatment of bone metastases usually includes surgical resection with local filling of methotrexate (MTX) in polymethyl methacrylate (PMMA) cement. We investigated whether incorporating carboxymethyl chitosan (CMCS) in MTX-PMMA cement might overcome disadvantages associated with MTX. To determine the optimal CMCS+MTX concentration to suppress the viability of cancer cells, an integrated microfluidic chip culturing highly metastatic lung cancer cells (H460) was employed. The mechanical properties, microstructure, and MTX release of (CMCS+MTX)-PMMA cement were evaluated respectively by universal mechanical testing machine, scanning electron microscopy (SEM), and incubation in simulated body fluid with subsequent HPLC-MS. Implants of MTX-PMMA and (CMCS+MTX)-PMMA cement were evaluated in vivo in guinea pig femurs over time using spiral computed tomography with three-dimensional image reconstruction, and SEM at 6 months. Viability of H460 cells was significantly lowest after treatment with 57 μg/mL CMCS + 21 μg/mL MTX, which was thus used in subsequent experiments. Incorporation of 1.6% (w/w) CMCS to MTX-PMMA significantly increased the bending modulus, bending strength, and compressive strength by 5, 2.8, and 5.2%, respectively, confirmed by improved microstructural homogeneity. Incorporation of CMCS delayed the time-to-plateau of MTX release by 2 days, but increased the fraction released at the plateau from 3.24% (MTX-PMMA) to 5.34%. Relative to the controls, the (CMCS+MTX)-PMMA implants integrated better with the host bone. SEM revealed pores in the cement of the (CMCS+MTX)-PMMA implants that were not obvious in the controls. In conclusion, incorporation of CMCS in MTX-PMMA appears a feasible and effective modification for improving the anti-tumor properties of MTX-PMMA cement. PMID:26657526

Effect of intermittent normobaric hypoxia on aerobic capacity and cognitive function in older people.

PubMed

Schega, Lutz; Peter, Beate; Brigadski, Tanja; Leßmann, Volkmar; Isermann, Berend; Hamacher, Dennis; Törpel, Alexander

2016-11-01

Physical exercise, especially aerobic training, improves physical performance and cognitive function of older people. Furthermore, it has been speculated that age-associated deteriorations in physical performance and cognitive function could be counteracted through exposures to passive intermittent normobaric hypoxia (IH). Thus, the present investigation aimed at investigating the effect of passive IH combined with subsequent aerobic training on hematological parameters and aerobic physical performance (V˙O 2max ) as well as peripheral levels of the neurotrophin brain-derived neurotrophic factor (BDNF) and cognitive function. Randomized controlled trial in a repeated measure design. 34 older participants were randomly assigned to an intervention group (IG) or control group (CG). While IG was supplied with passive IH for 90min, CG breathed ambient air. Subsequently, both groups underwent 30min of aerobic training three times per week for four consecutive weeks. Aerobic physical performance and cognitive function was tested with spiroergometry and the Stroop test. Blood samples were taken to measure hematological parameters and the peripheral serum BDNF-level. We found increases in the values of hematological parameters, the time to exhaustion in the load test and an augmented and sustainable improvement in cognitive function within the IG of the older people only. However, in both groups, the V˙O 2max and serum BDNF-level did not increase. Based on these results, hypoxic training seems to be beneficial to enhance hematological parameters, physical performance and cognitive function in older people. The current hypoxic-dose was not able to enhance the serum BDNF-level or V˙O 2max . Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effects of Incorporating Carboxymethyl Chitosan into PMMA Bone Cement Containing Methotrexate.

PubMed

Liu, Bo-Ming; Li, Ming; Yin, Bao-Sheng; Zou, Ji-Yang; Zhang, Wei-Guo; Wang, Shou-Yu

2015-01-01

Treatment of bone metastases usually includes surgical resection with local filling of methotrexate (MTX) in polymethyl methacrylate (PMMA) cement. We investigated whether incorporating carboxymethyl chitosan (CMCS) in MTX-PMMA cement might overcome disadvantages associated with MTX. To determine the optimal CMCS+MTX concentration to suppress the viability of cancer cells, an integrated microfluidic chip culturing highly metastatic lung cancer cells (H460) was employed. The mechanical properties, microstructure, and MTX release of (CMCS+MTX)-PMMA cement were evaluated respectively by universal mechanical testing machine, scanning electron microscopy (SEM), and incubation in simulated body fluid with subsequent HPLC-MS. Implants of MTX-PMMA and (CMCS+MTX)-PMMA cement were evaluated in vivo in guinea pig femurs over time using spiral computed tomography with three-dimensional image reconstruction, and SEM at 6 months. Viability of H460 cells was significantly lowest after treatment with 57 μg/mL CMCS + 21 μg/mL MTX, which was thus used in subsequent experiments. Incorporation of 1.6% (w/w) CMCS to MTX-PMMA significantly increased the bending modulus, bending strength, and compressive strength by 5, 2.8, and 5.2%, respectively, confirmed by improved microstructural homogeneity. Incorporation of CMCS delayed the time-to-plateau of MTX release by 2 days, but increased the fraction released at the plateau from 3.24% (MTX-PMMA) to 5.34%. Relative to the controls, the (CMCS+MTX)-PMMA implants integrated better with the host bone. SEM revealed pores in the cement of the (CMCS+MTX)-PMMA implants that were not obvious in the controls. In conclusion, incorporation of CMCS in MTX-PMMA appears a feasible and effective modification for improving the anti-tumor properties of MTX-PMMA cement.

Better imagined: Neural correlates of the episodic simulation boost to prospective memory performance.

PubMed

Spreng, R Nathan; Madore, Kevin P; Schacter, Daniel L

2018-05-01

Episodic simulation is an adaptive process that can support goal-directed activity and planning success. We investigated the neural architecture associated with the episodic simulation improvement to the likelihood of carrying out future actions by isolating the brain regions associated with this facilitation in a prospective memory paradigm. Participants performed a lexical decision task by making word/non-word judgments, with rarely occurring prospective memory target words requiring a pre-specified manual response. Prior to scanning, participants were given exposure to two lists of prospective memory targets: animals and tools. In a fully counterbalanced design, participants generated a rhyme to one target list and imagined their subsequent encounter (episodic simulation) with target words on the other list. Replicating prior behavioral work, episodic simulation improved subsequent prospective memory performance. Brain activation was assessed in a multivariate partial least squares analysis. Relative to lexical decision blocks with no prospective memory demand, sustained prospective memory replicated prior observations of frontal polar activation. Critically, maintaining the intention to respond to simulated targets, over and above rhyme targets, engaged middle frontal and angular gyri, and medial parietal and prefrontal cortices. Transient activity associated with prospective memory target hits revealed activation for simulated targets in medial prefrontal cortex, posterior cingulate, lateral temporal lobe and inferior parietal lobule. In contrast, rhyme target hits engaged more left lateralized dorsolateral prefrontal cortex and anterior insula. Episodic simulation, thus effectively shifts executive control strategy and boosts task performance. These results are consistent with a growing body of evidence implicating executive control and default network region interactions in adaptive, goal-directed behavior. Copyright © 2018 Elsevier Ltd. All rights reserved.

Threat facilitates subsequent executive control during anxious mood.

PubMed

Birk, Jeffrey L; Dennis, Tracy A; Shin, Lisa M; Urry, Heather L

2011-12-01

Dual competition framework (DCF) posits that low-level threat may facilitate behavioral performance by influencing executive control functions. Anxiety is thought to strengthen this effect by enhancing threat's affective significance. To test these ideas directly, we examined the effects of low-level threat and experimentally induced anxiety on one executive control function, the efficiency of response inhibition. In Study 1, briefly presented stimuli that were mildly threatening (i.e., fearful faces) relative to nonthreatening (i.e., neutral faces) led to facilitated executive control efficiency during experimentally induced anxiety. No such effect was observed during an equally arousing, experimentally induced happy mood state. In Study 2, we assessed the effects of low-level threat, experimentally induced anxiety, and individual differences in trait anxiety on executive control efficiency. Consistent with Study 1, fearful relative to neutral faces led to facilitated executive control efficiency during experimentally induced anxiety. No such effect was observed during an experimentally induced neutral mood state. Moreover, individual differences in trait anxiety did not moderate the effects of threat and anxiety on executive control efficiency. The findings are partially consistent with the predictions of DCF in that low-level threat improved executive control, at least during a state of anxiety. (c) 2011 APA, all rights reserved.

Too Exhausted to Perform at the Highest Level? On the Importance of Self-control Strength in Educational Settings

PubMed Central

Englert, Chris; Zavery, Alafia; Bertrams, Alex

2017-01-01

In order to perform at the highest level in educational settings (e.g., students in testing situations), individuals often have to control their impulses or desires (e.g., to study for an upcoming test or to prepare a course instead of spending time with the peer group). Previous research suggests that the ability to exert self-control is an important predictor of performance and behavior in educational contexts. According to the strength model, all self-control acts are based on one global energy pool whose capacity is assumed to be limited. After having performed a first act of self-control, this resource can become temporarily depleted which negatively affects subsequent self-control. In such a state of ego depletion, individuals tend to display impaired concentration and academic performance, fail to meet academic deadlines, or even disengage from their duties. In this mini-review, we report recent studies on ego depletion which have focused on children as well as adults in educational settings, derive practical implications for how to improve self-control strength in the realm of education and instruction, and discuss limitations regarding the assumptions of the strength model of self-control. PMID:28790963

Too Exhausted to Perform at the Highest Level? On the Importance of Self-control Strength in Educational Settings.

PubMed

Englert, Chris; Zavery, Alafia; Bertrams, Alex

2017-01-01

In order to perform at the highest level in educational settings (e.g., students in testing situations), individuals often have to control their impulses or desires (e.g., to study for an upcoming test or to prepare a course instead of spending time with the peer group). Previous research suggests that the ability to exert self-control is an important predictor of performance and behavior in educational contexts. According to the strength model, all self-control acts are based on one global energy pool whose capacity is assumed to be limited. After having performed a first act of self-control, this resource can become temporarily depleted which negatively affects subsequent self-control. In such a state of ego depletion, individuals tend to display impaired concentration and academic performance, fail to meet academic deadlines, or even disengage from their duties. In this mini-review, we report recent studies on ego depletion which have focused on children as well as adults in educational settings, derive practical implications for how to improve self-control strength in the realm of education and instruction, and discuss limitations regarding the assumptions of the strength model of self-control.

Dynamic learning from adaptive neural network control of a class of nonaffine nonlinear systems.

PubMed

Dai, Shi-Lu; Wang, Cong; Wang, Min

2014-01-01

This paper studies the problem of learning from adaptive neural network (NN) control of a class of nonaffine nonlinear systems in uncertain dynamic environments. In the control design process, a stable adaptive NN tracking control design technique is proposed for the nonaffine nonlinear systems with a mild assumption by combining a filtered tracking error with the implicit function theorem, input-to-state stability, and the small-gain theorem. The proposed stable control design technique not only overcomes the difficulty in controlling nonaffine nonlinear systems but also relaxes constraint conditions of the considered systems. In the learning process, the partial persistent excitation (PE) condition of radial basis function NNs is satisfied during tracking control to a recurrent reference trajectory. Under the PE condition and an appropriate state transformation, the proposed adaptive NN control is shown to be capable of acquiring knowledge on the implicit desired control input dynamics in the stable control process and of storing the learned knowledge in memory. Subsequently, an NN learning control design technique that effectively exploits the learned knowledge without re-adapting to the controller parameters is proposed to achieve closed-loop stability and improved control performance. Simulation studies are performed to demonstrate the effectiveness of the proposed design techniques.

Research for the development of best management practices for minimizing horse trail impacts on the Hoosier National Forest

USGS Publications Warehouse

Aust, M.W.; Marion, J.L.; Kyle, K.

2005-01-01

This research investigates horse trail impacts to gain an improved understanding of the relationship between various levels of horse use, horse trail management alternatives, and subsequent horse trail degradation. A survey of existing horse trails on the Hoosier National Forest was used to collect data on use-related, environmental and management factors to model horse trail impacts. Results are analyzed to identify which factors are most easily manipulated by managers to effectively avoid and minimize horse trail impacts. A specific focus includes evaluating the relative effect of trail use level, surfacing, grade, and water control on indices of erosion and trafficability such as trail cross sectional area, estimated erosion, muddiness, and incision. Overall, the Hoosier National Forest horse trails could be significantly improved by relocating or closing inherited trails that directly ascend slope or are excessively steep, reducing the distance between water control structures, and by applying gravel to harden trail surfaces and reduce soil erosion. A set of Best Management Practices for trails are included as a product of this work, with recommendations based on this research.

Advances/applications of MAGIC and SOS

NASA Astrophysics Data System (ADS)

Warren, Gary; Ludeking, Larry; Nguyen, Khanh; Smithe, David; Goplen, Bruce

1993-12-01

MAGIC and SOS have been applied to investigate a variety of accelerator-related devices. Examples include high brightness electron guns, beam-RF interactions in klystrons, cold-test modes in an RFQ and in RF sources, and a high-quality, flexible, electron gun with operating modes appropriate for gyrotrons, peniotrons, and other RF sources. Algorithmic improvements for PIC have been developed and added to MAGIC and SOS to facilitate these modeling efforts. Two new field algorithms allow improved control of computational numerical noise and selective control of harmonic modes in RF cavities. An axial filter in SOS accelerates simulations in cylindrical coordinates. The recent addition of an export/import feature now allows long devices to be modeled in sections. Interfaces have been added to receive electromagnetic field information from the Poisson group of codes and from EGUN and to send beam information to PARMELA for subsequent tracing of bunches through beam optics. Post-processors compute and display beam properties including geometric, normalized, and slice emittances, and phase-space parameters, and video. VMS, UNIX, and DOS versions are supported, with migration underway toward windows environments.

Transient inhibition of the ERK pathway prevents cerebellar developmental defects and improves long-term motor functions in murine models of neurofibromatosis type 1.

PubMed

Kim, Edward; Wang, Yuan; Kim, Sun-Jung; Bornhorst, Miriam; Jecrois, Emmanuelle S; Anthony, Todd E; Wang, Chenran; Li, Yi E; Guan, Jun-Lin; Murphy, Geoffrey G; Zhu, Yuan

2014-12-23

Individuals with neurofibromatosis type 1 (NF1) frequently exhibit cognitive and motor impairments and characteristics of autism. The cerebellum plays a critical role in motor control, cognition, and social interaction, suggesting that cerebellar defects likely contribute to NF1-associated neurodevelopmental disorders. Here we show that Nf1 inactivation during early, but not late stages of cerebellar development, disrupts neuronal lamination, which is partially caused by overproduction of glia and subsequent disruption of the Bergmann glia (BG) scaffold. Specific Nf1 inactivation in glutamatergic neuronal precursors causes premature differentiation of granule cell (GC) precursors and ectopic production of unipolar brush cells (UBCs), indirectly disrupting neuronal migration. Transient MEK inhibition during a neonatal window prevents cerebellar developmental defects and improves long-term motor performance of Nf1-deficient mice. This study reveals essential roles of Nf1 in GC/UBC migration by generating correct numbers of glia and controlling GC/UBC fate-specification/differentiation, identifying a therapeutic prevention strategy for multiple NF1-associcated developmental abnormalities.

Cardiac stem cell genetic engineering using the alphaMHC promoter.

PubMed

Bailey, Brandi; Izarra, Alberto; Alvarez, Roberto; Fischer, Kimberlee M; Cottage, Christopher T; Quijada, Pearl; Díez-Juan, Antonio; Sussman, Mark A

2009-11-01

Cardiac stem cells (CSCs) show potential as a cellular therapeutic approach to blunt tissue damage and facilitate reparative and regenerative processes after myocardial infarction. Despite multiple published reports of improvement, functional benefits remain modest using normal stem cells delivered by adoptive transfer into damaged myocardium. The goal of this study is to enhance survival and proliferation of CSCs that have undergone lineage commitment in early phases as evidenced by expression of proteins driven by the alpha-myosin heavy chain (alphaMHC) promoter. The early increased expression of survival kinases augments expansion of the cardiogenic CSC pool and subsequent daughter progeny. Normal CSCs engineered with fluorescent reporter protein constructs under control of the alphaMHC promoter show transgene protein expression, confirming activity of the promoter in CSCs. Cultured CSCs from both nontransgenic and cardiac-specific transgenic mice expressing survival kinases driven by the alphaMHC promoter were analyzed to characterize transgene expression following treatments to promote differentiation in culture. Therapeutic genes controlled by the alphaMHC promoter can be engineered into and expressed in CSCs and cardiomyocyte progeny with the goal of improving the efficacy of cardiac stem cell therapy.

Importance of leadership in cardiac arrest situations: from simulation to real life and back.

PubMed

Hunziker, Sabnina; Tschan, Franziska; Semmer, Norbert K; Marsch, Stephan

2013-04-18

The 2010 American Heart Association guidelines now recommend leadership training in Advanced Cardiac Life Support courses. In this review we provide a comprehensive summary of data derived from clinical studies that investigated the importance of leadership in cardiopulmonary resuscitation (CPR). Only a few, mostly observational, studies have been conducted under real-life conditions because of the high heterogeneity of the situations, difficulties in capturing the initial phase of CPR, and ethical issues. Well-controlled studies in the human simulator can fill existing gaps and provide important insights. High-fidelity video-assisted simulator studies from different research groups have shown that a prolonged process of teambuilding is associated with significant shortcomings in CPR, whereas effective leadership improves team performance. In addition, randomised controlled studies have provided evidence that medical students receiving leadership training subsequently showed improved CPR performance, which was sustained after a follow up of 4 months. In addition, leadership is influenced by gender and other factors such as emotional stress. Future studies are needed to investigate cultural differences and how findings from the simulator can be transferred to real-life situations.

Body weight gain induced by a newer antipsychotic agent reversed as negative symptoms improved.

PubMed

Koga, M; Nakayama, K

2005-07-01

We describe a patient in whom improvement in negative symptoms contributed to early weight loss and subsequent long-term improvement in weight management. Case report. A 26-year-old woman with schizophrenia gained 7 kg over the course of 1 year after starting treatment with olanzapine. However, as negative symptoms gradually improved with treatment, she became motivated to diet and exercise regularly. She quickly lost 9 kg and subsequently maintained optimal weight (55 kg; body mass index, 24.1 kg/m(2) ). Important strategies for minimizing weight gain in patients taking antipsychotic agents include improving negative symptoms of avolition and apathy, regular monitoring of body weight and potential medical consequences of overweight and obesity, and educating the patient about the importance of diet and regular exercise.

A passive heat maintenance strategy implemented during a simulated half-time improves lower body power output and repeated sprint ability in professional Rugby Union players.

PubMed

Russell, Mark; West, Daniel J; Briggs, Marc A; Bracken, Richard M; Cook, Christian J; Giroud, Thibault; Gill, Nicholas; Kilduff, Liam P

2015-01-01

Reduced physical performance has been observed following the half-time period in team sports players, likely due to a decrease in muscle temperature during this period. We examined the effects of a passive heat maintenance strategy employed between successive exercise bouts on core temperature (Tcore) and subsequent exercise performance. Eighteen professional Rugby Union players completed this randomised and counter-balanced study. After a standardised warm-up (WU) and 15 min of rest, players completed a repeated sprint test (RSSA 1) and countermovement jumps (CMJ). Thereafter, in normal training attire (Control) or a survival jacket (Passive), players rested for a further 15 min (simulating a typical half-time) before performing a second RSSA (RSSA 2) and CMJ's. Measurements of Tcore were taken at baseline, post-WU, pre-RSSA 1, post-RSSA 1 and pre-RSSA 2. Peak power output (PPO) and repeated sprint ability was assessed before and after the simulated half-time. Similar Tcore responses were observed between conditions at baseline (Control: 37.06±0.05°C; Passive: 37.03±0.05°C) and for all other Tcore measurements taken before half-time. After the simulated half-time, the decline in Tcore was lower (-0.74±0.08% vs. -1.54±0.06%, p<0.001) and PPO was higher (5610±105 W vs. 5440±105 W, p<0.001) in the Passive versus Control condition. The decline in PPO over half-time was related to the decline in Tcore (r = 0.632, p = 0.005). In RSSA 2, best, mean and total sprint times were 1.39±0.17% (p<0.001), 0.55±0.06% (p<0.001) and 0.55±0.06% (p<0.001) faster for Passive versus Control. Passive heat maintenance reduced declines in Tcore that were observed during a simulated half-time period and improved subsequent PPO and repeated sprint ability in professional Rugby Union players.

Academic Performance of Subsequent Schools and Impacts of Early Interventions: Evidence from a Randomized Controlled Trial in Head Start Settings

PubMed Central

Zhai, Fuhua; Raver, C. Cybele; Jones, Stephanie M.

2012-01-01

The role of subsequent school contexts in the long-term effects of early childhood interventions has received increasing attention, but has been understudied in the literature. Using data from the Chicago School Readiness Project (CSRP), a cluster-randomized controlled trial conducted in Head Start programs, we investigate whether the intervention had differential effects on academic and behavioral outcomes in kindergarten if children attended high- or low-performing schools subsequent to the preschool intervention year. To address the issue of selection bias, we adopt an innovative method, principal score matching, and control for a set of child, mother, and classroom covariates. We find that exposure to the CSRP intervention in the Head Start year had significant effects on academic and behavioral outcomes in kindergarten for children who subsequently attended high-performing schools, but no significant effects on children attending low-performing schools. Policy implications of the findings are discussed. PMID:22773872

Modifying surface resistivity and liquid moisture management property of keratin fibers through thiol-ene click reactions.

PubMed

Yu, Dan; Cai, Jackie Y; Church, Jeffrey S; Wang, Lijing

2014-01-22

This paper reports on a new method for improving the antistatic and liquid moisture management properties of keratinous materials. The method involves the generation of thiols by controlled reduction of cystine disulfide bonds in keratin with tris(2-carboxyethyl) phosphine hydrochloride and subsequent grafting of hydrophilic groups onto the reduced keratin by reaction with an acrylate sulfonate or acrylamide sulfonate through thiol-ene click chemistry. The modified substrates were characterized with Raman spectroscopy and scanning electron microscopy and evaluated for their performance changes in liquid moisture management, surface resistivity, and wet burst strength. The results have revealed that the thiol-acrylate reaction is more efficient than the thiol-acrylamide reaction, and the keratinous substrate modified with an acrylate sulfonate salt exhibits significantly improved antistatic and liquid moisture management properties.

Gait training strategies to optimize walking ability in people with stroke: A synthesis of the evidence

PubMed Central

Tang, Pei Fang

2011-01-01

Stroke is a leading cause of long-term disability. Impairments resulting from stroke lead to persistent difficulties with walking and subsequently, improved walking ability is one of the highest priorities for people living with a stroke. In addition, walking ability has important health implications in providing protective effects against secondary complications common after a stroke such as heart disease or osteoporosis. This paper systematically reviews common gait training strategies (neurodevelopmental techniques, muscle strengthening, treadmill training, intensive mobility exercises) to improve walking ability. The results (descriptive summaries as well as pooled effect sizes) from randomized controlled trials are presented and implications for optimal gait training strategies are discussed. Novel and emerging gait training strategies are highlighted and research directions proposed to enable the optimal recovery and maintenance of walking ability. PMID:17939776

3-D laser patterning process utilizing horizontal and vertical patterning

DOEpatents

Malba, Vincent; Bernhardt, Anthony F.

2000-01-01

A process which vastly improves the 3-D patterning capability of laser pantography (computer controlled laser direct-write patterning). The process uses commercially available electrodeposited photoresist (EDPR) to pattern 3-D surfaces. The EDPR covers the surface of a metal layer conformally, coating the vertical as well as horizontal surfaces. A laser pantograph then patterns the EDPR, which is subsequently developed in a standard, commercially available developer, leaving patterned trench areas in the EDPR. The metal layer thereunder is now exposed in the trench areas and masked in others, and thereafter can be etched to form the desired pattern (subtractive process), or can be plated with metal (additive process), followed by a resist stripping, and removal of the remaining field metal (additive process). This improved laser pantograph process is simpler, faster, move manufacturable, and requires no micro-machining.

Cognitive science in the field: A preschool intervention durably enhances intuitive but not formal mathematics.

PubMed

Dillon, Moira R; Kannan, Harini; Dean, Joshua T; Spelke, Elizabeth S; Duflo, Esther

2017-07-07

Many poor children are underprepared for demanding primary school curricula. Research in cognitive science suggests that school achievement could be improved by preschool pedagogy in which numerate adults engage children's spontaneous, nonsymbolic mathematical concepts. To test this suggestion, we designed and evaluated a game-based preschool curriculum intended to exercise children's emerging skills in number and geometry. In a randomized field experiment with 1540 children (average age 4.9 years) in 214 Indian preschools, 4 months of math game play yielded marked and enduring improvement on the exercised intuitive abilities, relative to no-treatment and active control conditions. Math-trained children also showed immediate gains on symbolic mathematical skills but displayed no advantage in subsequent learning of the language and concepts of school mathematics. Copyright © 2017, American Association for the Advancement of Science.

Excimer laser processing of backside-illuminated CCDS

NASA Technical Reports Server (NTRS)

Russell, S. D.

1993-01-01

An excimer laser is used to activate previously implanted dopants on the backside of a backside-illuminated CCD. The controlled ion implantation of the backside and subsequent thin layer heating and recrystallization by the short wavelength pulsed excimer laser simultaneously activates the dopant and anneals out implant damage. This improves the dark current response, repairs defective pixels and improves spectral response. This process heats a very thin layer of the material to high temperatures on a nanosecond time scale while the bulk of the delicate CCD substrate remains at low temperature. Excimer laser processing backside-illuminated CCD's enables salvage and utilization of otherwise nonfunctional components by bringing their dark current response to within an acceptable range. This process is particularly useful for solid state imaging detectors used in commercial, scientific and government applications requiring a wide spectral response and low light level detection.

Decreasing patient identification band errors by standardizing processes.

PubMed

Walley, Susan Chu; Berger, Stephanie; Harris, Yolanda; Gallizzi, Gina; Hayes, Leslie

2013-04-01

Patient identification (ID) bands are an essential component in patient ID. Quality improvement methodology has been applied as a model to reduce ID band errors although previous studies have not addressed standardization of ID bands. Our specific aim was to decrease ID band errors by 50% in a 12-month period. The Six Sigma DMAIC (define, measure, analyze, improve, and control) quality improvement model was the framework for this study. ID bands at a tertiary care pediatric hospital were audited from January 2011 to January 2012 with continued audits to June 2012 to confirm the new process was in control. After analysis, the major improvement strategy implemented was standardization of styles of ID bands and labels. Additional interventions included educational initiatives regarding the new ID band processes and disseminating institutional and nursing unit data. A total of 4556 ID bands were audited with a preimprovement ID band error average rate of 9.2%. Significant variation in the ID band process was observed, including styles of ID bands. Interventions were focused on standardization of the ID band and labels. The ID band error rate improved to 5.2% in 9 months (95% confidence interval: 2.5-5.5; P < .001) and was maintained for 8 months. Standardization of ID bands and labels in conjunction with other interventions resulted in a statistical decrease in ID band error rates. This decrease in ID band error rates was maintained over the subsequent 8 months.

Do social functioning and symptoms improve with continuation antidepressant treatment of persistent depressive disorder? An observational study.

PubMed

Hellerstein, David J; Hunnicutt-Ferguson, Kallio; Stewart, Jonathan W; McGrath, Patrick J; Keller, Samantha; Peterson, Bradley S; Chen, Ying

2017-03-01

To determine efficacy of continued treatment with the serotonin norepinephrine reuptake inhibitor duloxetine on symptom reduction and functional improvement in outpatients with dysthymia. Fifty outpatients with DSM-IV-TR diagnosed dysthymia who had participated in a 10 week double-blind, placebo-controlled study of duloxetine received open treatment for three months. Nineteen duloxetine responders continued duloxetine, 24 patients initially treated with placebo started open duloxetine treatment, and 7 duloxetine non-responders were treated with desvenlafaxine or bupropion, selected by clinician choice. Patients continuing duloxetine maintained symptom improvement, 84% meeting response and 63% remission criteria at week 22. Patients initially treated with placebo showed similarly high levels of response (83%) and remission (62%) at week 22, and most duloxetine non-responders subsequently responded to other antidepressants. Duloxetine-continuation patients improved modestly between weeks 10 and 22 on measures of social and cognitive functioning and temperament. Despite this improvement concurrently across several functional domains, 66.7% of patients continuing duloxetine remained in the impaired range of functioning according to the Social Adjustment Scale (SAS). Continued duloxetine treatment appears to be effective in maintaining symptom response in dysthymic disorder, and has positive effects on social functioning. However, the majority of patients do not show normalization of functioning, even when controlling for remission status. Additional treatments should be considered to target residual impairments in social functioning in mood remitted patients with persistent depressive disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Effect of a mobile health, sensor-driven asthma management platform on asthma control.

PubMed

Barrett, Meredith A; Humblet, Olivier; Marcus, Justine E; Henderson, Kelly; Smith, Ted; Eid, Nemr; Sublett, J Wesley; Renda, Andrew; Nesbitt, LaQuandra; Van Sickle, David; Stempel, David; Sublett, James L

2017-11-01

Asthma inflicts a significant health and economic burden in the United States. Self-management approaches to monitoring and treatment can be burdensome for patients. To assess the effect of a digital health management program on asthma outcomes. Residents of Louisville, Kentucky, with asthma were enrolled in a single-arm pilot study. Participants received electronic inhaler sensors that tracked the time, frequency, and location of short-acting β-agonist (SABA) use. After a 30-day baseline period during which reference medication use was recorded by the sensors, participants received access to a digital health intervention designed to enhance self-management. Changes in outcomes, including mean daily SABA use, symptom-free days, and asthma control status, were compared among the initial 30-day baseline period and all subsequent months of the intervention using mixed-model logistic regressions and χ 2 tests. The mean number of SABA events per participant per day was 0.44 during the control period and 0.27 after the first month of the intervention, a 39% reduction. The percentage of symptom-free days was 77% during the baseline period and 86% after the first month, a 12% improvement. Improvement was observed throughout the study; each intervention month demonstrated significantly lower SABA use and higher symptom-free days than the baseline month (P < .001). Sixty-nine percent had well-controlled asthma during the baseline period, 67% during the first month of the intervention. Each intervention month demonstrated significantly higher percentages than the baseline month (P < .001), except for month 1 (P = .80). A digital health asthma management intervention demonstrated significant reductions in SABA use, increased number of symptom-free days, and improvements in asthma control. ClinicalTrials.gov Identifier: NCT02162576. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Development and Impact Evaluation of an E-Learning Radiation Oncology Module

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

Alfieri, Joanne, E-mail: Joanne.alfieri@mail.mcgill.ca; Portelance, Lorraine; Souhami, Luis

Purpose: Radiation oncologists are faced with the challenge of irradiating tumors to a curative dose while limiting toxicity to healthy surrounding tissues. This can be achieved only with superior knowledge of radiologic anatomy and treatment planning. Educational resources designed to meet these specific needs are lacking. A web-based interactive module designed to improve residents' knowledge and application of key anatomy concepts pertinent to radiotherapy treatment planning was developed, and its effectiveness was assessed. Methods and Materials: The module, based on gynecologic malignancies, was developed in collaboration with a multidisciplinary team of subject matter experts. Subsequently, a multi-centre randomized controlled studymore » was conducted to test the module's effectiveness. Thirty-six radiation oncology residents participated in the study; 1920 were granted access to the module (intervention group), and 17 in the control group relied on traditional methods to acquire their knowledge. Pretests and posttests were administered to all participants. Statistical analysis was carried out using paired t test, analysis of variance, and post hoc tests. Results: The randomized control study revealed that the intervention group's pretest and posttest mean scores were 35% and 52%, respectively, and those of the control group were 37% and 42%, respectively. The mean improvement in test scores was 17% (p < 0.05) for the intervention group and 5% (p = not significant) for the control group. Retrospective pretest and posttest surveys showed a statistically significant change on all measured module objectives. Conclusions: The use of an interactive e-learning teaching module for radiation oncology is an effective method to improve the radiologic anatomy knowledge and treatment planning skills of radiation oncology residents.« less

Motivational aftercare planning to better care: Applying the principles of advanced directives and motivational interviewing to discharge planning for people with mental illness.

PubMed

Kisely, Steve; Wyder, Marianne; Dietrich, Josie; Robinson, Gail; Siskind, Dan; Crompton, David

2017-02-01

Improving the input of people with mental illness into their recovery plans can potentially lead to better outcomes. In the present study, we evaluated the introduction of motivational aftercare planning (MAP) into the discharge planning of psychiatric inpatients. MAP is a manualized intervention combining motivational interviewing with advance directives. We measured changes in the level of patient input into discharge planning following training staff in the use of MAP. This included the following: (i) documentation of early relapse signs along with successful past responses; (ii) evidence of aftercare planning; and (iii) the use of the patients' own words in the plan. We used a ward-level controlled before-and-after design comparing one intervention ward with two control wards. We used anonymized recovery plans, with a goal of 50 plans per ward before and after the intervention, to look for evidence of patient input into care planning with a standardized checklist. There were also qualitative interviews with individuals discharged from the unit. We reviewed 100 intervention ward plans and 197 control ones (total n = 297). There were no significant differences in recovery plans from intervention and control wards at baseline. Following MAP training, the intervention ward improved significantly (e.g. identification of triggers increased from 52 to 94%, χ 2  = 23.3, d.f. =1, P < 0.001). This did not occur in the control wards. The qualitative data (n = 20 interviews) showed improvements in participants' experiences of discharge planning. MAP increased inpatient input into discharge planning and was valued by participants. The effect on subsequent health service use needs evaluation. © 2016 Australian College of Mental Health Nurses Inc.

An investigation of radiographers' mobile phone use and the success of an awareness campaign at reducing the nosocomial infection risks.

PubMed

Crofton, C C; Foley, S J

2018-02-01

Mobile phone use by healthcare workers (HCWs) is widespread. Studies have shown that HCW's mobile phones can harbour pathogens associated with nosocomial infections. This study investigated whether an awareness campaign will result in an improvement in radiographers' phone and hand hygiene practices. Radiographers working in the general department of two university hospitals were invited to participate. One hospital was assigned as the experiment hospital and the other as a control. In the experiment hospital, adenosine triphosphate (ATP) testing of each participant's mobile phone determined the cleanliness of its surface. A corresponding survey was completed to determine their current practices and level of awareness. Subsequently, an infection control poster campaign took place for a one-month period, followed by re-testing. In the control hospital, the ATP testing and survey were also completed before and after a one-month period, but without a poster campaign. Radiographers were generally unaware of the infection risks associated with mobile phone use with 44% of all participants never cleaning their phone. The campaign successfully improved phone hygiene frequency and method in the experiment hospital. However, it did not improve hand hygiene practices and actual phone cleanliness (mean ATP count reductions of 10% (experiment hospital) and 20% (control)). The ATP testing as a less direct form of intervention showed similar levels of success in comparison to the poster campaign. A multifaceted educational approach is likely to be most effective in raising awareness and changing radiographers' phone and hand hygiene practices. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Preventive vaccination contributes to control classical swine fever in wild boar (Sus scrofa sp.).

PubMed

Rossi, S; Pol, F; Forot, B; Masse-Provin, N; Rigaux, S; Bronner, A; Le Potier, M-F

2010-04-21

Over the last 20 years, oral vaccination implementing a live attenuated vaccine has been experimented in Europe in order to control classical swine fever (CSF) in Wild Boar (Sus scrofa sp.). This has generally led to an enhanced seroprevalence and a decreased viroprevalence at the scale of the whole vaccinated populations, but no quantitative analysis has demonstrated the protective effect of preventive vaccination or intensive baiting. In the present paper we conducted a retrospective analysis at the scale of the municipality, taking into account the local dynamics and possible covariates of infection to test the effect of preventive vaccination and of the baiting effort. To be efficient, vaccination was expected to increase seroprevalence above the level considered as suitable for preventing disease invasion (40-60%) independently of infection, to protect free areas from disease invasion or contribute to control subsequent disease intensity and duration. We also hypothesized that a better baiting effort would be correlated with an improvement of immunisation and disease control. In uninfected municipalities, seroprevalence increased up to 40% after 1 year, i.e., three vaccination campaigns. We observed a significant protective effect of preventive vaccination, especially within municipalities that had been vaccinated at least 1 year before disease emergence and where virus detection did not last more than one quarter. On the other hand, we did not detect a significant effect of the baiting effort on local seroprevalence or disease dynamics, suggesting that the baiting system could be improved. We discuss these results regarding the improvement of management measures and further research perspective. Copyright 2009 Elsevier B.V. All rights reserved.

Air Quality Strategies on Public Health and Health Equity in Europe-A Systematic Review.

PubMed

Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

2016-12-02

Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO₂) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO₂ were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review.

Air Quality Strategies on Public Health and Health Equity in Europe—A Systematic Review

PubMed Central

Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

2016-01-01

Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO2) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review. PMID:27918457

FY 1998 Proposed Rail Improvement Program Supplement

DOT National Transportation Integrated Search

1997-01-01

This FY 1998 Proposed Rail Improvement Program Supplement contains those rail plan amendments which have been published subsequent to the FY 1997 Proposed Rail Improvement program supplement. This document also contains the benefit/cost methodology u...

Wildland fire limits subsequent fire occurrence

Treesearch

Sean A. Parks; Carol Miller; Lisa M. Holsinger; Scott Baggett; Benjamin J. Bird

2016-01-01

Several aspects of wildland fire are moderated by site- and landscape-level vegetation changes caused by previous fire, thereby creating a dynamic where one fire exerts a regulatory control on subsequent fire. For example, wildland fire has been shown to regulate the size and severity of subsequent fire. However, wildland fire has the potential to influence...

Understanding and Shaping the Morphology of the Barrier Layer of Supported Porous Anodized Alumina on Gold Underlayers.

PubMed

Berger, Nele; Es-Souni, Mohammed

2016-07-12

Large-area ordered nanorod (NR) arrays of various functional materials can be easily and cost-effectively processed using on-substrate anodized porous aluminum oxide (PAO) films as templates. However, reproducibility in the processing of PAO films is still an issue because they are prone to delamination, and control of fabrication parameters such as electrolyte type and concentration and anodizing time is critical for making robust templates and subsequently mechanically reliable NR arrays. In the present work, we systematically investigate the effects of the fabrication parameters on pore base morphology, devise a method to avoid delamination, and control void formation under the barrier layer of PAO films on gold underlayers. Via systematic control of the anodization parameters, particularly the anodization current density and time, we follow the different stages of void development and discuss their formation mechanisms. The practical aspect of this work demonstrates how void size can be controlled and how void formation can be utilized to control the shape of NR bases for improving the mechanical stability of the NRs.

Controlled Source 4D Seismic Imaging

NASA Astrophysics Data System (ADS)

Luo, Y.; Morency, C.; Tromp, J.

2009-12-01

Earth's material properties may change after significant tectonic events, e.g., volcanic eruptions, earthquake ruptures, landslides, and hydrocarbon migration. While many studies focus on how to interpret observations in terms of changes in wavespeeds and attenuation, the oil industry is more interested in how we can identify and locate such temporal changes using seismic waves generated by controlled sources. 4D seismic analysis is indeed an important tool to monitor fluid movement in hydrocarbon reservoirs during production, improving fields management. Classic 4D seismic imaging involves comparing images obtained from two subsequent seismic surveys. Differences between the two images tell us where temporal changes occurred. However, when the temporal changes are small, it may be quite hard to reliably identify and characterize the differences between the two images. We propose to back-project residual seismograms between two subsequent surveys using adjoint methods, which results in images highlighting temporal changes. We use the SEG/EAGE salt dome model to illustrate our approach. In two subsequent surveys, the wavespeeds and density within a target region are changed, mimicking possible fluid migration. Due to changes in material properties induced by fluid migration, seismograms recorded in the two surveys differ. By back propagating these residuals, the adjoint images identify the location of the affected region. An important issue involves the nature of model. For instance, are we characterizing only changes in wavespeed, or do we also consider density and attenuation? How many model parameters characterize the model, e.g., is our model isotropic or anisotropic? Is acoustic wave propagation accurate enough or do we need to consider elastic or poroelastic effects? We will investigate how imaging strategies based upon acoustic, elastic and poroelastic simulations affect our imaging capabilities.

Practical session assessments in human anatomy: Weightings and performance.

PubMed

McDonald, Aaron C; Chan, Siew-Pang; Schuijers, Johannes A

2016-07-08

Assessment weighting within a given module can be a motivating factor for students when deciding on their commitment level and time given to study a specific topic. In this study, an analysis of assessment performances of second year anatomy students was performed over four years to determine if (1) students performed better when a higher weighting was given to a set of practical session assessments and (2) whether an improved performance in the practical session assessments had a carry-over effect on other assessment tasks within that anatomy module and/or other anatomy modules that follow. Results showed that increasing the weighting of practical session assessments improved the average mark in that assessment and also improved the percentage of students passing that assessment. Further, it significantly improved performance in the written end-semester examination within the same module and had a carry-over effect on the anatomy module taught in the next teaching period, as students performed better in subsequent practical session assessments as well as subsequent end-semester examinations. It was concluded that the weighting of assessments had significant influences on a student's performance in that, and subsequent, assessments. It is postulated that practical session assessments, designed to develop deep learning skills in anatomy, improved efficacy in student performance in assessments undertaken in that and subsequent anatomy modules when the weighting of these assessments was greater. These deep learning skills were also transferable to other methods of assessing anatomy. Anat Sci Educ 9: 330-336. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

Lending to Parents and Insuring Children: Is There a Role for Microcredit in Complementing Health Insurance in Rural China?

PubMed

You, Jing

2016-05-01

This paper assesses the causal impact on child health of borrowing formal microcredit for Chinese rural households by exploiting a panel dataset (2000 and 2004) in a poor northwest province. Endogenous borrowing is controlled for in a dynamic regression-discontinuity design creating a quasi-experimental environment for causal inferences. There is causal relationship running from formal microcredit to improved child health in the short term, while past borrowing behaviour has no protracted impact on subsequent child health outcomes. Moreover, formal microcredit appears to be a complement to health insurance in improving child health through two mechanisms-it enhances affordability for out-of-pocket health care expenditure and helps buffer consumption against adverse health shocks and financial risk incurred by current health insurance arrangements. Government efforts in expanding health insurance for rural households would be more likely to achieve its optimal goals of improving child health outcomes if combined with sufficient access to formal microcredit. Copyright © 2015 John Wiley & Sons, Ltd.

Impact of single-point GPS integrated water vapor estimates on short-range WRF model forecasts over southern India

NASA Astrophysics Data System (ADS)

Kumar, Prashant; Gopalan, Kaushik; Shukla, Bipasha Paul; Shyam, Abhineet

2017-11-01

Specifying physically consistent and accurate initial conditions is one of the major challenges of numerical weather prediction (NWP) models. In this study, ground-based global positioning system (GPS) integrated water vapor (IWV) measurements available from the International Global Navigation Satellite Systems (GNSS) Service (IGS) station in Bangalore, India, are used to assess the impact of GPS data on NWP model forecasts over southern India. Two experiments are performed with and without assimilation of GPS-retrieved IWV observations during the Indian winter monsoon period (November-December, 2012) using a four-dimensional variational (4D-Var) data assimilation method. Assimilation of GPS data improved the model IWV analysis as well as the subsequent forecasts. There is a positive impact of ˜10 % over Bangalore and nearby regions. The Weather Research and Forecasting (WRF) model-predicted 24-h surface temperature forecasts have also improved when compared with observations. Small but significant improvements were found in the rainfall forecasts compared to control experiments.

Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

PubMed

Safeer, Richard; Bowen, Wendy; Maung, Zaw; Lucik, Meg

2018-02-01

The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

Comparing in situ removal strategies for improving styrene bioproduction.

PubMed

McKenna, Rebekah; Moya, Luis; McDaniel, Matthew; Nielsen, David R

2015-01-01

As an important conventional monomer compound, the biological production of styrene carries significant promise with respect to creating novel sustainable materials. Since end-product toxicity presently limits styrene production by previously engineered Escherichia coli, in situ product removal by both solvent extraction and gas stripping were explored as process-based strategies for circumventing its inhibitory effects. In solvent extraction, the addition of bis(2-ethylhexyl)phthalate offered the greatest productivity enhancement, allowing net volumetric production of 836 ± 64 mg/L to be reached, representing a 320 % improvement over single-phase cultures. Gas stripping rates, meanwhile, were controlled by rates of bioreactor agitation and, to a greater extent, aeration. A periodic gas stripping protocol ultimately enabled up to 561 ± 15 mg/L styrene to be attained. Lastly, by relieving the effects of styrene toxicity, new insight was gained regarding subsequent factors limiting its biosynthesis in E. coli and strategies for future strain improvement are discussed.

Improvement of mechanical and biological properties of Polycaprolactone loaded with Hydroxyapatite and Halloysite nanotubes.

PubMed

Torres, E; Fombuena, V; Vallés-Lluch, A; Ellingham, T

2017-06-01

Hydroxyapatite (HA) and Halloysite nanotubes (HNTs) percentages have been optimized in Polycaprolactone (PCL) polymeric matrices to improve mechanical, thermal and biological properties of the composites, thus, to be applied in bone tissue engineering or as fixation plates. Addition of HA guarantees a proper compatibility with human bone due to its osteoconductive and osteoinductive properties, facilitating bone regeneration in tissue engineering applications. Addition of HNTs ensures the presence of tubular structures for subsequent drug loading in their lumen, of molecules such as curcumin, acting as controlled drug delivery systems. The addition of 20% of HA and different amounts of HNTs leads to a substantial improvement in mechanical properties with values of flexural strength up to 40% over raw PCL, with an increase in degradation temperature. DMA analyses showed stability in mechanical and thermal properties, having as a result a potential composite to be used as tissue engineering scaffold or resorbable fixation plate. Copyright © 2017 Elsevier B.V. All rights reserved.

A cluster randomized control trial to assess the impact of active learning on child activity, attention control, and academic outcomes: The Texas I-CAN trial.

PubMed

Bartholomew, John B; Jowers, Esbelle M; Errisuriz, Vanessa L; Vaughn, Sharon; Roberts, Gregory

2017-10-01

Active learning is designed to pair physical activity with the teaching of academic content. This has been shown to be a successful strategy to increase physical activity and improve academic performance. The existing designs have confounded academic lessons with physical activity. As a result, it is impossible to determine if the subsequent improvement in academic performance is due to: (1) physical activity, (2) the academic content of the active learning, or (3) the combination of academic material taught through physical activity. The Texas I-CAN project is a 3-arm, cluster randomized control trial in which 28 elementary schools were assigned to either control, math intervention, or spelling intervention. As a result, each intervention condition serves as an unrelated content control for the other arm of the trial, allowing the impact of physical activity to be separated from the content. That is, schools that perform only active math lessons provide a content control for the spelling schools on spelling outcomes. This also calculated direct observations of attention and behavior control following periods of active learning. This design is unique in its ability to separate the impact of physical activity, in general, from the combination of physical activity and specific academic content. This, in combination with the ability to examine both proximal and distal outcomes along with measures of time on task will do much to guide the design of future, school-based interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

How do cardiorespiratory fitness improvements vary with physical training modality in heart failure patients? A quantitative guide

PubMed Central

Smart, Neil A

2013-01-01

BACKGROUND: Peak oxygen consumption (VO2) is the gold standard measure of cardiorespiratory fitness and a reliable predictor of survival in chronic heart failure patients. Furthermore, any form of physical training usually improves cardiorespiratory fitness, although the magnitude of improvement in peak VO2 may vary across different training prescriptions. OBJECTIVE: To quantify, and subsequently rank, the magnitude of improvement in peak VO2 for different physical training prescriptions using data from published meta-analyses and randomized controlled trials. METHODS: Prospective randomized controlled parallel trials and meta-analyses of exercise training in chronic heart failure patients that provided data on change in peak VO2 for nine a priori comparative analyses were examined. RESULTS: All forms of physical training were beneficial, although the improvement in peak VO2 varied with modality. High-intensity interval exercise yielded the largest increase in peak VO2, followed in descending order by moderate-intensity aerobic exercise, functional electrical stimulation, inspiratory muscle training, combined aerobic and resistance training, and isolated resistance training. With regard to setting, the present study was unable to determine whether outpatient or unsupervised home exercise provided greater benefits in terms of peak VO2 improvment. CONCLUSIONS: Interval exercise is not suitable for all patients, especially the high-intensity variety; however, when indicated, this form of exercise should be adopted to optimize peak VO2 adaptations. Other forms of activity, such as functional electrical stimulation, may be more appropriate for patients who are not capable of high-intensity interval training, especially for severely deconditioned patients who are initially unable to exercise. PMID:24294043

76 FR 52593 - Airworthiness Directives; Eurocopter Canada Ltd. Model BO 105 LS A-3 Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... fatigue failure of a TT strap, loss of a blade, and subsequent loss of control of the helicopter. DATES... failure of a TT strap, loss of a blade, and subsequent loss of control of the helicopter. Since issuing... ASB also describes and contains a graph for determining the revised life limit, and provides various...

A patient-centred team-coaching concept for medical rehabilitation.

PubMed

Körner, M; Becker, S; Dinius, J; Müller, C; Zimmermann, L; Rundel, M

2018-01-01

Team coaching enhances teamwork and subsequently improves patient-centredness in medical rehabilitation clinics. Even though interprofessional teamwork is regarded as a crucial factor in medical rehabilitation, to date no evaluated team-coaching approaches are available for improving interprofessional teamwork in medical rehabilitation in Germany. Based on a systematic literature search and interviews with staff, managers, and patients of rehabilitation clinics, we developed a team-coaching approach that is standardized in its process but based on the individual needs and requests of each clinic. It takes a systemic perspective and is goal-oriented and solution-focused. The approach mainly serves to provide impulses to make use of resources within the team and to support a self-directed organisational learning process. It is manualized and can, therefore, be used by professionals aiming to improve interprofessional teamwork in their clinic. A multi-centre, cluster-randomized controlled study that was conducted to evaluate the team-coaching approach showed positive results. Team organization, knowledge integration, and responsibility can be improved, and, therefore, the implementation of the patient-centred team-coaching approach in interprofessional rehabilitation teams can be recommended.

Treatment of metaphor interpretation deficits subsequent to traumatic brain injury.

PubMed

Brownell, Hiram; Lundgren, Kristine; Cayer-Meade, Carol; Milione, Janet; Katz, Douglas I; Kearns, Kevin

2013-01-01

To improve oral interpretation of metaphors by patients with traumatic brain injury (TBI). Both single subject experimental design and group analysis. Patients' homes. Eight adult patients with moderate to severe traumatic brain injury sustained 3 to 20 years before testing. The Metaphor Training Program consisted typically of 10 baseline sessions, 3 to 9 1-hour sessions of structured intervention, and 10 posttraining baseline sessions. Training used extensive practice with simple graphic displays to illustrate semantic associations. Quality of orally produced metaphor interpretation and accuracy of line orientation judgments served as dependent measures obtained during baseline, training, posttraining, and at a 3- to 4-month follow-up. Untrained line orientation judgments provided a control measure. Group data showed significant improvement in metaphor interpretation but not in line orientation. Six of 8 patients individually demonstrated significant improvement in metaphor interpretation. Gains persisted for 3 of the 6 patients at the 3- to 4-month follow-up. The Metaphor Training Program can improve cognitive-communication performance for individuals with moderate to severe traumatic brain injury. Results support the potential for treating patients' residual cognitive-linguistic deficits.

Resveratrol Improves Cell Cycle Arrest in Chronic Prostatitis Rats, by C-kit/SCF Suppression.

PubMed

He, Yi; Zeng, Huizhi; Yu, Yang; Zhang, Jiashu; Zeng, Xiaona; Gong, Fengtao; Liu, Qi; Yang, Bo

2017-08-01

Chronic prostatitis (CP) with complex pathogenesis is difficult for treatment. c-kit has been associated with the control of cell proliferation of prostate cells. This study aims to evaluate the role of resveratrol, an activator of Sirt1, in regulating the expression of c-kit in CP and investigate the consequent effects on cell cycle. Rat model of CP was established through subcutaneous injections of diphtheria-pertussis-tetanus vaccine and subsequently treated with resveratrol. Hematoxylin and eosin staining was performed to identify the histopathological changes in prostates. Western blotting and immunohistochemical staining examined the expression level of c-kit, stem cell factor (SCF), Sirt1, and cell cycle-associated proteins. The model group exhibited severe diffuse chronic inflammation, characterized by leukocyte infiltration and papillary frond protrusion into the gland cavities, and a notable increase in prostatic epithelial height. Gland lumen diameter was also significantly smaller; the activity of c-kit/SCF in the CP rats was increased significantly compared to the control group. Meanwhile, the cell cycle proteins are dysregulated significantly in CP rats. Resveratrol treatment significantly improved these factors by Sirt1 activation. Dysregulation of cell cycle was involved in the pathological processes of CP, which was improved after resveratrol treatment by the downregulation of c-kit/SCF by activating Sirt1.

Repetitive negative thinking predicts depression and anxiety symptom improvement during brief cognitive behavioral therapy.

PubMed

Kertz, Sarah J; Koran, Jennifer; Stevens, Kimberly T; Björgvinsson, Thröstur

2015-05-01

Repetitive negative thinking (RNT) is a common symptom across depression and anxiety disorders and preliminary evidence suggests that decreases in rumination and worry are related to improvement in depression and anxiety symptoms. However, despite its prevalence, relatively little is known about transdiagnostic RNT and its temporal associations with symptom improvement during treatment. The current study was designed to examine the influence of RNT on subsequent depression and anxiety symptoms during treatment. Participants (n = 131; 52% female; 93% White; M = 34.76 years) were patients presenting for treatment in a brief, cognitive behavior therapy based, partial hospitalization program. Participants completed multiple assessments of depression (Center for the Epidemiological Studies of Depression-10 scale), anxiety (the 7-item Generalized Anxiety Disorder Scale), and repetitive negative thinking (Perseverative Thinking Questionnaire) over the course of treatment. Results indicated statistically significant between and within person effects of RNT on depression and anxiety, even after controlling for the effect of time, previous symptom levels, referral source, and treatment length. RNT explained 22% of the unexplained variability in depression scores and 15% of the unexplained variability in anxiety scores beyond that explained by the control variables. RNT may be an important transdiagnostic treatment target for anxiety and depression. Copyright © 2015 Elsevier Ltd. All rights reserved.

From the doctor's workshop to the iron cage? Evolving modes of physician control in US health systems.

PubMed

Kitchener, Martin; Caronna, Carol A; Shortell, Stephen M

2005-03-01

As national health systems pursue the common goals of containing expenditure growth and improving quality, many have sought to replace autonomous modes (systems) of physician control that rely on initial professional training and subsequent peer review. A common approach has involved extending bureaucratic modes of physician control that employ techniques such as hierarchical coordination and salaried positions. This paper applies concepts from studies of professional work to frame an empirical analysis of emergent bureaucratic modes of physician control in US hospital-based systems. Conceptually, we draw from recent studies to update Scott's (Health Services Res. 17(3) (1982) 213) typology to specify three bureaucratic modes of physician control: heteronomous, conjoint, and custodial. Empirically, we use case study evidence from eight US hospital-based systems to illustrate the heterogeneity of bureaucratic modes of physician control that span each of the ideal types. The findings indicate that some influential analysts perpetuate a caricature of bureaucratic organization which underplays its capacity to provide multiple modes of physician control that maintain professional autonomy over the content of work, and present opportunities for aligning practice with social goals.

The effect of diabetes self-management education on body weight, glycemic control, and other metabolic markers in patients with type 2 diabetes mellitus.

PubMed

Yuan, Chuang; Lai, Christopher W K; Chan, Lawrence W C; Chow, Meyrick; Law, Helen K W; Ying, Michael

2014-01-01

To comprehensively evaluate the effect of a short-term diabetes self-management education (DSME) on metabolic markers and atherosclerotic parameters in patients with type 2 diabetes. 76 patients with type 2 diabetes were recruited in this study. They were divided into the intervention group (n = 36) and control group (n = 40). The patients in the intervention group received a 3-month intervention, including an 8-week education on self-management of diabetes mellitus and subsequent 4 weeks of practice of the self-management guidelines. The patients in the control group received standard advice on medical nutrition therapy. Metabolic markers, carotid intima-media thickness (CIMT), and carotid arterial stiffness (CAS) of the patients in both groups were assessed before and after the 3-month intervention. There was a significant reduction in hemoglobin A1c (HbA1c, -0.2 ± 0.56% versus 0.08 ± 0.741%; P < 0.05) and body weight (-1.19 ± 1.39 kg versus -0.61 ± 2.04 kg; P < 0.05) in the intervention group as compared to the control group. However, no significant improvements were found in other metabolic markers, CIMT and CAS (P > 0.05). DSME can improve HbA1c and body weight in patients with type 2 diabetes.

An fMRI investigation of the effects of attempted naming on word retrieval in aphasia

PubMed Central

Heath, Shiree; McMahon, Katie L.; Nickels, Lyndsey A.; Angwin, Anthony; MacDonald, Anna D.; van Hees, Sophia; McKinnon, Eril; Johnson, Kori; Copland, David A.

2015-01-01

In healthy controls, picture naming performance can be facilitated by a single prior exposure to the same picture (“priming”). This priming phenomenon is utilized in the treatment of aphasia, which often includes repeated picture naming as part of a therapeutic task. The current study sought to determine whether single and/or multiple exposures facilitate subsequent naming in aphasia and whether such facilitatory effects act through normal priming mechanisms. A functional magnetic resonance imaging paradigm was employed to explore the beneficial effects of attempted naming in two individuals with aphasia and a control group. The timing and number of prior exposures was manipulated, with investigation of both short-term effects (single prior exposure over a period of minutes) and long-term effects (multiple presentations over a period of days). Following attempted naming, both short-term and long-term facilitated items showed improvement for controls, while only the long-term condition showed benefits at a behavioral level for the participants with aphasia. At a neural level, effects of long-term facilitation were noted in the left precuneus for one participant with aphasia, a result also identified for the equivalent contrast in controls. It appears that multiple attempts are required to improve naming performance in the presence of anomia and that for some individuals with aphasia the source of facilitation may be similar to unimpaired mechanisms engaged outside the language network. PMID:26074801

Do detour tasks provide accurate assays of inhibitory control?

PubMed Central

Whiteside, Mark A.; Laker, Philippa R.; Beardsworth, Christine E.

2018-01-01

Transparent Cylinder and Barrier tasks are used to purportedly assess inhibitory control in a variety of animals. However, we suspect that performances on these detour tasks are influenced by non-cognitive traits, which may result in inaccurate assays of inhibitory control. We therefore reared pheasants under standardized conditions and presented each bird with two sets of similar tasks commonly used to measure inhibitory control. We recorded the number of times subjects incorrectly attempted to access a reward through transparent barriers, and their latencies to solve each task. Such measures are commonly used to infer the differential expression of inhibitory control. We found little evidence that their performances were consistent across the two different Putative Inhibitory Control Tasks (PICTs). Improvements in performance across trials showed that pheasants learned the affordances of each specific task. Critically, prior experience of transparent tasks, either Barrier or Cylinder, also improved subsequent inhibitory control performance on a novel task, suggesting that they also learned the general properties of transparent obstacles. Individual measures of persistence, assayed in a third task, were positively related to their frequency of incorrect attempts to solve the transparent inhibitory control tasks. Neophobia, Sex and Body Condition had no influence on individual performance. Contrary to previous studies of primates, pheasants with poor performance on PICTs had a wider dietary breadth assayed using a free-choice task. Our results demonstrate that in systems or taxa where prior experience and differences in development cannot be accounted for, individual differences in performance on commonly used detour-dependent PICTS may reveal more about an individual's prior experience of transparent objects, or their motivation to acquire food, than providing a reliable measure of their inhibitory control. PMID:29593115

Temperature stress deteriorates bed bug (Cimex lectularius) populations through decreased survival, fecundity and offspring success.

PubMed

Rukke, Bjørn Arne; Sivasubramaniam, Ranjeni; Birkemoe, Tone; Aak, Anders

2018-01-01

Sublethal heat stress may weaken bed bug infestations to potentially ease control. In the present study, experimental populations exposed to 34, 36 or 38°C for 2 or 3 weeks suffered significant mortality during exposure. Among survivors, egg production, egg hatching, moulting success and offspring proliferation decreased significantly in the subsequent 7 week recovery period at 22°C. The overall population success was negatively impacted by increasing temperature and duration of the stress. Such heat stress is inadequate as a single tool for eradication, but may be included as a low cost part of an integrated pest management protocol. Depending on the time available and infestation conditions, the success of some treatments can improve if sublethal heat is implemented prior to the onset of more conventional pest control measures.

Temperature stress deteriorates bed bug (Cimex lectularius) populations through decreased survival, fecundity and offspring success

PubMed Central

Rukke, Bjørn Arne; Sivasubramaniam, Ranjeni; Birkemoe, Tone; Aak, Anders

2018-01-01

Sublethal heat stress may weaken bed bug infestations to potentially ease control. In the present study, experimental populations exposed to 34, 36 or 38°C for 2 or 3 weeks suffered significant mortality during exposure. Among survivors, egg production, egg hatching, moulting success and offspring proliferation decreased significantly in the subsequent 7 week recovery period at 22°C. The overall population success was negatively impacted by increasing temperature and duration of the stress. Such heat stress is inadequate as a single tool for eradication, but may be included as a low cost part of an integrated pest management protocol. Depending on the time available and infestation conditions, the success of some treatments can improve if sublethal heat is implemented prior to the onset of more conventional pest control measures. PMID:29538429

Enzymatic and chemical treatment limits on the controlled solubilization of brewers' spent grain.

PubMed

Robertson, James A; Castro-Mariñas, Luis; Collins, Samuel R A; Faulds, Craig B; Waldron, Keith W

2011-10-26

The enzymatic hydrolysis of brewers' spent grain (BSG) has been investigated through treatment with commercial carbohydrases and proteases. Resultant residues were then chemically fractionated and delignified. Enzymatic treatments released 25-30% of the BSG mass and yielded precursors suitable for subsequent conversion to potentially value-added products. Controlled chemical fractionation selectively solubilized arabinoxylan but with no differences apparent due to prior enzyme treatment. The loss of non-polysaccharide components during alkali treatment suggests the presence of a high proportion of alkali-soluble lignin. Further delignification of the alkali-insoluble residues and further chemical fractionation released the remaining hemicellulose, to yield a residue which was >90% cellulose. Further knowledge of the properties and interaction between BSG polymers will facilitate an improved enzyme-assisted total deconstruction of BSG and hence the exploitation of its biomass.

Green pastures: Do US real estate prices respond to population health?

PubMed

Nau, Claudia; Bishai, David

2018-01-01

We investigate whether communities with improving population health will subsequently experience rising real estate prices. Home price indices (HPIs) for 371 MSAs from 1990 to 2010 are regressed against life-expectancy five years prior. HPIs come from the Federal Housing Finance Agency. Life expectancy estimates come from the Institute of Health Metrics. Our analysis uses random and fixed effect models with a comprehensive set of controls. Life expectancy predicted increases in the HPI controlling for potential confounders. We found that, this effect varied spatially. Communities that invest their revenue from property taxes in public health infrastructure could benefit from a virtuous cycle of better health leading to higher property values. Communities that do not invest in health could enter vicious cycles and this could widen geospatial health and wealth disparities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exercise leads to the re-emergence of the cholinergic/nestin neuronal phenotype within the medial septum/diagonal band and subsequent rescue of both hippocampal ACh efflux and spatial behavior.

PubMed

Hall, Joseph M; Savage, Lisa M

2016-04-01

Exercise has been shown to improve cognitive functioning in a range of species, presumably through an increase in neurotrophins throughout the brain, but in particular the hippocampus. The current study assessed the ability of exercise to restore septohippocampal cholinergic functioning in the pyrithiamine-induced thiamine deficiency (PTD) rat model of the amnestic disorder Korsakoff Syndrome. After voluntary wheel running or sedentary control conditions (stationary wheel attached to the home cage), PTD and control rats were behaviorally tested with concurrent in vivo microdialysis, at one of two time points: 24-h or 2-weeks post-exercise. It was found that only after the 2-week adaption period did exercise lead to an interrelated sequence of events in PTD rats that included: (1) restored spatial working memory; (2) rescued behaviorally-stimulated hippocampal acetylcholine efflux; and (3) within the medial septum/diagonal band, the re-emergence of the cholinergic (choline acetyltransferase [ChAT+]) phenotype, with the greatest change occurring in the ChAT+/nestin+ neurons. Furthermore, in control rats, exercise followed by a 2-week adaption period improved hippocampal acetylcholine efflux and increased the number of neurons co-expressing the ChAT and nestin phenotype. These findings demonstrate a novel mechanism by which exercise can modulate the mature cholinergic/nestin neuronal phenotype leading to improved neurotransmitter function as well as enhanced learning and memory. Copyright © 2016 Elsevier Inc. All rights reserved.

Potentially important periods of change in the development of social and role functioning in youth at clinical high risk for psychosis.

PubMed

Velthorst, Eva; Zinberg, Jamie; Addington, Jean; Cadenhead, Kristin S; Cannon, Tyrone D; Carrión, Ricardo E; Auther, Andrea; Cornblatt, Barbara A; McGlashan, Thomas H; Mathalon, Daniel H; Perkins, Diana O; Seidman, Larry J; Tsuang, Ming T; Walker, Elaine F; Woods, Scott W; Reichenberg, Abraham; Bearden, Carrie E

2018-02-01

The developmental course of daily functioning prior to first psychosis-onset remains poorly understood. This study explored age-related periods of change in social and role functioning. The longitudinal study included youth (aged 12-23, mean follow-up years = 1.19) at clinical high risk (CHR) for psychosis (converters [CHR-C], n = 83; nonconverters [CHR-NC], n = 275) and a healthy control group (n = 164). Mixed-model analyses were performed to determine age-related differences in social and role functioning. We limited our analyses to functioning before psychosis conversion; thus, data of CHR-C participants gathered after psychosis onset were excluded. In controls, social and role functioning improved over time. From at least age 12, functioning in CHR was poorer than in controls, and this lag persisted over time. Between ages 15 and 18, social functioning in CHR-C stagnated and diverged from that of CHR-NC, who continued to improve (p = .001). Subsequently, CHR-C lagged behind in improvement between ages 21 and 23, further distinguishing them from CHR-NC (p < .001). A similar period of stagnation was apparent for role functioning, but to a lesser extent (p = .007). The results remained consistent when we accounted for the time to conversion. Our findings suggest that CHR-C start lagging behind CHR-NC in social and role functioning in adolescence, followed by a period of further stagnation in adulthood.

Cognitive retraining for organizational impairment in obsessive-compulsive disorder.

PubMed

Buhlmann, Ulrike; Deckersbach, Thilo; Engelhard, Iris; Cook, Laura M; Rauch, Scott L; Kathmann, Norbert; Wilhelm, Sabine; Savage, Cary R

2006-11-15

Individuals with obsessive-compulsive disorder (OCD) have difficulties in organizing information during encoding associated with subsequent memory impairments. This study was designed to investigate whether impairments in organization in individuals with OCD can be alleviated with cognitive training. Thirty-five OCD subjects and 36 controls copied and recalled the Rey-Osterrieth Complex Figure Test (RCFT) [Osterrieth, P.A., 1944. Le test de copie d'une figure complexe: Contribution a l'étude de la perception et de la memoire (The test of copying a complex figure: A contribution to the study of perception and memory). Archive de Psychologie 30, 286-350.] before being randomly assigned to a training or non-training condition. The training condition was designed to improve the ability to organize complex visuospatial information in a meaningful way. The intervention phase was followed by another copy and recall trial of the RCFT. Both OCD and control subjects who underwent training improved more in organization and memory than subjects who did not receive organizational training, providing evidence that the training procedure was effective. OCD subjects improved more in organizational during encoding than control subjects, irrespective of whether or not they had received training. This suggests that organization impairment in OCD affects primarily the ability to spontaneously utilize strategies when faced with complex, ambiguous information but that the ability to implement such strategies when provided with additional trials is preserved. These findings support a distinction in OCD between failure to utilize a strategy and incapacity to implement a strategy.

International normalized ratio self-testing and self-management: improving patient outcomes.

PubMed

Pozzi, Matteo; Mitchell, Julia; Henaine, Anna Maria; Hanna, Najib; Safi, Ola; Henaine, Roland

2016-01-01

Long term oral anti-coagulation with vitamin K antagonists is a risk factor of hemorrhagic or thromebomlic complications. Periodic laboratory testing of international normalized ratio (INR) and a subsequent dose adjustment are therefore mandatory. The use of home testing devices to measure INR has been suggested as a potential way to improve the comfort and compliance of the patients and their families, the frequency of monitoring and, finally, the management and safety of long-term oral anticoagulation. In pediatric patients, increased doses to obtain and maintain the therapeutic target INR, more frequent adjustments and INR testing, multiple medication, inconstant nutritional intake, difficult venepunctures, and the need to go to the laboratory for testing (interruption of school and parents' work attendance) highlight those difficulties. After reviewing the most relevant published studies of self-testing and self-management of INR for adult patients and children on oral anticoagulation, it seems that these are valuable and effective strategies of INR control. Despite an unclear relationship between INR control and clinical effects, these self-strategies provide a better control of the anticoagulant effect, improve patients and their family quality of life, and are an appealing solution in term of cost-effectiveness. Structured education and knowledge evaluation by trained health care professionals is required for children, to be able to adjust their dose treatment safely and accurately. However, further data are necessary in order to best define those patients who might better benefit from this multidisciplinary approach.

Effect of high moisture storage of pearl millet (Pennisetum typhoides) with or without feed enzymes on growth and nutrient utilization in broiler chickens.

PubMed

Manwar, Satish Jagannath; Mandal, Asit Baran

2009-08-01

Effect of reconstitution of pearl millet with or without enzymes on its utilization in broiler chickens was studied. The pearl millet grains were reconstituted by adding water to raise the moisture level to 30%, followed by storage in sealed plastic buckets with or without feed enzymes (0.5 g/kg) for 21 days at room temperature (25 degrees C). Subsequently, the grains were sun-dried to reduce the moisture content up to 10% to avoid mould growth. Nine dietary treatments were formulated incorporating pearl millet either raw with or without enzymes or reconstituted with or without enzymes in maize-soya based control diet replacing maize at 50 and 75% levels. The birds fed on diets containing enzyme reconstituted pearl millet accrued higher body weight than maize based control diet. Addition of enzymes to raw pearl-millet based diet improved the body weight gain significantly. The reconstitution of pearl millet with or without enzymes increased (P < 0.01) the dietary nitrogen corrected apparent metabolizable energy (AMEn) values and the highest improvement (6.11%) was recorded in diets containing pearl millet reconstituted with enzymes at 75% level of maize replacement. The percent nitrogen retention in pearl millet based diets was comparable to maize based control diet. It may be concluded that the supplementation of the feed enzymes or reconstitution of pearl millet may improve the utilization of pearl millet in broiler chickens.

An Open, Multisite Pilot Study of Cognitive Therapy for Depressed Adolescents

PubMed Central

BELSHER, GAYLE; WILKES, T. C. R.; RUSH, A. J.

1995-01-01

In a 12-session open trial of cognitive therapy, depressed adolescent outpatients showed significant decreases in depressive symptomatology, although there was less improvement in a subgroup with comorbid attention-deficit hyperactivity or schizoid personality disorder. Decreases on measures of depressive symptoms and depressotypic cognition were maintained up to 5 months after acute-phase treatment. Outcome was not associated with age, gender, other comorbid diagnoses, concurrent use of antidepressants, duration of acute-phase therapy, or participation in subsequent booster sessions. Data suggest that cognitive therapy is a promising intervention for depressed adolescents and provide a rationale for pursuit of controlled cognitive therapy trials with this population. PMID:22700213

Wine and grape tannin interactions with salivary proteins and their impact on astringency: a review of current research.

PubMed

McRae, Jacqui M; Kennedy, James A

2011-03-11

Astringency is an important characteristic of red wine quality. The sensation is generally thought to be produced by the interaction of wine tannins with salivary proteins and the subsequent aggregation and precipitation of protein-tannin complexes. The importance of wine astringency for marketability has led to a wealth of research on the causes of astringency and how tannins impact the quality of the sensation, particularly with respect to tannin structure. Ultimately, the understanding of how tannin structure impacts astringency will allow the controlled manipulation of tannins via such methods as micro-oxygenation or fining to improve the quality of wines.

A Review of Subsequence Time Series Clustering

PubMed Central

Teh, Ying Wah

2014-01-01

Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies. PMID:25140332

A review of subsequence time series clustering.

PubMed

Zolhavarieh, Seyedjamal; Aghabozorgi, Saeed; Teh, Ying Wah

2014-01-01

Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies.

Training Attention Improves Decision Making in Individuals with Elevated Self-Reported Depressive Symptoms

PubMed Central

Cooper, Jessica A.; Gorlick, Marissa A.; Denny, Taylor; Worthy, Darrell A.; Beevers, Christopher G.; Maddox, W. Todd

2013-01-01

Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the current study, participants were required to learn to maximize reward during decision-making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli prior to performing the decision-making task (n=20; active training). The active training group was compared to two groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n=22; placebo training) and control subjects with low levels of depressive symptoms (n=33; non-depressive control). The placebo-training depressive group performed worse and switched between options more than non-depressive controls on the reward maximization task. However, depressives that received active training performed as well as non-depressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction errors, leading to more frequent switching. The non-depressive control and active training depressive groups showed similar learning from positive and negative prediction errors, leading to less frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli. PMID:24197612

Training attention improves decision making in individuals with elevated self-reported depressive symptoms.

PubMed

Cooper, Jessica A; Gorlick, Marissa A; Denny, Taylor; Worthy, Darrell A; Beevers, Christopher G; Maddox, W Todd

2014-06-01

Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work has reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the present study, participants were required to learn to maximize reward during decision making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli prior to performing the decision-making task (n = 20; active training). The active-training group was compared to two other groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n = 22; placebo training) and a control group with low levels of depressive symptoms (n = 33; nondepressive control). The placebo-training depressive group performed worse and switched between options more than did the nondepressive controls on the reward maximization task. However, depressives that received active training performed as well as the nondepressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction errors, leading to more frequent switching. The nondepressive control and active-training depressive groups showed similar learning from positive and negative prediction errors, leading to less-frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli.

An Implanted Upper-Extremity Neuroprosthesis Using Myoelectric Control

PubMed Central

Kilgore, Kevin L.; Hoyen, Harry A.; Bryden, Anne M.; Hart, Ronald L.; Keith, Michael W.; Peckham, P. Hunter

2009-01-01

Purpose The purpose of this study was evaluate the potential of a second-generation implantable neuroprosthesis that provides improved control of hand grasp and elbow extension for individuals with cervical level spinal cord injury. The key feature of this system is that users control their stimulated function through electromyographic (EMG) signals. Methods The second-generation neuroprosthesis consists of 12 stimulating electrodes, 2 EMG signal recording electrodes, an implanted stimulator-telemeter device, an external control unit, and a transmit/receive coil. The system was implanted in a single surgical procedure. Functional outcomes for each subject were evaluated in the domains of body functions and structures, activity performance, and societal participation. Results Three individuals with C5/C6 spinal cord injury received system implantation with subsequent prospective evaluation for a minimum of 2 years. All 3 subjects demonstrated that EMG signals can be recorded from voluntary muscles in the presence of electrical stimulation of nearby muscles. Significantly increased pinch force and grasp function was achieved for each subject. Functional evaluation demonstrated improvement in at least 5 activities of daily living using the Activities of Daily Living Abilities Test. Each subject was able to use the device at home. There were no system failures. Two of 6 EMG electrodes required surgical revision because of suboptimal location of the recording electrodes. Conclusions These results indicate that a neuroprosthesis with implanted myoelectric control is an effective method for restoring hand function in midcervical level spinal cord injury. Type of study/level of evidence Therapeutic IV. PMID:18406958

Stress training improves performance during a stressful flight.

PubMed

McClernon, Christopher K; McCauley, Michael E; O'Connor, Paul E; Warm, Joel S

2011-06-01

This study investigated whether stress training introduced during the acquisition of simulator-based flight skills enhances pilot performance during subsequent stressful flight operations in an actual aircraft. Despite knowledge that preconditions to aircraft accidents can be strongly influenced by pilot stress, little is known about the effectiveness of stress training and how it transfers to operational flight settings. For this study, 30 participants with no flying experience were assigned at random to a stress-trained treatment group or a control group. Stress training consisted of systematic pairing of skill acquisition in a flight simulator with stress coping mechanisms in the presence of a cold pressor. Control participants received identical flight skill acquisition training but without stress training. Participants then performed a stressful flying task in a Piper Archer aircraft. Stress-trained research participants flew the aircraft more smoothly, as recorded by aircraft telemetry data, and generally better, as recorded by flight instructor evaluations, than did control participants. Introducing stress coping mechanisms during flight training improved performance in a stressful flying task. The results of this study indicate that stress training during the acquisition of flight skills may serve to enhance pilot performance in stressful operational flight and, therefore, might mitigate the contribution of pilot stress to aircraft mishaps.

Monitoring memory errors: the influence of the veracity of retrieved information on the accuracy of judgements of learning.

PubMed

Rhodes, Matthew G; Tauber, Sarah K

2011-11-01

The current study examined the degree to which predictions of memory performance made immediately or at a delay are sensitive to confidently held memory illusions. Participants studied unrelated pairs of words and made judgements of learning (JOLs) for each item, either immediately or after a delay. Half of the unrelated pairs (deceptive items; e.g., nurse-dollar) had a semantically related competitor (e.g., doctor) that was easily accessible when given a test cue (e.g., nurse-do_ _ _r) and half had no semantically related competitor (control items; e.g., subject-dollar). Following the study phase, participants were administered a cued recall test. Results from Experiment 1 showed that memory performance was less accurate for deceptive compared with control items. In addition, delaying judgement improved the relative accuracy of JOLs for control items but not for deceptive items. Subsequent experiments explored the degree to which the relative accuracy of delayed JOLs for deceptive items improved as a result of a warning to ensure that retrieved memories were accurate (Experiment 2) and corrective feedback regarding the veracity of information retrieved prior to making a JOL (Experiment 3). In all, these data suggest that delayed JOLs may be largely insensitive to memory errors unless participants are provided with feedback regarding memory accuracy.

Emotional Stress as a Risk for Hypertension in Sub-Saharan Africans: Are We Ignoring the Odds?

PubMed

Malan, Leoné; Malan, Nico T

2017-01-01

Globally most interventions focus on improving lifestyle habits and treatment regimens to combat hypertension as a non-communicable disease (NCD). However, despite these interventions and improved medical treatments, blood pressure (BP) values are still on the rise and poorly controlled in sub-Saharan Africa (SSA). Other factors contributing to hypertension prevalence, such as chronic emotional stress, might provide some insight for future health policy approaches.Currently, Hypertension Society guidelines do not mention emotional stress as a probable cause for hypertension. Recently the 2014 World Global Health reports, suggested that African governments should consider using World Health Organization hypertension data as a proxy indicator for social well-being. However, the possibility that a stressful life and taxing environmental factors might disturb central neural control of BP regulation has largely been ignored in SSA.Linking emotional stress to vascular dysregulation is therefore one way to investigate increased cardiometabolic challenges, neurotransmitter depletion and disturbed hemodynamics. Disruption of stress response pathways and subsequent changes in lifestyle habits as ways of coping with a stressful life, and as probable cause for hypertension prevalence in SSA, may be included in future preventive measures. We will provide an overview on emotional stress and central neural control of BP and will include also implications thereof for clinical practice in SSA cohorts.

Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?

PubMed Central

Walczyńska-Dragon, Karolina; Baron, Stefan; Nitecka-Buchta, Aleksandra; Tkacz, Ewaryst

2014-01-01

Temporomandibular dysfunction (TMD) is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM) and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD) and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P > 0.05), cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility. PMID:25050363

Neural Correlates of Changes in a Visual Search Task due to Cognitive Training in Seniors

PubMed Central

Wild-Wall, Nele; Falkenstein, Michael; Gajewski, Patrick D.

2012-01-01

This study aimed to elucidate the underlying neural sources of near transfer after a multidomain cognitive training in older participants in a visual search task. Participants were randomly assigned to a social control, a no-contact control and a training group, receiving a 4-month paper-pencil and PC-based trainer guided cognitive intervention. All participants were tested in a before and after session with a conjunction visual search task. Performance and event-related potentials (ERPs) suggest that the cognitive training improved feature processing of the stimuli which was expressed in an increased rate of target detection compared to the control groups. This was paralleled by enhanced amplitudes of the frontal P2 in the ERP and by higher activation in lingual and parahippocampal brain areas which are discussed to support visual feature processing. Enhanced N1 and N2 potentials in the ERP for nontarget stimuli after cognitive training additionally suggest improved attention and subsequent processing of arrays which were not immediately recognized as targets. Possible test repetition effects were confined to processes of stimulus categorisation as suggested by the P3b potential. The results show neurocognitive plasticity in aging after a broad cognitive training and allow pinpointing the functional loci of effects induced by cognitive training. PMID:23029625

Effectiveness of an interactive telerehabilitation system with home-based exercise training in patients after total hip or knee replacement: study protocol for a multicenter, superiority, no-blinded randomized controlled trial.

PubMed

Eichler, Sarah; Rabe, Sophie; Salzwedel, Annett; Müller, Steffen; Stoll, Josefine; Tilgner, Nina; John, Michael; Wegscheider, Karl; Mayer, Frank; Völler, Heinz

2017-09-21

Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain. This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints. We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas. German Clinical Trials Register (DRKS), ID: DRKS00010009 . Registered on 11 May 2016.

Neuromuscular Fatigue Alters Postural Control and Sagittal Plane Hip Biomechanics in Active Females With Anterior Cruciate Ligament Reconstruction

PubMed Central

Frank, Barnett S.; Gilsdorf, Christine M.; Goerger, Benjamin M.; Prentice, William E.; Padua, Darin A.

2014-01-01

Background: Females with history of anterior cruciate ligament (ACL) injury and subsequent ligament reconstruction are at high risk for future ACL injury. Fatigue may influence the increased risk of future injury in females by altering lower extremity biomechanics and postural control. Hypothesis: Fatigue will promote lower extremity biomechanics and postural control deficits associated with ACL injury. Study Design: Descriptive laboratory study. Methods: Fourteen physically active females with ACL reconstruction (mean age, 19.64 ± 1.5 years; mean height, 163.52 ± 6.18 cm; mean mass, 62.6 ± 13.97 kg) volunteered for this study. Postural control and lower extremity biomechanics were assessed in the surgical limb during single-leg balance and jump-landing tasks before and after a fatigue protocol. Main outcome measures were 3-dimensional hip and knee joint angles at initial contact, peak angles, joint angular displacements and peak net joint moments, anterior tibial shear force, and vertical ground reaction force during the first 50% of the loading phase of the jump-landing task. During the single-leg stance task, the main outcome measure was center of pressure sway speed. Results: Initial contact hip flexion angle decreased (t = −2.82, P = 0.01; prefatigue, 40.98° ± 9.79°; postfatigue, 36.75° ± 8.61°) from pre- to postfatigue. Hip flexion displacement (t = 2.23, P = 0.04; prefatigue, 45.19° ± 14.1°; postfatigue, 47.48° ± 14.21°) and center of pressure sway speed (t = 3.95, P < 0.05; prefatigue, 5.18 ± 0.96 cm/s; postfatigue, 6.20 ± 1.72 cm/s) increased from pre- to postfatigue. There was a trending increase in hip flexion moment (t = 2.14, P = 0.05; prefatigue, 1.66 ± 0.68 Nm/kg/m; postfatigue, 1.91 ± 0.62 Nm/kg/m) from pre- to postfatigue. Conclusion: Fatigue may induce lower extremity biomechanics and postural control deficits that may be associated with ACL injury in physically active females with ACL reconstruction. Clinical Relevance: Rehabilitation and maintenance programs should incorporate activities that aim to improve muscular endurance and improve the neuromuscular system’s tolerance to fatiguing exercise in efforts to maintain stability and safe landing technique during subsequent physical activity. PMID:24982701

Chronic histiocytic intervillositis - Clinical, biochemical and radiological findings: An observational study.

PubMed

Koby, Lawrence; Keating, Sarah; Malinowski, Ann Kinga; D'Souza, Rohan

2018-04-01

Chronic histiocytic intervillositis (CHI) of the placenta although rare, has a high recurrence rate, is associated with serious adverse pregnancy outcomes and has no available treatment. This study aims to determine clinical, biochemical and radiological factors associated with CHI, to guide management of subsequent pregnancies. This retrospective observational study included consecutive cases with a histopathologic diagnosis of CHI after 18 weeks of gestation, between 2001 and 2014, and no controls. Clinical (maternal, fetal and delivery outcomes), biochemical (first- and second-trimester biomarkers for fetal aneuploidy and serum alkaline phosphatase) and radiological (second- and third-trimester fetal, placental and Doppler ultrasound) factors associated with a histopathological diagnosis of CHI were identified and results presented as percentages. Outcomes of subsequent pregnancies were described. Of 231 identified cases of 'intervillositis', 33 were confirmed to have CHI, of which only 4/33 (12.1%) had prior uncomplicated term deliveries. During pregnancy, 10/18 (55.5%) had abnormal first-trimester screening, 4/16 (25%) had abnormal second-trimester screening, 6/19 (31.6%) had at least one elevated alkaline phosphatase level, and 15/20 (75%) had at least one abnormal feature on mid-trimester placental ultrasound. In subsequent pregnancies that were closely followed with a combination of biochemical and radiologic tests, there were no cases of fetal loss, and lower incidence of fetal growth restriction and preterm birth. No clinical, biochemical or radiological finding is consistently associated with CHI and adverse outcomes thereof. Whether the incorporation of these tests in individualized care-plans could improve outcomes in subsequent pregnancies needs to be studied further. Copyright © 2018 Elsevier Ltd. All rights reserved.

Event segmentation improves event memory up to one month later.

PubMed

Flores, Shaney; Bailey, Heather R; Eisenberg, Michelle L; Zacks, Jeffrey M

2017-08-01

When people observe everyday activity, they spontaneously parse it into discrete meaningful events. Individuals who segment activity in a more normative fashion show better subsequent memory for the events. If segmenting events effectively leads to better memory, does asking people to attend to segmentation improve subsequent memory? To answer this question, participants viewed movies of naturalistic activity with instructions to remember the activity for a later test, and in some conditions additionally pressed a button to segment the movies into meaningful events or performed a control condition that required button-pressing but not attending to segmentation. In 5 experiments, memory for the movies was assessed at intervals ranging from immediately following viewing to 1 month later. Performing the event segmentation task led to superior memory at delays ranging from 10 min to 1 month. Further, individual differences in segmentation ability predicted individual differences in memory performance for up to a month following encoding. This study provides the first evidence that manipulating event segmentation affects memory over long delays and that individual differences in event segmentation are related to differences in memory over long delays. These effects suggest that attending to how an activity breaks down into meaningful events contributes to memory formation. Instructing people to more effectively segment events may serve as a potential intervention to alleviate everyday memory complaints in aging and clinical populations. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Cold and drought stress in combination with pyrene exposure: studies with Protaphorura armata (Collembola: Onychiuridae).

PubMed

Sjursen, Heidi; Holmstrup, Martin

2004-02-01

Adult survival of the springtail Protaphorura armata exposed to pyrene, a common soil pollutant, was investigated in combination with cold and drought stress, in three separate experiments. (1) A drought stress imposed subsequent to pyrene exposure in soil resulted in a significant decrease in springtail survival, when compared with controls exposed to pyrene and subsequently to 100% relative humidity. (2) A previous exposure to drought stress resulted in slightly improved survival of pyrene exposure at a concentration of 10mg/kg, but not at higher pyrene concentrations. When comparing tests 1 and 2, better survival was found in the latter test. When comparing the drought survival of springtails that had been previously exposed to pyrene with drought survival of springtails with no previous history of pyrene exposure, survival was significantly lower in the former. (3) Springtail survival of pyrene exposure was investigated at several temperatures. Springtails showed a significant improvement in survival at temperatures fluctuating between +1 degrees C and -1 degrees C in 12:12-h cycles, and at a constant -3 degrees C, at the highest pyrene concentration (300 mg/kg), while survival remained the same at all temperatures when springtails were exposed to lower pyrene concentrations. It is concluded that temperature and water availability are important factors when assessing the springtails' susceptibility to pyrene exposure.

Improving the Nurse–Family Partnership in Community Practice

PubMed Central

Donelan-McCall, Nancy; O’Brien, Ruth; MacMillan, Harriet; Jack, Susan; Jenkins, Thomas; Dunlap, Wallace P.; O’Fallon, Molly; Yost, Elly; Thorland, Bill; Pinto, Francesca; Gasbarro, Mariarosa; Baca, Pilar; Melnick, Alan; Beeber, Linda

2013-01-01

BACKGROUND: Evidence-based preventive interventions are rarely final products. They have reached a stage of development that warrant public investment but require additional research and development to strengthen their effects. The Nurse-Family Partnership (NFP), a program of nurse home visiting, is grounded in findings from replicated randomized controlled trials. OBJECTIVE: Evidence-based programs require replication in accordance with the models tested in the original randomized controlled trials in order to achieve impacts comparable to those found in those trials, and yet they must be changed in order to improve their impacts, given that interventions require continuous improvement. This article provides a framework and illustrations of work our team members have developed to address this tension. METHODS: Because the NFP is delivered in communities outside of research contexts, we used quantitative and qualitative research to identify challenges with the NFP program model and its implementation, as well as promising approaches for addressing them. RESULTS: We describe a framework used to address these issues and illustrate its use in improving nurses’ skills in retaining participants, reducing closely spaced subsequent pregnancies, responding to intimate partner violence, observing and promoting caregivers’ care of their children, addressing parents’ mental health problems, classifying families’ risks and strengths as a guide for program implementation, and collaborating with indigenous health organizations to adapt and evaluate the program for their populations. We identify common challenges encountered in conducting research in practice settings and translating findings from these studies into ongoing program implementation. CONCLUSIONS: The conduct of research focused on quality improvement, model improvement, and implementation in NFP practice settings is challenging, but feasible, and holds promise for improving the impact of the NFP. PMID:24187112

Effect of a High-Protein, High-Fiber Beverage Preload on Subjective Appetite Ratings and Subsequent Ad Libitum Energy Intake in Overweight Men and Women: A Randomized, Double-Blind Placebo-Controlled, Crossover Study

PubMed Central

Sharafi, Mastaneh; Alamdari, Nima; Wilson, Michael; Leidy, Heather J; Glynn, Erin L

2018-01-01

Abstract Background Dietary protein and fiber have been shown to independently improve subjective measures of appetite control. Objective The aim of this study was to determine the acute effects of a high-protein, high-fiber (HP/HFb) beverage taken as a preload compared with an isocaloric lower-protein, lower-fiber (LP/LFb) placebo beverage on subjective appetite ratings and subsequent energy intake at an ad libitum meal in healthy adults. Methods A total of 50 overweight/obese men and women [n = 25 men, 25 women; age 30 ± 2 y; body mass index (BMI) 29.6 ± 0.3 kg/m2] received a 160 kcal HP/HFb beverage containing 17 g protein and 6 g fiber on one occasion and an isocaloric LP/LFb placebo beverage containing 1 g protein and 3 g fiber on another occasion in a randomized, double-blind, crossover design. Thirty min after consumption of the beverage preload, an ad libitum pizza meal was provided to be consumed over a 30-min period. Visual analog scales (VAS) were used to assess subjective appetite ratings throughout the testing period. The Revised Restraint Scale (RRS) was used to classify participants as restrained or unrestrained eaters. Results HP/HFb led to greater reductions in postprandial desire to eat and hunger compared with LP/LFb (both, P < 0.05) but did not significantly affect postprandial fullness or prospective food consumption. Subsequent meal energy intake tended to be lower after HP/HFb compared with LP/LFb (P = 0.09). A subanalysis showed lower energy intake after HP/HFb in older participants (≥25 y) compared with LP/LFb, which was not observed in the younger participants (<25 y). Conclusions Compared with LP/LFb, a HP/HFb beverage preload reduced hunger, desire to eat, and tended to reduce subsequent food intake. Dietary restraint and age appear to influence subsequent energy intake and should be taken into account when designing nutrition interventions for weight reduction and/or maintenance. This trial was registered at clinicaltrials.gov as NCT02979717.

The Worksite Heart Health Improvement Project (WHHIP): feasibility and efficacy.

PubMed

Flannery, Kelly; Resnick, Barbara; Galik, Elizabeth; Lipscomb, Jane; McPhaul, Kathleen; Shaughnessy, Marianne

2012-01-01

Test the feasibility and efficacy of the Worksite Heart Health Improvement Project (WHHIP). The WHHIP was a quasi-experimental 6-month pilot performed in 2 long-term care facilities. Thirty-nine female minority nursing assistants participated in this study with a mean age of 42.39 (SD = 12.79) years. Measures were collected at baseline, 3, and 6 months and included blood pressure, lipid panel, body mass index, physical activity levels, diet behaviors, depressive symptoms, and self-efficacy outcomes. The 3-month WHHIP intervention included 3 components: environmental and policy assessment; education; and on-going motivation. The control site received education only. Subject participation averaged 47% and 58% in exercise and diet related activities, respectively. Generalized estimating equations showed the treatment group showed significant improvements in depressive symptoms (p = .012), systolic blood pressure (p = .028), total cholesterol (p = .002) and triglycerides (p = .011) over time. The treatment group also showed trends for improvement in diet behaviors (p = .069) and diastolic blood pressure (p = .073). This study provided feasibility evidence for the WHHIP and preliminary evidence that the WHHIP can improve heart healthy behaviors and subsequent outcomes among nursing assistants in long-term care settings. © 2012 Wiley Periodicals, Inc.

Rationale and design of a randomized controlled, clinical trial investigating a comprehensive exercise stimulus for improving mobility disability outcomes in persons with multiple sclerosis.

PubMed

Motl, Robert W; Pilutti, Lara A; Sandroff, Brian M; Klaren, Rachel; Balantrapu, Swathi; McAuley, Edward; Sosnoff, Jacob J; Fernhall, Bo

2013-05-01

This randomized controlled trial (RCT) examines the effect of a comprehensive exercise training stimulus on physiological function and mobility disability (i.e., problems walking) in individuals with multiple sclerosis (MS) who have walking impairment. This trial will recruit 30 persons with MS across central Illinois who have an Expanded Disability Status Scale score between 4.0 and 6.0, and those persons will be randomized into either the intervention or control arm of the study; the participants will not be blinded regarding group assignment. The intervention will incorporate equal amounts of aerobic, resistance, and balance modes of training delivered 3 times/week with a gradual progression of duration and intensity across a 6-month period. The control will involve stretching along with minimal muscle strengthening stimuli and will be delivered on the same frequency and duration. The primary outcomes will be clinical, kinematic, patient-rated, and physiological measures of mobility disability. The secondary outcomes will be measures of physiological function including aerobic capacity, muscle strength, and balance. This study will lay the foundation for the design of a subsequent Phase II or Phase III RCT by (a) providing effect sizes that can be included in a power analysis for sample size estimation and (b) investigating whether aerobic capacity, muscle strength, and balance are possible factors associated with the beneficial effect of exercise training on walking outcomes. Taken as a whole, the proposed study and our subsequent research agenda has the potential for advancing the management of mobility disability using exercise training in the 2nd stage of MS. Copyright © 2013 Elsevier Inc. All rights reserved.

Longitudinal and concurrent links between memory span, anxiety symptoms, and subsequent executive functioning in young children

PubMed Central

Visu-Petra, Laura; Stanciu, Oana; Benga, Oana; Miclea, Mircea; Cheie, Lavinia

2014-01-01

It has been conjectured that basic individual differences in attentional control influence higher-level executive functioning and subsequent academic performance in children. The current study sets out to complement the limited body of research on early precursors of executive functions (EFs). It provides both a cross-sectional, as well as a longitudinal exploration of the relationship between EF and more basic attentional control mechanisms, assessed via children's performance on memory storage tasks, and influenced by individual differences in anxiety. Multiple measures of verbal and visuospatial short-term memory (STM) were administered to children between 3 and 6 years old, alongside a non-verbal measure of intelligence, and a parental report of anxiety symptoms. After 9 months, children were re-tested on the same STM measures, at which time we also administered multiple measures of executive functioning: verbal and visuospatial working memory (WM), inhibition, and shifting. A cross-sectional view of STM development indicated that between 3 and 6 years the trajectory of visuospatial STM and EF underwent a gradual linear improvement. However, between 5 and 6 years progress in verbal STM performance stagnated. Hierarchical regression models revealed that trait anxiety was negatively associated with WM and shifting, while non-verbal intelligence was positively related to WM span. When age, gender, non-verbal intelligence, and anxiety were controlled for, STM (measured at the first assessment) was a very good predictor of overall executive performance. The models were most successful in predicting WM, followed by shifting, yet poorly predicted inhibition measures. Further longitudinal research is needed to directly address the contribution of attentional control mechanisms to emerging executive functioning and to the development of problematic behavior during early development. PMID:24904462

Response of the modern lactating sow and progeny to source and level of supplemental dietary fat during high ambient temperatures.

PubMed

Rosero, D S; van Heugten, E; Odle, J; Arellano, C; Boyd, R D

2012-08-01

The objective of this study was to determine the response to increments of 2 sources of dietary fat on lactating sow and progeny performance during high ambient temperatures. Data were collected from 391 sows (PIC Camborough) from June to September in a 2,600-sow commercial unit in Oklahoma. Sows were randomly assigned to a 2 × 3 factorial arrangement of treatments and a control diet. Factors included 1) fat sources, animal-vegetable blend (A-V) and choice white grease (CWG), and 2) fat levels (2%, 4%, and 6%). The A-V blend contained 14.5% FFA with an iodine value of 89, peroxide value of 4.2 mEq/kg, and anisidine value of 23, whereas CWG contained 3.7% FFA with an iodine value of 62, peroxide value of 9.8 mEq/kg, and anisidine value of 5. Diets were corn-soybean meal based, with 8.0% distillers dried grains with solubles and 6.0% wheat middlings, and contained 3.56-g standardized ileal digestible Lys/Mcal ME. Sows were balanced by parity, with 192 and 199 sows representing parity 1 and parity 3 to 5, respectively. Feed refusal increased linearly (P < 0.001) with the addition of supplemental fat, but feed and energy intake increased linearly (P < 0.01) with increasing dietary fat. Sows fed CWG diets had reduced (linear, P < 0.05) BW loss during lactation. Litter growth rate was not affected by additional dietary fat. Addition of CWG to the diets improved G:F (sow and litter gain relative to feed intake) compared with the G:F of sows fed the control diet or the diets containing the A-V blend (0.50, 0.43, and 0.44, respectively; P < 0.05). Gain:ME (kg/Mcal ME) was greater (P < 0.05) for CWG (0.146) than A-V blend (0.129) but was not different from that of the control diet (0.131). Addition of A-V blend and CWG both improved (P < 0.05) conception and farrowing rates and subsequent litter size compared with the control diet. In conclusion, energy intake increased with the addition of fat. The A-V blend contained a greater amount of aldehydes (quantified by anisidine value) and was more susceptible to oxidation, resulting in reduced feed efficiency than CWG. Subsequent litter size and reproductive performance was improved by inclusion of both sources of fat in diets fed to lactating sows.

Motivational interviews to improve contraceptive use in populations at high risk of unintended pregnancy: a systematic review and meta-analysis.

PubMed

Wilson, Amie; Nirantharakumar, Krishnarajah; Truchanowicz, Ewa G; Surenthirakumaran, Rajendra; MacArthur, Christine; Coomarasamy, Arri

2015-08-01

Effective contraceptive use has the potential to prevent around 230 million births each year. An estimated 222 million women want to delay pregnancy or cease childbearing, but are not actively using contraception. Lack of education is a known barrier for effective contraceptive use. Motivational interviews are presumed to improve effective contraceptive use, but studies to date report varied findings. Some studies demonstrate an improvement and others report no effect. A systematic review of evidence on the impact of motivational interviews on contraceptive use in women of childbearing age was carried out using MEDLINE, EMBASE, BNI, Cochrane library, CINHAL, African Index Medicus, Web of Science, the Reproductive Health Library, and the Science Citation Index (inception-January 2013) without language restriction. Search terms included 'motivational interview* AND contraception OR family planning OR maternal OR pregnancy'. Randomised controlled trials comparing the effect of motivational interviews with standard practice on effective contraception use in women of reproductive age were included. The outcome measures were use of effective contraception or use of high-level contraception, and subsequent births or pregnancies. The random effects model was used to pool the risk ratios from individual studies. Eight randomised controlled trials were included in the review with a total of 3424 women at high risk of pregnancy. Meta-analysis showed an increase in effective contraceptive use with motivational interviews when compared with control (RR 1.32 95%CI 1.11, 1.56: P=0.002) in the period of zero to four months post intervention. No difference in effective contraceptive use was shown at four to eight months (RR 1.10, 95%CI 0.93, 1.32: P=0.27), and between eight to twelve months (RR 1.18 95%CI 0.96, 1.46: P=0.12). No evidence of effect in the reduction of subsequent pregnancies or births at twelve to twenty-four months was seen with motivational interviews (RR 0.80 95%CI 0.51, 1.26: P=0.34). Motivational interviews significantly increase effective contraceptive use immediately after and up to four months post-intervention. The effect without reinforcement is short lasting as no evidence of effect is seen after four months post-intervention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The impact of instructional design in a case-based, computer-assisted instruction module on learning liver pathology in a medical school pathology course

NASA Astrophysics Data System (ADS)

Latham, Patricia S.

The purpose of this quantitative experimental study was to test the impact of three learning interventions on student learning and satisfaction when the interventions were embedded in the instructional design of case-based, Computer-Assisted Instruction (CAI) modules for learning liver pathology in an in-class, self-study, laboratory exercise during a Year-2 medical school Pathology course. The hypothesis was that inclusion of the learning interventions would enhance student satisfaction in using the CAI and improve subsequent CAI-directed exam performance. Three learning interventions were studied, including the use of microscopic virtual slides instead of only static images, the use of interactive image annotations instead of only still annotations, and the use of guiding questions before presenting new information. Students were randomly assigned to with one of eight CAI learning modules configured to control for each of the three learning interventions. Effectiveness of the CAI for student learning was assessed by student performance on questions included in subsequent CAI-directed exams in a pretest and on posttests immediately after the lab exercise, at two weeks and two months. Student satisfaction and perceived learning was assessed by a student survey. Results showed that the learning interventions did not improve subsequent student exam performance, although satisfaction and perceived learning with use of the CAI learning modules was enhanced. Student class rank was evaluated to determine if the learning interventions might have a differential effect based on class rank, but there were no significant differences. Class rank at the time of the lab exercise was itself the strongest predictor of exam performance. The findings suggest that the addition of virtual slides, interactive annotations and guiding questions as learning interventions in self-study, case-based CAI for learning liver pathology in a medical class room setting are not likely to increase performance on subsequent MCQ-based exams, but student satisfaction with use of the CAI can be enhanced, which could provide to be an incentive for students to use similar CAI learning modules for future self-directed learning.

Outcomes of subsequent pregnancies after conservative treatment for placenta accreta.

PubMed

Kabiri, Doron; Hants, Yael; Shanwetter, Neta; Simons, Moshe; Weiniger, Carolyn F; Gielchinsky, Yuval; Ezra, Yossef

2014-11-01

To estimate the association between conservative treatment for placenta accreta and subsequent pregnancy outcomes. In a retrospective study, data were analyzed on women who received conservative treatment for placenta accreta (removal of the placenta with uterine preservation) at a tertiary hospital in Jerusalem, Israel, between 1990 and 2000. Data were collected on subsequent pregnancies and neonatal outcomes until 2010, and compared with those from a matched control group of women who did not have placenta accreta. A total of 134 women were included in both groups. Placenta accreta occurred in 62 (22.8%) of 272 subsequent deliveries in the study group for which data were available and 5 (1.9%) of 266 in the control group (relative risk [RR] 12.13; 95% confidence interval [CI] 4.95-29.69; P<0.001). Early postpartum hemorrhage occurred in 23 (8.6%) of 268 deliveries in the study group and 7 (2.6%) of 268 in the control group (RR 3.29; 95% CI 1.43-7.53; P<0.001). The odds ratio for recurrent placenta accreta in subsequent deliveries in the study group was 15.41 (95% CI 6.09-39.03; P<0.001). Although subsequent pregnancies after conservative treatment for placenta accreta were mostly successful, the risk of recurrent placenta accreta and postpartum hemorrhage is high in future deliveries. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury - Randomized Prospective Trial

PubMed Central

Fishlev, Gregori; Bechor, Yair; Volkov, Olga; Bergan, Jacob; Friedman, Mony; Hoofien, Dan; Shlamkovitch, Nathan; Ben-Jacob, Eshel; Efrati, Shai

2013-01-01

Background Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments. Methods and Findings The trial population included 56 mTBI patients 1–5 years after injury with prolonged post-concussion syndrome (PCS). The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. “Mindstreams” was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements. Conclusions HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage. Trial Registration ClinicalTrials.gov NCT00715052 PMID:24260334

Perceived Control is a Transdiagnostic Predictor of Cognitive-Behavior Therapy Outcome for Anxiety Disorders

PubMed Central

Gallagher, Matthew W.; Naragon-Gainey, Kristin; Brown, Timothy A.

2013-01-01

Perceived control has been proposed to be a general psychological vulnerability factor that confers an elevated risk for developing anxiety disorders, but there is limited research examining perceived control during cognitive-behavioral therapies (CBT). The present study examined whether treatment resulted in improvements in perceived control, and the indirect effects of CBT on changes in symptoms of obsessive-compulsive disorder, social phobia, generalized anxiety disorder, and panic disorder via changes in perceived control. Participants (n = 606) were a large clinical sample presenting for treatment at an outpatient anxiety disorders clinic. Participants completed a series of self-report questionnaires and a structured clinical interview at an intake evaluation and at two follow-up assessments 12 and 24 months later, with the majority of participants initiating CBT between the first two assessments. Results of latent growth curve models indicated that individuals initiating CBT subsequently reported large increases in perceived control and significant indirect effects of treatment on intraindividual changes in each of the four anxiety disorders examined via intraindividual changes in perceived control. These results suggest that the promotion of more adaptive perceptions of control is associated with recovery from anxiety disorders. Furthermore, the consistent finding of indirect effects across the four anxiety disorders examined underscores the transdiagnostic importance of perceived control in predicting CBT outcomes. PMID:24563563

Impact of a complex chronic care patient case conference on quality and utilization.

PubMed

Weppner, William G; Davis, Kyle; Tivis, Rick; Willis, Janet; Fisher, Amber; King, India; Smith, C Scott

2018-05-23

There is need for effective venues to allow teams to coordinate care for high-risk or high-need patients. In addition, health systems need to assess the impact of such approaches on outcomes related to chronic health conditions and patient utilization. We evaluate the clinical impact of a novel case conference involving colocated trainees and supervisors in an interprofessional academic primary care clinic. The study utilized a prospective cohort with control group. Intervention patients (N = 104) were matched with controls (N = 104) from the same provider's panel using propensity scores based on age, gender, risk predictors, and prior utilization patterns. Clinical outcomes and subsequent utilization patterns were compared prior to and up to 6 months following the conference. In terms of utilization, intervention patients demonstrated increased visits with primary care team members (p = .0002) compared with controls, without a corresponding increase in the number of primary care providers' visits. There was a trend towards decreased urgent care and emergency visits (p = .07) and a significant decrease in the rate of hospitalizations (p = .04). Patients with poorly-controlled hypertension saw significant decreases in mean systolic blood pressure from 167 to 146 mm Hg. However, there were no differences between the intervention and control groups. Intervention patients with diabetes demonstrated a nonsignificant trend towards decreased hemoglobin A1c from 9.8 to 9.4, when compared with controls. Interprofessional case conferences have potential to improve care coordination and may be associated with improved disease management, decreased unplanned care, and overall reduced hospitalizations.

Opisthorchiasis control in Thailand.

PubMed

Jongsuksuntigul, P; Imsomboon, T

2003-11-01

History of opisthorchiasis control started in 1950 as a small scale helminthiasis control program in some high risk areas. Following a number of studies and trial projects of the Faculty of Tropical Medicine, Mahidol University, the national liver fluke control program has been developed and operated under several National Public Health Development Plans. Presently, the program is being operated in some provinces of the Central, and all provinces of the Northeast and North of Thailand. The main strategies for liver fluke control comprise of three interrelated approaches, namely stool examinations and treatment of positive cases with praziquantel for eliminating human host reservoir; health education for a promotion of cooked fish consumption to prevent infection, and the improvement of hygienic defecation for the interruption of disease transmission. Between 1984 and 1987, the positive rate of liver fluke infection was 63.6%. In 1988, the positive rate went down to 35.6%. Following the region wide control program started in 1989, the annual positive rates had subsequently decreased to 9.4% in the year 2001. The prevalence rate was remarkably high in the North and moderately high in the Northeast, while the prevalence in the Central region was considerably low and there was no evidence of disease transmission in the South.

Use of active control systems to improve bending and rotor flapping response of a tilt rotor VTOL airplane

NASA Technical Reports Server (NTRS)

Whitaker, H. P.; Cheng, Y.

1975-01-01

The results are summarized of an analytical study of the use of active control systems for the purpose of reducing the root mean square response of wing vertical bending and rotor flapping to atmospheric turbulence for a tilt-rotor VTOL airplane. Only the wing/rotor assembly was considered so that results of a wind tunnel test program would be applicable in a subsequent phase of the research. The capabilities and limitations of simple single feedback configurations were identified, and the most promising multiloop feedback configurations were then investigated. Design parameters were selected so as to minimize either wing bending or rotor flapping response. Within the constraints imposed by practical levels of feedback gains and complexity and by considerations of safety, reduction in response due to turbulence of the order of 30 to 50 percent is predicted using the rotor longitudinal cyclic and a trailing edge wing flap as control effectors.

Implementation of a clinical quality control program in a mammography screening service of Brazil.

PubMed

DE Souza Sabino, Silvia Maria Prioli; Silva, Thiago Buosi; Watanabe, Anapaula Hidemi Uema; Syrjänen, Kari; Carvalho, André Lopes; Mauad, Edmundo Carvalho

2014-09-01

To evaluate the effect of a clinical quality control program on the final quality of a mammography screening service. We conducted retrospective assessment of the clinical quality of 5,000 mammograms taken in a Mammography Screening Program between November 2010 and September 2011, following the implementation of a Clinical Quality Control Program based on the European Guidelines. Among the 105,000 evaluated quality items, there were 8,588 failures (8.2%) - 1.7 failures per examination. Altogether, 89% of the failures were associated with positioning. The recall rate due to a technical error reached a maximum of 0.5% in the early phase of the observation period and subsequently stabilized (0.09%). The ongoing education and monitoring combined with personalized training increased the critical thinking of the involved professionals, reducing the technical failures and unnecessary exposure of patients to radiation, with substantial improvement in the final quality of mammography. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Controlling Hyperhydricity in Date Palm In Vitro Culture by Reduced Concentration of Nitrate Nutrients.

PubMed

El-Dawayati, Maiada M; Zayed, Zeinab E

2017-01-01

Hyperhydricity (or vitrification) is a fundamental physiological disorder in date palm micropropagation. Several factors have been ascribed as being responsible for hyperhydricity, which are related to the explant, medium, culture vessel, and environment. The optimization of inorganic nutrients in the culture medium improves in vitro growth and morphogenesis, in addition to controlling hyperhydricity. This chapter describes a protocol for controlling hyperhydricity during the embryogenic callus stage by optimizing the ratio of nitrogen salts of the Murashige and Skoog (MS) nutrient culture medium. The best results of differentiation from cured hyperhydric callus are obtained using modification at a ratio of NH 4+ /NO 3- at 10:15 (825:1425 mg/L) of the MS culture medium to remedy hyperhydric date palm callus and achieve the recovery of normal embryogenic callus and subsequent regeneration of plantlets. Based on the results of this study, nutrient medium composition has an important role in avoiding hyperhydricity problems during date palm micropropagation.

A spiritual-hypnosis assisted treatment of children with PTSD after the 2002 Bali terrorist attack.

PubMed

Lesmana, C B J; Suryani, L K; Jensen, G D; Tiliopoulos, Niko

2009-07-01

The aim of this study was to assess the effectiveness of a spiritual-hypnosis assisted therapy (SHAT) for treatment of posttraumatic stress disorder (PTSD) in children. All children, age 6-12 years (N=226; 52.7% females), who experienced the terrorist bomb blasts in Bali in 2002, and subsequently were diagnosed with PTSD were studied, through a longitudinal, quasi-experimental (pre-post test), single-blind, randomized control design. Of them, 48 received group SHAT (treatment group), and 178 did not receive any therapy (control group). Statistically significant results showed that SHAT produced a 77.1% improvement rate, at a two-year follow up, compared to 24% in the control group, while at the same time, the mean PTSD symptom score differences were significantly lower in the former group. We conclude that the method of spiritual-hypnosis is highly effective, economic, and easily implemented, and has a potential for therapy of PTSD in other cultures or other catastrophic life-threatening events.

Designing a warm-up protocol for elite bob-skeleton athletes.

PubMed

Cook, Christian; Holdcroft, Danny; Drawer, Scott; Kilduff, Liam P

2013-03-01

To investigate how different warm-ups influenced subsequent sled-pull sprint performance in Olympic-level bob-skeleton athletes as part of their preparation for the 2010 Winter Olympics. Three female and 3 male athletes performed 5 different randomized warm-ups of differing intensities, durations, and timing relative to subsequent testing, each 2 days apart, all repeated twice. After warm-ups, testing on a sled-pull sprint over 20 m, 3 repeats 3 min apart, took place. Performance testing showed improvement (P < .001, ES > 1.2) with both increasing intensity of warm-up and closeness of completion to testing, with 20-m sled sprinting being 0.1-0.25 s faster in higher-intensity protocols performed near testing In addition, supplementing the warm-ups by wearing of a light survival coat resulted in further performance improvement (P = .000, ES 1.8). Changing timing and intensity of warm-up and using an ancillary passive heat-retention device improved sprint performance in Olympic-level bob-skeleton athletes. Subsequent adoption of these on the competitive circuit was associated with a seasonal improvement in push times and was ultimately implemented in the 2010 Winter Olympics.

Protein aggregation, cardiovascular diseases, and exercise training: Where do we stand?

PubMed

Gouveia, Marisol; Xia, Ke; Colón, Wilfredo; Vieira, Sandra I; Ribeiro, Fernando

2017-11-01

Cells ensure their protein quality control through the proteostasis network. Aging and age-related diseases, such as neurodegenerative and cardiovascular diseases, have been associated to the reduction of proteostasis network efficiency and, consequently, to the accumulation of protein misfolded aggregates. The decline in protein homeostasis has been associated with the development and progression of atherosclerotic cardiovascular disease, cardiac hypertrophy, cardiomyopathies, and heart failure. Exercise training is a key component of the management of patients with cardiovascular disease, consistently improving quality of life and prognosis. In this review, we give an overview on age-related protein aggregation, the role of the increase of misfolded protein aggregates on cardiovascular pathophysiology, and describe the beneficial or deleterious effects of the proteostasis network on the development of cardiovascular disease. We subsequently discuss how exercise training, a key lifestyle intervention in those with cardiovascular disease, could restore proteostasis and improve disease status. Copyright © 2017 Elsevier B.V. All rights reserved.

Video noise reduction

NASA Astrophysics Data System (ADS)

Drewery, J. O.; Storey, R.; Tanton, N. E.

1984-07-01

A video noise and film grain reducer is described which is based on a first-order recursive temporal filter. Filtering of moving detail is avoided by inhibiting recursion in response to the amount of motion in a picture. Motion detection is based on the point-by-point power of the picture difference signal coupled with a knowledge of the noise statistics. A control system measures the noise power and adjusts the working point of the motion detector accordingly. A field trial of a manual version of the equipment at Television Center indicated that a worthwhile improvement in the quality of noisy or grainy pictures received by the viewer could be obtained. Subsequent trials of the automated version confirmed that the improvement could be maintained. Commercial equipment based on the design is being manufactured and marketed by Pye T.V.T. under license. It is in regular use on both the BBC1 and BBC2 networks.

[Bio-ecological control of chronic liver disease and encephalopathy].

PubMed

Bengmark, S; Di Cocco, P; Clemente, K; Corona, L; Angelico, R; Manzia, T; Famulari, A; Pisani, F; Orlando, G

2011-08-01

Minimal encephalopathy was originally associated with chronic liver disease but is increasingly associated with most other chronic diseases and particularly with diabetes and also chronic disorders in other organs: kidneys, lungs, thyroid and with obesity. It is increasingly with dramatically increased and more or less permanent increase in systemic inflammation, most likely a result of Western lifestyle. Frequent physical exercise and intake of foods rich in vitamins, antioxidants, fibres, lactic acid bacteria etc in combination with reduction in intake of refined and processed foods is known to reduce systemic inflammation and prevent chronic diseases. Some lactic acid bacteria, especially Lb paracasei, lb plantarum and pediococcus pentosaceus have proven effective to reduce inflammation and eliminate encephalopathy. Significant reduction in blood ammonia levels and endotoxin levels were reported in parallel to improvement of liver disease. Subsequent studies with other lactic acid bacteria seem to demonstrate suppression of inflammation and one study also provides evidence of clinical improvement.

Are parent-reported outcomes for self-directed or telephone-assisted behavioral family intervention enhanced if parents are observed?

PubMed

Morawska, Alina; Sanders, Matthew R

2007-05-01

The study examined the effects of conducting observations as part of a broader assessment of families participating in behavior family intervention (BFI). It was designed to investigate whether the observations improve intervention outcomes. Families were randomly assigned to different levels of BFI or a waitlist control condition and subsequently randomly assigned to either observation or no-observation conditions. This study demonstrated significant intervention and observation effects. Mothers in more intensive BFI reported more improvement in their child's behavior and their own parenting. Observed mothers reported lower intensity of child behavior problems and more effective parenting styles. There was also a trend for less anger among mothers who were observed and evidence of an observation-intervention interaction for parental anger, with observed mothers in more intensive intervention reporting less anger compared to those not observed. Implications for clinical and research intervention contexts are discussed.

Compound management beyond efficiency.

PubMed

Burr, Ian; Winchester, Toby; Keighley, Wilma; Sewing, Andreas

2009-06-01

Codeveloping alongside chemistry and in vitro screening, compound management was one of the first areas in research recognizing the need for efficient processes and workflows. Material management groups have centralized, automated, miniaturized and, importantly, found out what not to do with compounds. While driving down cost and improving quality in storage and processing, researchers still face the challenge of interfacing optimally with changing business processes, in screening groups, and with external vendors and focusing on biologicals in many companies. Here we review our strategy to provide a seamless link between compound acquisition and screening operations and the impact of material management on quality of the downstream processes. Although this is driven in part by new technologies and improved quality control within material management, redefining team structures and roles also drives job satisfaction and motivation in our teams with a subsequent positive impact on cycle times and customer feedback.

Scabies in animals and humans: history, evolutionary perspectives, and modern clinical management.

PubMed

Currier, Russell W; Walton, Shelley F; Currie, Bart J

2011-08-01

Scabies, a mite infestation frequently sexually transmitted, dates back to antiquity but remains a challenging parasite for study in clinical practice and community settings. Its history is one of centuries of slow progress to recognize the mite and to finally establish its nexus to the clinical syndrome of pruritis with several protean manifestations and different epidemiological patterns. Contemporary methods of management are briefly reviewed, with the future promise of improved evolutionary knowledge associated with the advent of molecular and genetic technology. Current information indicates that humans and earlier protohumans were most likely the source of animal scabies, first of dogs, and later of other species with subsequent spread to wildlife. Morphologically identical variants of Sarcoptes scabiei are nonetheless host specific, as determined by recent DNA studies, and invite future investigations into the dynamics of this troublesome sexually transmissible agent, with the goal of improved recognition and control. © 2012 New York Academy of Sciences.

Advanced emissions-speciation methodologies for the auto/oil air-quality improvement research program. 2. Aldehydes, ketones, and alcohols. SAE technical paper series

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

Swarin, S.J.; Loo, J.F.; Chladek, E.

1992-01-01

Analytical methods for determining individual aldehyde, ketone, and alcohol emissions from gasoline-, methanol-, and variable-fueled vehicles are described. These methods were used in the Auto/Oil Air Quality Improvement Research Program to provide emission data for comparison of individual reformulated fuels, individual vehicles, and for air modeling studies. The emission samples are collected in impingers which contain either 2,4-dinitrophenylhydrazine solution for the aldehydes and ketones or deionized water for the alcohols. Subsequent analyses by liquid chromatography for the aldehydes and ketones and gas chromatography for the alcohols utilized auto injectors and computerized data systems which permit high sample throughput with minimalmore » operator intervention. The quality control procedures developed and interlaboratory comparisons conducted as part of the program are also described. (Copyright (c) 1992 Society of Automotive Engineers, Inc.)« less

Application of the Athlete's Performance Passport for Doping Control: A Case Report.

PubMed

Iljukov, Sergei; Bermon, Stephane; Schumacher, Yorck O

2018-01-01

The efficient use of testing resources is a key issue in the fight against doping. The longitudinal tracking of sporting performances to identify unusual improvements possibly caused by doping, so-called "athlete's performance passport" (APP) is a new concept to improve targeted anti-doping testing. In fact, unusual performances by an athlete would trigger a more thorough testing program. In the present case report, performance data is modeled using the critical power concept for a group of athletes based on their past performances. By these means, an athlete with unusual deviations from his predicted performances was identified. Subsequent target testing using blood testing and the athlete biological passport resulted in an anti-doping rule violation procedure and suspension of the athlete. This case demonstrates the feasibility of the APP approach where athlete's performance is monitored and might serve as an example for the practical implementation of the method.

Application of the Athlete's Performance Passport for Doping Control: A Case Report

PubMed Central

Iljukov, Sergei; Bermon, Stephane; Schumacher, Yorck O.

2018-01-01

The efficient use of testing resources is a key issue in the fight against doping. The longitudinal tracking of sporting performances to identify unusual improvements possibly caused by doping, so-called “athlete's performance passport” (APP) is a new concept to improve targeted anti-doping testing. In fact, unusual performances by an athlete would trigger a more thorough testing program. In the present case report, performance data is modeled using the critical power concept for a group of athletes based on their past performances. By these means, an athlete with unusual deviations from his predicted performances was identified. Subsequent target testing using blood testing and the athlete biological passport resulted in an anti-doping rule violation procedure and suspension of the athlete. This case demonstrates the feasibility of the APP approach where athlete's performance is monitored and might serve as an example for the practical implementation of the method. PMID:29651247

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed

Tozzi, Alberto E; Gesualdo, Francesco; D'Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges.

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed Central

Tozzi, Alberto E.; Gesualdo, Francesco; D’Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges. PMID:27014673

Using decision analysis to support proactive management of emerging infectious wildlife diseases

USGS Publications Warehouse

Grant, Evan H. Campbell; Muths, Erin L.; Katz, Rachel A.; Canessa, Stefano; Adams, Michael J.; Ballard, Jennifer R.; Berger, Lee; Briggs, Cheryl J.; Coleman, Jeremy; Gray, Matthew J.; Harris, M. Camille; Harris, Reid N.; Hossack, Blake R.; Huyvaert, Kathryn P.; Kolby, Jonathan E.; Lips, Karen R.; Lovich, Robert E.; McCallum, Hamish I.; Mendelson, Joseph R.; Nanjappa, Priya; Olson, Deanna H.; Powers, Jenny G.; Richgels, Katherine L. D.; Russell, Robin E.; Schmidt, Benedikt R.; Spitzen-van der Sluijs, Annemarieke; Watry, Mary Kay; Woodhams, Douglas C.; White, C. LeAnn

2017-01-01

Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts even before a disease is detected, and plan subsequent actions that are conditional on disease emergence. We identify four main obstacles to developing proactive management strategies for the newly discovered salamander pathogen Batrachochytrium salamandrivorans (Bsal). Given that uncertainty is a hallmark of wildlife disease management and that associated decisions are often complicated by multiple competing objectives, we advocate using decision analysis to create and evaluate trade-offs between proactive (pre-emergence) and reactive (post-emergence) management options. Policy makers and natural resource agency personnel can apply principles from decision analysis to improve strategies for countering emerging infectious diseases.

Error detection and response adjustment in youth with mild spastic cerebral palsy: an event-related brain potential study.

PubMed

Hakkarainen, Elina; Pirilä, Silja; Kaartinen, Jukka; van der Meere, Jaap J

2013-06-01

This study evaluated the brain activation state during error making in youth with mild spastic cerebral palsy and a peer control group while carrying out a stimulus recognition task. The key question was whether patients were detecting their own errors and subsequently improving their performance in a future trial. Findings indicated that error responses of the group with cerebral palsy were associated with weak motor preparation, as indexed by the amplitude of the late contingent negative variation. However, patients were detecting their errors as indexed by the amplitude of the response-locked negativity and thus improved their performance in a future trial. Findings suggest that the consequence of error making on future performance is intact in a sample of youth with mild spastic cerebral palsy. Because the study group is small, the present findings need replication using a larger sample.

The optimization of total laboratory automation by simulation of a pull-strategy.

PubMed

Yang, Taho; Wang, Teng-Kuan; Li, Vincent C; Su, Chia-Lo

2015-01-01

Laboratory results are essential for physicians to diagnose medical conditions. Because of the critical role of medical laboratories, an increasing number of hospitals use total laboratory automation (TLA) to improve laboratory performance. Although the benefits of TLA are well documented, systems occasionally become congested, particularly when hospitals face peak demand. This study optimizes TLA operations. Firstly, value stream mapping (VSM) is used to identify the non-value-added time. Subsequently, batch processing control and parallel scheduling rules are devised and a pull mechanism that comprises a constant work-in-process (CONWIP) is proposed. Simulation optimization is then used to optimize the design parameters and to ensure a small inventory and a shorter average cycle time (CT). For empirical illustration, this approach is applied to a real case. The proposed methodology significantly improves the efficiency of laboratory work and leads to a reduction in patient waiting times and increased service level.

Mechanism for rapid growth of organic–inorganic halide perovskite crystals

PubMed Central

Nayak, Pabitra K.; Moore, David T.; Wenger, Bernard; Nayak, Simantini; Haghighirad, Amir A.; Fineberg, Adam; Noel, Nakita K.; Reid, Obadiah G.; Rumbles, Garry; Kukura, Philipp; Vincent, Kylie A.; Snaith, Henry J.

2016-01-01

Optoelectronic devices based on hybrid halide perovskites have shown remarkable progress to high performance. However, despite their apparent success, there remain many open questions about their intrinsic properties. Single crystals are often seen as the ideal platform for understanding the limits of crystalline materials, and recent reports of rapid, high-temperature crystallization of single crystals should enable a variety of studies. Here we explore the mechanism of this crystallization and find that it is due to reversible changes in the solution where breaking up of colloids, and a change in the solvent strength, leads to supersaturation and subsequent crystallization. We use this knowledge to demonstrate a broader range of processing parameters and show that these can lead to improved crystal quality. Our findings are therefore of central importance to enable the continued advancement of perovskite optoelectronics and to the improved reproducibility through a better understanding of factors influencing and controlling crystallization. PMID:27830749

Cosmetic micromanipulation of vitrified-warmed cleavage stage embryos does not improve ART outcomes: An ultrastructural study of fragments.

PubMed

Safari, Somayyeh; Khalili, Mohammad Ali; Barekati, Zeinab; Halvaei, Iman; Anvari, Morteza; Nottola, Stefania A

2017-09-01

The aim was to study the ultrastructure of cytoplasmic fragments along with the effect of cosmetic micromanipulation (CM) on the morphology and development of vitrified-warmed embryos as well as assisted reproductive technology (ART) outcomes. A total of 96 frozen embryo transfer (FET) cycles were included in this prospective randomized study. They were divided into three groups of CM (n=32), sham (n=32) and control (n=32). In the CM group, the vitrified- warmed embryos were subjected to fragments and coarse granules removal (cosmetic micromanipulation) after laser assisted zona hatching (LAH); sham group subjected only to LAH and no intervention was taken for the control group. Fragmented embryo was evaluated by transmission electron microscopy (TEM). Significant improvement was observed in the morphological parameters, such as fragmentation degrees, evenness of the blastomeres and embryo grade during the subsequent development, after applying cosmetic micromanipulation, when compared to sham or control groups (P=0.00001). However, there were no differences in the clinical outcomes amongst the three studied groups e.g. the rates of clinical, ongoing and multiple pregnancies, implantation, delivery and live birth. In fine structure view, fragments exhibited uniform cytoplasmic texture containing majority of organelles that were observed in normal blastomeres including mitochondria. In conclusion, application of cosmetic micromanipulation in low-grade vitrified-warmed embryos showed significant improvement on embryo morphology parameters; however, did not result in noticeable improvements in clinical outcomes of the patients undergoing ART program. In addition, embryo vitrification had no adverse effects on fine structure of the fragments. Copyright © 2017 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Nigral stimulation for resistant axial motor impairment in Parkinson's disease? A randomized controlled trial.

PubMed

Weiss, Daniel; Walach, Margarete; Meisner, Christoph; Fritz, Melanie; Scholten, Marlieke; Breit, Sorin; Plewnia, Christian; Bender, Benjamin; Gharabaghi, Alireza; Wächter, Tobias; Krüger, Rejko

2013-07-01

Gait and balance disturbances typically emerge in advanced Parkinson's disease with generally limited response to dopaminergic medication and subthalamic nucleus deep brain stimulation. Therefore, advanced programming with interleaved pulses was put forward to introduce concomittant nigral stimulation on caudal contacts of a subthalamic lead. Here, we hypothesized that the combined stimulation of subthalamic nucleus and substantia nigra pars reticulata improves axial symptoms compared with standard subthalamic nucleus stimulation. Twelve patients were enrolled in this 2 × 2 cross-over double-blind randomized controlled clinical trial and both the safety and efficacy of combined subthalamic nucleus and substantia nigra pars reticulata stimulation were evaluated compared with standard subthalamic nucleus stimulation. The primary outcome measure was the change of a broad-scaled cumulative axial Unified Parkinson's Disease Rating Scale score (Scale II items 13-15, Scale III items 27-31) at '3-week follow-up'. Secondary outcome measures specifically addressed freezing of gait, balance, quality of life, non-motor symptoms and neuropsychiatric symptoms. For the primary outcome measure no statistically significant improvement was observed for combined subthalamic nucleus and substantia nigra pars reticulata stimulation at the '3-week follow-up'. The secondary endpoints, however, revealed that the combined stimulation of subthalamic nucleus and substantia nigra pars reticulata might specifically improve freezing of gait, whereas balance impairment remained unchanged. The combined stimulation of subthalamic nucleus and substantia nigra pars reticulata was safe, and of note, no clinically relevant neuropsychiatric adverse effect was observed. Patients treated with subthalamic nucleus and substantia nigra pars reticulata stimulation revealed no 'global' effect on axial motor domains. However, this study opens the perspective that concomittant stimulation of the substantia nigra pars reticulata possibly improves otherwise resistant freezing of gait and, therefore, highly warrants a subsequent phase III randomized controlled trial.

Attentional focus and performance anxiety: effects on simulated race-driving performance and heart rate variability.

PubMed

Mullen, Richard; Faull, Andrea; Jones, Eleri S; Kingston, Kieran

2012-01-01

Previous studies have demonstrated that an external focus can enhance motor learning compared to an internal focus. The benefits of adopting an external focus are attributed to the use of less effortful automatic control processes, while an internal focus relies upon more effort-intensive consciously controlled processes. The aim of this study was to compare the effectiveness of a distal external focus with an internal focus in the acquisition of a simulated driving task and subsequent performance in a competitive condition designed to increase state anxiety. To provide further evidence for the automatic nature of externally controlled movements, the study included heart rate variability (HRV) as an index of mental effort. Sixteen participants completed eight blocks of four laps in either a distal external or internal focus condition, followed by two blocks of four laps in the competitive condition. During acquisition, the performance of both groups improved; however, the distal external focus group outperformed the internal focus group. The poorer performance of the internal focus group was accompanied by a larger reduction in HRV, indicating a greater investment of mental effort. In the competition condition, state anxiety increased, and for both groups, performance improved as a function of the increased anxiety. Increased heart rate and self-reported mental effort accompanied the performance improvement. The distal external focus group also outperformed the internal focus group across both neutral and competitive conditions and this more effective performance was again associated with lower levels of HRV. Overall, the results offer support for the suggestion that an external focus promotes a more automatic mode of functioning. In the competitive condition, both foci enhanced performance and while the improved performance may have been achieved at the expense of greater compensatory mental effort, this was not reflected in HRV scores.

Application of overlay modeling and control with Zernike polynomials in an HVM environment

NASA Astrophysics Data System (ADS)

Ju, JaeWuk; Kim, MinGyu; Lee, JuHan; Nabeth, Jeremy; Jeon, Sanghuck; Heo, Hoyoung; Robinson, John C.; Pierson, Bill

2016-03-01

Shrinking technology nodes and smaller process margins require improved photolithography overlay control. Generally, overlay measurement results are modeled with Cartesian polynomial functions for both intra-field and inter-field models and the model coefficients are sent to an advanced process control (APC) system operating in an XY Cartesian basis. Dampened overlay corrections, typically via exponentially or linearly weighted moving average in time, are then retrieved from the APC system to apply on the scanner in XY Cartesian form for subsequent lot exposure. The goal of the above method is to process lots with corrections that target the least possible overlay misregistration in steady state as well as in change point situations. In this study, we model overlay errors on product using Zernike polynomials with same fitting capability as the process of reference (POR) to represent the wafer-level terms, and use the standard Cartesian polynomials to represent the field-level terms. APC calculations for wafer-level correction are performed in Zernike basis while field-level calculations use standard XY Cartesian basis. Finally, weighted wafer-level correction terms are converted to XY Cartesian space in order to be applied on the scanner, along with field-level corrections, for future wafer exposures. Since Zernike polynomials have the property of being orthogonal in the unit disk we are able to reduce the amount of collinearity between terms and improve overlay stability. Our real time Zernike modeling and feedback evaluation was performed on a 20-lot dataset in a high volume manufacturing (HVM) environment. The measured on-product results were compared to POR and showed a 7% reduction in overlay variation including a 22% terms variation. This led to an on-product raw overlay Mean + 3Sigma X&Y improvement of 5% and resulted in 0.1% yield improvement.

Unusual progression and subsequent improvement in cystic lung disease in a child with radiation-induced lung injury

PubMed Central

Wolf, Michael S.; Chadha, Ashley D.; Carroll, Clinton M.; Borinstein, Scott C.

2014-01-01

Radiation-induced lung disease is a known complication of therapeutic lung irradiation, but the features have not been well described in children. We report the clinical, radiologic and histologic features of interstitial lung disease (ILD) in a 4-year-old child who had previously received lung irradiation as part of successful treatment for metastatic Wilms tumor. Her radiologic abnormalities and clinical symptoms developed in an indolent manner. Clinical improvement gradually occurred with corticosteroid therapy. However, the observed radiologic progression from interstitial and reticulonodular opacities to diffuse cystic lung disease, with subsequent improvement, is striking and has not been previously described in children. PMID:25434733

An Exploratory Study of Instructional Strategies, Academic Integration, and Subsequent Institutional Commitment

ERIC Educational Resources Information Center

Brown, Jennifer L.; Robinson-McDonald, Dawn

2014-01-01

As student persistence efforts remain stagnant and the level of accountability grows for higher education, the classroom environment could offer some assistance toward improving academic integration and subsequent institutional commitment. The process of student persistence at four-year commuter colleges and universities differs from the process…

Penicillin: the medicine with the greatest impact on therapeutic outcomes.

PubMed

Kardos, Nelson; Demain, Arnold L

2011-11-01

The principal point of this paper is that the discovery of penicillin and the development of the supporting technologies in microbiology and chemical engineering leading to its commercial scale production represent it as the medicine with the greatest impact on therapeutic outcomes. Our nomination of penicillin for the top therapeutic molecule rests on two lines of evidence concerning the impact of this event: (1) the magnitude of the therapeutic outcomes resulting from the clinical application of penicillin and the subsequent widespread use of antibiotics and (2) the technologies developed for production of penicillin, including both microbial strain selection and improvement plus chemical engineering methods responsible for successful submerged fermentation production. These became the basis for production of all subsequent antibiotics in use today. These same technologies became the model for the development and production of new types of bioproducts (i.e., anticancer agents, monoclonal antibodies, and industrial enzymes). The clinical impact of penicillin was large and immediate. By ushering in the widespread clinical use of antibiotics, penicillin was responsible for enabling the control of many infectious diseases that had previously burdened mankind, with subsequent impact on global population demographics. Moreover, the large cumulative public effect of the many new antibiotics and new bioproducts that were developed and commercialized on the basis of the science and technology after penicillin demonstrates that penicillin had the greatest therapeutic impact event of all times. © Springer-Verlag 2011

An acute exercise session increases self-efficacy in sedentary endometrial cancer survivors and controls.

PubMed

Hughes, Daniel; Baum, George; Jovanovic, Jennifer; Carmack, Cindy; Greisinger, Anthony; Basen-Engquist, Karen

2010-11-01

Self-efficacy can be affected by mastery experiences and somatic sensations. A novel exercise experience and associated sensations may impact self-efficacy and subsequent behaviors. We investigated the effect of a single exercise session on self-efficacy for sedentary endometrial cancer survivors compared with sedentary women of a similar age, but with no cancer history. Twenty survivors and 19 controls completed an exercise session performed as a submaximal cycle ergometry test. Sensations and efficacy were measured before and after exercise. Repeated measures analysis of variance (ANOVA) was performed. Regression models were used to determine predictors of self-efficacy and subsequent exercise. Self-efficacy increased for both survivors and controls, but survivors had a higher rate of increase, and the change predicted subsequent exercise. The association between exercise-related somatic sensations and self-efficacy differed between the 2 groups. A novel exercise experience had a larger effect on self-efficacy and subsequent exercise activity for endometrial cancer survivors than controls. Somatic sensations experienced during exercise may differ for survivors, which may be related to the experience of having cancer. Understanding factors affecting confidence in novel exercise experiences for populations with specific cancer histories is of the utmost importance in the adoption of exercise behaviors.

Lignocellulose nanofibers prepared by ionic liquid pretreatment and subsequent mechanical nanofibrillation of bagasse powder: Application to esterified bagasse/polypropylene composites.

PubMed

Ninomiya, Kazuaki; Abe, Megumi; Tsukegi, Takayuki; Kuroda, Kosuke; Tsuge, Yota; Ogino, Chiaki; Taki, Kentaro; Taima, Tetsuya; Saito, Joji; Kimizu, Mitsugu; Uzawa, Kiyoshi; Takahashi, Kenji

2018-02-15

In the present study, we examined the efficacy of choline acetate (ChOAc, a cholinium ionic liquid))-assisted pretreatment of bagasse powder for subsequent mechanical nanofibrillation to produce lignocellulose nanofibers. Bagasse sample with ChOAc pretreatment and subsequent nanofibrillation (ChOAc/NF-bagasse) was prepared and compared to untreated control bagasse sample (control bagasse), bagasse sample with nanofibrillation only (NF-bagasse) and with ChOAc pretreatment only (ChOAc-bagasse). The specific surface area was 0.83m 2 /g, 3.1m 2 /g, 6.3m 2 /g, and 32m 2 /g for the control bagasse, ChOAc-bagasse, NF-bagasse, and the ChOAc/NF-bagasse, respectively. Esterified bagasse/polypropylene composites were prepared using the bagasse samples. ChOAc/NF-bagasse exhibited the best dispersion in the composites. The tensile toughness of the composites was 0.52J/cm 3 , 0.73J/cm 3 , 0.92J/cm 3 , and 1.29J/cm 3 for the composites prepared using control bagasse, ChOAc-bagasse, NF-bagasse, and ChOAc/NF-bagasse, respectively. Therefore, ChOAc pretreatment and subsequent nanofibrillation of bagasse powder resulted in enhanced tensile toughness of esterified bagasse/polypropylene composites. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evidence for a differential contribution of early perceptual and late cognitive processes during encoding to episodic memory impairment in schizophrenia.

PubMed

Green, Amity E; Fitzgerald, Paul B; Johnston, Patrick J; Nathan, Pradeep J; Kulkarni, Jayashri; Croft, Rodney J

2017-08-01

Schizophrenia is characterised by significant episodic memory impairment that is thought to be related to problems with encoding, however the neuro-functional mechanisms underlying these deficits are not well understood. The present study used a subsequent recognition memory paradigm and event-related potentials (ERPs) to investigate temporal aspects of episodic memory encoding deficits in schizophrenia. Electroencephalographic data was recorded in 24 patients and 19 healthy controls whilst participants categorised single words as pleasant/unpleasant. ERPs were generated to subsequently recognised versus unrecognised words on the basis of a forced-choice recognition memory task. Subsequent memory effects were examined with the late positive component (LPP). Group differences in N1, P2, N400 and LPP were examined for words correctly recognised. Patients performed more poorly than controls on the recognition task. During encoding patients had significantly reduced N400 and LPP amplitudes than controls. LPP amplitude correlated with task performance however amplitudes did not differ between patients and controls as a function of subsequent memory. No significant differences in N1 or P2 amplitude or latency were observed. The present results indicate that early sensory processes are intact and dysfunctional higher order cognitive processes during encoding are contributing to episodic memory impairments in schizophrenia.

Constant Switching Frequency DTC for Matrix Converter Fed Speed Sensorless Induction Motor Drive

NASA Astrophysics Data System (ADS)

Mir, Tabish Nazir; Singh, Bhim; Bhat, Abdul Hamid

2018-05-01

The paper presents a constant switching frequency scheme for speed sensorless Direct Torque Control (DTC) of Matrix Converter fed Induction Motor Drive. The use of matrix converter facilitates improved power quality on input as well as motor side, along with Input Power Factor control, besides eliminating the need for heavy passive elements. Moreover, DTC through Space Vector Modulation helps in achieving a fast control over the torque and flux of the motor, with added benefit of constant switching frequency. A constant switching frequency aids in maintaining desired power quality of AC mains current even at low motor speeds, and simplifies input filter design of the matrix converter, as compared to conventional hysteresis based DTC. Further, stator voltage estimation from sensed input voltage, and subsequent stator (and rotor) flux estimation is done. For speed sensorless operation, a Model Reference Adaptive System is used, which emulates the speed dependent rotor flux equations of the induction motor. The error between conventionally estimated rotor flux (reference model) and the rotor flux estimated through the adaptive observer is processed through PI controller to generate the rotor speed estimate.

Successful hazard analysis critical control point implementation in the United Kingdom: understanding the barriers through the use of a behavioral adherence model.

PubMed

Gilling, S J; Taylor, E A; Kane, K; Taylor, J Z

2001-05-01

Hazard analysis critical control point (HACCP), a system of risk management designed to control food safety, has emerged over the last decade as the primary approach to securing the safety of the food supply. It is thus an important tool in combatting the worldwide escalation of foodborne disease. Yet despite wide dissemination and scientific support of its principles, successful HACCP implementation has been limited. This report takes a psychological approach to this problem by examining processes and factors that could impede adherence to the internationally accepted HACCP Guidelines and subsequent successful implementation of HACCP. Utilizing knowledge of medical clinical guideline adherence models and practical experience of HACCP implementation problems, the potential advantages of applying a behavioral model to food safety management are highlighted. The models' applicability was investigated using telephone interviews from over 200 businesses in the United Kingdom. Eleven key barriers to HACCP guideline adherence were identified. In-depth narrative interviews with food business proprietors then confirmed these findings and demonstrated the subsequent negative effect(s) on HACCP implementation. A resultant HACCP awareness to adherence model is proposed that demonstrates the complex range of potential knowledge, attitude, and behavior-related barriers involved in failures of HACCP guideline adherence. The model's specificity and detail provide a tool whereby problems can be identified and located and in this way facilitate tailored and constructive intervention. It is suggested that further investigation into the barriers involved and how to overcome them would be of substantial benefit to successful HACCP implementation and thereby contribute to an overall improvement in public health.

Effects of sorbitol on porcine oocyte maturation and embryo development in vitro.

PubMed

Lin, Tao; Zhang, Jin Yu; Diao, Yun Fei; Kang, Jung Won; Jin, Dong-Il

2015-04-01

In the present study, a porcine system was supplemented with sorbitol during in vitro maturation (IVM) or in vitro culture (IVC), and the effects of sorbitol on oocyte maturation and embryonic development following parthenogenetic activation were assessed. Porcine immature oocytes were treated with different concentrations of sorbitol during IVM, and the resultant metaphase II stage oocytes were activated and cultured in porcine zygote medium-3 (PZM-3) for 7 days. No significant difference was observed in cumulus expansion and the nuclear maturation between the control and sorbitol-treated groups, with the exception of the 100 mM group, which showed significantly decreased nuclear maturation and cumulus expansion. There was no significant difference in the intracellular reactive oxygen species (ROS) levels between oocytes matured with 10 or 20 mM sorbitol and control groups, but 50 and 100 mM groups had significantly higher ROS levels than other groups. The 20 mM group showed significant increases in intracellular glutathione and subsequent blastocyst formation rates following parthenogenetic activation compared with the other groups. During IVC, supplementation with sorbitol significantly reduced blastocyst formation and increased the apoptotic index compared with the control. The apoptotic index of blastocysts from the sorbitol-treated group for entire culture period was significantly higher than those of the partially sorbitol-exposed groups. Based on these findings, it can be concluded that the addition of a low concentration of sorbitol (20 mM) during IVM of porcine oocytes benefits subsequent blastocyst development and improves embryo quality, whereas sorbitol supplement during IVC has a negative effect on blastocyst formation.

The business process management software for successful quality management and organization: A case study from the University of Split School of Medicine.

PubMed

Sapunar, Damir; Grković, Ivica; Lukšić, Davor; Marušić, Matko

2016-05-01

Our aim was to describe a comprehensive model of internal quality management (QM) at a medical school founded on the business process analysis (BPA) software tool. BPA software tool was used as the core element for description of all working processes in our medical school, and subsequently the system served as the comprehensive model of internal QM. The quality management system at the University of Split School of Medicine included the documentation and analysis of all business processes within the School. The analysis revealed 80 weak points related to one or several business processes. A precise analysis of medical school business processes allows identification of unfinished, unclear and inadequate points in these processes, and subsequently the respective improvements and increase of the QM level and ultimately a rationalization of the institution's work. Our approach offers a potential reference model for development of common QM framework allowing a continuous quality control, i.e. the adjustments and adaptation to contemporary educational needs of medical students. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Prior stress exposure increases pain behaviors in a rat model of full thickness thermal injury.

PubMed

Nyland, Jennifer E; McLean, Samuel A; Averitt, Dayna L

2015-12-01

Thermal burns among individuals working in highly stressful environments, such as firefighters and military Service Members, are common. Evidence suggests that pre-injury stress may exaggerate pain following thermal injury; however current animal models of burn have not evaluated the potential influence of pre-burn stress. This sham-controlled study evaluated the influence of prior stress exposure on post-burn thermal and mechanical sensitivity in male Sprague-Dawley rats. Rats were exposed to 20 min of inescapable swim stress or sham stress once per day for three days. Exposure to inescapable swim stress (1) increased the intensity and duration of thermal hyperalgesia after subsequent burn and (2) accelerated the onset of thermal hyperalgesia and mechanical allodynia after subsequent burn. This stress-induced exacerbation of pain sensitivity was reversed by pretreatment and concurrent treatment with the serotonin-norepinephrine reuptake inhibitor (SNRI) duloxetine. These data suggest a better understanding of mechanisms by which prior stress augments pain after thermal burn may lead to improved pain treatments for burn survivors. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Effects of peer tutoring and consequences on the math performance of elementary classroom students1

PubMed Central

Harris, V. William; Sherman, James A.

1973-01-01

The effects of unstructured peer-tutoring procedures on the math performance of fourth- and fifth-grade students were investigated. Students' performances in two daily math sessions, during which they worked problems of the same type and difficulty, were compared. When students tutored each other over the same math problems as they subsequently worked, higher accuracies and rates of performance were associated with the tutored math sessions. The use of consequences for accurate performance seemed to enhance the effects of tutoring on accuracy. The results from an independent-study control condition, which was the same peer-tutoring except that students did not interact with each other, suggested that interactions between students during the tutoring procedure were, in part, responsible for improved accuracy and rate of performance. When students tutored each other over different but related problems to those that they were subsequently asked to solve, accuracies and rates during tutored math sessions were also higher, suggesting the development of generalized skills in solving particular types of math problems. PMID:16795443

Supersonic Retropulsion Surface Preparation of Carbon Fiber Reinforced Epoxy Composites for Adhesive Bonding

NASA Technical Reports Server (NTRS)

Palmieri, Frank L.; Belcher, Marcus A.; Wohl, Christopher J.; Blohowiak, Kay Y.; Connell, John W.

2013-01-01

Surface preparation is widely recognized as a key step to producing robust and predictable bonds in a precise and reproducible manner. Standard surface preparation techniques, including grit blasting, manual abrasion, and peel ply, can lack precision and reproducibility, which can lead to variation in surface properties and subsequent bonding performance. The use of a laser to ablate composite surface resin can provide an efficient, precise, and reproducible means of preparing composite surfaces for adhesive bonding. Advantages include elimination of physical waste (i.e., grit media and sacrificial peel ply layers that ultimately require disposal), reduction in process variability due to increased precision (e.g. increased reproducibility), and automation of surface preparation, all of which improve reliability and process control. This paper describes a Nd:YAG laser surface preparation technique for composite substrates and the mechanical performance and failure modes of bonded laminates thus prepared. Additionally, bonded specimens were aged in a hot, wet environment for approximately one year and subsequently mechanically tested. The results of a one year hygrothermal aging study will be presented.

Preparations of an inorganic-framework proton exchange nanochannel membrane

NASA Astrophysics Data System (ADS)

Yan, X. H.; Jiang, H. R.; Zhao, G.; Zeng, L.; Zhao, T. S.

2016-09-01

In this work, a proton exchange membrane composed of straight and aligned proton conducting nanochannels is developed. Preparation of the membrane involves the surface sol-gel method assisted with a through-hole anodic aluminum oxide (AAO) template to form the framework of the PEM nanochannels. A monomolecular layer (SO3Hsbnd (CH2)3sbnd Sisbnd (OCH3)3) is subsequently added onto the inner surfaces of the nanochannels to shape a proton-conducting pathway. Straight nanochannels exhibit long range order morphology, contributing to a substantial improvement in the proton mobility and subsequently proton conductivity. In addition, the nanochannel size can be altered by changing the surface sol-gel condition, allowing control of the active species/charge carrier selectivity via pore size exclusion. The proton conductivity of the nanochannel membrane is reported as high as 11.3 mS cm-1 at 70 °C with a low activation energy of 0.21 eV (20.4 kJ mol-1). First-principle calculations reveal that the activation energy for proton transfer is impressively low (0.06 eV and 0.07 eV) with the assistance of water molecules.

The effect of tilmicosin administered to ewes prior to lambing on incidence of clinical mastitis and subsequent lamb performance.

PubMed Central

Croft, A; Duffield, T; Menzies, P; Leslie, K; Bagg, R; Dick, P

2000-01-01

The effect of tilmicosin on the incidence of clinical mastitis and subsequent lamb performance was studied in 9 sheep flocks in Ontario. Ewes were treated randomly with either tilmicosin or placebo approximately one month prior to lambing. Outcome was assessed by comparing rates of clinical mastitis, palpable udder abnormalities, and preweaning (50-day) lamb weights between the 2 treatment groups, while controlling for other important variables. Lambs raised by multiparous ewes treated with tilmicosin were significantly heavier than lambs from placebo-treated multiparous ewes at 50 days. Lambs from tilmicosin-treated ewes were on average 0.52 kg heavier than lambs in the placebo group. There was no difference between treatment groups in the weight of lambs from first parity ewes. Tilmicosin treatment resulted in a 43% decrease in palpable udder abnormalities. Incidence of clinical mastitis did not differ between experimental groups. The administration of tilmicosin prelambing, at the time of routine clostridial disease vaccination, may be a beneficial and convenient way to reduce mastitis infection and improve the preweaning gain of lambs. PMID:10769768

Emotion regulation and its effects on mood improvement in response to an in vivo peer rejection challenge.

PubMed

Reijntjes, Albert; Stegge, Hedy; Terwogt, Mark Meerum; Kamphuis, Jan H; Telch, Michael J

2006-11-01

This study examined children's spontaneous use of behavioral emotion regulation (ER) strategies and their effects on subsequent mood change in response to an in vivo peer rejection manipulation. Participants (N = 186), ranging between 10 and 13 years of age, played a computer game based on the television show Survivor and were randomized to either peer rejection (being voted out of the game) or nonrejection control. In response to rejection, more than one third of the participants (38%) displayed a marked worsening (i.e., reliable change) in state mood. After receiving feedback, time spent on several behavioral ER strategies during a 5-minute postfeedback period was assessed. At the end of the postfeedback period, children's cognitive activity was also assessed. More time spent on behavioral distraction was positively linked to subsequent increases in positive affect, whereas the reverse pattern was found for disengagement/passive behavior. Moreover, higher endorsement ratings for the strategy of "cognitive analysis" were associated with stronger increases in negative affect. Copyright 2006 APA, all rights reserved.

Intravaginal metronidazole gel versus metronidazole plus nystatin ovules for bacterial vaginosis: a randomized controlled trial.

PubMed

Sanchez, Sixto; Garcia, Patricia J; Thomas, Katherine K; Catlin, Mary; Holmes, King K

2004-12-01

We compared metronidazole 0.75% gel (containing 37.5 mg metronidazole per dose) with ovules containing metronidazole 500 mg and nystatin 100,000 U, for intravaginal treatment of bacterial vaginosis (BV). In a single-blinded trial, symptomatic women with BV by both Amsel and Nugent criteria were randomly assigned to gel or ovules, once nightly for 5 nights, and asked to return 3 times after treatment. Analyses were intent-to-treat. Of 151 women with BV by both criteria at enrollment, 138 (91%) returned at least once. Product limit estimates for persistence or recurrence of BV at 14, 42, and 104 days were 20% (95% CI 10%-29%), 38% (95% CI 25%-48%), and 52% (95% CI 37%-63%) after gel treatment, and 4% (95% CI 0%-9%), 17% (95% CI 7%-26%), and 33% (95% CI 21%-46%) after ovule treatment ( P = .01). Among women without BV at first follow-up, subsequent intercourse without condoms independently predicted subsequent recurrence ( P

Chronically elevated bilirubin protects from cardiac reperfusion injury in the male Gunn rat.

PubMed

Bakrania, B; Du Toit, E F; Ashton, K J; Wagner, K-H; Headrick, J P; Bulmer, A C

2017-08-01

Bilirubin is associated with reduced risk of cardiovascular disease, as evidenced in conditions of mild hyperbilirubinaemia (Gilbert's Syndrome). Little is known regarding myocardial stress resistance in hyperbilirubinaemic conditions or whether life-long exposure modifies cardiac function, which might contribute to protection from cardiovascular disease. Hyperbilirubinaemic rats and littermate controls underwent echocardiography at 3, 6 and 12 months of age, with hearts subsequently assessed for resistance to 30 min of ischaemia. Heart tissue was then collected for assessment of bilirubin content. No difference in baseline cardiac function was evident until 6 months onwards, where Gunn rats demonstrated aortic dilatation and reduced peak ejection velocities. Additionally, duration of ventricular ejection increased progressively, indicating a negative inotropic effect of bilirubin in vivo. Ex vivo analysis of baseline function revealed reduced left ventricular pressure development (LVDP) and contractility in hyperbilirubinaemic rats. Furthermore, stress resistance was improved in Gunn hearts: post-ischaemic recoveries of LVDP (76 ± 22% vs. 29 ± 17% Control, P < 0.01) and coronary flow (96 ± 9% vs. 86 ± 16% Control, P < 0.01) were improved in Gunn hearts, accompanied by reduced infarct area (21 ± 5% vs. 47 ± 15% Control, P < 0.01), and ventricular malondialdehyde and protein carbonyl content. Expression of myocardial nitric oxide-regulating genes including Nos1 and Noa1 were not significantly different. These data reveal life-long hyperbilirubinaemia induces age-dependent hypocontractility in male Gunn rats, and improved stress resistance. In addition, bilirubin exerts sex-independent effects on vascular structure, myocardial function and ischaemic tolerance, the latter likely mediated via bilirubin's antioxidant properties. © 2017 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

Decrease in skin collagen glycation with improved glycemic control in patients with insulin-dependent diabetes mellitus.

PubMed Central

Lyons, T J; Bailie, K E; Dyer, D G; Dunn, J A; Baynes, J W

1991-01-01

Glycation, oxidation, and nonenzymatic browning of protein have all been implicated in the development of diabetic complications. The initial product of glycation of protein, fructoselysine (FL), undergoes further reactions, yielding a complex mixture of browning products, including the fluorescent lysine-arginine cross-link, pentosidine. Alternatively, FL may be cleaved oxidatively to form N(epsilon)-(carboxymethyl)lysine (CML), while glycated hydroxylysine, an amino-acid unique to collagen, may yield N(epsilon)-(carboxymethyl)hydroxylysine (CMhL). We have measured FL, pentosidine, fluorescence (excitation = 328 nm, emission = 378 nm), CML, and CMhL in insoluble skin collagen from 14 insulin-dependent diabetic patients before and after a 4-mo period of intensive therapy to improve glycemic control. Mean home blood glucose fell from 8.7 +/- 2.5 (mean +/- 1 SD) to 6.8 +/- 1.4 mM (P less than 0.005), and mean glycated hemoglobin (HbA1) from 11.6 +/- 2.3% to 8.3 +/- 1.1% (P less than 0.001). These changes were accompanied by a significant decrease in glycation of skin collagen, from 13.2 +/- 4.3 to 10.6 +/- 2.3 mmol FL/mol lysine (P less than 0.002). However, levels of browning and oxidation products (pentosidine, CML, and CMhL) and fluorescence were unchanged. These results show that the glycation of long-lived proteins can be decreased by improved glycemic control, but suggest that once cumulative damage to collagen by browning and oxidation reactions has occurred, it may not be readily reversed. Thus, in diabetic patients, institution and maintenance of good glycemic control at any time could potentially limit the extent of subsequent long-term damage to proteins by glycation and oxidation reactions. PMID:1904067

Improvement of Fitness and Efficacy of a Fire Blight Biocontrol Agent via Nutritional Enhancement Combined with Osmoadaptation ▿

PubMed Central

Cabrefiga, J.; Francés, J.; Montesinos, E.; Bonaterra, A.

2011-01-01

The efficacy of Pseudomonas fluorescens EPS62e in the biocontrol of Erwinia amylovora was improved by a procedure of physiological adaptation to increase colonization and survival in the phytosphere of rosaceous plants. The procedure consisted of osmoadaptation (OA) and nutritional enhancement (NE). OA was based on saline stress and osmolyte amendment of the growth medium during inoculum preparation. NE consisted of addition of glycine and Tween 80 to the formulation. NE and OA increased the growth rate and carrying capacity of EPS62e under high-relative-humidity (RH) conditions and improved survival at low RH on flowers under controlled environmental conditions. NE did not promote growth or affect infection capacity of E. amylovora. The effect of both methods was tested in the field by following the population of EPS62e using quantitative PCR (Q-PCR) (total population) and CFU counting (culturable population) methods. Following field application, EPS62e colonized blossoms, but it was stressed, as indicated by a sharp decrease in culturable compared to total population levels. However, once established in flowers and at the end of bloom, almost all the total population was culturable. The physiological adaptation treatments increased population levels of EPS62e over those of nonadapted cells during the late stage of the flowering period. Control of fire blight infections in flowers and immature fruits was tested by field application of EPS62e and subsequent inoculation with E. amylovora under controlled-environment conditions. The efficacy of fire blight control increased significantly with the combination of nutritional enhancement and osmoadaptation, in comparison with the absence of physiological adaptation. PMID:21441337

Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: a phase II randomized controlled trial.

PubMed

Michielsen, Marian E; Selles, Ruud W; van der Geest, Jos N; Eckhardt, Martine; Yavuzer, Gunes; Stam, Henk J; Smits, Marion; Ribbers, Gerard M; Bussmann, Johannes B J

2011-01-01

To evaluate for any clinical effects of home-based mirror therapy and subsequent cortical reorganization in patients with chronic stroke with moderate upper extremity paresis. A total of 40 chronic stroke patients (mean time post .onset, 3.9 years) were randomly assigned to the mirror group (n = 20) or the control group (n = 20) and then joined a 6-week training program. Both groups trained once a week under supervision of a physiotherapist at the rehabilitation center and practiced at home 1 hour daily, 5 times a week. The primary outcome measure was the Fugl-Meyer motor assessment (FMA). The grip force, spasticity, pain, dexterity, hand-use in daily life, and quality of life at baseline-posttreatment and at 6 months-were all measured by a blinded assessor. Changes in neural activation patterns were assessed with functional magnetic resonance imaging (fMRI) at baseline and posttreatment in an available subgroup (mirror, 12; control, 9). Posttreatment, the FMA improved more in the mirror than in the control group (3.6 ± 1.5, P < .05), but this improvement did not persist at follow-up. No changes were found on the other outcome measures (all Ps >.05). fMRI results showed a shift in activation balance within the primary motor cortex toward the affected hemisphere in the mirror group only (weighted laterality index difference 0.40 ± 0.39, P < .05). This phase II trial showed some effectiveness for mirror therapy in chronic stroke patients and is the first to associate mirror therapy with cortical reorganization. Future research has to determine the optimum practice intensity and duration for improvements to persist and generalize to other functional domains.

Improving Coverage and Compliance in Mass Drug Administration for the Elimination of LF in Two ‘Endgame’ Districts in Indonesia Using Micronarrative Surveys

PubMed Central

Krentel, Alison; Damayanti, Rita; Titaley, Christiana Rialine; Suharno, Nugroho; Bradley, Mark; Lynam, Timothy

2016-01-01

Background As the Global Programme to Eliminate Lymphatic Filariasis (LF) approaches its 2020 goal, an increasing number of districts will enter the endgame phase where drug coverage rates from mass drug administration (MDA) are used to assess whether MDA can be stopped. As reported, the gap between reported and actual drug coverage in some contexts has overestimated the true rates, thus causing premature administration of transmission assessment surveys (TAS) that detect ongoing LF transmission. In these cases, districts must continue with additional rounds of MDA. Two districts in Indonesia (Agam District, Depok City) fit this criteria—one had not met the pre-TAS criteria and the other, had not passed the TAS criteria. In both cases, the district health teams needed insight into their drug delivery programs in order to improve drug coverage in the subsequent MDA rounds. Methodology/Principal Findings To inform the subsequent MDA round, a micronarrative survey tool was developed to capture community members’ experience with MDA and the social realm where drug delivery and compliance occur. A baseline survey was implemented after the 2013 MDA in endemic communities in both districts using the EPI sampling criteria (n = 806). Compliance in the last MDA was associated with perceived importance of the LF drugs for health (p<0.001); perceived safety of the LF drugs (p<0.001) and knowing someone in the household has complied (p<0.001). Results indicated that specialized messages were needed to reach women and younger men. Both districts used these recommendations to implement changes to their MDA without additional financial support. An endline survey was performed after the 2014 MDA using the same sampling criteria (n = 811). Reported compliance in the last MDA improved in both districts from 57% to 77% (p<0.05). Those who reported having ever taken the LF drug rose from 79% to 90% (p<0.001) in both sites. Conclusions/Significance Micronarrative surveys were shown to be a valid and effective tool to detect operational issues within MDA programs. District health staff felt ownership of the results, implementing feasible changes to their programs that resulted in significant improvements to coverage and compliance in the subsequent MDA. This kind of implementation research using a micronarrative survey tool could benefit underperforming MDA programs as well as other disease control programs where a deeper understanding is needed to improve healthcare delivery. PMID:27812107

Targeting the postpartum period to promote weight loss: a systematic review and meta-analysis.

PubMed

Dodd, Jodie M; Deussen, Andrea R; O'Brien, Cecelia M; Schoenaker, Danielle A J M; Poprzeczny, Amanda; Gordon, Adrienne; Phelan, Suzanne

2018-06-07

Many international clinical guidelines recommend that overweight and obese women lose weight prior to pregnancy to reduce the risk of adverse pregnancy outcomes. Women who have recently given birth and plan future pregnancies are an important target population for preconception weight-loss interventions. A systematic review to evaluate postpartum dietary and/or physical activity interventions to promote weight loss and improve health in a subsequent pregnancy was conducted. Five databases-the Cochrane Central Register of Controlled Trials, MEDLINE (through PubMed), Embase, the Australian New Zealand Clinical Trials Registry, and the International Clinical Trials Registry-were searched using the following terms: preconception, pregnancy, postpartum, pregnancy outcomes, body mass index, weight gain, weight loss, weight change, postpartum weight retention, dietary or lifestyle intervention, and randomiz(s)ed controlled trial. The date of last search was November 2017. Data were extracted from each identified study using a standard form. The primary outcomes were weight loss at the completion of the intervention and at follow-up assessments. Secondary endpoints included maternal and infant outcomes in a subsequent pregnancy. Mean differences (MDs) were calculated for continuous data and risk ratios for dichotomous data, both with 95%CIs. A total of 235 abstracts (193 after duplicates were excluded) were identified, from which 37 manuscripts were selected for full-text review. In total, 27 trials were identified for inclusion. Outcome data were available for approximately 75% of participants (n = 3485). A combined dietary and physical activity intervention provided post partum produced greater postpartum weight loss (MD, -2.49 kg; 95%CI, -3.34 to -1.63 kg [random-effects model]; 12 studies, 1156 women), which was maintained at 12 months post partum (MD, -2.41 kg; 95%CI, -3.89 to -0.93 kg [random-effects model]; 4 studies, 405 women), compared with no intervention. No studies reported maternal or infant health outcomes in a subsequent pregnancy. Providing a postpartum intervention is associated with weight loss after birth, but effects on maternal and infant health in a subsequent pregnancy are uncertain.

Low cognitive load and reduced arousal impede practice effects on executive functioning, metacognitive confidence and decision making.

PubMed

Jackson, Simon A; Kleitman, Sabina; Aidman, Eugene

2014-01-01

The present study investigated the effects of low cognitive workload and the absence of arousal induced via external physical stimulation (motion) on practice-related improvements in executive (inhibitory) control, short-term memory, metacognitive monitoring and decision making. A total of 70 office workers performed low and moderately engaging passenger tasks in two successive 20-minute simulated drives and repeated a battery of decision making and inhibitory control tests three times—before, between and after these drives. For half the participants, visual simulation was synchronised with (moderately arousing) motion generated through LAnd Motion Platform, with vibration levels corresponding to a well-maintained unsealed road. The other half performed the same simulated drive without motion. Participants' performance significantly improved over the three test blocks, which is indicative of typical practice effects. The magnitude of these improvements was the highest when both motion and moderate cognitive load were present. The same effects declined either in the absence of motion (low arousal) or following a low cognitive workload task, thus suggesting two distinct pathways through which practice-related improvements in cognitive performance may be hampered. Practice, however, degraded certain aspects of metacognitive performance, as participants became less likely to detect incorrect decisions in the decision-making test with each subsequent test block. Implications include consideration of low cognitive load and arousal as factors responsible for performance decline and targets for the development of interventions/strategies in low load/arousal conditions such as autonomous vehicle operations and highway driving.

Standard-Fractionated Radiotherapy for Optic Nerve Sheath Meningioma: Visual Outcome Is Predicted by Mean Eye Dose

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

Abouaf, Lucie; Girard, Nicolas; Claude Bernard University, Lyon

2012-03-01

Purpose: Radiotherapy has shown its efficacy in controlling optic nerve sheath meningiomas (ONSM) tumor growth while allowing visual acuity to improve or stabilize. However, radiation-induced toxicity may ultimately jeopardize the functional benefit. The purpose of this study was to identify predictive factors of poor visual outcome in patients receiving radiotherapy for ONSM. Methods and Materials: We conducted an extensive analysis of 10 patients with ONSM with regard to clinical, radiologic, and dosimetric aspects. All patients were treated with conformal radiotherapy and subsequently underwent biannual neuroophthalmologic and imaging assessments. Pretreatment and posttreatment values of visual acuity and visual field were comparedmore » with Wilcoxon's signed rank test. Results: Visual acuity values significantly improved after radiotherapy. After a median follow-up time of 51 months, 6 patients had improved visual acuity, 4 patients had improved visual field, 1 patient was in stable condition, and 1 patient had deteriorated visual acuity and visual field. Tumor control rate was 100% at magnetic resonance imaging assessment. Visual acuity deterioration after radiotherapy was related to radiation-induced retinopathy in 2 patients and radiation-induced mature cataract in 1 patient. Study of radiotherapy parameters showed that the mean eye dose was significantly higher in those 3 patients who had deteriorated vision. Conclusions: Our study confirms that radiotherapy is efficient in treating ONSM. Long-term visual outcome may be compromised by radiation-induced side effects. Mean eye dose has to be considered as a limiting constraint in treatment planning.« less

Summer cover crops and soil amendments to improve growth and nutrient uptake of okra

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

Wang, Q.R.; Li, Y.C.; Klassen, W.

2006-04-15

A pot experiment with summer cover crops and soil amendments was conducted in two consecutive years to elucidate the effects of these cover crops and soil amendments on 'Clemson Spineless 80' okra (Abelmoschus esculentus) yields and biomass production, and the uptake and distribution of soil nutrients and trace elements. The cover crops were sunn hemp (Crotalaria juncea), cowpea (Vigna unguiculata), velvetbean (Mucuna deeringiana), and sorghum sudan-grass (Sorghum bicolor x S. bicolor var. sudanense) with fallow as the control. The organic soil amendments were biosolids (sediment from wastewater plants), N-Viro Soil (a mixture of biosolids and coal ash), coal ash (amore » combustion by-product from power plants), co-compost (a mixture of 3 biosolids: 7 yard waste), and yard waste compost (mainly from leaves and branches of trees and shrubs, and grass clippings) with a soil-incorporated cover crop as the control. As a subsequent vegetable crop, okra was grown after the cover crops, alone or together with the organic soil amendments, had been incorporated. All of the cover crops, except sorghum sudangrass in 2002-03, significantly improved okra fruit yields and the total biomass production. Both cover crops and soil amendments can substantially improve nutrient uptake and distribution. The results suggest that cover crops and appropriate amounts of soil amendments can be used to improve soil fertility and okra yield without adverse environmental effects or risk of contamination of the fruit. Further field studies will be required to confirm these findings.« less

Addition by Subtraction: The Relation Between Dropout Rates and School-Level Academic Achievement.

PubMed

Glennie, Elizabeth; Bonneau, Kara; Vandellen, Michelle; Dodge, Kenneth A

2012-01-01

Efforts to improve student achievement should increase graduation rates. However, work investigating the effects of student-level accountability has consistently demonstrated that increases in the standards for high school graduation are correlated with increases in dropout rates. The most favored explanation for this finding is that high-stakes testing policies that mandate grade repetition and high school exit exams may be the tipping point for students who are already struggling academically. These extra demands may, in fact, push students out of school. This article examines two hypotheses regarding the relation between school-level accountability and dropout rates. The first posits that improvements in school performance lead to improved success for everyone. If school-level accountability systems improve a school for all students, then the proportion of students performing at grade level increases, and the dropout rate decreases. The second hypothesis posits that schools facing pressure to improve their overall accountability score may pursue this increase at the cost of other student outcomes, including dropout rate. Our approach focuses on the dynamic relation between school-level academic achievement and dropout rates over time-that is, between one year's achievement and the subsequent year's dropout rate, and vice versa. This article employs longitudinal data of records on all students in North Carolina public schools over an 8-year period. Analyses employ fixed-effects models clustering schools and districts within years and controls each year for school size, percentage of students who were free/reduced-price lunch eligible, percentage of students who are ethnic minorities, and locale. This study finds partial evidence that improvements in school-level academic performance will lead to improvements (i.e., decreases) in school-level dropout rates. Schools with improved performance saw decreased dropout rates following these successes. However, we find more evidence of a negative side of the quest for improved academic performance. When dropout rates increase, the performance composites in subsequent years increase. Accountability systems need to remove any indirect benefit a school may receive from increasing its dropout rate. Schools should be held accountable for those who drop out of school. Given the personal and social costs of dropping out, accountability systems need to place more emphasis on dropout prevention. Such an emphasis could encompass increasing the dropout age and having the school's performance composite include scores of zero on end-of-grade tests for those who leave school.

Controlled Substance Reconciliation Accuracy Improvement Using Near Real-Time Drug Transaction Capture from Automated Dispensing Cabinets.

PubMed

Epstein, Richard H; Dexter, Franklin; Gratch, David M; Perino, Michael; Magrann, Jerry

2016-06-01

Accurate accounting of controlled drug transactions by inpatient hospital pharmacies is a requirement in the United States under the Controlled Substances Act. At many hospitals, manual distribution of controlled substances from pharmacies is being replaced by automated dispensing cabinets (ADCs) at the point of care. Despite the promise of improved accountability, a high prevalence (15%) of controlled substance discrepancies between ADC records and anesthesia information management systems (AIMS) has been published, with a similar incidence (15.8%; 95% confidence interval [CI], 15.3% to 16.2%) noted at our institution. Most reconciliation errors are clerical. In this study, we describe a method to capture drug transactions in near real-time from our ADCs, compare them with documentation in our AIMS, and evaluate subsequent improvement in reconciliation accuracy. ADC-controlled substance transactions are transmitted to a hospital interface server, parsed, reformatted, and sent to a software script written in Perl. The script extracts the data and writes them to a SQL Server database. Concurrently, controlled drug totals for each patient having care are documented in the AIMS and compared with the balance of the ADC transactions (i.e., vending, transferring, wasting, and returning drug). Every minute, a reconciliation report is available to anesthesia providers over the hospital Intranet from AIMS workstations. The report lists all patients, the current provider, the balance of ADC transactions, the totals from the AIMS, the difference, and whether the case is still ongoing or had concluded. Accuracy and latency of the ADC transaction capture process were assessed via simulation and by comparison with pharmacy database records, maintained by the vendor on a central server located remotely from the hospital network. For assessment of reconciliation accuracy over time, data were collected from our AIMS from January 2012 to June 2013 (Baseline), July 2013 to April 2014 (Next Day Reports), and May 2014 to September 2015 (Near Real-Time Reports) and reconciled against pharmacy records from the central pharmacy database maintained by the vendor. Control chart (batch means) methods were used between successive epochs to determine if improvement had taken place. During simulation, 100% of 10,000 messages, transmitted at a rate of 1295 per minute, were accurately captured and inserted into the database. Latency (transmission time to local database insertion time) was 46.3 ± 0.44 milliseconds (SEM). During acceptance testing, only 1 of 1384 transactions analyzed had a difference between the near real-time process and what was in the central database; this was for a "John Doe" patient whose name had been changed subsequent to data capture. Once a transaction was entered at the ADC workstation, 84.9% (n = 18 bins; 95% CI, 78.4% to 91.3%) of these transactions were available in the database on the AIMS server within 2 minutes. Within 5 minutes, 98.2% (n = 18 bins; 95% CI, 97.2% to 99.3%) were available. Among 145,642 transactions present in the central pharmacy database, only 24 were missing from the local database table (mean = 0.018%; 95% CI, 0.002% to 0.034%). Implementation of near real-time reporting improved the controlled substance reconciliation error rate compared to the previous Next Day Reports epoch, from 8.8% to 5.2% (difference = -3.6%; 95% CI, -4.3% to -2.8%; P < 10). Errors were distributed among staff, with 50% of discrepancies accounted for by 12.4% of providers and 80% accounted for by 28.5% of providers executing transactions during the Near Real-Time Reports epoch. The near real-time system for the capture of transactional data flowing over the hospital network was highly accurate, reliable, and exhibited acceptable latency. This methodology can be used to implement similar data capture for transactions from their drug ADCs. Reconciliation accuracy improved significantly as a result of implementation. Our approach may be of particular utility at facilities with limited pharmacy resources to audit anesthesia records for controlled substance administration and reconcile them against dispensing records.

Suppressing Emotions Impairs Subsequent Stroop Performance and Reduces Prefrontal Brain Activation

PubMed Central

Luechinger, Roger; Boesiger, Peter; Rasch, Björn

2013-01-01

Abundant behavioral evidence suggests that the ability to self-control is limited, and that any exertion of self-control will increase the likelihood of subsequent self-control failures. Here we investigated the neural correlates underlying the aftereffects of self-control on future control processes using functional magnetic resonance imaging (fMRI). An initial act of self-control (suppressing emotions) impaired subsequent performance in a second task requiring control (Stroop task). On the neural level, increased activity during emotion suppression was followed by a relative decrease in activity during the Stroop task in a cluster in the right lateral prefrontal cortex (PFC) including the dorsolateral prefrontal cortex (DLPFC), an area engaged in the effortful implementation of control. There was no reliable evidence for reduced activity in the medial frontal cortex (MFC) including the anterior cingulate cortex (ACC), which is involved in conflict detection processes and has previously also been implicated in self-control. Follow-up analyses showed that the detected cluster in the right lateral PFC and an area in the MFC were involved in both the emotion suppression task and the Stroop task, but only the cluster in the right lateral PFC showed reduced activation after emotion suppression during the Stroop task. Reduced activity in lateral prefrontal areas relevant for the implementation of control may be a critical consequence of prior self-control exertion if the respective areas are involved in both self-control tasks. PMID:23565239

Effects of internet-based pain coping skills training prior to home exercise for individuals with hip osteoarthritis (HOPE trial): a randomised controlled trial.

PubMed

Bennell, Kim L; Nelligan, Rachel K; Rini, Christine; Keefe, Francis J; Kasza, Jessica; French, Simon; Forbes, Andrew; Dobson, Fiona; Abbott, J Haxby; Dalwood, Andrew; Harris, Anthony; Vicenzino, Bill; Hodges, Paul W; Hinman, Rana S

2018-05-22

This assessor-, therapist- and participant-blinded randomised controlled trial evaluated the effects of an automated internet-based pain coping skills training (PCST) program prior to home exercise for people with clinically-diagnosed hip osteoarthritis (OA). 144 people were randomised to either the PCST group or the comparator group. In the first 8 weeks, the PCST group received online education and PCST while the comparison group received online education only. From weeks 8-24, both groups visited a physiotherapist 5 times for home exercise prescription. Assessments were performed at baseline, 8, 24 and 52 weeks. Primary outcomes were hip pain on walking (11-point numerical rating scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) at 24 weeks. Secondary outcomes were other measures of pain, quality-of-life, global change, self-efficacy, pain coping, pain catastrophizing, depression, anxiety, stress, physical activity and adverse events. Primary outcomes were completed by 137 (95%), 131 (91%) and 127 (88%) participants at 8, 24 and 52 weeks, respectively. There were no significant between-group differences in primary outcomes at week 24 (change in: walking pain (mean difference 0.5 units; 95%CI, -0.3 to 1.3) and function (-0.9 units; 95%CI, -4.8 to 2.9)), with both groups showing clinically-relevant improvements. At week 8, the PCST group had greater improvements in function, pain coping and global improvement than comparison. Greater pain coping improvements persisted at 24 and 52 weeks. In summary, online PCST immediately improved pain coping and function but did not confer additional benefits to a subsequent exercise program, despite sustained pain coping improvements.

Chlorogenic acid supplementation during in vitro maturation improves maturation, fertilization and developmental competence of porcine oocytes.

PubMed

Nguyen, T-V; Tanihara, F; Do, Ltk; Sato, Y; Taniguchi, M; Takagi, M; Van Nguyen, T; Otoi, T

2017-12-01

Chlorogenic acid (CGA) is a quinic acid conjugate of caffeic acid, and a phytochemical found in many fruits and beverages that acts as an antioxidant. The present study investigated the effects of CGA supplementation during in vitro maturation (IVM), on in vitro development of porcine oocytes, to improve the porcine in vitro production (IVP) system. Oocytes were matured either without (control) or with CGA (10, 50, 100 and 200 μM). Subsequently, the matured oocytes were fertilized and cultured in vitro for 7 day. The rates of maturation, fertilization and blastocyst formation of oocytes matured with 50 μM CGA were significantly (p < .05) higher than those of the control oocytes. Hydrogen peroxide (H 2 O 2 ) is one of the reactive oxygen species and induces DNA damage in porcine oocytes. When oocytes were matured with 1 mM H 2 O 2 to assess the protective effect of CGA, 50 μM CGA supplementation improved the maturation rate and the proportion of DNA-fragmented nuclei in oocytes compared with control oocytes matured without CGA. Moreover, when oocytes were matured with either 50 μM CGA (control) or caffeic acid (10, 50 and 100 μM), the rates of maturation, fertilization and the blastocyst formation of oocytes matured with 50 μM CGA were similar to those of oocytes matured with 10 and 50 μM caffeic acid. Our results suggest that CGA has comparable effects to caffeic acid, and IVM with 50 μM CGA is particularly beneficial to IVP of porcine embryos and protects oocytes from DNA damage induced by oxidative stress. Supplementation of CGA to the maturation medium has a potential to improve porcine IVP system. © 2017 Blackwell Verlag GmbH.

Striatal functional connectivity changes following specific balance training in elderly people: MRI results of a randomized controlled pilot study.

PubMed

Magon, Stefano; Donath, Lars; Gaetano, Laura; Thoeni, Alain; Radue, Ernst-Wilhelm; Faude, Oliver; Sprenger, Till

2016-09-01

Practice-induced effects of specific balance training on brain structure and activity in elderly people are largely unknown. In the present study, we investigated morphological and functional brain changes following slacking training (balancing over nylon ribbons) in a group of elderly people. Twenty-eight healthy volunteers were recruited and randomly assigned to the intervention (mean age: 62.3±5.4years) or control group (mean age: 61.8±5.3years). The intervention group completed six-weeks of slackline training. Brain morphological changes were investigated using voxel-based morphometry and functional connectivity changes were computed via independent component analysis and seed-based analyses. All analyses were applied to the whole sample and to a subgroup of participants who improved in slackline performance. The repeated measures analysis of variance showed a significant interaction effect between groups and sessions. Specifically, the Tukey post-hoc analysis revealed a significantly improved slackline standing performance after training for the left leg stance time (pre: 4.5±3.6s vs. 26.0±30.0s, p<0.038) as well as for tandem stance time (pre: 1.4±0.6s vs. post: 4.5±4.0s, p=0.003) in the intervention group. No significant changes in balance performance were observed in the control group. The MRI analysis did not reveal morphological or functional connectivity differences before or after the training between the intervention and control groups (whole sample). However, subsequent analysis in subjects with improved slackline performance showed a decrease of connectivity between the striatum and other brain areas during the training period. These preliminary results suggest that improved balance performance with slackline training goes along with an increased efficiency of the striatal network. Copyright © 2016 Elsevier B.V. All rights reserved.

A review of studies of the effect of severe malnutrition on mental development.

PubMed

Grantham-McGregor, S

1995-08-01

This is a review of studies on the relationship between mental development and severe malnutrition. School-age children who suffered from early childhood malnutrition have generally been found to have poorer IQ levels, cognitive function, school achievement and greater behavioral problems than matched controls and, to a lesser extent, siblings. The disadvantages last at least until adolescence. There is no consistent evidence of a specific cognitive deficit. The evidence of a causal relationship is strong but not unequivocal because of difficulties in interpreting retrospective case control studies. Marked improvements in development can occur after adoption or intervention. Therefore, the outcome depends to a large extent on the quality of the subsequent environment. It is likely that extremely deprived environments would exacerbate the effects. There is limited evidence that other nutritional deficiencies may interact with previous malnutrition in affecting cognition. The mechanism linking malnutrition to poor development is still not established.

III-nitride integration on ferroelectric materials of lithium niobate by molecular beam epitaxy

NASA Astrophysics Data System (ADS)

Namkoong, Gon; Lee, Kyoung-Keun; Madison, Shannon M.; Henderson, Walter; Ralph, Stephen E.; Doolittle, W. Alan

2005-10-01

Integration of III-nitride electrical devices on the ferroelectric material lithium niobate (LiNbO3) has been demonstrated. As a ferroelectric material, lithium niobate has a polarization which may provide excellent control of the polarity of III-nitrides. However, while high temperature, 1000°C, thermal treatments produce atomically smooth surfaces, improving adhesion of GaN epitaxial layers on lithium niobate, repolarization of the substrate in local domains occurs. These effects result in multi domains of mixed polarization in LiNbO3, producing inversion domains in subsequent GaN epilayers. However, it is found that AlN buffer layers suppress inversion domains of III-nitrides. Therefore, two-dimensional electron gases in AlGaN /GaN heterojunction structures are obtained. Herein, the demonstration of the monolithic integration of high power devices with ferroelectric materials presents possibilities to control LiNbO3 modulators on compact optoelectronic/electronic chips.

Military tobacco policies: the good, the bad, and the ugly.

PubMed

Jahnke, Sara A; Hoffman, Kevin M; Haddock, C Keith; Long, Mark A D; Williams, Larry N; Lando, Harry A; Poston, W S Carlos

2011-12-01

The United States military has the legacy of a pro-tobacco culture and still has prevalence rates of tobacco use that are higher than their civilian counterparts. One tactic for decreasing use and the subsequent health problems is through effective tobacco control policies. We collected available tobacco control policies from all four branches of the military and, through qualitative analysis, identified policies that were unique either as providing more or less detail and restriction than peer group policies. Best and worst practice policies in the areas of enforcement, smoking cessation, smokeless tobacco use, environmental tobacco smoke, framing tobacco as non-normative, designated tobacco use areas, and monitoring of tobacco use are presented. Because policy making can be an effective tool for improving the health of military members, understanding what policy components are comparatively positive or negative is an important tool for health advocates both in the military and civilian settings.

Military Tobacco Policies: The Good, The Bad, and The Ugly

PubMed Central

Jahnke, Sara A.; Hoffman, Kevin M.; Haddock, C. Keith; Long, Mark A. D.; Williams, CAPT Larry N.; Lando, Harry A.; Carlos Poston, W. S.

2012-01-01

The United States military has the legacy of a pro-tobacco culture and still has prevalence rates of tobacco use that are higher than their civilian counterparts. One tactic for decreasing use and the subsequent health problems is through effective tobacco control policies. We collected available tobacco control policies from all four branches of the military and, through qualitative analysis, identified policies that were unique either as providing more or less detail and restriction than peer group policies. Best and worst practice policies in the areas of enforcement, smoking cessation, smokeless tobacco use, environmental tobacco smoke, framing tobacco as non-normative, designated tobacco use areas, and monitoring of tobacco use are presented. Because policy making can be an effective tool for improving the health of military members, understanding what policy components are comparatively positive or negative is an important tool for health advocates both in the military and civilian settings. PMID:22338352

A stimulus control technique for improving the efficacy of an established toilet training program.

PubMed

Taylor, S; Cipani, E; Clardy, A

1994-06-01

Standard toilet training regimens used with children with developmental disabilities have demonstrated effectiveness at achieving bladder and bowel continence. However, in some clinical applications in everyday practice, success has not been achieved, necessitating research into possible modifications of the current approaches. A widely used toilet training program was modified to reduce toileting accidents of a referred child. The modification involved the assessment of the discriminative stimulus for eliminating, namely, his undergarments. By removing the undergarments when an elimination became imminent, an "errorless" learning paradigm was established that allowed for more rapid and enduring acquisition of toileting skills than seen in previous training attempts. The results indicate the present procedure could expedite training for individuals who are difficult to teach appropriate toileting skills through an analysis of the controlling antecedent stimulus for accidents and subsequent manipulation of such stimuli.

Input preshaping with frequency domain information for flexible-link manipulator control

NASA Technical Reports Server (NTRS)

Tzes, Anthony; Englehart, Matthew J.; Yurkovich, Stephen

1989-01-01

The application of an input preshaping scheme to flexible manipulators is considered. The resulting control corresponds to a feedforward term that convolves in real-time the desired reference input with a sequence of impulses and produces a vibration free output. The robustness of the algorithm with respect to injected disturbances and modal frequency variations is not satisfactory and can be improved by convolving the input with a longer sequence of impulses. The incorporation of the preshaping scheme to a closed-loop plant, using acceleration feedback, offers satisfactory disturbance rejection due to feedback and cancellation of the flexible mode effects due to the preshaping. A frequency domain identification scheme is used to estimate the modal frequencies on-line and subsequently update the spacing between the impulses. The combined adaptive input preshaping scheme provides the fastest possible slew that results in a vibration free output.

COMPLETE - a school-based intervention project to increase completion of upper secondary school in Norway: study protocol for a cluster randomized controlled trial.

PubMed

Larsen, T; Urke, H B; Holsen, I; Anvik, C H; Olsen, T; Waldahl, R H; Antonsen, K M; Johnson, R; Tobro, M; Brastad, B; Hansen, T B

2018-03-09

Drop out from upper secondary school represents a risk for the future health and wellbeing of young people. Strengthening of psychosocial aspects of the learning environment may be an effective strategy to promote completion of upper secondary school. This paper is a study protocol of a school based cluster randomized controlled trial (RCT) evaluating two school-based interventions, namely the Dream School Program (DSP) and the Mental Health Support Team (MHST). The interventions aim to improve psychosocial learning environments and subsequently school achievements and decrease drop-out and absence. The COMPLETE RCT is aimed at youth in upper secondary school, grade 1 (age 15-16 years), and examines the effect of the combination of the DSP and the MHST; and the DSP only, compared with a comparison group on the following primary outcomes: student completion, presence, average grade, and self-reported mental health. Seventeen upper secondary schools from four counties in Norway were randomized to one of the three arms: 1) DSP and MHST; 2) DSP; and 3) comparison (offered DSP intervention in 2018/2019). The study will evaluate the interventions based on information from two cohorts of students (cohort 1 (C1) and cohort 2 (C2)). For C1, data was collected at baseline (August 2016), and at first follow-up seven months later. Second follow-up will be collected 19 months after baseline. For C2, data was collected at baseline (August 2017), and first and second follow-up will be collected similarly to that of C2 seven and 19 months respectively after baseline. Process evaluations based on focus groups, interviews and observation will be conducted twice (first completed spring 2017). The COMPLETE trial is a large study that can provide useful knowledge about what interventions might effectively improve completion of upper secondary school. Its thorough process evaluation will provide critical information about barriers and points of improvement for optimizing intervention implementation. Findings can guide school development in the perspective of improving psychosocial learning environments and subsequent completion of upper secondary schooling. The trial was retrospectively registered in the ClinicalTrials.gov register on December 22.2017: NCT03382080 .

Stratospheric controlled perturbation experiment: a small-scale experiment to improve understanding of the risks of solar geoengineering

PubMed Central

Dykema, John A.; Keith, David W.; Anderson, James G.; Weisenstein, Debra

2014-01-01

Although solar radiation management (SRM) through stratospheric aerosol methods has the potential to mitigate impacts of climate change, our current knowledge of stratospheric processes suggests that these methods may entail significant risks. In addition to the risks associated with current knowledge, the possibility of ‘unknown unknowns’ exists that could significantly alter the risk assessment relative to our current understanding. While laboratory experimentation can improve the current state of knowledge and atmospheric models can assess large-scale climate response, they cannot capture possible unknown chemistry or represent the full range of interactive atmospheric chemical physics. Small-scale, in situ experimentation under well-regulated circumstances can begin to remove some of these uncertainties. This experiment—provisionally titled the stratospheric controlled perturbation experiment—is under development and will only proceed with transparent and predominantly governmental funding and independent risk assessment. We describe the scientific and technical foundation for performing, under external oversight, small-scale experiments to quantify the risks posed by SRM to activation of halogen species and subsequent erosion of stratospheric ozone. The paper's scope includes selection of the measurement platform, relevant aspects of stratospheric meteorology, operational considerations and instrument design and engineering. PMID:25404681

Stratospheric controlled perturbation experiment: a small-scale experiment to improve understanding of the risks of solar geoengineering.

PubMed

Dykema, John A; Keith, David W; Anderson, James G; Weisenstein, Debra

2014-12-28

Although solar radiation management (SRM) through stratospheric aerosol methods has the potential to mitigate impacts of climate change, our current knowledge of stratospheric processes suggests that these methods may entail significant risks. In addition to the risks associated with current knowledge, the possibility of 'unknown unknowns' exists that could significantly alter the risk assessment relative to our current understanding. While laboratory experimentation can improve the current state of knowledge and atmospheric models can assess large-scale climate response, they cannot capture possible unknown chemistry or represent the full range of interactive atmospheric chemical physics. Small-scale, in situ experimentation under well-regulated circumstances can begin to remove some of these uncertainties. This experiment-provisionally titled the stratospheric controlled perturbation experiment-is under development and will only proceed with transparent and predominantly governmental funding and independent risk assessment. We describe the scientific and technical foundation for performing, under external oversight, small-scale experiments to quantify the risks posed by SRM to activation of halogen species and subsequent erosion of stratospheric ozone. The paper's scope includes selection of the measurement platform, relevant aspects of stratospheric meteorology, operational considerations and instrument design and engineering.

Smart markers for watershed-based cell segmentation.

PubMed

Koyuncu, Can Fahrettin; Arslan, Salim; Durmaz, Irem; Cetin-Atalay, Rengul; Gunduz-Demir, Cigdem

2012-01-01

Automated cell imaging systems facilitate fast and reliable analysis of biological events at the cellular level. In these systems, the first step is usually cell segmentation that greatly affects the success of the subsequent system steps. On the other hand, similar to other image segmentation problems, cell segmentation is an ill-posed problem that typically necessitates the use of domain-specific knowledge to obtain successful segmentations even by human subjects. The approaches that can incorporate this knowledge into their segmentation algorithms have potential to greatly improve segmentation results. In this work, we propose a new approach for the effective segmentation of live cells from phase contrast microscopy. This approach introduces a new set of "smart markers" for a marker-controlled watershed algorithm, for which the identification of its markers is critical. The proposed approach relies on using domain-specific knowledge, in the form of visual characteristics of the cells, to define the markers. We evaluate our approach on a total of 1,954 cells. The experimental results demonstrate that this approach, which uses the proposed definition of smart markers, is quite effective in identifying better markers compared to its counterparts. This will, in turn, be effective in improving the segmentation performance of a marker-controlled watershed algorithm.

Transient inhibition of the ERK pathway prevents cerebellar developmental defects and improves long-term motor functions in murine models of neurofibromatosis type 1

PubMed Central

Kim, Edward; Wang, Yuan; Kim, Sun-Jung; Bornhorst, Miriam; Jecrois, Emmanuelle S; Anthony, Todd E; Wang, Chenran; Li, Yi E; Guan, Jun-Lin; Murphy, Geoffrey G; Zhu, Yuan

2014-01-01

Individuals with neurofibromatosis type 1 (NF1) frequently exhibit cognitive and motor impairments and characteristics of autism. The cerebellum plays a critical role in motor control, cognition, and social interaction, suggesting that cerebellar defects likely contribute to NF1-associated neurodevelopmental disorders. Here we show that Nf1 inactivation during early, but not late stages of cerebellar development, disrupts neuronal lamination, which is partially caused by overproduction of glia and subsequent disruption of the Bergmann glia (BG) scaffold. Specific Nf1 inactivation in glutamatergic neuronal precursors causes premature differentiation of granule cell (GC) precursors and ectopic production of unipolar brush cells (UBCs), indirectly disrupting neuronal migration. Transient MEK inhibition during a neonatal window prevents cerebellar developmental defects and improves long-term motor performance of Nf1-deficient mice. This study reveals essential roles of Nf1 in GC/UBC migration by generating correct numbers of glia and controlling GC/UBC fate-specification/differentiation, identifying a therapeutic prevention strategy for multiple NF1-associcated developmental abnormalities. DOI: http://dx.doi.org/10.7554/eLife.05151.001 PMID:25535838

Application of Six Sigma methodology to a cataract surgery unit.

PubMed

Taner, Mehmet Tolga

2013-01-01

The article's aim is to focus on the application of Six Sigma to minimise intraoperative and post-operative complications rates in a Turkish public hospital cataract surgery unit. Implementing define-measure-analyse-improve and control (DMAIC) involves process mapping, fishbone diagrams and rigorous data-collection. Failure mode and effect analysis (FMEA), pareto diagrams, control charts and process capability analysis are applied to redress cataract surgery failure root causes. Inefficient skills of assistant surgeons and technicians, low quality of IOLs used, wrong IOL placement, unsystematic sterilisation of surgery rooms and devices, and the unprioritising network system are found to be the critical drivers of intraoperative-operative and post-operative complications. Sigma level was increased from 2.60 to 3.75 subsequent to extensive training of assistant surgeons, ophthalmologists and technicians, better quality IOLs, systematic sterilisation and air-filtering, and the implementation of a more sophisticated network system. This article shows that Six Sigma measurement and process improvement can become the impetus for cataract unit staff to rethink their process and reduce malpractices. Measuring, recording and reporting data regularly helps them to continuously monitor their overall process and deliver safer treatments. This is the first Six Sigma ophthalmology study in Turkey.

A suggestion to improve a day keeps your depletion away: Examining promotive and prohibitive voice behaviors within a regulatory focus and ego depletion framework.

PubMed

Lin, Szu-Han Joanna; Johnson, Russell E

2015-09-01

One way that employees contribute to organizational effectiveness is by expressing voice. They may offer suggestions for how to improve the organization (promotive voice behavior), or express concerns to prevent harmful events from occurring (prohibitive voice behavior). Although promotive and prohibitive voices are thought to be distinct types of behavior, very little is known about their unique antecedents and consequences. In this study we draw on regulatory focus and ego depletion theories to derive a theoretical model that outlines a dynamic process of the antecedents and consequences of voice behavior. Results from 2 multiwave field studies revealed that promotion and prevention foci have unique ties to promotive and prohibitive voice, respectively. Promotive and prohibitive voice, in turn, were associated with decreases and increases, respectively, in depletion. Consistent with the dynamic nature of self-control, depletion was associated with reductions in employees' subsequent voice behavior, regardless of the type of voice (promotive or prohibitive). Results were consistent across 2 studies and remained even after controlling for other established antecedents of voice and alternative mediating mechanisms beside depletion. (c) 2015 APA, all rights reserved).

Automated electrochemical synthesis and photoelectrochemical characterization of Zn1-xCo(x)O thin films for solar hydrogen production.

PubMed

Jaramillo, Thomas F; Baeck, Sung-Hyeon; Kleiman-Shwarsctein, Alan; Choi, Kyoung-Shin; Stucky, Galen D; McFarland, Eric W

2005-01-01

High-throughput electrochemical methods have been developed for the investigation of Zn1-xCo(x)O films for photoelectrochemical hydrogen production from water. A library of 120 samples containing 27 different compositions (0

Effects of glyceryl glucoside on AQP3 expression, barrier function and hydration of human skin.

PubMed

Schrader, A; Siefken, W; Kueper, T; Breitenbach, U; Gatermann, C; Sperling, G; Biernoth, T; Scherner, C; Stäb, F; Wenck, H; Wittern, K-P; Blatt, T

2012-01-01

Aquaporins (AQPs) present in the epidermis are essential hydration-regulating elements controlling cellular water and glycerol transport. In this study, the potential of glyceryl glucoside [GG; alpha-D-glucopyranosyl-alpha-(1->2)-glycerol], an enhanced glycerol derivative, to increase the expression of AQP3 in vitro and ex vivo was evaluated. In vitro studies with real-time RT-PCR and FACS measurements were performed to test the induction by GG (3% w/v) of AQP3 mRNA and protein in cultured human keratinocytes. GG-containing formulations were applied topically to volunteer subjects and suction blister biopsies were analyzed to assess whether GG (5%) could penetrate the epidermis of intact skin, and subsequently upregulate AQP3 mRNA expression and improve barrier function. AQP3 mRNA and protein levels were significantly increased in cultured human keratinocytes. In the studies on volunteer subjects, GG significantly increased AQP3 mRNA levels in the skin and reduced transepidermal water loss compared with vehicle-controlled areas. GG promotes AQP3 mRNA and protein upregulation and improves skin barrier function, and may thus offer an effective treatment option for dehydrated skin. Copyright © 2012 S. Karger AG, Basel.

Assessment and Management of Hypertension in Transplant Patients

PubMed Central

Burgess, Ellen D.; Cooper, James E.; Fenves, Andrew Z.; Goldsmith, David; McKay, Dianne; Mehrotra, Anita; Mitsnefes, Mark M.; Sica, Domenic A.; Taler, Sandra J.

2015-01-01

Hypertension in renal transplant recipients is common and ranges from 50% to 80% in adult recipients and from 47% to 82% in pediatric recipients. Cardiovascular morbidity and mortality and shortened allograft survival are important consequences of inadequate control of hypertension. In this review, we examine the epidemiology, pathophysiology, and management considerations of post-transplant hypertension. Donor and recipient factors, acute and chronic allograft injury, and immunosuppressive medications may each explain some of the pathophysiology of post-transplant hypertension. As observed in other patient cohorts, renal artery stenosis and adrenal causes of hypertension may be important contributing factors. Notably, BP treatment goals for renal transplant recipients remain an enigma because there are no adequate randomized controlled trials to support a benefit from targeting lower BP levels on graft and patient survival. The potential for drug-drug interactions and altered pharmacokinetics and pharmacodynamics of the different antihypertensive medications need to be carefully considered. To date, no specific antihypertensive medications have been shown to be more effective than others at improving either patient or graft survival. Identifying the underlying pathophysiology and subsequent individualization of treatment goals are important for improving long-term patient and graft outcomes in these patients. PMID:25653099

Effects of cues to event segmentation on subsequent memory.

PubMed

Gold, David A; Zacks, Jeffrey M; Flores, Shaney

2017-01-01

To remember everyday activity it is important to encode it effectively, and one important component of everyday activity is that it consists of events. People who segment activity into events more adaptively have better subsequent memory for that activity, and event boundaries are remembered better than event middles. The current study asked whether intervening to improve segmentation by cuing effective event boundaries would enhance subsequent memory for events. We selected a set of movies that had previously been segmented by a large sample of observers and edited them to provide visual and auditory cues to encourage segmentation. For each movie, cues were placed either at event boundaries or event middles, or the movie was left unedited. To further support the encoding of our everyday event movies, we also included post-viewing summaries of the movies. We hypothesized that cuing at event boundaries would improve memory, and that this might reduce age differences in memory. For both younger and older adults, we found that cuing event boundaries improved memory-particularly for the boundaries that were cued. Cuing event middles also improved memory, though to a lesser degree; this suggests that imposing a segmental structure on activity may facilitate memory encoding, even when segmentation is not optimal. These results provide evidence that structural cuing can improve memory for everyday events in younger and older adults.

The relationship between eye movements and subsequent recognition: Evidence from individual differences and amnesia.

PubMed

Olsen, Rosanna K; Sebanayagam, Vinoja; Lee, Yunjo; Moscovitch, Morris; Grady, Cheryl L; Rosenbaum, R Shayna; Ryan, Jennifer D

2016-12-01

There is consistent agreement regarding the positive relationship between cumulative eye movement sampling and subsequent recognition, but the role of the hippocampus in this sampling behavior is currently unknown. It is also unclear whether the eye movement repetition effect, i.e., fewer fixations to repeated, compared to novel, stimuli, depends on explicit recognition and/or an intact hippocampal system. We investigated the relationship between cumulative sampling, the eye movement repetition effect, subsequent memory, and the hippocampal system. Eye movements were monitored in a developmental amnesic case (H.C.), whose hippocampal system is compromised, and in a group of typically developing participants while they studied single faces across multiple blocks. The faces were studied from the same viewpoint or different viewpoints and were subsequently tested with the same or different viewpoint. Our previous work suggested that hippocampal representations support explicit recognition for information that changes viewpoint across repetitions (Olsen et al., 2015). Here, examination of eye movements during encoding indicated that greater cumulative sampling was associated with better memory among controls. Increased sampling, however, was not associated with better explicit memory in H.C., suggesting that increased sampling only improves memory when the hippocampal system is intact. The magnitude of the repetition effect was not correlated with cumulative sampling, nor was it related reliably to subsequent recognition. These findings indicate that eye movements collect information that can be used to strengthen memory representations that are later available for conscious remembering, whereas eye movement repetition effects reflect a processing change due to experience that does not necessarily reflect a memory representation that is available for conscious appraisal. Lastly, H.C. demonstrated a repetition effect for fixed viewpoint faces but not for variable viewpoint faces, which suggests that repetition effects are differentially supported by neocortical and hippocampal systems, depending upon the representational nature of the underlying memory trace. Copyright © 2016 Elsevier Ltd. All rights reserved.

Serotonin 2C receptor antagonist improves fear discrimination and subsequent safety signal recall.

PubMed

Foilb, Allison R; Christianson, John P

2016-02-04

The capacity to discriminate between safety and danger is fundamental for survival, but is disrupted in individuals with posttraumatic stress disorder (PTSD). Acute stressors cause a release of serotonin (5-HT) in the forebrain, which is one mechanism for enhanced fear and anxiety; these effects are mediated by the 5-HT2Creceptor. Using a fear discrimination paradigm where a danger signal conditioned stimulus (CS+) co-terminates with a mild footshock and a safety signal (CS-) indicates the absence of shock, we demonstrate that danger/safety discrimination and fear inhibition develop over the course of 4 daily conditioning sessions. Systemic administration of the 5-HT2Creceptor antagonist SB 242084 (0.25 or 1.0mg/kg) prior to conditioning reduced behavioral freezing during conditioning, and improved learning and subsequent inhibition of fear by the safety signal. Discrimination was apparent in the first recall test, and discrimination during training was evident after 3days of conditioning versus 5days in the vehicle treated controls. These results suggest a novel therapeutic use for 5-HT2Creceptor antagonists to improve learning under stressful circumstances. Potential anatomical loci for 5-HT2Creceptor modulation of fear discrimination learning and cognitive performance enhancement are discussed. John P. Christianson and Allison R. Foilb, the authors, verify that animal research was carried out in accordance with the National Institute of Health Guide for the Care and Use of Laboratory Animals (NIH Publications No. 80-23) and all procedures involving animals were reviewed and approved by the Boston College Animal Care and Use Committee. All efforts were made to limit the number of animals used and their suffering. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving zero-training brain-computer interfaces by mixing model estimators

NASA Astrophysics Data System (ADS)

Verhoeven, T.; Hübner, D.; Tangermann, M.; Müller, K. R.; Dambre, J.; Kindermans, P. J.

2017-06-01

Objective. Brain-computer interfaces (BCI) based on event-related potentials (ERP) incorporate a decoder to classify recorded brain signals and subsequently select a control signal that drives a computer application. Standard supervised BCI decoders require a tedious calibration procedure prior to every session. Several unsupervised classification methods have been proposed that tune the decoder during actual use and as such omit this calibration. Each of these methods has its own strengths and weaknesses. Our aim is to improve overall accuracy of ERP-based BCIs without calibration. Approach. We consider two approaches for unsupervised classification of ERP signals. Learning from label proportions (LLP) was recently shown to be guaranteed to converge to a supervised decoder when enough data is available. In contrast, the formerly proposed expectation maximization (EM) based decoding for ERP-BCI does not have this guarantee. However, while this decoder has high variance due to random initialization of its parameters, it obtains a higher accuracy faster than LLP when the initialization is good. We introduce a method to optimally combine these two unsupervised decoding methods, letting one method’s strengths compensate for the weaknesses of the other and vice versa. The new method is compared to the aforementioned methods in a resimulation of an experiment with a visual speller. Main results. Analysis of the experimental results shows that the new method exceeds the performance of the previous unsupervised classification approaches in terms of ERP classification accuracy and symbol selection accuracy during the spelling experiment. Furthermore, the method shows less dependency on random initialization of model parameters and is consequently more reliable. Significance. Improving the accuracy and subsequent reliability of calibrationless BCIs makes these systems more appealing for frequent use.

The longitudinal prevalence of MRSA in care home residents and the effectiveness of improving infection prevention knowledge and practice on colonisation using a stepped wedge study design

PubMed Central

Horner, C; Barr, B; Hall, D; Hodgson, G; Parnell, P; Tompkins, D

2012-01-01

Objectives To determine the prevalence and health outcomes of meticillin-resistant Staphylococcus aureus (MRSA) colonisation in elderly care home residents. To measure the effectiveness of improving infection prevention knowledge and practice on MRSA prevalence. Setting Care homes for elderly residents in Leeds, UK. Participants Residents able to give informed consent. Design A controlled intervention study, using a stepped wedge design, comprising 65 homes divided into three groups. Baseline MRSA prevalence was determined by screening the nares of residents (n=2492). An intervention based upon staff education and training on hand hygiene was delivered at three different times according to group number. Scores for three assessment methods, an audit of hand hygiene facilities, staff hand hygiene observations and an educational questionnaire, were collected before and after the intervention. After each group of homes received the intervention, all participants were screened for MRSA nasal colonisation. In total, four surveys took place between November 2006 and February 2009. Results MRSA prevalence was 20%, 19%, 22% and 21% in each survey, respectively. There was a significant improvement in scores for all three assessment methods post-intervention (p≤0.001). The intervention was associated with a small but significant increase in MRSA prevalence (p=0.023). MRSA colonisation was associated with previous and subsequent MRSA infection but was not significantly associated with subsequent hospitalisation or mortality. Conclusions The intervention did not result in a decrease in the prevalence of MRSA colonisation in care home residents. Additional measures will be required to reduce endemic MRSA colonisation in care homes. PMID:22240647

Control strategies for systems with limited actuators

NASA Technical Reports Server (NTRS)

Marcopoli, Vincent R.; Phillips, Stephen M.

1994-01-01

This work investigates the effects of actuator saturation in multi-input, multi-output (MIMO) control systems. The adverse system behavior introduced by the saturation nonlinearity is viewed here as resulting from two mechanisms: controller windup - a problem caused by the discrepancy between the limited actuator commands and the corresponding control signals, and directionality - the problem of how to use nonlimited actuators when a limited condition exists. The tracking mode and Hanus methods are two common strategies for dealing with the windup problem. It is seen that while these methods alleviate windup, performance problems remain due to plant directionality. Though high gain conventional antiwindup as well as more general linear methods have the potential to address both windup and directionality, no systematic design method for these schemes has emerged; most approaches used in practice are application driven. An alternative method of addressing the directionality problem is presented which involves the introduction of a control direction preserving nonlinearity to the Hanus antiwindup system. A nonlinearity is subsequently proposed which reduces the conservation inherent in the former direction-preserving approach, improving performance. The concept of multivariable sensitivity is seen to play a key role in the success of the new method.

The effect of pre-course e-learning prior to advanced life support training: a randomised controlled trial.

PubMed

Perkins, Gavin D; Fullerton, James N; Davis-Gomez, Nicole; Davies, Robin P; Baldock, Catherine; Stevens, Harry; Bullock, Ian; Lockey, Andrew S

2010-07-01

The role of e-learning in contemporary healthcare education is quickly developing. The aim of this study was to examine the relationship between the use of an e-learning simulation programme (Microsim, Laerdal, UK) prior to attending an Advanced Life Support (ALS) course and the subsequent relationship to candidate performance. An open label, multi-centre randomised controlled study was conducted. The control group received a course manual and pre-course MCQ four weeks prior to the face to face course. The intervention group in addition received the Microsim programme on a CD. The primary outcome was performance during a simulated cardiac arrest at the end of the course. Secondary outcomes were performance during multiple choice exams, resuscitation skills assessments and feedback to Microsim programme. 572 participants were randomised (287 Microsim, 285 control). There were no significant differences in the primary outcome (performance during a standard cardiac arrest simulation) or secondary outcomes. User evaluations were favorable. 79% would recommend it to colleagues. 9% stated Microsim could replace the entire ALS course, 25% parts. Over 70% of participants' perceived that Microsim improved their understanding of the key learning domains of the ALS course. Distributing Microsim to healthcare providers prior to attending an ALS courses did not improve either cognitive or psychomotor skills performance during cardiac arrest simulation testing. The challenge that lies ahead is to identify the optimal way to use e-learning as part of a blended approach to learning for this type of training programme.

School Nurse Inspections Improve Handwashing Supplies

PubMed Central

Ramos, Mary M.; Schrader, Ronald; Trujillo, Rebecca; Blea, Mary; Greenberg, Cynthia

2013-01-01

BACKGROUND Handwashing in the school setting is important for infectious disease control, yet maintaining adequate handwashing supplies is often made difficult by lack of funds, limited staff time, and student vandalism. This study measured the availability of handwashing supplies for students in New Mexico public schools and determined the impact of scheduled school nurse inspections on the availability of handwashing supplies. METHODS Participating school districts in New Mexico were matched by size and randomized into intervention and control groups. Baseline inspections were conducted in November 2008 followed by 2 subsequent bimonthly inspections. For each student bathroom, the presence or absence of soap and either paper towels or hand dryers was indicated on an inspection checklist. The intervention group reported findings to the New Mexico Department of Health (NMDOH) and to school administrative and custodial staff requesting that any identified problems be addressed. The control group reported inspection findings to the NMDOH only. Descriptive analyses were conducted to determine the proportion of bathrooms with soap and either paper towels or hand dryers. Comparisons were made between the intervention schools and the control schools at baseline and during the intervention period. RESULTS The intervention group had significantly higher probability of bathrooms being supplied with soap (p < .05) and paper towels/hand dryers (p < .02) during the intervention period. CONCLUSIONS Regularly scheduled school nurse inspections of hand hygiene supplies, with reporting to appropriate school officials, can improve the availability of handwashing supplies for students. PMID:21592131

A community-randomised controlled trial promoting waterless hand sanitizer and handwashing with soap, Dhaka, Bangladesh.

PubMed

Luby, Stephen P; Kadir, Mohammad Abdul; Yushuf Sharker, M A; Yeasmin, Farzana; Unicomb, Leanne; Sirajul Islam, M

2010-12-01

To pilot two intensive hand hygiene promotion interventions, one using soap and one using a waterless hand sanitizer, in low-income housing compounds in Dhaka, Bangladesh and assess subsequent changes in handwashing behaviour and hand microbiology. Fieldworkers randomized 30 housing compounds: 10 received handwashing promotion with free soap, 10 received handwashing promotion with free waterless hand sanitizer and 10 were non-intervention controls. Fieldworkers assessed handwashing behaviour by structured observation and collected hand rinse specimens. At baseline, compound residents washed their hands with soap 26% of the time after defecation and 30% after cleaning a child's anus but <1% at other times. Compared with baseline, residents of soap intervention compounds were much more likely to wash their hands with soap after faecal contact (85-91%), before preparing food (26%) and before eating (26%). Compounds that received waterless hand sanitizer cleansed their hands more commonly than control compounds that used soap (10.4%vs. 2.3%), but less commonly than soap intervention compounds used soap (25%). Post-intervention hand rinse samples from soap and sanitizer compounds had lower concentrations of faecal indicator bacteria compared with baseline and control compounds. Waterless hand sanitizer was readily adopted by this low-income community and reduced hand contamination but did not improve the frequency of handwashing compared with soap. Future deployments of waterless hand sanitizers may improve hand hygiene more effectively by targeting settings where soap and water is unavailable. © 2010 Blackwell Publishing Ltd.

Studies of some unconventional systems for solving various landing problems. [air cushion landing system

NASA Technical Reports Server (NTRS)

Leland, T. J.; Mcgehee, J. R.; Dreher, R. C.

1981-01-01

Solutions to various landing problems were obtained through unconventional systems. The first, of these is the air cushion landing system, where efforts were concentrated on development of adequate braking and steering systems and an improved understanding of scaling laws and behavior. The second was concentrated on use of a wire brush skid as a drag producing device, which was shown to have good friction coefficients and reasonable wear rates at ground bearing pressures up to 689 kPa and forward speeds up to 80 km/hr. The third showed great promise in an active control landing gear where significant load reductions were possible during landing impact and subsequent rollout.

SPEECH PERCEPTION AS A TALKER-CONTINGENT PROCESS

PubMed Central

Nygaard, Lynne C.; Sommers, Mitchell S.; Pisoni, David B.

2011-01-01

To determine how familiarity with a talker’s voice affects perception of spoken words, we trained two groups of subjects to recognize a set of voices over a 9-day period. One group then identified novel words produced by the same set of talkers at four signal-to-noise ratios. Control subjects identified the same words produced by a different set of talkers. The results showed that the ability to identify a talker’s voice improved intelligibility of novel words produced by that talker. The results suggest that speech perception may involve talker-contingent processes whereby perceptual learning of aspects of the vocal source facilitates the subsequent phonetic analysis of the acoustic signal. PMID:21526138

Dietary and exercise change following acute cardiac syndrome onset: A latent class growth modelling analysis.

PubMed

Bennett, Paul; Gruszczynska, Ewa; Marke, Victoria

2016-10-01

The present study aim determine sub-group trajectories of change on measures of diet and exercise following acute coronary syndrome. 150 participants were assessed in hospital, 1 month and 6 months subsequently on measures including physical activity, diet, illness beliefs, coping and mood. Change trajectories were measured using latent class growth modelling. Multinomial logistic regression was used to predict class membership. These analyses revealed changes in exercise were confined to a sub-group of participants already reporting relatively high exercise levels; those eating less healthily evidenced modest dietary improvements. Coping, gender, depression and perceived control predicted group membership to a modest degree. © The Author(s) 2015.

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.

A feasibility study of expert patient and community mental health team led bipolar psychoeducation groups: implementing an evidence based practice

PubMed Central

2013-01-01

Background Group psychoeducation is a cost effective intervention which reduces relapse and improves functioning in bipolar disorder but is rarely implemented. The aim of this study was to identify the acceptability and feasibility of a group psychoeducation programme delivered by community mental health teams (CMHTs) and peer specialist (PS) facilitators. Organisational learning was used to identify and address systematically barriers and enablers, at organisational, health professional and patient levels, to its implementation into a routine service. Methods A systematic examination of barriers and enablers to a three day training process informed the delivery of a first treatment group and a similar process informed the delivery of the second treatment group. Triangulation of research methods improved its internal validity: direct observation of training, self-rated surveys of participant experiences, group discussion, and thematically analysed individual participant and facilitator interviews were employed. Results Barriers and enablers were identified at organisational, educational, treatment content, facilitator and patient levels. All barriers under the control of the research team were addressed with subsequent improvements in patient knowledge about the condition and about local service. In addition, self-management, agency and altruism were enhanced. Barriers that could not be addressed required senior clinical and education leadership outside the research team’s control. PS and professional facilitators were successfully trained and worked together to deliver groups which were generally reported as being beneficial. Conclusion Psychoeducation groups involving CMHT and PS facilitators is acceptable and feasible but their sustainment requires senior leadership within and outside the organisation that control finance and education services. PMID:24215655

Co-extrusion of electrolyte/anode functional layer/anode triple-layer ceramic hollow fibres for micro-tubular solid oxide fuel cells-electrochemical performance study

NASA Astrophysics Data System (ADS)

Li, Tao; Wu, Zhentao; Li, K.

2015-01-01

In this study, the effects of an anode functional layer (AFL) with controlled thickness on physical and electrochemical properties of a micro-tubular SOFC have been systematically studied. A series of electrolyte/AFL/anode triple-layer hollow fibres with controllable AFL thicknesses (16.9-52.7 μm) have been fabricated via a single-step phase-inversion assisted co-extrusion technique. Both robustness of the cell and gas-tightness of the electrolyte layer are considerably improved by introducing the AFL of this type. The fracture force of the sample with the thickest AFL (9.67 N) almost doubles when compared to the electrolyte/anode dual-layer counterpart (5.24 N). Gas-tightness of the electrolyte layer is also considerably increased as AFL contributes to better-matched sintering behaviours between different components. Moreover, the formation of an AFL simultaneously with electrolyte and anode significantly improves the cell performances. The sample with the thinnest AFL (approximately 16.9 μm, 6% of the total anode thickness) leads to a 30% (from 0.89 to 1.21 W cm-2) increase in maximum power density, due to increased triple-phase boundaries (TPB). However, further increase in TPB from a thicker AFL is less effective for improving the cell performance, due to the substantially increased fuel diffusion resistance and subsequently higher concentration polarization. This indicates that the control over the AFL thickness is critically important in avoiding offsetting the benefits of extended TPB and consequently decreased cell performances.

Electronic reminders improve procedure documentation compliance and professional fee reimbursement.

PubMed

Kheterpal, Sachin; Gupta, Ruchika; Blum, James M; Tremper, Kevin K; O'Reilly, Michael; Kazanjian, Paul E

2007-03-01

Medicolegal, clinical, and reimbursement needs warrant complete and accurate documentation. We sought to identify and improve our compliance rate for the documentation of arterial catheterization in the perioperative setting. We first reviewed 12 mo of electronic anesthesia records to establish a baseline compliance rate for arterial catheter documentation. Residents and Certified Registered Nurse Anesthetists were randomly assigned to a control group and experimental group. When surgical incision and anesthesia end were documented in the electronic record keeper, a reminder routine checked for an invasive arterial blood pressure tracing. If a case used an arterial catheter, but no procedure note was observed, the resident or Certified Registered Nurse Anesthetist assigned to the case was sent an automated alphanumeric pager and e-mail reminder. Providers in the control group received no pager or e-mail message. After 2 mo, all staff received the reminders. A baseline compliance rate of 80% was observed (1963 of 2459 catheters documented). During the 2-mo study period, providers in the control group documented 152 of 202 (75%) arterial catheters, and the experimental group documented 177 of 201 (88%) arterial lines (P < 0.001). After all staff began receiving reminders, 309 of 314 arterial lines were documented in a subsequent 2 mo period (98%). Extrapolating this compliance rate to 12 mo of expected arterial catheter placement would result in an annual incremental $40,500 of professional fee reimbursement. The complexity of the tertiary care process results in documentation deficiencies. Inexpensive automated reminders can drastically improve compliance without the need for complicated negative or positive feedback.

Innovations in coating technology.

PubMed

Behzadi, Sharareh S; Toegel, Stefan; Viernstein, Helmut

2008-01-01

Despite representing one of the oldest pharmaceutical techniques, coating of dosage forms is still frequently used in pharmaceutical manufacturing. The aims of coating range from simply masking the taste or odour of drugs to the sophisticated controlling of site and rate of drug release. The high expectations for different coating technologies have required great efforts regarding the development of reproducible and controllable production processes. Basically, improvements in coating methods have focused on particle movement, spraying systems, and air and energy transport. Thereby, homogeneous distribution of coating material and increased drying efficiency should be accomplished in order to achieve high end product quality. Moreover, given the claim of the FDA to design the end product quality already during the manufacturing process (Quality by Design), the development of analytical methods for the analysis, management and control of coating processes has attracted special attention during recent years. The present review focuses on recent patents claiming improvements in pharmaceutical coating technology and intends to first familiarize the reader with the available procedures and to subsequently explain the application of different analytical tools. Aiming to structure this comprehensive field, coating technologies are primarily divided into pan and fluidized bed coating methods. Regarding pan coating procedures, pans rotating around inclined, horizontal and vertical axes are reviewed separately. On the other hand, fluidized bed technologies are subdivided into those involving fluidized and spouted beds. Then, continuous processing techniques and improvements in spraying systems are discussed in dedicated chapters. Finally, currently used analytical methods for the understanding and management of coating processes are reviewed in detail in the last section of the review.

Randomized clinical trial of virtual reality simulation for laparoscopic skills training.

PubMed

Grantcharov, T P; Kristiansen, V B; Bendix, J; Bardram, L; Rosenberg, J; Funch-Jensen, P

2004-02-01

This study examined the impact of virtual reality (VR) surgical simulation on improvement of psychomotor skills relevant to the performance of laparoscopic cholecystectomy. Sixteen surgical trainees performed a laparoscopic cholecystectomy on patients in the operating room (OR). The participants were then randomized to receive VR training (ten repetitions of all six tasks on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR)) or no training. Subsequently, all subjects performed a further laparoscopic cholecystectomy in the OR. Both operative procedures were recorded on videotape, and assessed by two independent and blinded observers using predefined objective criteria. Time to complete the procedure, error score and economy of movement score were assessed during the laparoscopic procedure in the OR. No differences in baseline variables were found between the two groups. Surgeons who received VR training performed laparoscopic cholecystectomy significantly faster than the control group (P=0.021). Furthermore, those who had VR training showed significantly greater improvement in error (P=0.003) and economy of movement (P=0.003) scores. Surgeons who received VR simulator training showed significantly greater improvement in performance in the OR than those in the control group. VR surgical simulation is therefore a valid tool for training of laparoscopic psychomotor skills and could be incorporated into surgical training programmes. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Contribution of High-Pressure-Induced Protein Modifications to the Microenvironment and Functional Properties of Rabbit Meat Sausages.

PubMed

Xue, Siwen; Yu, Xiaobo; Yang, Huijuan; Xu, Xinglian; Ma, Hanjun; Zhou, Guanghong

2017-06-01

Rabbit meat batters were subjected to high pressure (HP, 100 to 300 MPa for 3, 9, or 15 min) to elucidate their effects on proteins structures, the microenvironment, and the resulting functionalities of the subsequently heated products. To determine these effects, we investigated structural and microenvironmental changes using Raman spectroscopy and also expressible moisture content, textural characteristics, and dynamic rheological properties of batters during heating (20 to 80 °C). Untreated samples served as controls. Analysis of specific Raman spectral regions demonstrated that applications of HP to rabbit meat batters tended to induce the transformation of the all-gauche S-S conformation to gauche-gauche-trans in the batter system. HP treatment higher than 100 MPa for 9 min promoted secondary structural rearrangements, and molecular polarity enhancement in the proteins prior to cooking. Also, increases of O-H stretching intensities of rabbit meat sausages were obtained by HP treatment, denoting the strengthening of water-holding capacity. These HP-induced alterations resulted in improved texture and, perhaps, improved juiciness of rabbit meat sausages (P < 0.05), however they had relatively poorer rheological properties than the controls. Nevertheless, HP treatment, especially 200 MPa for 9 or 15 min, was an effective technique for improving the functionalities of gel-type products through modification of meat proteins. © 2017 Institute of Food Technologists®.

Knockdown of nuclease activity in the gut enhances RNAi efficiency in the Colorado potato beetle, Leptinotarsa decemlineata, but not in the desert locust, Schistocerca gregaria.

PubMed

Spit, Jornt; Philips, Annelies; Wynant, Niels; Santos, Dulce; Plaetinck, Geert; Vanden Broeck, Jozef

2017-02-01

The responsiveness towards orally delivered dsRNA and the potency of a subsequent environmental RNA interference (RNAi) response strongly differs between different insect species. While some species are very sensitive to dsRNA delivery through the diet, others are not. The underlying reasons for this may vary, but degradation of dsRNA by nucleases in the gut lumen is believed to play a crucial role. The Colorado potato beetle, Leptinotarsa decemlineata, is a voracious defoliator of potato crops worldwide, and is currently under investigation for novel control methods based on dsRNA treatments. Here we describe the identification and characterization of two nuclease genes exclusively expressed in the gut of this pest species. Removal of nuclease activity in adults increased the sensitivity towards dsRNA and resulted in improved protection of potato plants. A similar strategy in the desert locust, Schistocerca gregaria, for which we show a far more potent nuclease activity in the gut juice, did however not lead to an improvement of the RNAi response. Possible reasons for this are discussed. Taken together, the present data confirm a negative effect of nucleases in the gut on the environmental RNAi response, and further suggest that interfering with this activity is a strategy worth pursuing for improving RNAi efficacy in insect pest control applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Chemically coupled microwave and ultrasonic pre-hydrolysis of pulp and paper mill waste-activated sludge: effect on sludge solubilisation and anaerobic digestion.

PubMed

Tyagi, Vinay Kumar; Lo, Shang-Lien; Rajpal, Ankur

2014-05-01

The effects of alkali-enhanced microwave (MW; 50-175 °C) and ultrasonic (US) (0.75 W/mL, 15-60 min) pretreatments, on solubilisation and subsequent anaerobic digestion efficiency of pulp and paper mill waste-activated sludge, were investigated. Improvements in total chemical oxygen demand and volatile suspended solids (VSS) solubilisation were limited to 33 and 39 % in MW pretreatment only (175 °C). It reached 78 and 66 % in combined MW-alkali pretreatment (pH 12 + 175 °C), respectively. Similarly, chemical oxygen demand and VSS solubilisation were 58 and 37 % in US pretreatment alone (60 min) and it improved by 66 and 49 % after US-alkali pretreatment (pH 12 + 60 min), respectively. The biogas yield for US 60 min-alkali (pH 12)-pretreated sludge was significantly improved by 47 and 20 % over the control and US 60 reactors, respectively. The biogas generation for MW (150 °C)-alkali (pH 12)-pretreated sludge was only 6.3 % higher than control; however, it was 8.3 % lower than the MW (150 °C) reactor, which was due to the inhibition of anaerobic activity under harsh thermal-alkali treatment condition.

Train the trainer in dementia care. A program to foster communication skills in nursing home staff caring for dementia patients.

PubMed

Franzmann, J; Haberstroh, J; Pantel, J

2016-04-01

Improvement of communication skills in nursing home staff is key to provide better care for dementia patients and decrease occupational mental stress. An innovative train-the-trainer program to improve and maintain professional caregivers' social competencies in nursing home dementia care is described. Over a period of 6 months, a group of 6 senior staff members were qualified as program trainers (multiplicators) for the TANDEM training program, which qualified them to design, deliver, and evaluate training sessions that foster specific social competencies in dementia care. In a subsequent intervention study with 116 geriatric caregivers in 14 nursing homes, training was provided either by multiplicators (intervention group) or directly by project coworkers (control group). Participants in both groups improved their dementia-specific communication skills. In a follow-up survey, the intervention group also reported lasting reductions in mental stressors at work (p < 0.05) and occupational mental stress (p < 0.01) compared with the control group. The qualification of staff members in German nursing homes to be multiplicators for the TANDEM train-the-trainer program for dementia-specific communication skills has a beneficial influence on social competencies, mental stressors at work, and occupational mental stress of staff who care for dementia patients and may contribute to a sustainable implementation of dementia-specific social competencies.