KSC-2009-5546

NASA Image and Video Library

2009-10-20

CAPE CANAVERAL, Fla. - The towering 327-foot-tall Ares I-X rocket rides aboard a crawler-transporter as it exits the massive Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. The rocket is bolted to its mobile launcher platform for the move to the launch pad. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, along with the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. Part of the Constellation Program, the Ares I-X is the test vehicle for the Ares I. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5529

NASA Image and Video Library

2009-10-20

CAPE CANAVERAL, Fla. – Spotlighted against the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the 327-foot-tall Ares I-X rocket begins its slow trek to Launch Pad 39B. The move, known as "rollout," began at 1:39 a.m. EDT. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, along with the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. Part of the Constellation Program, the Ares I-X is the test vehicle for the Ares I. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Jim Grossmann

ML Crew Access Arm Move

NASA Image and Video Library

2017-10-16

The Orion crew access arm departs Precision Fabricating and Cleaning in Cocoa, Florida, atop a flatbed truck. The access arm is transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Robotic system for retractable teleoperated arm within enclosed shell with capability of operating within a confined space

DOEpatents

Randolph, John David; Lloyd, Peter Downes; Love, Lonnie Joe; Kwon, Dong Soo; Blank, James Allen; Davis, Hurley Thomas

2001-01-01

An apparatus for performing a task in a confined space having an access port. The apparatus comprise: a confinement box securable to the access port of the confined space; a shell extending from the confinement box; a teleoperated arm movable between a retracted position, in which the teleoperated arm is disposed within the shell, and a deployed position, in which the teleoperated arm extends through the access port and into the confined space to perform the task; and a control system for commanding the teleoperated arm. The arm links and joint connectors of the teleoperated arm assembly are the conduits for the process

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes are used to lower the Orion crew access arm onto a work stand in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is being secured on a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is being secured onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is secured on a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

The Orion crew access arm is being moved by crane onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

A flatbed truck with the Orion crew access arm secured atop travels along a road in Cocoa, Florida, after departing Precision Fabricating and Cleaning. The access arm will be transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

The Orion crew access arm departs Precision Fabricating and Cleaning in Cocoa, Florida, atop a flatbed truck. The access arm will be transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes lower the Orion crew access arm onto a work stand in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

A flatbed truck with the Orion crew access arm secured atop arrives in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

KSC-2009-5916

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – As the sun rises over Launch Pad 39B at NASA's Kennedy Space Center in Florida, the rotating service structure and the arms of the vehicle stabilization system have been retracted from around the Constellation Program's 327-foot-tall Ares I-X rocket, resting atop its mobile launcher platform, for launch. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5911

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – Workers on Launch Pad 39B at NASA's Kennedy Space Center in Florida prepare the Constellation Program's 327-foot-tall Ares I-X rocket for launch. The rotating service structure and the arms of the vehicle stabilization system will be moved from around the rocket for liftoff. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5912

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. - Workers on Launch Pad 39B at NASA's Kennedy Space Center in Florida make final preparations for launch of the Constellation Program's 327-foot-tall Ares I-X rocket. The rotating service structure and the arms of the vehicle stabilization system will be moved from around the rocket for liftoff. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

HIV Self-Testing Increases HIV Testing Frequency in High Risk Men Who Have Sex with Men: A Randomized Controlled Trial.

PubMed

Katz, David A; Golden, Matthew R; Hughes, James P; Farquhar, Carey; Stekler, Joanne D

2018-04-24

Self-testing may increase HIV testing and decrease the time people with HIV are unaware of their status, but there is concern that absence of counseling may result in increased HIV risk. Seattle, Washington. We randomly assigned 230 high-risk HIV-negative men who have sex with men (MSM) to have access to oral fluid HIV self-tests at no cost versus testing as usual .for 15 months. The primary outcome was self-reported number of HIV tests during follow-up. To evaluate self-testing's impact on sexual behavior, we compared the following between arms: non-HIV-concordant condomless anal intercourse (CAI) and number of male CAI partners in the last 3 months (measured at 9 and 15 months) and diagnosis with a bacterial sexually transmitted infection (STI: early syphilis, gonorrhea, chlamydial infection) at the final study visit (15 months). A post hoc analysis compared the number of STI tests reported during follow-up. Men randomized to self-testing reported significantly more HIV tests during follow-up (mean=5.3, 95%CI=4.7-6.0) than those randomized to testing as usual (3.6, 3.2-4.0; p<.0001), representing an average increase of 1.7 tests per participant over 15 months. Men randomized to self-testing reported using an average of 3.9 self-tests. Self-testing was non-inferior with respect to all markers of HIV risk. Men in the self-testing arm reported significantly fewer STI tests during follow-up (mean=2.3, 95%CI=1.9-2.7) than men in the control arm (3.2, 2.8-3.6; p=0.0038). Access to free HIV self-testing increased testing frequency among high-risk MSM and did not impact sexual behavior or STI acquisition.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-09

The Orion crew access arm is secured in a storage location at NASA's Kennedy Space Center in Florida. The access arm will be prepared for its move to the mobile launcher (ML) tower near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

Two heavy-lift cranes are used to lower the Orion crew access arm onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

Two heavy-lift cranes are being used to move the Orion crew access arm and lower it onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes are used to tilt and lower the Orion crew access arm onto a work stand in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Prep for Transport to Kennedy Sp

NASA Image and Video Library

2017-10-16

Two heavy-lift cranes are being used to lower the Orion crew access arm onto a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida. The crew access arm will be transported to a storage location near NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

Two heavy-lift cranes are used to lift the Orion crew access arm up from a flatbed truck in a storage location at NASA's Kennedy Space Center in Florida. The access arm was transported from Precision Fabricating and Cleaning in Cocoa, Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

SLC-41 Water Deluge Test

NASA Image and Video Library

2017-11-02

NASA and Boeing personnel experience conditions during a water deluge test on the Crew Access Tower at Space Launch Complex 41 on Cape Canaveral Air Force Station in Florida. The test gathered data on how launch site and astronaut crews would exit in the event of an emergency from the white room at the end of the crew access arm to the emergency escape system on the pad. Boeing’s Starliner will launch on a United Launch Alliance Atlas V rocket to the International Space Station as part of NASA’s Commercial Crew Program.

SLC-41 Water Deluge Test

NASA Image and Video Library

2017-11-02

NASA, Boeing and United Launch Alliance personnel run a water deluge test on the Crew Access Tower at Space Launch Complex 41 on Cape Canaveral Air Force Station in Florida. The test gathered data on how launch site and astronaut crews would exit in the event of an emergency from the white room at the end of the crew access arm to the emergency escape system on the pad. Boeing’s Starliner will launch on a United Launch Alliance Atlas V rocket to the International Space Station as part of NASA’s Commercial Crew Program.

SLC-41 Water Deluge Test

NASA Image and Video Library

2017-11-02

NASA, Boeing and United Launch Alliance personnel begin a water deluge test on the Crew Access Tower at Space Launch Complex 41 on Cape Canaveral Air Force Station in Florida. The test gathered data on how launch site and astronaut crews would exit in the event of an emergency from the white room at the end of the crew access arm to the emergency escape system on the pad. Boeing’s Starliner will launch on a United Launch Alliance Atlas V rocket to the International Space Station as part of NASA’s Commercial Crew Program.

Superior Patency of Upper Arm Arteriovenous Fistulae in High Risk Patients

PubMed Central

Chiulli, Larissa C; Vasilas, Penny; Dardik, Alan

2011-01-01

Background Despite an increased propensity to primary failure in forearm arteriovenous fistulae compared to upper arm fistulae, forearm fistulae remain the preferred primary access type for chronic hemodialysis patients. In a high risk patient population with multiple medical comorbidities associated with requirement for intravenous access we compared the rates of access failure in forearm and upper arm fistulae. Materials and Methods The records of all patients having primary native arteriovenous fistulae placed between 2004 and 2009 at the VA Connecticut Healthcare system were reviewed (n=118). Primary and secondary patency of upper arm and forearm fistulae were evaluated using Kaplan-Meier survival analysis. The effects of medical comorbidities on access patency were analyzed with Cox regression. Results The median time to primary failure of the vascular access was 0.288 years in the forearm group compared to 0.940 years in the upper arm group (p=0.028). Secondary patency was 52% at 4.9 years in upper arm fistulae compared to 52% at 1.1 years in the forearm group (p=0.036). There was no significant effect of patient comorbidities on fistula failure; however, there was a trend toward upper arm surgical site as a protective factor for primary fistula patency (Hazard Ratio=0.573, p=0.076). Conclusions In veterans needing hemodialysis, a high risk population with extensive comorbid factors often requiring intravascular access, upper arm fistulae are not only a viable option for primary vascular access, but are likely to be a superior option to classic forearm fistulae. PMID:21571318

Comparison of the FaroArm Laser Scanner With the MicroScribe Digitizer Using Basicranial Measurements.

PubMed

Vu, Alexander F; Chundury, Rao V; Perry, Julian D

2017-07-01

To compare the results of a mechanical 3-dimensional laser scanner for craniofacial measurements of the basicranium to a validated coordinate device. Access was granted by the Cleveland Natural History Museum to evaluate the Hamann-Todd Human Osteological Collection for this study. The MicroScribe and the FaroArm were used to gather coordinate data of various bony landmarks measurements including the prosthion, staphylion, hormion, and basion. Seventy-three human skulls were measured and scanned. Distances calculated from the coordinates were tested for agreement using the Bland-Altman test. There were no significant differences in the bias or slope measures between the MicroScribe and the FaroArm. In addition to the univariate test for slope significance, multivariable analysis using age, gender, and race as additional predictors showed no significant difference in any variable (P < 0.05). This is the first study demonstrating agreement of the FaroArm in any human skull measurement with the validated MicroScribe digitizer. Compared with the MicroScribe digitizer, the FaroArm allows for 3-dimensional imaging and the ability to store, handle, and view data digitally. Future use of real-time facial measurements using the FaroArm offers potential for improved surgical planning and outcomes.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carries the Orion crew access arm along the NASA Causeway east toward State Road 3 at NASA's Kennedy Space Center in Florida. The access arm will be moved to the mobile launcher (ML) near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carries the Orion crew access arm along the NASA Causeway east toward State Road 3 at NASA's Kennedy Space Center in Florida. The access arm will be moved to the mobile launcher (ML) near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

KSC-2009-5536

NASA Image and Video Library

2009-10-20

CAPE CANAVERAL, Fla. – The 327-foot-tall Ares I-X rocket clears the door of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, on its way to Launch Pad 39B. The move to the launch pad, known as "rollout," began at 1:39 a.m. EDT. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, along with the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. Part of the Constellation Program, the Ares I-X is the test vehicle for the Ares I. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Jack Pfaller

Vaccine testing for emerging infections: the case for individual randomisation

PubMed Central

Eyal, Nir; Lipsitch, Marc

2017-01-01

During the 2014–2015 Ebola outbreak in Guinea, Liberia and Sierra Leone, many opposed the use of individually randomised controlled trials to test candidate Ebola vaccines. For a raging fatal disease, they explained, it is unethical to relegate some study participants to control arms. In Zika and future emerging infections, similar opposition may hinder urgent vaccine research, so it is best to address these questions now. This article lays out the ethical case for individually randomised control in testing vaccines against many emerging infections, including lethal infections in low-income countries, even when at no point in the trial do the controls receive the countermeasures being tested. When individual randomisation is feasible—and it often will be—it tends to save more lives than alternative designs would. And for emerging infections, individual randomisation also tends as such to improve care, access to the experimental vaccine and prospects for all participants relative to their opportunities absent the trial, and no less than alternative designs would. That obtains even under placebo control and without equipoise—requiring which would undermine individual randomisation and the alternative designs that opponents proffered. Our arguments expound four often-neglected factors: benefits to non-participants, benefits to participants once a trial is over including post-trial access to the study intervention, participants’ prospects before randomisation to arms and the near-inevitable disparity between arms in any randomised controlled trial. PMID:28396558

CCP Crew Access Arm Arrival

NASA Image and Video Library

2016-08-11

A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, arrives at Complex 41 at Cape Canaveral Air Force Station in Florida. The arm will be installed on the Complex 41 Crew Access Tower. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- One of a team of robotic experts prepares the site scraped on the robotic arm for removal. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

An Exploration Based Cognitive Bias Test for Mice: Effects of Handling Method and Stereotypic Behaviour.

PubMed

Novak, Janja; Bailoo, Jeremy D; Melotti, Luca; Rommen, Jonas; Würbel, Hanno

2015-01-01

Behavioural tests to assess affective states are widely used in human research and have recently been extended to animals. These tests assume that affective state influences cognitive processing, and that animals in a negative affective state interpret ambiguous information as expecting a negative outcome (displaying a negative cognitive bias). Most of these tests however, require long discrimination training. The aim of the study was to validate an exploration based cognitive bias test, using two different handling methods, as previous studies have shown that standard tail handling of mice increases physiological and behavioural measures of anxiety compared to cupped handling. Therefore, we hypothesised that tail handled mice would display a negative cognitive bias. We handled 28 female CD-1 mice for 16 weeks using either tail handling or cupped handling. The mice were then trained in an eight arm radial maze, where two adjacent arms predicted a positive outcome (darkness and food), while the two opposite arms predicted a negative outcome (no food, white noise and light). After six days of training, the mice were also given access to the four previously unavailable intermediate ambiguous arms of the radial maze and tested for cognitive bias. We were unable to validate this test, as mice from both handling groups displayed a similar pattern of exploration. Furthermore, we examined whether maze exploration is affected by the expression of stereotypic behaviour in the home cage. Mice with higher levels of stereotypic behaviour spent more time in positive arms and avoided ambiguous arms, displaying a negative cognitive bias. While this test needs further validation, our results indicate that it may allow the assessment of affective state in mice with minimal training-a major confound in current cognitive bias paradigms.

An Exploration Based Cognitive Bias Test for Mice: Effects of Handling Method and Stereotypic Behaviour

PubMed Central

Novak, Janja; Bailoo, Jeremy D.; Melotti, Luca; Rommen, Jonas; Würbel, Hanno

2015-01-01

Behavioural tests to assess affective states are widely used in human research and have recently been extended to animals. These tests assume that affective state influences cognitive processing, and that animals in a negative affective state interpret ambiguous information as expecting a negative outcome (displaying a negative cognitive bias). Most of these tests however, require long discrimination training. The aim of the study was to validate an exploration based cognitive bias test, using two different handling methods, as previous studies have shown that standard tail handling of mice increases physiological and behavioural measures of anxiety compared to cupped handling. Therefore, we hypothesised that tail handled mice would display a negative cognitive bias. We handled 28 female CD-1 mice for 16 weeks using either tail handling or cupped handling. The mice were then trained in an eight arm radial maze, where two adjacent arms predicted a positive outcome (darkness and food), while the two opposite arms predicted a negative outcome (no food, white noise and light). After six days of training, the mice were also given access to the four previously unavailable intermediate ambiguous arms of the radial maze and tested for cognitive bias. We were unable to validate this test, as mice from both handling groups displayed a similar pattern of exploration. Furthermore, we examined whether maze exploration is affected by the expression of stereotypic behaviour in the home cage. Mice with higher levels of stereotypic behaviour spent more time in positive arms and avoided ambiguous arms, displaying a negative cognitive bias. While this test needs further validation, our results indicate that it may allow the assessment of affective state in mice with minimal training—a major confound in current cognitive bias paradigms. PMID:26154309

CCP Crew Access Arm Arrival

NASA Image and Video Library

2016-08-11

A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, travels along the road toward Complex 41 at Cape Canaveral Air Force Station in Florida. The arm will be installed on the Complex 41 Crew Access Tower. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

CCP Crew Access Arm Arrival

NASA Image and Video Library

2016-08-11

A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, backs up toward Complex 41 at Cape Canaveral Air Force Station in Florida. The arm will be installed on the Complex 41 Crew Access Tower. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

Formalization of the Access Control on ARM-Android Platform with the B Method

NASA Astrophysics Data System (ADS)

Ren, Lu; Wang, Wei; Zhu, Xiaodong; Man, Yujia; Yin, Qing

2018-01-01

ARM-Android is a widespread mobile platform with multi-layer access control mechanisms, security-critical in the system. Many access control vulnerabilities still exist due to the course-grained policy and numerous engineering defects, which have been widely studied. However, few researches focus on the mechanism formalization, including the Android permission framework, kernel process management and hardware isolation. This paper first develops a comprehensive formal access control model on the ARM-Android platform using the B method, from the Android middleware to hardware layer. All the model specifications are type checked and proved to be well-defined, with 75%of proof obligations demonstrated automatically. The results show that the proposed B model is feasible to specify and verify access control schemes in the ARM-Android system, and capable of implementing a practical control module.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- One of a team of robotic experts looks at the site of the scrape on the surface of the honeycomb shell on the robotic arm that occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- Workers in Endeavour's payload bay look at the site of the scrape on the surface of the honeycomb shell on the robotic arm that occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- The site being identified in the photo is the scrape on the surface of the honeycomb shell on Endeavour's robotic arm. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- One of a team of robotic experts looks at the site of the scrape on the surface of the the robotic arm's honeycomb shell. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in Endeavour's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

CCP Crew Access Arm Arrival

NASA Image and Video Library

2016-08-11

A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, passes through the entrance to NASA’s Kennedy Space Center in Florida. The arm will be installed on the Complex 41 Crew Access Tower at Cape Canaveral Air Force Station. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

Stress-induced endocrine response and anxiety: the effects of comfort food in rats.

PubMed

Ortolani, Daniela; Garcia, Márcia Carvalho; Melo-Thomas, Liana; Spadari-Bratfisch, Regina Celia

2014-05-01

The long-term effects of comfort food in an anxiogenic model of stress have yet to be analyzed. Here, we evaluated behavioral, endocrine and metabolic parameters in rats submitted or not to chronic unpredictable mild stress (CUMS), with access to commercial chow alone or to commercial chow and comfort food. Stress did not alter the preference for comfort food but decreased food intake. In the elevated plus-maze (EPM) test, stressed rats were less likely to enter/remain in the open arms, as well as being more likely to enter/remain in the closed arms, than were control rats, both conditions being more pronounced in the rats given access to comfort food. In the open field test, stress decreased the time spent in the centre, independent of diet; neither stress nor diet affected the number of crossing, rearing or grooming episodes. The stress-induced increase in serum corticosterone was attenuated in rats given access to comfort food. Serum concentration of triglycerides were unaffected by stress or diet, although access to comfort food increased total cholesterol and glucose. It is concluded that CUMS has an anorexigenic effect. Chronic stress and comfort food ingestion induced an anxiogenic profile although comfort food attenuated the endocrine stress response. The present data indicate that the combination of stress and access to comfort food, common aspects of modern life, may constitute a link among stress, feeding behavior and anxiety.

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

Le Blanche, Alain F.; Pautas, Eric; Gouin, Isabelle

Purpose. To evaluate routine use of access sites in the arm for percutaneous caval filter placement (PCFP) in elderly patients. Neck arthritis, patient anxiety, access site thrombosis or fecal/urinary incontinence complicating jugular or femoral access may require alternative access sites in this population. Methods. Access via the right arm was chosen for PCFP (VenaTech LP). The indication for PCFP was deep vein thrombosis, a history of pulmonary embolism, and a contraindication to anticoagulant therapy. Ultrasound-guided puncture was performed after diameter measurement of the arm veins (O{sub AV}). The filter was inserted with standard imaging procedures. Procedural difficulty was graded andmore » compared with O{sub AV} and the angle from the arm vein to the superior vena cava ({alpha}{sub AV/SVC}). Results. Over 2 years, 16 patients (14 women, 2 men) with an average age of 90 years (range 79-97 years) were included in the study. The average O{sub AV} value of the basilic or brachial veins was 4.2 mm (range 3.0-5.1 mm). The minimal O{sub AV} for successful access was determined after the first 15 patients. No hematoma occurred at the puncture sites. The average {alpha}{sub AV/SVC} value was 62 deg. (range 29 deg. - 90 deg.). Arm access was possible in 12 of 16 patients (75%) with O{sub AV} {>=} 3.5 mm and {alpha}{sub AV/SVC} {>=} 29 deg. Every procedure via the arm was graded 'easy' by the operator, regardless of angulation values. Femoral access was used in one case due to the impossibility of traversing the heart (patient no. 2), and jugular access was used in 3 of 16 (19%) patients due to puncture failure (patient no. 4), small O{sub AV} (3 mm) (patient no. 6), and stenosis of the distal right subclavian vein (patient no.16), respectively. Conclusion. PCFP via the arm can be routinely accomplished in patients older than 75 years, provided O{sub AV} {>=} 3.5 mm, and {alpha}{sub AV/SVC} {>=} 200119 d.« less

CCP Crew Access Arm Arrival

NASA Image and Video Library

2016-08-11

A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, departs from Oak Hill, Florida, and heads to NASA’s Kennedy Space Center in Florida. The arm will be installed on the Complex 41 Crew Access Tower at Cape Canaveral Air Force Station. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings

PubMed Central

Fuller, Sebastian S; Mercer, Catherine H; Copas, Andrew J; Saunders, John; Sutcliffe, Lorna J; Cassell, Jackie A; Hart, Graham; Johnson, Anne M; Roberts, Tracy E; Jackson, Louise J; Muniina, Pamela; Estcourt, Claudia S

2015-01-01

Background Uptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability. Methods We developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake. Results Across the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally ‘enhanced’ by some team captains actively publicising screening events. Conclusions Compared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation. PMID:25512674

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carrying the Orion crew access arm nears the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

CCP Crew Access Arm Arrival

NASA Image and Video Library

2016-08-11

A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, crosses the Haulover Canal Bridge on its way to the entrance of NASA’s Kennedy Space Center in Florida. The arm will be installed on the Complex 41 Crew Access Tower at Cape Canaveral Air Force Station. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

Randomized evaluation and cost-effectiveness of HIV and sexual and reproductive health service referral and linkage models in Zambia.

PubMed

Hewett, Paul C; Nalubamba, Mutinta; Bozzani, Fiammetta; Digitale, Jean; Vu, Lung; Yam, Eileen; Nambao, Mary

2016-08-12

Provision of HIV prevention and sexual and reproductive health services in Zambia is largely characterized by discrete service provision with weak client referral and linkage. The literature reveals gaps in the continuity of care for HIV and sexual and reproductive health. This study assessed whether improved service delivery models increased the uptake and cost-effectiveness of HIV and sexual and reproductive health services. Adult clients 18+ years of age accessing family planning (females), HIV testing and counseling (females and males), and male circumcision services (males) were recruited, enrolled and individually randomized to one of three study arms: 1) the standard model of service provision at the entry point (N = 1319); 2) an enhanced counseling and referral to add-on service with follow-up (N = 1323); and 3) the components of study arm two, with the additional offer of an escort (N = 1321). Interviews were conducted with the same clients at baseline, six weeks and six months. Uptake of services for HIV, family planning, male circumcision, and cervical cancer screening at six weeks and six months were the primary endpoints. Pairwise chi-square and multivariable logistic regression statistical tests assessed differences across study arms, which were also assessed for incremental cost-efficiency and cost-effectiveness. A total of 3963 clients, 1920 males and 2043 females, were enrolled; 82 % of participants at six weeks were tracked and 81 % at six months; follow-up rates did not vary significantly by study arm. The odds of clients accessing HIV testing and counseling, cervical cancer screening services among females, and circumcision services among males varied significantly by study arm at six weeks and six months; less consistent findings were observed for HIV care and treatment. Client uptake of family planning services did not vary significantly by study arm. Integrated services were found to be more efficiently provided than vertical service provision; the cost-effectiveness for HIV/AIDS and cervical cancer was high in the enhanced service models. Study results provide evidence for increasing the linkages and integration of a selection of HIV and sexual and reproductive health services. The study provided cost-effective service delivery models that enhanced the likelihood of clients accessing some additional needed health services. ISRCTN84228514 Retrospectively registered. The study was retrospectively registered in the ISRCTN clinical trials registry on 06 October 2015. The first recruitment of participants occurred on 17 December 2013.

KSC-2009-5913

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – At Launch Pad 39B at NASA's Kennedy Space Center in Florida, the rotating service structure has been rolled back from the Constellation Program's 327-foot-tall Ares I-X rocket, sitting atop its mobile launcher platform, during preparations for launch. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5914

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – At Launch Pad 39B at NASA's Kennedy Space Center in Florida, xenon lights illuminate the Constellation Program's 327-foot-tall Ares I-X rocket after the rotating service structure, has been retracted from around it for launch. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

KSC-2009-5917

NASA Image and Video Library

2009-10-27

CAPE CANAVERAL, Fla. – Daybreak at Launch Pad 39B at NASA's Kennedy Space Center in Florida reveals the rotating service structure rolled back from around the Constellation Program's 327-foot-tall Ares I-X rocket for launch. The transfer of the pad from the Space Shuttle Program to the Constellation Program took place May 31. Modifications made to the pad include the removal of shuttle unique subsystems, such as the orbiter access arm and a section of the gaseous oxygen vent arm, and the installation of three 600-foot lightning towers, access platforms, environmental control systems and a vehicle stabilization system. The data returned from more than 700 sensors throughout the rocket will be used to refine the design of future launch vehicles and bring NASA one step closer to reaching its exploration goals. The Ares I-X flight test is targeted for Oct. 27. For information on the Ares I-X vehicle and flight test, visit http://www.nasa.gov/aresIX. Photo credit: NASA/Kim Shiflett

Mobile Launcher Crew Access Arm Transport from Cocoa FL to KSC

NASA Image and Video Library

2017-10-17

The Orion crew access arm is secured on a flatbed truck at Precision Fabricating and Cleaning in Cocoa, Florida and ready to be transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

KSC-2009-3797

NASA Image and Video Library

2009-06-20

CAPE CANAVERAL, Fla. – The slings from a large crane are being attached to the orbiter access arm, which ends in the White Room, that is part of the fixed service structure, or FSS, on Launch Pad 39B at NASA's Kennedy Space Center in Florida. The White Room provided entry into space shuttles that were on the pad. The arm is being removed from the FSS for the pad's conversion as launch site for the Constellation Program's Ares I-X. The launch of the Ares I-X flight test is targeted for August 2009. Photo credit: NASA/Kim Shiflett

KSC-2009-3800

NASA Image and Video Library

2009-06-20

CAPE CANAVERAL, Fla. – The slings from a large crane are in place on the orbiter access arm, which ends in the White Room, that is part of the fixed service structure, or FSS, on Launch Pad 39B at NASA's Kennedy Space Center in Florida. The White Room provided entry into space shuttles that were on the pad. The arm is being removed from the FSS for the pad's conversion as launch site for the Constellation Program's Ares I-X. The launch of the Ares I-X flight test is targeted for August 2009. Photo credit: NASA/Kim Shiflett

KSC-2009-3799

NASA Image and Video Library

2009-06-20

CAPE CANAVERAL, Fla. – The slings from a large crane are in place on the orbiter access arm, which ends in the White Room, that is part of the fixed service structure, or FSS, on Launch Pad 39B at NASA's Kennedy Space Center in Florida. The White Room provided entry into space shuttles that were on the pad. The arm is being removed from the FSS for the pad's conversion as launch site for the Constellation Program's Ares I-X. The launch of the Ares I-X flight test is targeted for August 2009. Photo credit: NASA/Kim Shiflett

KSC-2009-3801

NASA Image and Video Library

2009-06-20

CAPE CANAVERAL, Fla. – The slings from a large crane swing the detached orbiter access arm, which ends in the White Room, away from the fixed service structure, or FSS, on Launch Pad 39B at NASA's Kennedy Space Center in Florida. The White Room provided entry into space shuttles that were on the pad. The arm is being removed from the FSS for the pad's conversion as launch site for the Constellation Program's Ares I-X. The launch of the Ares I-X flight test is targeted for August 2009. Photo credit: NASA/Kim Shiflett

KSC-2009-3798

NASA Image and Video Library

2009-06-20

CAPE CANAVERAL, Fla. – The slings from a large crane are being attached to the orbiter access arm, which ends in the White Room, that is part of the fixed service structure, or FSS, on Launch Pad 39B at NASA's Kennedy Space Center in Florida. The White Room provided entry into space shuttles that were on the pad. The arm is being removed from the FSS for the pad's conversion as launch site for the Constellation Program's Ares I-X. The launch of the Ares I-X flight test is targeted for August 2009. Photo credit: NASA/Kim Shiflett

Commerical Crew Program (CCP) Access Arm Installation

NASA Image and Video Library

2016-08-15

The Crew Access Arm and White Room for Boeing's CST-100 Starliner are attached to the Crew Access Tower at Cape Canaveral Air Force Station’s Space Launch Complex 41. The arm will serve as the connection that astronauts will walk through prior to boarding the Starliner spacecraft when stacked atop a United Launch Alliance Atlas V rocket. This installation completes the major construction of the first new Crew Access Tower to be built at the Cape since the Apollo era. Under a Commercial Crew Transportation Capability contract with NASA, Boeing’s Starliner system will be certified by NASA's Commercial Crew Program to fly crews to and from the International Space Station.

Comparative feasibility of implementing rapid diagnostic test and microscopy for parasitological diagnosis of malaria in Uganda.

PubMed

Batwala, Vincent; Magnussen, Pascal; Nuwaha, Fred

2011-12-19

In Uganda, parasite-based diagnosis is recommended for every patient suspected to have malaria before prescribing anti-malarials. However, the majority of patients are still treated presumptively especially in low-level health units. The feasibility of implementing parasite-based diagnosis for uncomplicated malaria in rural health centres (HCs) was investigated with a view to recommending measures for scaling up the policy. Thirty HCs were randomized to implement parasite-based diagnosis based on rapid diagnostic tests [RDTs] (n = 10), blood microscopy (n = 10) and presumptive diagnosis (control arm) (n = 10). Feasibility was assessed by comparing the proportion of patients who received parasite-based diagnosis; with a positive malaria parasite-based diagnosis who received artemether-lumefantrine (AL); with a negative malaria parasite-based diagnosis who received AL; and patient waiting time. Clinicaltrials.gov: NCT00565071. 102, 087 outpatients were enrolled. Patients were more likely to be tested in the RDT 44, 565 (96.6%) than in microscopy arm 19, 545 (60.9%) [RR: 1.59]. RDTs reduced patient waiting time compared to microscopy and were more convenient to health workers and patients. Majority 23, 804 (99.7%) in presumptive arm were prescribed AL. All (100%) of patients who tested positive for malaria in RDT and microscopy arms were prescribed anti-malarials. Parasitological-based diagnosis significantly reduced AL prescription in RDT arm [RR: 0.62] and microscopy arm [RR: 0.72] compared to presumptive treatment. Among patients not tested in the two intervention arms, 12, 044 (96.1%) in microscopy and 965 (61.6%) in RDT arm were treated with AL [RR: 1.56]. Overall 10, 558 (29.4%) with negative results [5, 110 (23.4%) in RDT and 5, 448 (39.0%) in microscopy arms] were prescribed AL. It was more feasible to implement parasite-based diagnosis for malaria using RDT than with microscopy. A high proportion of patients with negative malaria results are still prescribed anti-malarials. There is need to increase access to parasite-based diagnosis where microscopy is used. In order to fully harness the benefits of parasitological confirmation of malaria, it is necessary to reduce the prescription of anti-malarials in negative patients.

A novel Interactive Health Communication Application (IHCA) for parents of children with long-term conditions: Development, implementation and feasibility assessment.

PubMed

Swallow, Veronica; Carolan, Ian; Smith, Trish; Webb, Nicholas J A; Knafl, Kathleen; Santacroce, Sheila; Campbell, Malcolm; Harper-Jones, Melanie; Hanif, Noreen; Hall, Andrew

2016-01-01

Few evidence-based, on-line resources exist to support home-based care of childhood long-term conditions. In a feasibility study, children with stages 3, 4, or 5 chronic kidney disease, parents and professionals collaboratively developed a novel Online Parent Information and Support (OPIS) application. Parents were randomized to an intervention arm with access to OPIS or a control arm without access. OPIS usage was assessed using Google Analytics. Parents in the intervention arm completed the Suitability Assessment of Materials (SAM) and User Interface Satisfaction (USE) questionnaires and participated in qualitative interviews. Twenty parents accessed OPIS with a mean of 23.3 (SD 20.8, range 2-64) visits per user. Responses from the SAM and USE questionnaires were positive, most respondents rating OPIS highly and finding it easy to use. Qualitative suggestions include refinement of OPIS components, enabling personalization of OPIS functionalities and proactive endorsements of OPIS by professionals. Implementation of OPIS into standard practice is feasible in the centre where it was developed. Suggested developments will augment reported strengths to inform ongoing testing in the wider UK network of units. Our design and methods are transferrable to developing and evaluating web-applications to support home-based clinical care-giving for other long-term conditions.

Crew Access Arm arrival at Mobile Launcher

NASA Image and Video Library

2017-11-09

A heavy-load transport truck carrying the Orion crew access arm arrives at the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carrying the Orion crew access arm passes the Vehicle Assembly Building on its way to the mobile launcher at NASA's Kennedy Space Center in Florida. The access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-09

The Orion crew access arm, secured on a stand, is being prepared for its move from a storage location at NASA's Kennedy Space Center in Florida, to the mobile launcher (ML) tower near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

A heavy-load transport truck carrying the Orion crew access arm makes its way toward the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

Vaccine testing for emerging infections: the case for individual randomisation.

PubMed

Eyal, Nir; Lipsitch, Marc

2017-09-01

During the 2014-2015 Ebola outbreak in Guinea, Liberia and Sierra Leone, many opposed the use of individually randomised controlled trials to test candidate Ebola vaccines. For a raging fatal disease, they explained, it is unethical to relegate some study participants to control arms. In Zika and future emerging infections, similar opposition may hinder urgent vaccine research, so it is best to address these questions now. This article lays out the ethical case for individually randomised control in testing vaccines against many emerging infections, including lethal infections in low-income countries, even when at no point in the trial do the controls receive the countermeasures being tested. When individual randomisation is feasible-and it often will be-it tends to save more lives than alternative designs would. And for emerging infections, individual randomisation also tends as such to improve care, access to the experimental vaccine and prospects for all participants relative to their opportunities absent the trial, and no less than alternative designs would. That obtains even under placebo control and without equipoise-requiring which would undermine individual randomisation and the alternative designs that opponents proffered. Our arguments expound four often-neglected factors: benefits to non-participants, benefits to participants once a trial is over including post-trial access to the study intervention, participants' prospects before randomisation to arms and the near-inevitable disparity between arms in any randomised controlled trial. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: A cluster-randomized controlled health systems trial.

PubMed

Ortblad, Katrina; Kibuuka Musoke, Daniel; Ngabirano, Thomson; Nakitende, Aidah; Magoola, Jonathan; Kayiira, Prossy; Taasi, Geoffrey; Barresi, Leah G; Haberer, Jessica E; McConnell, Margaret A; Oldenburg, Catherine E; Bärnighausen, Till

2017-11-01

HIV self-testing allows HIV testing at any place and time and without health workers. HIV self-testing may thus be particularly useful for female sex workers (FSWs), who should test frequently but face stigma and financial and time barriers when accessing healthcare facilities. We conducted a cluster-randomized controlled health systems trial among FSWs in Kampala, Uganda, to measure the effect of 2 HIV self-testing delivery models on HIV testing and linkage to care outcomes. FSW peer educator groups (1 peer educator and 8 participants) were randomized to either (1) direct provision of HIV self-tests, (2) provision of coupons for free collection of HIV self-tests in a healthcare facility, or (3) standard of care HIV testing. We randomized 960 participants in 120 peer educator groups from October 18, 2016, to November 16, 2016. Participants' median age was 28 years (IQR 24-32). Our prespecified primary outcomes were self-report of any HIV testing at 1 month and at 4 months; our prespecified secondary outcomes were self-report of HIV self-test use, seeking HIV-related medical care and ART initiation. In addition, we analyzed 2 secondary outcomes that were not prespecified: self-report of repeat HIV testing-to understand the intervention effects on frequent testing-and self-reported facility-based testing-to quantify substitution effects. Participants in the direct provision arm were significantly more likely to have tested for HIV than those in the standard of care arm, both at 1 month (risk ratio [RR] 1.33, 95% CI 1.17-1.51, p < 0.001) and at 4 months (RR 1.14, 95% CI 1.07-1.22, p < 0.001). Participants in the direct provision arm were also significantly more likely to have tested for HIV than those in the facility collection arm, both at 1 month (RR 1.18, 95% CI 1.07-1.31, p = 0.001) and at 4 months (RR 1.03, 95% CI 1.01-1.05, p = 0.02). At 1 month, fewer participants in the intervention arms had sought medical care for HIV than in the standard of care arm, but these differences were not significant and were reduced in magnitude at 4 months. There were no statistically significant differences in ART initiation across study arms. At 4 months, participants in the direct provision arm were significantly more likely to have tested twice for HIV than those in the standard of care arm (RR 1.51, 95% CI 1.29-1.77, p < 0.001) and those in the facility collection arm (RR 1.22, 95% CI 1.08-1.37, p = 0.001). Participants in the HIV self-testing arms almost completely replaced facility-based testing with self-testing. Two adverse events related to HIV self-testing were reported: interpersonal violence and mental distress. Study limitations included self-reported outcomes and limited generalizability beyond FSWs in similar settings. In this study, HIV self-testing appeared to be safe and increased recent and repeat HIV testing among FSWs. We found that direct provision of HIV self-tests was significantly more effective in increasing HIV testing among FSWs than passively offering HIV self-tests for collection in healthcare facilities. HIV self-testing could play an important role in supporting HIV interventions that require frequent HIV testing, such as HIV treatment as prevention, behavior change for transmission reduction, and pre-exposure prophylaxis. ClinicalTrials.gov NCT02846402.

HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial.

PubMed

Chanda, Michael M; Ortblad, Katrina F; Mwale, Magdalene; Chongo, Steven; Kanchele, Catherine; Kamungoma, Nyambe; Fullem, Andrew; Dunn, Caitlin; Barresi, Leah G; Harling, Guy; Bärnighausen, Till; Oldenburg, Catherine E

2017-11-01

HIV self-testing (HIVST) may play a role in addressing gaps in HIV testing coverage and as an entry point for HIV prevention services. We conducted a cluster randomized trial of 2 HIVST distribution mechanisms compared to the standard of care among female sex workers (FSWs) in Zambia. Trained peer educators in Kapiri Mposhi, Chirundu, and Livingstone, Zambia, each recruited 6 FSW participants. Peer educator-FSW groups were randomized to 1 of 3 arms: (1) delivery (direct distribution of an oral HIVST from the peer educator), (2) coupon (a coupon for collection of an oral HIVST from a health clinic/pharmacy), or (3) standard-of-care HIV testing. Participants in the 2 HIVST arms received 2 kits: 1 at baseline and 1 at 10 weeks. The primary outcome was any self-reported HIV testing in the past month at the 1- and 4-month visits, as HIVST can replace other types of HIV testing. Secondary outcomes included linkage to care, HIVST use in the HIVST arms, and adverse events. Participants completed questionnaires at 1 and 4 months following peer educator interventions. In all, 965 participants were enrolled between September 16 and October 12, 2016 (delivery, N = 316; coupon, N = 329; standard of care, N = 320); 20% had never tested for HIV. Overall HIV testing at 1 month was 94.9% in the delivery arm, 84.4% in the coupon arm, and 88.5% in the standard-of-care arm (delivery versus standard of care risk ratio [RR] = 1.07, 95% CI 0.99-1.15, P = 0.10; coupon versus standard of care RR = 0.95, 95% CI 0.86-1.05, P = 0.29; delivery versus coupon RR = 1.13, 95% CI 1.04-1.22, P = 0.005). Four-month rates were 84.1% for the delivery arm, 79.8% for the coupon arm, and 75.1% for the standard-of-care arm (delivery versus standard of care RR = 1.11, 95% CI 0.98-1.27, P = 0.11; coupon versus standard of care RR = 1.06, 95% CI 0.92-1.22, P = 0.42; delivery versus coupon RR = 1.05, 95% CI 0.94-1.18, P = 0.40). At 1 month, the majority of HIV tests were self-tests (88.4%). HIV self-test use was higher in the delivery arm compared to the coupon arm (RR = 1.14, 95% CI 1.05-1.23, P = 0.001) at 1 month, but there was no difference at 4 months. Among participants reporting a positive HIV test at 1 (N = 144) and 4 months (N = 235), linkage to care was non-significantly lower in the 2 HIVST arms compared to the standard-of-care arm. There were 4 instances of intimate partner violence related to study participation, 3 of which were related to HIV self-test use. Limitations include the self-reported nature of study outcomes and overall high uptake of HIV testing. In this study among FSWs in Zambia, we found that HIVST was acceptable and accessible. However, HIVST may not substantially increase HIV cascade progression in contexts where overall testing and linkage are already high. ClinicalTrials.gov NCT02827240.

HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial

PubMed Central

Chanda, Michael M.; Mwale, Magdalene; Chongo, Steven; Kanchele, Catherine; Kamungoma, Nyambe; Fullem, Andrew; Dunn, Caitlin; Barresi, Leah G.; Bärnighausen, Till

2017-01-01

Background HIV self-testing (HIVST) may play a role in addressing gaps in HIV testing coverage and as an entry point for HIV prevention services. We conducted a cluster randomized trial of 2 HIVST distribution mechanisms compared to the standard of care among female sex workers (FSWs) in Zambia. Methods and findings Trained peer educators in Kapiri Mposhi, Chirundu, and Livingstone, Zambia, each recruited 6 FSW participants. Peer educator–FSW groups were randomized to 1 of 3 arms: (1) delivery (direct distribution of an oral HIVST from the peer educator), (2) coupon (a coupon for collection of an oral HIVST from a health clinic/pharmacy), or (3) standard-of-care HIV testing. Participants in the 2 HIVST arms received 2 kits: 1 at baseline and 1 at 10 weeks. The primary outcome was any self-reported HIV testing in the past month at the 1- and 4-month visits, as HIVST can replace other types of HIV testing. Secondary outcomes included linkage to care, HIVST use in the HIVST arms, and adverse events. Participants completed questionnaires at 1 and 4 months following peer educator interventions. In all, 965 participants were enrolled between September 16 and October 12, 2016 (delivery, N = 316; coupon, N = 329; standard of care, N = 320); 20% had never tested for HIV. Overall HIV testing at 1 month was 94.9% in the delivery arm, 84.4% in the coupon arm, and 88.5% in the standard-of-care arm (delivery versus standard of care risk ratio [RR] = 1.07, 95% CI 0.99–1.15, P = 0.10; coupon versus standard of care RR = 0.95, 95% CI 0.86–1.05, P = 0.29; delivery versus coupon RR = 1.13, 95% CI 1.04–1.22, P = 0.005). Four-month rates were 84.1% for the delivery arm, 79.8% for the coupon arm, and 75.1% for the standard-of-care arm (delivery versus standard of care RR = 1.11, 95% CI 0.98–1.27, P = 0.11; coupon versus standard of care RR = 1.06, 95% CI 0.92–1.22, P = 0.42; delivery versus coupon RR = 1.05, 95% CI 0.94–1.18, P = 0.40). At 1 month, the majority of HIV tests were self-tests (88.4%). HIV self-test use was higher in the delivery arm compared to the coupon arm (RR = 1.14, 95% CI 1.05–1.23, P = 0.001) at 1 month, but there was no difference at 4 months. Among participants reporting a positive HIV test at 1 (N = 144) and 4 months (N = 235), linkage to care was non-significantly lower in the 2 HIVST arms compared to the standard-of-care arm. There were 4 instances of intimate partner violence related to study participation, 3 of which were related to HIV self-test use. Limitations include the self-reported nature of study outcomes and overall high uptake of HIV testing. Conclusions In this study among FSWs in Zambia, we found that HIVST was acceptable and accessible. However, HIVST may not substantially increase HIV cascade progression in contexts where overall testing and linkage are already high. Trial registration ClinicalTrials.gov NCT02827240 PMID:29161260

Highly Palatable Food during Adolescence Improves Anxiety-Like Behaviors and Hypothalamic-Pituitary-Adrenal Axis Dysfunction in Rats that Experienced Neonatal Maternal Separation

PubMed Central

Lee, Jong-Ho; Kim, Jin Young

2014-01-01

Background This study was conducted to examine the effects of ad libitum consumption of highly palatable food (HPF) during adolescence on the adverse behavioral outcome of neonatal maternal separation. Methods Male Sprague-Dawley pups were separated from dam for 3 hours daily during the first 2 weeks of birth (maternal separation, MS) or left undisturbed (nonhandled, NH). Half of MS pups received free access to chocolate cookies in addition to ad libitum chow from postnatal day 28 (MS+HPF). Pups were subjected to behavioral tests during young adulthood. The plasma corticosterone response to stress challenge was analyzed by radioimmunoassay. Results Daily caloric intake and body weight gain did not differ among the experimental groups. Ambulatory activities were decreased defecation activity and rostral grooming were increased in MS controls (fed with chow only) compared with NH rats. MS controls spent less time in open arms, and more time in closed arms during the elevated plus maze test, than NH rats. Immobility duration during the forced swim test was increased in MS controls compared with NH rats. Cookie access normalized the behavioral scores of ambulatory and defecation activities and grooming, but not the scores during the elevated plus maze and swim tests in MS rats. Stress-induced corticosterone increase was blunted in MS rats fed with chow only, and cookie access normalized it. Conclusion Prolonged access to HPF during adolescence and youth partly improves anxiety-related, but not depressive, symptoms in rats that experienced neonatal maternal separation, possibly in relation with improved function of the hypothalamic-pituitary-adrenal (HPA) axis. PMID:25031890

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-10

The Orion crew access arm is secured on a flatbed transporter for its move from a storage location at NASA's Kennedy Space Center in Florida to the mobile launcher (ML) tower near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

Surface Catalysis and Characterization of Proposed Candidate TPS for Access-to-Space Vehicles

NASA Technical Reports Server (NTRS)

Stewart, David A.

1997-01-01

Surface properties have been obtained on several classes of thermal protection systems (TPS) using data from both side-arm-reactor and arc-jet facilities. Thermochemical stability, optical properties, and coefficients for atom recombination were determined for candidate TPS proposed for single-stage-to-orbit vehicles. The systems included rigid fibrous insulations, blankets, reinforced carbon carbon, and metals. Test techniques, theories used to define arc-jet and side-arm-reactor flow, and material surface properties are described. Total hemispherical emittance and atom recombination coefficients for each candidate TPS are summarized in the form of polynomial and Arrhenius expressions.

The effect of referral for genetic counseling on genetic testing and surgical prevention in women at high risk for ovarian cancer: Results from a randomized controlled trial.

PubMed

Drescher, Charles W; Beatty, J David; Resta, Robert; Andersen, M Robyn; Watabayashi, Kate; Thorpe, Jason; Hawley, Sarah; Purkey, Hannah; Chubak, Jessica; Hanson, Nancy; Buist, Diana S M; Urban, Nicole

2016-07-22

Guidelines recommend genetic counseling and testing for women who have a pedigree suggestive of an inherited susceptibility for ovarian cancer. The authors evaluated the effect of referral to genetic counseling on genetic testing and prophylactic oophorectomy in a randomized controlled trial. Data from an electronic mammography reporting system identified 12,919 women with a pedigree that included breast cancer, of whom 625 were identified who had a high risk for inherited susceptibility to ovarian cancer using a risk-assessment questionnaire. Of these, 458 women provided informed consent and were randomized 1:1 to intervention consisting of a genetic counseling referral (n = 228) or standard clinical care (n = 230). Participants were predominantly aged 45 to 65 years, and 30% and 20% reported a personal history of breast cancer or a family history of ovarian cancer, respectively. Eighty-five percent of women in the intervention group participated in a genetic counseling session. Genetic testing was reported by 74 (33%) and 20 (9%) women in the intervention and control arms (P < .005), respectively. Five women in the intervention arm and 2 in the control arm were identified as germline mutation carriers. Ten women in the intervention arm and 3 in the control arm underwent prophylactic bilateral salpingo-oophorectomy (P < .05). Routine referral of women at high risk for ovarian cancer to genetic counseling promotes genetic testing and prophylactic surgery. The findings from the current randomized controlled trial demonstrate the value of implementing strategies that target women at high risk for ovarian cancer to ensure they are offered access to recommended care. CA Cancer J Clin 2016. © 2016 American Cancer Society, Inc. © 2016 American Cancer Society.

Astronauts Bob Behnken and Eric Boe walk the Crew Access Arm at

NASA Image and Video Library

2017-08-30

Astronauts Bob Behnken, left, and Eric Boe walk down the Crew Access Arm being built by SpaceX for Launch Complex 39A at NASA’s Kennedy Space Center in Florida. The access arm will be installed on the launch pad, providing a bridge between the launch tower it’s the Fixed Service Structure, as noted below, and SpaceX’s Dragon 2 spacecraft for astronauts flying to the International Space Station on the company’s Falcon 9 rocket as part of NASA’s Commercial Crew Program. The access arm is being readied for installation in early 2018. It will be installed 70 feet higher than the former space shuttle access arm on the launch pad’s Fixed Service Structure. SpaceX continues to modify the historic launch site from its former space shuttle days, removing more than 500,000 pounds of steel from the pad structure, including the Rotating Service Structure that was once used for accessing the payload bay of the shuttle. SpaceX also is using the modernized site to launch commercial payloads, as well as cargo resupply missions to and from the International Space Station for NASA. The first SpaceX launch from the historic Apollo and space shuttle site was this past February. NASA’s Commercial Crew Program is working with private companies, Boeing and SpaceX, with a goal of once again flying people to and from the International Space Station, launching from the United States.

Karyotype variation in cultivars and spontaneous cocoa mutants (Theobroma cacao L.).

PubMed

Figueiredo, G S F; Melo, C A F; Souza, M M; Araújo, I S; Zaidan, H A; Pires, J L; Ahnert, D

2013-10-18

Four mutant cocoa accessions with morphological changes and a cultivar sample were karyomorphologically characterized. Slides were prepared by enzymatic digestion of the root meristem and squashed in 45% acetic acid, followed by 2% Giemsa staining. The chromosome number of 2n = 20 was seen in all accessions. The karyotype formula for Cacau Comum and Cacau Rui was 2n = 20m. Submetacentric chromosomes were observed in Cacau Pucala and Cacau Jaca, both with 2n = 18m + 2sm, but the karyotype formula for Cacau Sem Vidro was 2n = 16m + 4sm. Satellites were located on the long arm of the 1st and 2nd chromosome pairs of Cacau Comum, whereas Cacau Pucala had satellites on the 6th chromosome pair. Greater karyotypic variation in Cacau Sem Vidro was found, whose 1st and 2nd chromosome pairs had satellites on the long arm and 6th and 10th pairs had satellites on the short arm. Analysis revealed a lower average chromosome length in Cacau Comum (1.53 ± 0.026 µm) and a higher length in Cacau Sem Vidro (2.26 ± 0.038 µm). ANOVA revealed significant difference (P < 0.01) for the average chromosome length and the length of chromosome pairs within and between accessions. The average chromosome lengths of mutants of Cacau Rui and Cacau Jaca were not statistically different by the Tukey test at 5% probability. The karyotypic diversity observed in this study is not necessarily associated with the changing character of the accessions analyzed, but may reflect the genetic variation observed in Theobroma cacao.

To Arm or Not to Arm: The Case Against Arming Vietnam and the Philippines

DTIC Science & Technology

2015-04-13

23 Bouchat, 103. 24 Freedom House, “Freedom in the World 2014: The Democratic Leadership Gap,” https://freedomhouse. org/sites/default...files/publications- pdf/CNAS_TailoredCoercion_report.pdf (accessed Sep 21, 2014). 49 Freedom House. “Freedom in the World 2014: The Democratic ... Leadership Gap.” https://freedomhouse.org/sites/default/files/FIW%202014%20Scores%20- %20Countries%20and%20Territories.pdf (accessed Nov 24, 2014

Addressing Unmet Need for HIV Testing in Emergency Care Settings: A Role for Computer-facilitated Rapid HIV Testing?

PubMed Central

Kurth, Ann E.; Severynen, Anneleen; Spielberg, Freya

2014-01-01

HIV testing in emergency departments (EDs) remains underutilized. We evaluated a computer tool to facilitate rapid HIV testing in an urban ED. Randomly assigned non-acute adult ED patients to computer tool (‘CARE’) and rapid HIV testing before standard visit (n=258) or to standard visit (n=259) with chart access. Assessed intervention acceptability and compared noted HIV risks. Participants were 56% non-white, 58% male; median age 37 years. In the CARE arm nearly all (251/258) completed the session and received HIV results; 4 declined test consent. HIV risks were reported by 54% of users and there was one confirmed HIV-positive and 2 false-positives (seroprevalence 0.4%, 95% CI 0.01–2.2%). Half (55%) preferred computerized, over face-to-face, counseling for future HIV testing. In standard arm, one HIV test and 2 referrals for testing occurred. Computer-facilitated HIV testing appears acceptable to ED patients. Future research should assess cost-effectiveness compared with staff-delivered approaches. PMID:23837807

Multi-access laser communications terminal

NASA Technical Reports Server (NTRS)

1992-01-01

The Optical Multi-Access (OMA) Terminal is capable of establishing up to six simultaneous high-data-rate communication links between low-Earth-orbit satellites and a host satellite at synchronous orbit with only one 16-inch-diameter antenna on the synchronous satellite. The advantage over equivalent RF systems in space weight, power, and swept volume is great when applied to NASA satellite communications networks. A photograph of the 3-channel prototype constructed under the present contract to demonstrate the feasibility of the concept is presented. The telescope has a 10-inch clear aperture and a 22 deg full field of view. It consists of 4 refractive elements to achieve a telecentric focus, i.e., the focused beam is normal to the focal plane at all field angles. This feature permits image pick-up optics in the focal plane to track satellite images without tilting their optic axes to accommodate field angle. The geometry of the imager-pick-up concept and the coordinate system of the swinging arm and disk mechanism for image pick-up are shown. Optics in the arm relay the telescope focus to a communications and tracking receiver and introduce the transmitted beacon beam on a path collinear with the receive path. The electronic circuits for the communications and tracking receivers are contained on the arm and disk assemblies and relay signals to an associated PC-based operator's console for control of the arm and disk motor drive through a flexible cable which permits +/- 240 deg travel for each arm and disk assembly. Power supplies and laser transmitters are mounted in the cradle for the telescope. A single-mode fiber in the cable is used to carry the laser transmitter signal to the arm optics. The promise of the optical multi-access terminal towards which the prototype effort worked is shown. The emphasis in the prototype development was the demonstration of the unique aspect of the concept, and where possible, cost avoidance compromises were implemented in areas already proven on other programs. The design details are described in section 2, the prototype test results in section 3, additional development required in section 4, and conclusions in section 5.

Creating Access Points to Instrument-Based Atmospheric Data: Perspectives from the ARM Metadata Manager

NASA Astrophysics Data System (ADS)

Troyan, D.

2016-12-01

The Atmospheric Radiation Measurement (ARM) program has been collecting data from instruments in diverse climate regions for nearly twenty-five years. These data are made available to all interested parties at no cost via specially designed tools found on the ARM website (www.arm.gov). Metadata is created and applied to the various datastreams to facilitate information retrieval using the ARM website, the ARM Data Discovery Tool, and data quality reporting tools. Over the last year, the Metadata Manager - a relatively new position within the ARM program - created two documents that summarize the state of ARM metadata processes: ARM Metadata Workflow, and ARM Metadata Standards. These documents serve as guides to the creation and management of ARM metadata. With many of ARM's data functions spread around the Department of Energy national laboratory complex and with many of the original architects of the metadata structure no longer working for ARM, there is increased importance on using these documents to resolve issues from data flow bottlenecks and inaccurate metadata to improving data discovery and organizing web pages. This presentation will provide some examples from the workflow and standards documents. The examples will illustrate the complexity of the ARM metadata processes and the efficiency by which the metadata team works towards achieving the goal of providing access to data collected under the auspices of the ARM program.

Design of mechanisms to lock/latch systems under rotational or translational motion

NASA Technical Reports Server (NTRS)

Billimoria, R. P.

1976-01-01

Bodies/systems need to be stopped and locked/latched at the end of their path. Some examples of these systems in the aerospace industry (including launch vehicle, spacecraft, and the ground support equipment) are the command module access arm, service arms, docking module of the ASTP and the orbiter access arm for the space shuttle. Two major aspects are covered: (1) various methods of latching and (2) selection of the optimum method for latching, depending on the application and the design requirement criteria.

Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: A cluster-randomized controlled health systems trial

PubMed Central

Kibuuka Musoke, Daniel; Ngabirano, Thomson; Nakitende, Aidah; Magoola, Jonathan; Kayiira, Prossy; Taasi, Geoffrey; Barresi, Leah G.; McConnell, Margaret A.; Bärnighausen, Till

2017-01-01

Background HIV self-testing allows HIV testing at any place and time and without health workers. HIV self-testing may thus be particularly useful for female sex workers (FSWs), who should test frequently but face stigma and financial and time barriers when accessing healthcare facilities. Methods and findings We conducted a cluster-randomized controlled health systems trial among FSWs in Kampala, Uganda, to measure the effect of 2 HIV self-testing delivery models on HIV testing and linkage to care outcomes. FSW peer educator groups (1 peer educator and 8 participants) were randomized to either (1) direct provision of HIV self-tests, (2) provision of coupons for free collection of HIV self-tests in a healthcare facility, or (3) standard of care HIV testing. We randomized 960 participants in 120 peer educator groups from October 18, 2016, to November 16, 2016. Participants’ median age was 28 years (IQR 24–32). Our prespecified primary outcomes were self-report of any HIV testing at 1 month and at 4 months; our prespecified secondary outcomes were self-report of HIV self-test use, seeking HIV-related medical care and ART initiation. In addition, we analyzed 2 secondary outcomes that were not prespecified: self-report of repeat HIV testing—to understand the intervention effects on frequent testing—and self-reported facility-based testing—to quantify substitution effects. Participants in the direct provision arm were significantly more likely to have tested for HIV than those in the standard of care arm, both at 1 month (risk ratio [RR] 1.33, 95% CI 1.17–1.51, p < 0.001) and at 4 months (RR 1.14, 95% CI 1.07–1.22, p < 0.001). Participants in the direct provision arm were also significantly more likely to have tested for HIV than those in the facility collection arm, both at 1 month (RR 1.18, 95% CI 1.07–1.31, p = 0.001) and at 4 months (RR 1.03, 95% CI 1.01–1.05, p = 0.02). At 1 month, fewer participants in the intervention arms had sought medical care for HIV than in the standard of care arm, but these differences were not significant and were reduced in magnitude at 4 months. There were no statistically significant differences in ART initiation across study arms. At 4 months, participants in the direct provision arm were significantly more likely to have tested twice for HIV than those in the standard of care arm (RR 1.51, 95% CI 1.29–1.77, p < 0.001) and those in the facility collection arm (RR 1.22, 95% CI 1.08–1.37, p = 0.001). Participants in the HIV self-testing arms almost completely replaced facility-based testing with self-testing. Two adverse events related to HIV self-testing were reported: interpersonal violence and mental distress. Study limitations included self-reported outcomes and limited generalizability beyond FSWs in similar settings. Conclusions In this study, HIV self-testing appeared to be safe and increased recent and repeat HIV testing among FSWs. We found that direct provision of HIV self-tests was significantly more effective in increasing HIV testing among FSWs than passively offering HIV self-tests for collection in healthcare facilities. HIV self-testing could play an important role in supporting HIV interventions that require frequent HIV testing, such as HIV treatment as prevention, behavior change for transmission reduction, and pre-exposure prophylaxis. Trial registration ClinicalTrials.gov NCT02846402 PMID:29182634

REVIEW: Widespread access to predictive models in the motor system: a short review

NASA Astrophysics Data System (ADS)

Davidson, Paul R.; Wolpert, Daniel M.

2005-09-01

Recent behavioural and computational studies suggest that access to internal predictive models of arm and object dynamics is widespread in the sensorimotor system. Several systems, including those responsible for oculomotor and skeletomotor control, perceptual processing, postural control and mental imagery, are able to access predictions of the motion of the arm. A capacity to make and use predictions of object dynamics is similarly widespread. Here, we review recent studies looking at the predictive capacity of the central nervous system which reveal pervasive access to forward models of the environment.

5 CFR 2100.9 - Appeal of denial to grant access or to amend records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... amend records. 2100.9 Section 2100.9 Administrative Personnel ARMED FORCES RETIREMENT HOME ARMED FORCES RETIREMENT HOME PRIVACY ACT PROCEDURES § 2100.9 Appeal of denial to grant access or to amend records. (a) All... the following addresses: Associate Director, Resource Management, U.S. Soldiers' and Airmen's Home...

Adding a PECS II block for proximal arm arteriovenous access - a randomised study.

PubMed

Quek, K H; Low, E Y; Tan, Y R; Ong, A S C; Tang, T Y; Kam, J W; Kiew, A S C

2018-05-01

Brachial plexus block is often utilised for proximal arm arteriovenous access creation. However, the medial upper arm and axilla are often inadequately anaesthetised, requiring repeated, intraoperative local anaesthetic supplementation, or conversion into general anaesthesia. We hypothesised that the addition of a PECS II block would improve anaesthesia and analgesia for proximal arm arteriovenous access surgery. In this prospective, double-blinded, randomised proof-of-concept study, 36 consenting adults with end-stage renal disease aged between 21 and 90 years received either a combined supraclavicular and PECS II block (Group PECS, n = 18), or combined supraclavicular and sham block (Group SCB, n = 18) for proximal arm arteriovenous access surgery. Primary outcome was whether patients required intraoperative local anaesthetic supplementation by the surgeon. In Group PECS, 33.3% (6/18) needed local anaesthetic supplementation vs. 100% (18/18) in Group SCB. Group SCB had three times (RR 3.0, 95% CI 1.6-5.8; P < 0.001) the risk of requiring intraoperative local anaesthetic supplementation. Group PECS required lower volume of supplemental local anaesthetic compared to Group SCB (0.0 ml, IQR 0.0-6.3 ml vs. 15.0 ml, IQR 7.4-17.8 ml; P < 0.001). Group SCB had twice [RR 2.2, 95% CI 1.1-4.4; (P = 0.019)] the risk of needing additional sedation or analgesia. There were no significant differences between the groups with respect to postoperative visual analogue scale pain scores, time to first rescue analgesia or patient satisfaction. The results suggest that adding a PECS II block to a supraclavicular block improves regional anaesthesia for patients with end-stage renal disease undergoing proximal arm arteriovenous access surgery. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Further Analyses of the Test of Paid Radio Advertising for Armed Services Recruitment. Volume IV,

DTIC Science & Technology

1977-03-01

During Fall 1975, a test was designed and executed to determine the effectiveness of paid radio as an addition to the advertising media mix in...support of military recruiting. A number of markets were matched on the basis of factors related to contracts for accession. Markets were subdivided, some...receiving radio for only a single service, other markets using radio for three different services, and remaining markets serving as controls. The

Addressing unmet need for HIV testing in emergency care settings: a role for computer-facilitated rapid HIV testing?

PubMed

Kurth, Ann E; Severynen, Anneleen; Spielberg, Freya

2013-08-01

HIV testing in emergency departments (EDs) remains underutilized. The authors evaluated a computer tool to facilitate rapid HIV testing in an urban ED. Randomly assigned nonacute adult ED patients were randomly assigned to a computer tool (CARE) and rapid HIV testing before a standard visit (n = 258) or to a standard visit (n = 259) with chart access. The authors assessed intervention acceptability and compared noted HIV risks. Participants were 56% nonWhite and 58% male; median age was 37 years. In the CARE arm, nearly all (251/258) of the patients completed the session and received HIV results; four declined to consent to the test. HIV risks were reported by 54% of users; one participant was confirmed HIV-positive, and two were confirmed false-positive (seroprevalence 0.4%, 95% CI [0.01, 2.2]). Half (55%) of the patients preferred computerized rather than face-to-face counseling for future HIV testing. In the standard arm, one HIV test and two referrals for testing occurred. Computer-facilitated HIV testing appears acceptable to ED patients. Future research should assess cost-effectiveness compared with staff-delivered approaches.

Bioengineered human acellular vessels for dialysis access in patients with end-stage renal disease: two phase 2 single-arm trials

PubMed Central

Lawson, Jeffrey H; Glickman, Marc H; Ilzecki, Marek; Jakimowicz, Tomasz; Jaroszynski, Andrzej; Peden, Eric K; Pilgrim, Alison J; Prichard, Heather L; Guziewicz, Malgorzata; Przywara, Stanisław; Szmidt, Jacek; Turek, Jakub; Witkiewicz, Wojciech; Zapotoczny, Norbert; Zubilewicz, Tomasz; Niklason, Laura E

2016-01-01

Summary Background For patients with end-stage renal disease who are not candidates for fistula, dialysis access grafts are the best option for chronic haemodialysis. However, polytetrafluoroethylene arteriovenous grafts are prone to thrombosis, infection, and intimal hyperplasia at the venous anastomosis. We developed and tested a bioengineered human acellular vessel as a potential solution to these limitations in dialysis access. Methods We did two single-arm phase 2 trials at six centres in the USA and Poland. We enrolled adults with end-stage renal disease. A novel bioengineered human acellular vessel was implanted into the arms of patients for haemodialysis access. Primary endpoints were safety (freedom from immune response or infection, aneurysm, or mechanical failure, and incidence of adverse events), and efficacy as assessed by primary, primary assisted, and secondary patencies at 6 months. All patients were followed up for at least 1 year, or had a censoring event. These trials are registered with ClinicalTrials.gov, NCT01744418 and NCT01840956. Findings Human acellular vessels were implanted into 60 patients. Mean follow-up was 16 months (SD 7·6). One vessel became infected during 82 patient-years of follow-up. The vessels had no dilatation and rarely had post-cannulation bleeding. At 6 months, 63% (95% CI 47–72) of patients had primary patency, 73% (57–81) had primary assisted patency, and 97% (85–98) had secondary patency, with most loss of primary patency because of thrombosis. At 12 months, 28% (17–40) had primary patency, 38% (26–51) had primary assisted patency, and 89% (74–93) had secondary patency. Interpretation Bioengineered human acellular vessels seem to provide safe and functional haemodialysis access, and warrant further study in randomised controlled trials. Funding Humacyte and US National Institutes of Health. PMID:27203778

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-24

At NASA's Kennedy Space Center in Florida, the Orion crew access arm (CAA) is lifted and attached to the Mobile Launcher (ML). The arm is installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Install on Mobile Launcher

NASA Image and Video Library

2018-02-24

At NASA's Kennedy Space Center in Florida, the Orion crew access arm (CAA) is lifted and attached to the Mobile Launcher (ML). The arm is installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

At NASA's Kennedy Space Center in Florida, a crane positions the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML). The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

At NASA's Kennedy Space Center in Florida, a crane lifts the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML). The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

At NASA's Kennedy Space Center in Florida, a crane begins lifting the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML). The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Rationale and design of the Baptist Employee Healthy Heart Study: a randomized trial assessing the efficacy of the addition of an interactive, personalized, web-based, lifestyle intervention tool to an existing health information web platform in a high-risk employee population.

PubMed

Post, Janisse M; Ali, Shozab S; Roberson, Lara L; Aneni, Ehimen C; Shaharyar, Sameer; Younus, Adnan; Jamal, Omar; Ahmad, Rameez; Aziz, Muhammad A; Malik, Rehan; Spatz, Erica S; Feldman, Theodore; Fialkow, Jonathan; Veledar, Emir; Cury, Ricardo C; Agatston, Arthur S; Nasir, Khurram

2016-07-01

Metabolic syndrome (MetS) and diabetes confer a high risk for developing subsequent cardiovascular disease (CVD). Persons with MetS constitute 24-34 % of the employee population at Baptist Health South Florida (BHSF), a self-insured healthcare organization. The Baptist Employee Healthy Heart Study (BEHHS) aims to assess the addition of a personalized, interactive, web-based, nutrition-management and lifestyle-management program to the existing health-expertise web platform available to BHSF employees in reducing and/or stabilizing CVD and lifestyle risk factors and markers of subclinical CVD. Subjects with MetS or Type II Diabetes will be recruited from an employee population at BHSF and randomized to either an intervention or a control arm. The intervention arm will be given access to a web-based personalized diet-modification and weight-modification program. The control arm will be reminded to use the standard informational health website available and accessible to all BHSF employees. Subjects will undergo coronary calcium testing, carotid intima-media thickness scans, peripheral arterial tonometry, and advanced lipid panel testing at visit 1, in addition to lifestyle and medical history questionnaires. All tests will be repeated at visits 2 and 4 with the exception of the coronary calcium test, which will only be performed at baseline and visit 4. Visit 3 will capture vitals, anthropometrics, and responses to the questionnaires only. Results of this study will provide information on the effectiveness of personalized, web-based, lifestyle-management tools in reducing healthcare costs, promoting healthy choices, and reducing cardiovascular risk in an employee population. It will also provide information about the natural history of carotid atherosclerosis and endothelial dysfunction in asymptomatic but high-risk populations. ClinicalTrials.gov registry, NCT01912209 . Registered on 3 July 2013.

Evaluation of computational endomicroscopy architectures for minimally-invasive optical biopsy

NASA Astrophysics Data System (ADS)

Dumas, John P.; Lodhi, Muhammad A.; Bajwa, Waheed U.; Pierce, Mark C.

2017-02-01

We are investigating compressive sensing architectures for applications in endomicroscopy, where the narrow diameter probes required for tissue access can limit the achievable spatial resolution. We hypothesize that the compressive sensing framework can be used to overcome the fundamental pixel number limitation in fiber-bundle based endomicroscopy by reconstructing images with more resolvable points than fibers in the bundle. An experimental test platform was assembled to evaluate and compare two candidate architectures, based on introducing a coded amplitude mask at either a conjugate image or Fourier plane within the optical system. The benchtop platform consists of a common illumination and object path followed by separate imaging arms for each compressive architecture. The imaging arms contain a digital micromirror device (DMD) as a reprogrammable mask, with a CCD camera for image acquisition. One arm has the DMD positioned at a conjugate image plane ("IP arm"), while the other arm has the DMD positioned at a Fourier plane ("FP arm"). Lenses were selected and positioned within each arm to achieve an element-to-pixel ratio of 16 (230,400 mask elements mapped onto 14,400 camera pixels). We discuss our mathematical model for each system arm and outline the importance of accounting for system non-idealities. Reconstruction of a 1951 USAF resolution target using optimization-based compressive sensing algorithms produced images with higher spatial resolution than bicubic interpolation for both system arms when system non-idealities are included in the model. Furthermore, images generated with image plane coding appear to exhibit higher spatial resolution, but more noise, than images acquired through Fourier plane coding.

ARM User Survey Report: Data Access, Quality, and Delivery

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

Mather, JH; Roeder, LR; Sivaraman, C

The objective of this survey was to obtain user feedback to determine how users of the Atmospheric Radiation Measurement (ARM) Climate Research Facility Data Archive interact with the more than 2000 available types of datastreams. The survey also gathered information about data discovery and data quality. The Market and Competitive Analysis group at Pacific Northwest National Laboratory worked with web administrators to develop a landing page from which users could access the survey. A survey invitation was sent by ARM via email to about 6100 users on February 22, 2012. The invitation was also posted on the ARM website andmore » Facebook page. Reminders were sent via e-mail and posted on Facebook while the survey was open, February 22-March 23, 2012.« less

Incorporation of the fluoroless C-Arm Trainer at the American Urological Association hands on training percutaneous renal access.

PubMed

Noureldin, Yasser A; Hoenig, David M; Zhao, Philip; Elsamra, Sammy E; Stern, Joshua; Gaunay, Geoffrey; Motamedinia, Piruz; Okeke, Zeph; Rastinehad, Ardeshir R; Sweet, Robert M

2018-07-01

To assess for usefulness and validity evidence for incorporating the C-Arm Trainer (CAT) simulator into the annual AUA hands on course for training percutaneous nephrolithotomy (PCNL). The course started with a didactic session followed by four stations for training the "bull's eye" technique using the CAT simulator. Each station included a pre-test, 30-min practice on the simulator, and post-test. All participants were assessed using a 4-item checklist. All participants were asked to fill in a qualitative self-assessment questionnaire after the pre- and the post-test, and respond to a course evaluation questionnaire and post-course survey. A total of 38 physicians, who attended the hands on course, voluntarily participated in the study. Only 21.1% had previous practice on PCNL simulators. Compared with the results of the checklist total score and the qualitative self-assessment questionnaire scores after the pre-test, there was significant improvement in the checklist total score (p < 0.001), temporal demands (p = 0.003), situational stress (p = 0.003, and performance (0.003) after the post-test. A total of 14 (36%) participants responded to the course evaluation questionnaire, 50% evaluated the course as excellent, 28.6% as very good, and 21.4% as good. Unfortunately, only five (13%) participants responded to the post-course survey, 4/5 implemented the new competencies and knowledge into their practice, and 3/5 have attempted to obtain fluoroscopic guided PCA without assistance. The CAT simulator was considered useful for training the percutaneous renal access procedure. There was significant improvement in the qualitative and quantitative assessment parameters after the post-test compared with the pre-test.

Personnel occupied woven envelope robot

NASA Technical Reports Server (NTRS)

Wessling, Francis; Teoh, William; Ziemke, M. Carl

1988-01-01

The Personnel Occupied Woven Envelope Robot (POWER) provides an alternative to extravehicular activity (EVA) of space suited astronauts and/or use of long slender manipulator arms such as are used in the Shuttle Remote Manipulator System. POWER provides the capability for a shirt sleeved astronaut to perform such work by entering a control pod through air locks at both ends of an inflated flexible bellows (access tunnel). The exoskeleton of the tunnel is a series of six degrees of freedom (Six-DOF) articulated links compressible to 1/6 of their fully extended length. The operator can maneuver the control pod to almost any location within about 50 m of the base attachment to the space station. POWER can be envisioned as a series of hollow Six-DOF manipulator segments or arms wherein each arm grasps the shoulder of the next arm. Inside the hollow arms ia a bellow-type access tunnel. The control pod is the fist of the series of linked hollow arms. The fingers of the fist are conventional manipulator arms under direct visual control of the nearby operator in the pod. The applications and progress to date of the POWER system is given.

Uptake of Home-Based HIV Testing, Linkage to Care, and Community Attitudes about ART in Rural KwaZulu-Natal, South Africa: Descriptive Results from the First Phase of the ANRS 12249 TasP Cluster-Randomised Trial

PubMed Central

Okesola, Nonhlanhla; Tanser, Frank; Thiebaut, Rodolphe; Rekacewicz, Claire; Newell, Marie-Louise

2016-01-01

Background The 2015 WHO recommendation of antiretroviral therapy (ART) for all immediately following HIV diagnosis is partially based on the anticipated impact on HIV incidence in the surrounding population. We investigated this approach in a cluster-randomised trial in a high HIV prevalence setting in rural KwaZulu-Natal. We present findings from the first phase of the trial and report on uptake of home-based HIV testing, linkage to care, uptake of ART, and community attitudes about ART. Methods and Findings Between 9 March 2012 and 22 May 2014, five clusters in the intervention arm (immediate ART offered to all HIV-positive adults) and five clusters in the control arm (ART offered according to national guidelines, i.e., CD4 count ≤ 350 cells/μl) contributed to the first phase of the trial. Households were visited every 6 mo. Following informed consent and administration of a study questionnaire, each resident adult (≥16 y) was asked for a finger-prick blood sample, which was used to estimate HIV prevalence, and offered a rapid HIV test using a serial HIV testing algorithm. All HIV-positive adults were referred to the trial clinic in their cluster. Those not linked to care 3 mo after identification were contacted by a linkage-to-care team. Study procedures were not blinded. In all, 12,894 adults were registered as eligible for participation (5,790 in intervention arm; 7,104 in control arm), of whom 9,927 (77.0%) were contacted at least once during household visits. HIV status was ever ascertained for a total of 8,233/9,927 (82.9%), including 2,569 ascertained as HIV-positive (942 tested HIV-positive and 1,627 reported a known HIV-positive status). Of the 1,177 HIV-positive individuals not previously in care and followed for at least 6 mo in the trial, 559 (47.5%) visited their cluster trial clinic within 6 mo. In the intervention arm, 89% (194/218) initiated ART within 3 mo of their first clinic visit. In the control arm, 42.3% (83/196) had a CD4 count ≤ 350 cells/μl at first visit, of whom 92.8% initiated ART within 3 mo. Regarding attitudes about ART, 93% (8,802/9,460) of participants agreed with the statement that they would want to start ART as soon as possible if HIV-positive. Estimated baseline HIV prevalence was 30.5% (2,028/6,656) (95% CI 25.0%, 37.0%). HIV prevalence, uptake of home-based HIV testing, linkage to care within 6 mo, and initiation of ART within 3 mo in those with CD4 count ≤ 350 cells/μl did not differ significantly between the intervention and control clusters. Selection bias related to noncontact could not be entirely excluded. Conclusions Home-based HIV testing was well received in this rural population, although men were less easily contactable at home; immediate ART was acceptable, with good viral suppression and retention. However, only about half of HIV-positive people accessed care within 6 mo of being identified, with nearly two-thirds accessing care by 12 mo. The observed delay in linkage to care would limit the individual and public health ART benefits of universal testing and treatment in this population. Trial registration ClinicalTrials.gov NCT01509508 PMID:27504637

Uptake of Home-Based HIV Testing, Linkage to Care, and Community Attitudes about ART in Rural KwaZulu-Natal, South Africa: Descriptive Results from the First Phase of the ANRS 12249 TasP Cluster-Randomised Trial.

PubMed

Iwuji, Collins C; Orne-Gliemann, Joanna; Larmarange, Joseph; Okesola, Nonhlanhla; Tanser, Frank; Thiebaut, Rodolphe; Rekacewicz, Claire; Newell, Marie-Louise; Dabis, Francois

2016-08-01

The 2015 WHO recommendation of antiretroviral therapy (ART) for all immediately following HIV diagnosis is partially based on the anticipated impact on HIV incidence in the surrounding population. We investigated this approach in a cluster-randomised trial in a high HIV prevalence setting in rural KwaZulu-Natal. We present findings from the first phase of the trial and report on uptake of home-based HIV testing, linkage to care, uptake of ART, and community attitudes about ART. Between 9 March 2012 and 22 May 2014, five clusters in the intervention arm (immediate ART offered to all HIV-positive adults) and five clusters in the control arm (ART offered according to national guidelines, i.e., CD4 count ≤ 350 cells/μl) contributed to the first phase of the trial. Households were visited every 6 mo. Following informed consent and administration of a study questionnaire, each resident adult (≥16 y) was asked for a finger-prick blood sample, which was used to estimate HIV prevalence, and offered a rapid HIV test using a serial HIV testing algorithm. All HIV-positive adults were referred to the trial clinic in their cluster. Those not linked to care 3 mo after identification were contacted by a linkage-to-care team. Study procedures were not blinded. In all, 12,894 adults were registered as eligible for participation (5,790 in intervention arm; 7,104 in control arm), of whom 9,927 (77.0%) were contacted at least once during household visits. HIV status was ever ascertained for a total of 8,233/9,927 (82.9%), including 2,569 ascertained as HIV-positive (942 tested HIV-positive and 1,627 reported a known HIV-positive status). Of the 1,177 HIV-positive individuals not previously in care and followed for at least 6 mo in the trial, 559 (47.5%) visited their cluster trial clinic within 6 mo. In the intervention arm, 89% (194/218) initiated ART within 3 mo of their first clinic visit. In the control arm, 42.3% (83/196) had a CD4 count ≤ 350 cells/μl at first visit, of whom 92.8% initiated ART within 3 mo. Regarding attitudes about ART, 93% (8,802/9,460) of participants agreed with the statement that they would want to start ART as soon as possible if HIV-positive. Estimated baseline HIV prevalence was 30.5% (2,028/6,656) (95% CI 25.0%, 37.0%). HIV prevalence, uptake of home-based HIV testing, linkage to care within 6 mo, and initiation of ART within 3 mo in those with CD4 count ≤ 350 cells/μl did not differ significantly between the intervention and control clusters. Selection bias related to noncontact could not be entirely excluded. Home-based HIV testing was well received in this rural population, although men were less easily contactable at home; immediate ART was acceptable, with good viral suppression and retention. However, only about half of HIV-positive people accessed care within 6 mo of being identified, with nearly two-thirds accessing care by 12 mo. The observed delay in linkage to care would limit the individual and public health ART benefits of universal testing and treatment in this population. ClinicalTrials.gov NCT01509508.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-24

At NASA's Kennedy Space Center in Florida, a crane is prepared to lift the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML). The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System, or SLS, rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

Under the watchful eye of technicians and engineers, a crane begins lifting the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

At NASA's Kennedy Space Center in Florida, technicians assist as a crane lifts the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML). The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

KSC-02pd1733

NASA Image and Video Library

2002-11-14

KENNEDY SPACE CENTER, FLA. -- One of a team of robotic experts prepares the site scraped on the robotic arm for removal. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Playskin Lift: Development and Initial Testing of an Exoskeletal Garment to Assist Upper Extremity Mobility and Function.

PubMed

Lobo, Michele A; Koshy, John; Hall, Martha L; Erol, Ozan; Cao, Huantian; Buckley, Jenner M; Galloway, James C; Higginson, Jill

2016-03-01

A person's ability to move his or her arms against gravity is important for independent performance of critical activities of daily living and for exploration that facilitates early cognitive, language, social, and perceptual-motor development. Children with a variety of diagnoses have difficulty moving their arms against gravity. The purpose of this technical report is to detail the design process and initial testing of a novel exoskeletal garment, the Playskin Lift, that assists and encourages children to lift their arms against gravity. This report details the design theory and process, the device, and the results of field testing with a toddler with impaired upper extremity function due to arthrogryposis multiplex congenita. The Playskin Lift is an inexpensive (<$30 material costs), easy to use (5/5 rating), comfortable (5/5 rating), and attractive (4/5 rating) device. While wearing the device, the child was able to contact objects more often throughout an increased play space, to look at toys more while contacting them, and to perform more complex interactions with toys. This report details initial testing with one child. Future testing with more participants is recommended. These results suggest that by considering the broad needs of users, including cost, accessibility, comfort, aesthetics, and function, we can design inexpensive devices that families and clinicians can potentially fabricate in their own communities to improve function, participation, exploration, and learning for children with disabilities. © 2016 American Physical Therapy Association.

Playskin Lift: Development and Initial Testing of an Exoskeletal Garment to Assist Upper Extremity Mobility and Function

PubMed Central

Koshy, John; Hall, Martha L.; Erol, Ozan; Cao, Huantian; Buckley, Jenner M.; Galloway, James C.; Higginson, Jill

2016-01-01

Background A person's ability to move his or her arms against gravity is important for independent performance of critical activities of daily living and for exploration that facilitates early cognitive, language, social, and perceptual-motor development. Children with a variety of diagnoses have difficulty moving their arms against gravity. Objective The purpose of this technical report is to detail the design process and initial testing of a novel exoskeletal garment, the Playskin Lift, that assists and encourages children to lift their arms against gravity. Design This report details the design theory and process, the device, and the results of field testing with a toddler with impaired upper extremity function due to arthrogryposis multiplex congenita. Results The Playskin Lift is an inexpensive (<$30 material costs), easy to use (5/5 rating), comfortable (5/5 rating), and attractive (4/5 rating) device. While wearing the device, the child was able to contact objects more often throughout an increased play space, to look at toys more while contacting them, and to perform more complex interactions with toys. Limitations This report details initial testing with one child. Future testing with more participants is recommended. Conclusions These results suggest that by considering the broad needs of users, including cost, accessibility, comfort, aesthetics, and function, we can design inexpensive devices that families and clinicians can potentially fabricate in their own communities to improve function, participation, exploration, and learning for children with disabilities. PMID:26316534

Mental health service acceptability for the armed forces veteran community.

PubMed

Farrand, P; Jeffs, A; Bloomfield, T; Greenberg, N; Watkins, E; Mullan, E

2018-06-15

Despite developments in mental health services for armed forces veterans and family members, barriers to access associated with poor levels of acceptability regarding service provision remain. Adapting a Step 2 mental health service based on low-intensity cognitive behavioural therapy (CBT) interventions to represent a familiar context and meet the needs of the armed forces veteran community may serve to enhance acceptability and reduce help-seeking barriers. To examine acceptability of a Step 2 low-intensity CBT mental health service adapted for armed forces veterans and family members provided by a UK Armed Forces charity. Qualitative study using individual semi-structured interviews with armed forces veterans and family members of those injured or becoming unwell while serving in the British Armed Forces. Data analysis was undertaken using thematic alongside disconfirming case analysis. Adapting a Step 2 mental health service for armed forces veterans and family members enhanced acceptability and promoted help-seeking. Wider delivery characteristics associated with Step 2 mental health services within the Improving Access to Psychological Therapies (IAPT) programme also contributed to service acceptability. However, limitations of Step 2 mental health service provision were also identified. A Step 2 mental health service adapted for armed forces veterans and family members enhances acceptability and may potentially overcome help-seeking barriers. However, concerns remain regarding ways to accommodate the treatment of post-traumatic stress disorder and provide support for family members.

Linking Publications to Instruments, Field Campaigns, Sites and Working Groups: The ARM Experience

NASA Astrophysics Data System (ADS)

Lehnert, K.; Parsons, M. A.; Ramachandran, R.; Fils, D.; Narock, T.; Fox, P. A.; Troyan, D.; Cialella, A. T.; Gregory, L.; Lazar, K.; Liang, M.; Ma, L.; Tilp, A.; Wagener, R.

2017-12-01

For the past 25 years, the ARM Climate Research Facility - a US Department of Energy scientific user facility - has been collecting atmospheric data in different climatic regimes using both in situ and remote instrumentation. Configuration of the facility's components has been designed to improve the understanding and representation, in climate and earth system models, of clouds and aerosols. Placing a premium on long-term continuous data collection resulted in terabytes of data having been collected, stored, and made accessible to any interested person. All data is accessible via the ARM.gov website and the ARM Data Discovery Tool. A team of metadata professionals assign appropriate tags to help facilitate searching the databases for desired data. The knowledge organization tools and concepts are used to create connections between data, instruments, field campaigns, sites, and measurements are familiar to informatics professionals. Ontology, taxonomy, classification, and thesauri are among the customized concepts put into practice for ARM's purposes. In addition to the multitude of data available, there have been approximately 3,000 journal articles that utilize ARM data. These have been linked to specific ARM web pages. Searches of the complete ARM publication database can be done using a separate interface. This presentation describes how ARM data is linked to instruments, sites, field campaigns, and publications through the application of standard knowledge organization tools and concepts.

Reducing cancer screening disparities in medicare beneficiaries through cancer patient navigation.

PubMed

Braun, Kathryn L; Thomas, William L; Domingo, Jermy-Leigh B; Allison, Amanda L; Ponce, Avette; Haunani Kamakana, P; Brazzel, Sandra S; Emmett Aluli, N; Tsark, JoAnn U

2015-02-01

Significant racial disparities in cancer mortality are seen between Medicare beneficiaries. A randomized controlled trial tested the use of lay navigators (care managers) to increase cancer screening of Asian and Pacific Islander Medicare beneficiaries. The study setting was Moloka'i General Hospital on the island of Moloka'i, Hawai'i, which was one of six sites participating in the Cancer Prevention and Treatment Demonstration sponsored by the Centers for Medicare and Medicaid Services. Between 2006 and 2009, 488 Medicare beneficiaries (45% Hawaiian, 35% Filipino, 11% Japanese, 8% other) were randomized to have a navigator help them access cancer screening services (experimental condition, n = 242) or cancer education (control condition, n = 246). Self-reported data on screening participation were collected at baseline and exit from the study, and differences were tested using chi-square. Groups were similar in demographic characteristics and baseline screening prevalence of breast, cervical, prostate, and colorectal cancers. At study exit, 57.0% of women in the experimental arm and 36.4% of controls had had a Papanicolaou test in the past 24 months (P = .001), 61.7% of women in the experimental arm and 42.4% of controls had had a mammogram in the past 12 months (P = .003), 54.4% of men in the experimental arm and 36.0% of controls had had a prostate-specific antigen test in the past 12 months (P = .008), and 43.0% of both sexes in the experimental arm and 27.2% of controls had had a flexible sigmoidoscopy or colonoscopy in the past 5 years (P < .001). Findings suggest that navigation services can increase cancer screening in Medicare beneficiaries in groups with significant disparities. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

To Arm or Not to Arm: The Case Against Arming Vietnam and the Philippines

DTIC Science & Technology

2015-04-13

Freedom in the World 2014: The Democratic Leadership Gap,” https://freedomhouse. org/sites/default/files/FIW%202014%20Scores%20%20Countries%20and...CNAS_TailoredCoercion_report.pdf (accessed Sep 21, 2014). 49 Freedom House. “Freedom in the World 2014: The Democratic Leadership Gap.” https://freedomhouse.org

Mini Versus Standard Percutaneous Nephrolithotomy: The Impact of Sheath Size on Intrarenal Pelvic Pressure and Infectious Complications in a Porcine Model.

PubMed

Loftus, Christopher J; Hinck, Bryan; Makovey, Iryna; Sivalingam, Sri; Monga, Manoj

2018-04-01

To determine how sheath and endoscope size affect intrarenal pelvic pressures and risk of postoperative infectious complications comparing "Mini" vs "Standard" percutaneous nephrolithotomy (PCNL). Uropathogenic Escherichia coli were grown and 10 9 of them were instilled into the porcine renal pelvis through retrograde access for 1 hour. Percutaneous access utilized a 14/16F 20 cm ureteral access sheath for the Mini arm and a 30F sheath for the Standard arm. Nephroscopy was simulated utilizing either an 8/9.8F semirigid ureteroscope or 26F nephroscope for 1 hour while intrarenal pelvic pressure was continuously monitored. Blood and tissue cultures of kidney, liver, and spleen biopsies were plated and incubated and positive cultures were confirmed with polymerase chain reaction. Intrapelvic pressures were higher in the Mini group, 18.76 ± 5.82 mm Hg vs 13.56 ± 5.82 mm Hg (p < 0.0001). Time spent above 30 mm Hg was greater in the Mini arm, 117.0 seconds vs 66.1 seconds (p = 0.0452). All pigs had positive kidney tissue cultures whereas spleen cultures were positive in 100% and 60% of pigs in the Mini and Standard arms, respectively (p = 0.0253); 90% and 30% had positive liver tissue culture in the Mini and Standard arms, respectively (p = 0.0062). Blood cultures were positive in 30% of pigs in the Mini arm compared with none in the Standard arm (p = 0.0603). Mini-PCNL was associated with higher intrarenal pressures and higher risk of end organ bacterial seeding in the setting of an infected collecting system. This suggests a higher potential for infectious complications in a clinical setting.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-24

Under the watchful eye of technicians and engineers, a crane is prepared to lift the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System, or SLS, rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

Seen to the right of the iconic Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, a crane positions the Orion crew access arm (CAA) so it can be attached to the mobile launcher (ML). The arm will be installed at about the 274-foot level on the ML tower. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Science of Human Measures Workshop: Summary and Conclusions

DTIC Science & Technology

2009-10-01

to human aptitudes, attitudes, knowledge, and skills, but not to mental or physical health. The Army uses human measures to support multiple...activity, and physical health, only 28% of young adults (ages 17–24) are eligible to enlist. When the Armed Forces Qualification Test (AFQT) criteria are...incentives would be effective. In closing, if the Army is going to find ways to access, attract , and retain individuals who are currently ineligible to

A Media Mix Test of Paid Radio Advertising for Armed Services Recruitment. Volume I.

DTIC Science & Technology

1976-05-01

The Department of Defense has not employed paid broadcast advertising in support of military recruiting since 1971. In the meantime the military...services have developed their advertising media plans without access to either radio or television advertising except on a public service basis. In 1975...the Office of The Secretary of Defense (OSD) began an analysis of the relative effectiveness of paid broadcast advertising in support of the All

KSC-02pd1728

NASA Image and Video Library

2002-11-14

KENNEDY SPACE CENTER, FLA. -- The site being identified in the photo is the scrape on the surface of the honeycomb shell on Endeavour's robotic arm. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Basilic vein transposition fistulas versus prosthetic bridge grafts in patients with end-stage renal failure.

PubMed

Basel, Halil; Ekim, Hasan; Odabasi, Dolunay; Kiymaz, Adem; Aydin, Cemalettin; Dostbil, Aysenur

2011-07-01

Basilic vein transposition fistulas (BVTFs) and prosthetic bridge grafts (PBGs) provide good vascular access for hemodialysis. To evaluate the patency and complication rates after arteriovenous fistula formation, a concurrent series of patients was reviewed. Between September 2003 and September 2009, 147 hemodialysis access procedures were performed in 147 consecutive patients at Van Research and Training Hospital and Yuzuncu Yil University Hospital, Van, Turkey. All access procedures were planned on the basis of preoperative duplex scans of arm and forearm veins. Functional patency was defined as the ability to cannulate hemodialysis patients successfully. Primary and secondary cumulative functional patency rates of BVTFs and PBGs were determined with life-table analysis and differences were analyzed with retrospective study. Differences in revision rates, including thrombolysis thrombectomies and operative revisions, were analyzed with the Fisher exact t-test. Mean follow-up was 15 months (range, 3-24 months). Risk factors were similar between the two groups. BVTFs had better patency at 15 months. The dialysis access complications were higher in the PBG group versus BVTF group, and the PBG group had a higher infection rate than the BVTF group. The primary and secondary patency rates were superior in the BVTF group. Our data strongly support the contention that as long as the patient is a candidate for an upper arm BVTF based on anatomical criteria, BVTF always be considered before a PBG. Copyright © 2011. Published by Elsevier Inc.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- Robotic arm experts begin inspection of a scrape on the surface of the honeycomb shell on Endeavour's robotic arm. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22..

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- A piece of the honeycomb shell around Endeavour's robotic arm has been cut to inspect the arm. A scrape of the shell occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- Robotic arm experts begin inspection of a scrape on the surface of the honeycomb shell on Endeavour's robotic arm. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

US conventional arms transfer policy. Strategy research project

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

Langhorst, R.H.

1996-04-15

Millions of people around the world have been killed by conventional arms since the end of World War II. If increasing access to conventional arms is partly responsible for political and military aggression in post-Cold War Europe, what should be the United States` response. This study explores the new US Conventional Arms Transfer Policy of February 1995 in terms of ends1 ways and means and its linkages to US National Security and National Military Strategies. Analysis focuses mainly on post- Cold War Europe, providing examples of multilateral arms control successes and recommendations for US policy implementation.

Bench-Top Feasibility Testing of a Novel Percutaneous Renal Access Technique: The Laser Direct Alignment Radiation Reduction Technique (DARRT).

PubMed

Khater, Nazih; Shen, Jim; Arenas, Javier; Keheila, Mohamed; Alsyouf, Muhannad; Martin, Jacob A; Lightfoot, Michelle A; Li, Roger; Olgin, Gaudencio; Smith, Jason C; Baldwin, D Duane

2016-11-01

Traditional techniques for obtaining percutaneous renal access utilize continuous fluoroscopy. In an attempt to minimize radiation exposure, we describe a novel laser direct alignment radiation reduction technique (DARRT) for percutaneous access and test it in a bench-top model. In this randomized-controlled bench-top study, 20 medical personnel obtained renal accesses using both the conventional bullseye technique and the laser DARRT. The primary endpoint was total fluoroscopy time. Secondary endpoints included insertion time, puncture attempts, course corrections, and subjective procedural difficulty. In the laser DARRT, fluoroscopy was used with the C-arm positioned with the laser beam at a 30° angle. The access needle and hub were aligned with the laser beam. Effective caliceal puncture was confirmed with fluoroscopy and direct vision. The Paired samples Wilcoxon signed rank test was used for statistical analysis with significance at p < 0.05. A total of 120 needle placements were recorded. Fluoroscopy time for needle access using the laser DARRT was significantly lower than the bullseye technique in all groups as follows: attendings (7.09 vs 18.51 seconds; p < 0.001), residents (6.55 vs 13.93 seconds; p = 0.001), and medical students (6.69 vs 20.22 seconds; p < 0.001). Students rated the laser DARRT easier to use (2.56 vs 4.89; p < 0.001). No difference was seen in total access time, puncture attempts, or course corrections between techniques. The laser DARRT reduced fluoroscopy time by 63%, compared with the conventional bullseye technique. The least experienced users found the laser DARRT significantly easier to learn. This novel technique is promising and merits additional testing in animal and human models.

Custom-made raster method for fistula and graft.

PubMed

Blokker, C

2005-01-01

Unfamiliarity with fistula and graft characteristics can lead to failed punctures, haematomas and sometimes access occlusion. The Custom-made Raster Method provides detailed shunt visualisation and angiographic images by using photo-editing software. Access veins of an individual shunt and an adapted raster are projected on a digital picture of the arm. During angiography the shunt arm is fixated and a digital picture is taken from a fixed vertical angle and distance. Reference points are marked on the shunt arm, which serves as a fixation to draw a raster with coordination points. In this way a picture is created similar to a roadmap with veins. There is complete integration of digital and radiological images by using software programmes Adobe Photoshop + Illustrator or Agfa Web 1000 under Windows XP. All illustrations fit 1:1 by scaling up or down without distortion. Editing with Photoshop gives a precise projection of shunt veins on the real coloured background of the digital photograph. In this projection the grey angiography background is made completely transparent. The system can contain more detailed information in combination with echo (duplex) images of depth and diameter. This visualisation method is a useful tool for multi disciplinary access meetings with intervention radiologists, access surgeons and nephrologists. Access malfunction, aneurysms and stenosis can be projected at the exact location. The system leads to clear and concrete puncture advice. Transfer of access information and communication to other dialysis centres is facilitated.

KSC-02pd1731

NASA Image and Video Library

2002-11-14

KENNEDY SPACE CENTER, FLA. -- One of a team of robotic experts looks at the site of the scrape on the surface of the the robotic arm's honeycomb shell. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in Endeavour's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

KSC-02pd1730

NASA Image and Video Library

2002-11-14

KENNEDY SPACE CENTER, FLA. -- One of a team of robotic experts looks at the site of the scrape on the surface of the the robotic arm's honeycomb shell. The scrape occurred while work platforms were being installed to gain access to repair the oxygen leak in Endeavour's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

KSC-02pd1729

NASA Image and Video Library

2002-11-14

KENNEDY SPACE CENTER, FLA. -- Workers in Endeavour's payload bay look at the site of the scrape on the surface of the honeycomb shell on the robotic arm that occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

KSC-02pd1732

NASA Image and Video Library

2002-11-14

KENNEDY SPACE CENTER, FLA. -- One of a team of robotic experts looks at the site of the scrape on the surface of the honeycomb shell on the robotic arm that occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. The site will be cut out and ultrasound testing will be done on the structure underneath. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

The Accuracy of 6 Inexpensive Pulse Oximeters Not Cleared by the Food and Drug Administration: The Possible Global Public Health Implications.

PubMed

Lipnick, Michael S; Feiner, John R; Au, Paul; Bernstein, Michael; Bickler, Philip E

2016-08-01

Universal access to pulse oximetry worldwide is often limited by cost and has substantial public health consequences. Low-cost pulse oximeters have become increasingly available with limited regulatory agency oversight. The accuracy of these devices often has not been validated, raising questions about performance. The accuracy of 6 low-cost finger pulse oximeters during stable arterial oxygen saturations (SaO2) between 70% and 100% was evaluated in 22 healthy subjects. Oximeters tested were the Contec CMS50DL, Beijing Choice C20, Beijing Choice MD300C23, Starhealth SH-A3, Jumper FPD-500A, and Atlantean SB100 II. Inspired oxygen, nitrogen, and carbon dioxide partial pressures were monitored and adjusted via a partial rebreathing circuit to achieve 10 to 12 stable target SaO2 plateaus between 70% and 100% and PaCO2 values of 35 to 45 mm Hg. Comparisons of pulse oximeter readings (SpO2) with arterial SaO2 (by Radiometer ABL90 and OSM3) were used to calculate bias (SpO2 - SaO2) mean, precision (SD of the bias), and root mean square error (ARMS). Pulse oximeter readings corresponding to 536 blood samples were analyzed. Four of the 6 oximeters tested showed large errors (up to -6.30% mean bias, precision 4.30%, 7.53 ARMS) in estimating saturation when SaO2 was reduced <80%, and half of the oximeters demonstrated large errors when estimating saturations between 80% and 90%. Two of the pulse oximeters tested (Contec CMS50DL and Beijing Choice C20) demonstrated ARMS of <3% at SaO2 between 70% and 100%, thereby meeting International Organization for Standardization (ISO) criteria for accuracy. Many low-cost pulse oximeters sold to consumers demonstrate highly inaccurate readings. Unexpectedly, the accuracy of some low-cost pulse oximeters tested here performed similarly to more expensive, ISO-cleared units when measuring hypoxia in healthy subjects. None of those tested here met World Federation of Societies of Anaesthesiologists standards, and the ideal testing conditions do not necessarily translate these findings to the clinical setting. Nonetheless, further development of accurate, low-cost oximeters for use in clinical practice is feasible and, if pursued, could improve access to safe care, especially in low-income countries.

KSC-02pd0392

NASA Image and Video Library

2002-04-03

KENNEDY SPACE CENTER, FLA. -- With the Rotating Service Structure rolled back, Space Shuttle Atlantis stands ready for launch on mission STS-110. The Orbiter Access Arm extends from the Fixed Service Structure (FSS) to the crew compartment hatch, through which the STS-110 crew will enter Atlantis. Above the golden external tank is the vent hood (known as the "beanie cap") at the end of the gaseous oxygen vent arm. Vapors are created as the liquid oxygen in the external tank boil off. The hood vents the gaseous oxygen vapors away from the Space Shuttle vehicle. The RSS provides protected access to the orbiter for changeout and servicing of payloads at the pad. The structure has access platforms at five levels to provide access to the payload bay. The FSS provides access to the orbiter and the RSS. Mission STS-110 is scheduled to launch April 4 on its 11-day mission to the International Space Station

Rapid learning of magnetic compass direction by C57BL/6 mice in a 4-armed 'plus' water maze.

PubMed

Phillips, John B; Youmans, Paul W; Muheim, Rachel; Sloan, Kelly A; Landler, Lukas; Painter, Michael S; Anderson, Christopher R

2013-01-01

Magnetoreception has been demonstrated in all five vertebrate classes. In rodents, nest building experiments have shown the use of magnetic cues by two families of molerats, Siberian hamsters and C57BL/6 mice. However, assays widely used to study rodent spatial cognition (e.g. water maze, radial arm maze) have failed to provide evidence for the use of magnetic cues. Here we show that C57BL/6 mice can learn the magnetic direction of a submerged platform in a 4-armed (plus) water maze. Naïve mice were given two brief training trials. In each trial, a mouse was confined to one arm of the maze with the submerged platform at the outer end in a predetermined alignment relative to magnetic north. Between trials, the training arm and magnetic field were rotated by 180(°) so that the mouse had to swim in the same magnetic direction to reach the submerged platform. The directional preference of each mouse was tested once in one of four magnetic field alignments by releasing it at the center of the maze with access to all four arms. Equal numbers of responses were obtained from mice tested in the four symmetrical magnetic field alignments. Findings show that two training trials are sufficient for mice to learn the magnetic direction of the submerged platform in a plus water maze. The success of these experiments may be explained by: (1) absence of alternative directional cues (2), rotation of magnetic field alignment, and (3) electromagnetic shielding to minimize radio frequency interference that has been shown to interfere with magnetic compass orientation of birds. These findings confirm that mice have a well-developed magnetic compass, and give further impetus to the question of whether epigeic rodents (e.g., mice and rats) have a photoreceptor-based magnetic compass similar to that found in amphibians and migratory birds.

Rapid Learning of Magnetic Compass Direction by C57BL/6 Mice in a 4-Armed ‘Plus’ Water Maze

PubMed Central

Phillips, John B.; Youmans, Paul W.; Muheim, Rachel; Sloan, Kelly A.; Landler, Lukas; Painter, Michael S.; Anderson, Christopher R.

2013-01-01

Magnetoreception has been demonstrated in all five vertebrate classes. In rodents, nest building experiments have shown the use of magnetic cues by two families of molerats, Siberian hamsters and C57BL/6 mice. However, assays widely used to study rodent spatial cognition (e.g. water maze, radial arm maze) have failed to provide evidence for the use of magnetic cues. Here we show that C57BL/6 mice can learn the magnetic direction of a submerged platform in a 4-armed (plus) water maze. Naïve mice were given two brief training trials. In each trial, a mouse was confined to one arm of the maze with the submerged platform at the outer end in a predetermined alignment relative to magnetic north. Between trials, the training arm and magnetic field were rotated by 180° so that the mouse had to swim in the same magnetic direction to reach the submerged platform. The directional preference of each mouse was tested once in one of four magnetic field alignments by releasing it at the center of the maze with access to all four arms. Equal numbers of responses were obtained from mice tested in the four symmetrical magnetic field alignments. Findings show that two training trials are sufficient for mice to learn the magnetic direction of the submerged platform in a plus water maze. The success of these experiments may be explained by: (1) absence of alternative directional cues (2), rotation of magnetic field alignment, and (3) electromagnetic shielding to minimize radio frequency interference that has been shown to interfere with magnetic compass orientation of birds. These findings confirm that mice have a well-developed magnetic compass, and give further impetus to the question of whether epigeic rodents (e.g., mice and rats) have a photoreceptor-based magnetic compass similar to that found in amphibians and migratory birds. PMID:24023673

Maximizing Use of Robot-Arm No. 3 in Da Vinci–Assisted Thoracic Surgery

PubMed Central

Kajiwara, Naohiro; Maeda, Junichi; Yoshida, Koichi; Kato, Yasufumi; Hagiwara, Masaru; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

2015-01-01

We have previously reported on the importance of appropriate robot-arm settings and replacement of instrument ports in robot-assisted thoracic surgery, because the thoracic cavity requires a large space to access all lesions in various areas of the thoracic cavity from the apex to the diaphragm and mediastinum and the chest wall.1–3 Moreover, it can be difficult to manipulate the da Vinci Surgical System using only arms No. 1 and No. 2 depending on the tumor location. However, arm No. 3 is usually positioned on the same side as arm No. 2, and sometimes it is only used as an assisting-arm to avoid conflict with other arms (Fig. 1). In this report, we show how robot-arm No. 3 can be used with maximum effectiveness in da Vinci-assisted thoracic surgery. PMID:26011219

A multi-level intervention in worksites to increase fruit and vegetable access and intake: Rationale, design and methods of the 'Good to Go' cluster randomized trial.

PubMed

Risica, Patricia M; Gorham, Gemma; Dionne, Laura; Nardi, William; Ng, Doug; Middler, Reese; Mello, Jennifer; Akpolat, Rahmet; Gettens, Katelyn; Gans, Kim M

2018-02-01

Fruit and vegetable (F&V) consumption is an important contributor to chronic disease prevention. However, most Americans do not eat adequate amounts. The worksite is an advantageous setting to reach large, diverse segments of the population with interventions to increase F&V intake, but research gaps exist. No studies have evaluated the implementation of mobile F&V markets at worksites nor compared the effectiveness of such markets with or without nutrition education. This paper describes the protocol for Good to Go (GTG), a cluster randomized trial to evaluate F&V intake change in employees from worksites randomized into three experimental arms: discount, fresh F&V markets (Access Only arm); markets plus educational components including campaigns, cooking demonstrations, videos, newsletters, and a web site (Access Plus arm); and an attention placebo comparison intervention on physical activity and stress reduction (Comparison). Secondary aims include: 1) Process evaluation to determine costs, reach, fidelity, and dose as well as the relationship of these variables with changes in F&V intake; 2) Applying a mediating variable framework to examine relationships of psychosocial factors/determinants with changes in F&V consumption; and 3) Cost effectiveness analysis of the different intervention arms. The GTG study will fill important research gaps in the field by implementing a rigorous cluster randomized trial to evaluate the efficacy of an innovative environmental intervention providing access and availability to F&V at the worksite and whether this access intervention is further enhanced by accompanying educational interventions. GTG will provide an important contribution to public health research and practice. Trial registration number NCT02729675, ClinicalTrials.gov. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

A multi-level intervention in worksites to increase fruit and vegetable access and intake: Rationale, design and methods of the ‘Good to Go’ cluster randomized trial

PubMed Central

Risica, Patricia M.; Gorham, Gemma; Dionne, Laura; Nardi, William; Ng, Doug; Middler, Reese; Mello, Jennifer; Akpolat, Rahmet; Gettens, Katelyn; Gans, Kim M.

2018-01-01

Background Fruit and vegetable (F&V) consumption is an important contributor to chronic disease prevention. However, most Americans do not eat adequate amounts. The worksite is an advantageous setting to reach large, diverse segments of the population with interventions to increase F&V intake, but research gaps exist. No studies have evaluated the implementation of mobile F&V markets at worksites nor compared the effectiveness of such markets with or without nutrition education. Methods This paper describes the protocol for Good to Go (GTG), a cluster randomized trial to evaluate F&V intake change in employees from worksites randomized into three experimental arms: discount, fresh F&V markets (Access Only arm); markets plus educational components including campaigns, cooking demonstrations, videos, newsletters, and a web site (Access Plus arm); and an attention placebo comparison intervention on physical activity and stress reduction (Comparison). Secondary aims include: 1) Process evaluation to determine costs, reach, fidelity, and dose as well as the relationship of these variables with changes in F&V intake; 2) Applying a mediating variable framework to examine relationships of psychosocial factors/determinants with changes in F&V consumption; and 3) Cost effectiveness analysis of the different intervention arms. Discussion The GTG study will fill important research gaps in the field by implementing a rigorous cluster randomized trial to evaluate the efficacy of an innovative environmental intervention providing access and availability to F&V at the worksite and whether this access intervention is further enhanced by accompanying educational interventions. GTG will provide an important contribution to public health research and practice. Trial registration number NCT02729675, ClinicalTrials.gov PMID:29242108

Simple trigonometry on computed tomography helps in planning renal access.

PubMed

Bilen, Cenk Yücel; Koçak, Burak; Kitirci, Gürcan; Danaci, Murat; Sarikaya, Saban

2007-08-01

To retrospectively assess the usefulness of the measurements on preoperative computed tomography (CT) of patients with urinary stone disease for planning the access site using vertical angulation of the C-arm. Of the patients who underwent percutaneous nephrolithotomy from November 2001 to October 2006, 41 patients with superior calix access had undergone preoperative CT. The depth of the target stone (y) and the vertical distance from that point to the first rib free slice (x) were measured on CT. The limit of the ratio of x over y was accepted as 0.58, with ratios below that indicating that infracostal access could be achieved by vertical angulation of the C-arm. We achieved an approach to the superior calix through an infracostal access in 28 patients. The preoperative trigonometric study on CT predicted 24 of them. The stone-free rate was 92.6%, and no chest-related complications developed. Simple trigonometry on CT of the patients with complex stones could help endourologists in planning renal access.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- An ultrasound device is held at the site where the honeycomb shell around Endeavour's robotic arm has been cut to inspect the arm. A scrape of the shell occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Scrape on Endeavour's robotic arm during oxygen leak repairs

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- The opening shown here is the site where the honeycomb shell around Endeavour's robotic arm has been cut to inspect the arm. A scrape of the shell occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

Robotic arm

DOEpatents

Kwech, Horst

1989-04-18

A robotic arm positionable within a nuclear vessel by access through a small diameter opening and having a mounting tube supported within the vessel and mounting a plurality of arm sections for movement lengthwise of the mounting tube as well as for movement out of a window provided in the wall of the mounting tube. An end effector, such as a grinding head or welding element, at an operating end of the robotic arm, can be located and operated within the nuclear vessel through movement derived from six different axes of motion provided by mounting and drive connections between arm sections of the robotic arm. The movements are achieved by operation of remotely-controllable servo motors, all of which are mounted at a control end of the robotic arm to be outside the nuclear vessel.

Airfoil-Shaped Fluid Flow Tool for Use in Making Differential Measurements

NASA Technical Reports Server (NTRS)

England, John Dwight (Inventor); Kelley, Anthony R. (Inventor); Cronise, Raymond J. (Inventor)

2014-01-01

A fluid flow tool includes an airfoil structure and a support arm. The airfoil structure's high-pressure side and low-pressure side are positioned in a conduit by the support arm coupled to the conduit. The high-pressure and low-pressure sides substantially face opposing walls of the conduit. At least one measurement port is formed in the airfoil structure at each of its high-pressure side and low-pressure side. A first manifold, formed in the airfoil structure and in fluid communication with each measurement port so-formed at the high-pressure side, extends through the airfoil structure and support arm to terminate and be accessible at the exterior wall of the conduit. A second manifold, formed in the airfoil structure and in fluid communication with each measurement port so-formed at the low-pressure side, extends through the airfoil structure and support arm to terminate and be accessible at the exterior wall of the conduit.

Effects of Water Provision and Hydration on Cognitive Function among Primary-School Pupils in Zambia: A Randomized Trial

PubMed Central

Trinies, Victoria; Chard, Anna N.; Mateo, Tommy; Freeman, Matthew C.

2016-01-01

There is a well-established link between hydration and improved cognitive performance among adults, with evidence of similar findings among children. No trials have investigated the impact of water provision on cognitive performance among schoolchildren in hot and arid low-resource settings. We conducted a randomized-controlled trial in five schools with limited water access in Chipata district in Eastern province, Zambia, to assess the efficacy of water provision on cognition. Pupils in grades 3–6 were randomly assigned to either receive a bottle of drinking water that they could refill throughout the day (water group, n = 149) or only have access to drinking water that was normally available at the school (control group, n = 143). Hydration was assessed in the morning before provision of water and in the afternoon through urine specific gravity (Usg) measured with a portable refractometer. In the afternoon we administered six cognitive tests to assess short-term memory, concentration, visual attention, and visual motor skills. Morning prevalence of dehydration, defined as Usg≥1.020, was 42%. Afternoon dehydration increased to 67% among the control arm and dropped to 10% among the intervention arm. We did not find that provision of water or hydration impacted cognitive test scores, although there were suggestive relationships between both water provision and hydration and increased scores on tests measuring visual attention. We identified key improvements to the study design that are warranted to further investigate this relationship. Trial Registration: ClinicalTrials.gov NCT01924546 PMID:26950696

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

With a control panel visible in the foreground, a technician begins installation of the Orion crew access arm (CAA) to the mobile launcher (ML) tower at NASA's Kennedy Space Center in Florida. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System, or SLS, rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

Viewed from the 274-foot level mobile launcher (ML), technicians help install the Orion crew access arm (CAA) to the tower at NASA's Kennedy Space Center in Florida. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System (SLS), rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Arm Pain

MedlinePlus

... to Differential Diagnosis. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed Jan. 16, ... Medicine. 5th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://accessmedicine. com. Accessed Jan. 16, ...

A Unified Approach for Reporting ARM Measurement Uncertainties Technical Report

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

Campos, E; Sisterson, DL

The Atmospheric Radiation Measurement (ARM) Climate Research Facility is observationally based, and quantifying the uncertainty of its measurements is critically important. With over 300 widely differing instruments providing over 2,500 datastreams, concise expression of measurement uncertainty is quite challenging. The ARM Facility currently provides data and supporting metadata (information about the data or data quality) to its users through a number of sources. Because the continued success of the ARM Facility depends on the known quality of its measurements, the Facility relies on instrument mentors and the ARM Data Quality Office (DQO) to ensure, assess, and report measurement quality. Therefore,more » an easily-accessible, well-articulated estimate of ARM measurement uncertainty is needed.« less

Accreditation for Armed Forces Educational Institutions.

ERIC Educational Resources Information Center

Tarquine, Robert Blaine

The report established the need for educational accreditation and consolidates the various means of achieving accreditation that are available to the Armed Forces, into one accessible reference. The scope of each accrediting method is presented in detail, allowing educational officials to evaluate the methods in respect to their individual…

Effect of Motivational Interviewing on Weight Efficacy Lifestyle among Women with Overweight and Obesity: A Randomized Controlled Trial.

PubMed

Mirkarimi, Kamal; Kabir, Mohammad Javad; Honarvar, Mohammad Reza; Ozouni-Davaji, Rahman Berdi; Eri, Maryam

2017-03-01

Obesity and overweight have become increasingly a major public health problem across the world. This study aimed at exploring the effects of motivational interviewing on weight efficacy lifestyle among women with obesity and overweight. A single-blind randomized clinical trial study was conducted on 100 overweight and obese women who attended a nutrition clinic. The samples were selected based on the clinical records and assigned into two groups, namely motivational interviewing arm (50 samples) and nutrition education arm (50 samples). Data were collected using a standard validated questionnaire entitled "weight efficacy lifestyle". The intervention was designed according to five motivation sessions and four nutrition education programs, such that the participants of the nutrition education arm were also provided with the nutrition pamphlets related to weight control. Data were finally analyzed using the SPSS statistical software by performing the independent t-test, chi-square, LSD and repeated measures ANOVA tests. P<0.05 were considered statistically significant. The mean age of women was 39.9±9.1 and 36.3±8.9 years in the control and motivational interviewing arms, respectively. Compared with the control group, the score of the motivational interviewing group was statistically significant in terms of weight efficacy lifestyle P=0.0001) and all subscales including social pressure (P=0.0001), physical discomfort (P=0.005), food accessibility (P=0.0001), positive and entertainment activities (P=0.0001), as well as negative emotions (P=0.003). Motivational interviewing appeared to be effective in increasing weight efficacy lifestyle among women with overweight and obesity. IRCT2014051817736N1.

Support for the development and implementation of an access management program through research and analysis of collision data : final report.

DOT National Transportation Integrated Search

2015-11-11

The South Carolina Access and Roadside Management Standards (ARMS) provides standards and guidelines for : permitting access encroachments onto SCDOT right-of-way. In April, 2013, SCDOT initiated research that would be : used to update this manual wi...

Highly palatable food access during adolescence increased anxiety-/depression-like behaviors in male, but not in female, rats.

PubMed

Kim, Jin Young; Kim, Doyun; Park, Kyungpyo; Lee, Jong-Ho; Jahng, Jeong Won

2017-04-11

This study was conducted to examine the sexual dimorphic effects of highly palatable food (HPF) access during adolescence on the neurochemistry and depression-/anxiety-like behaviors of rats. Male and female Sprague-Dawley pups had free access to chocolate cookie rich in fat (HPF) from postnatal day 28 in addition to ad libitum chow, and the control groups received only chow. The food conditions were continued throughout the entire experimental period, and the neurochemical and behavioral measurements were performed during young adulthood. Rats were subjected to the ambulatory activity, elevated plus maze, and forced swim tests. Corticosterone levels during 2 h of restraint stress were analyzed with radioimmunoassay, and ΔFosB and brain-derived neurotrophic factor (BDNF) expression in the nucleus accumbens (NAc) with Western blot analysis. Cookie access did not affect body weight gain and total caloric intake in both sexes; however, it increased retroperitoneal fat depot only in males. The time spent in open arms during elevated plus maze test was decreased and immobility during forced swim test was increased in cookie-fed males, but not in cookie-fed females. Main effect of food condition on the stress-induced corticosterone increase was observed in males, but not in females, and cookie access increased BDNF expression in the NAc only in males. Increased BDNF expression in the NAc and fat depot, in addition to the stress axis dysfunction, may play roles in the pathophysiology of depression- and/or anxiety-like behaviors induced by cookie access.

Reduced-dose C-arm computed tomography applications at a pediatric institution.

PubMed

Acord, Michael; Shellikeri, Sphoorti; Vatsky, Seth; Srinivasan, Abhay; Krishnamurthy, Ganesh; Keller, Marc S; Cahill, Anne Marie

2017-12-01

Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning. To describe dose-reduction techniques for C-arm CT at a pediatric institution and to provide guidance for implementation. We conducted a 5-year retrospective study on procedures using an institution-specific reduced-dose protocol: 5 or 8 s Dyna Rotation, 248/396 projection images/acquisition and 0.1-0.17 μGy/projection dose at the detector with 0.3/0.6/0.9-mm copper (Cu) filtration. We categorized cases by procedure type and average patient age and calculated C-arm CT and total dose area product (DAP). Two hundred twenty-two C-arm CT-guided procedures were performed with a dose-reduction protocol. The most common procedures were temporomandibular and sacroiliac joint injections (48.6%) and sclerotherapy (34.2%). C-arm CT was utilized in cases of difficult percutaneous access in less common applications such as cecostomy and gastrostomy placement, foreign body retrieval and thoracentesis. C-arm CT accounted for between 9.9% and 80.7% of the total procedural DAP. Dose-reducing techniques can preserve image quality for intervention while reducing radiation exposure to the child. This technology has multiple applications within pediatric interventional radiology and can be considered as an adjunctive imaging tool in a variety of procedures, particularly when percutaneous access is challenging despite routine fluoroscopic or ultrasound guidance.

Increases in HIV Testing and Case Detection from NIMH Project Accept (HPTN 043) among 16–32 Year Olds: A Randomized Community-Based Intervention in Tanzania, Zimbabwe, and Thailand

PubMed Central

Sweat, Michael; Morin, Stephen; Celentano, David; Mulawa, Marta; Singh, Basant; Mbwambo, Jessie; Kawichai, Surinda; Chingono, Alfred; Khumalo-Sakutukwa, Gertrude; Gray, Glenda; Richter, Linda; Kulich, Michal; Sadowski, Andrew; Coates, Thomas

2011-01-01

SUMMARY BACKGROUND HIV counseling and testing is the gateway to treatment and care and provides important preventative and personal benefits to recipients. However, in developing countries the majority of HIV infected persons have not been tested for HIV. Combining community mobilization, mobile community-based HIV testing and counseling, and post-test support may increase HIV testing rates. METHODS We randomly assigned half of 10 rural communities in Tanzania, 8 in Zimbabwe, and 14 in Thailand to receive a multiple component community-based voluntary counseling and testing (CBVCT) intervention together with access to standard clinic-based voluntary counseling and testing (SVCT). The control communities received only SVCT. The intervention was provided for approximately 3 years. The primary study endpoint is HIV incidence and is pending completion of the post-intervention assessment. This is a descriptive interim analysis examining the percentage of the total population aged 16–32 years tested for HIV across study arms, and differences in client characteristics by study arm. FINDINGS A higher percentage of 16–32 year-olds were tested in intervention communities than in control communities (37% vs. 9% in Tanzania; 51% vs. 5% in Zimbabwe; and 69% vs. 23% in Thailand). The mean difference between the percentage of the population tested in CBVCT versus SVCT communities was 40.4% across the 3 country study arm pairs, (95% CI 15.8% – 64.7%, p-value 0.019, df=2). Despite higher prevalence of HIV among those testing at SVCT venues the intervention detected 3.6 times more HIV infected clients in the CBVCT communities than in SVCT communities (952 vs. 264, p< 0.001). Over time the rate of repeat testing grew substantially across all sites to 28% of all those testing for HIV by the end of the intervention period. INTERPRETATION This multiple component, community-level intervention is effective at both increasing HIV testing rates and detecting HIV cases in rural settings in developing countries. PMID:21546309

Comparison of patient comprehension of rapid HIV pre-test fundamentals by information delivery format in an emergency department setting

PubMed Central

Merchant, Roland C; Gee, Erin M; Clark, Melissa A; Mayer, Kenneth H; Seage, George R; DeGruttola, Victor G

2007-01-01

Background Two trials were conducted to compare emergency department patient comprehension of rapid HIV pre-test information using different methods to deliver this information. Methods Patients were enrolled for these two trials at a US emergency department between February 2005 and January 2006. In Trial One, patients were randomized to a no pre-test information or an in-person discussion arm. In Trial Two, a separate group of patients were randomized to an in-person discussion arm or a Tablet PC-based video arm. The video, "Do you know about rapid HIV testing?", and the in-person discussion contained identical Centers for Disease Control and Prevention-suggested pre-test information components as well as information on rapid HIV testing with OraQuick®. Participants were compared by information arm on their comprehension of the pre-test information by their score on a 26-item questionnaire using the Wilcoxon rank-sum test. Results In Trial One, 38 patients completed the no-information arm and 31 completed the in-person discussion arm. Of these 69 patients, 63.8% had twelve years or fewer of formal education and 66.7% had previously been tested for HIV. The mean score on the questionnaire for the in-person discussion arm was higher than for the no information arm (18.7 vs. 13.3, p ≤ 0.0001). In Trial Two, 59 patients completed the in-person discussion and 55 completed the video arms. Of these 114 patients, 50.9% had twelve years or fewer of formal education and 68.4% had previously been tested for HIV. The mean score on the questionnaire for the video arm was similar to the in-person discussion arm (20.0 vs. 19.2; p ≤ 0.33). Conclusion The video "Do you know about rapid HIV testing?" appears to be an acceptable substitute for an in-person pre-test discussion on rapid HIV testing with OraQuick®. In terms of adequately informing ED patients about rapid HIV testing, either form of pre-test information is preferable than for patients to receive no pre-test information. PMID:17850670

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

Viewed from the 274-foot level mobile launcher (ML), the Orion crew access arm (CAA) is beign installed on the tower. The CAA will support the Space launch System (SLS) rocket at NASA's Kennedy Space Center in Florida. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System, or SLS, rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

Viewed from the 274-foot level mobile launcher (ML), a technician begins installation of the Orion crew access arm (CAA) to the tower. The CAA will support the Space launch System (SLS) rocket at NASA's Kennedy Space Center in Florida. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the Space launch System, or SLS, rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

Crew Access Arm Installation onto Mobile Launcher

NASA Image and Video Library

2018-02-26

Viewed from the 274-foot level mobile launcher (ML), a crane positions the Orion crew access arm (CAA) so it can be attached to the tower that will support the Space launch System (SLS) rocket at NASA's Kennedy Space Center in Florida. NASA's Exploration Ground Systems organization has been overseeing installation of umbilicals and other launch accessories on the 380-foot-tall ML in preparation for stacking the first launch of the SLS, rocket with an Orion spacecraft. The CAA is designed to rotate from its retracted position and line up with Orion's crew hatch providing entry for astronauts and technicians.

32 CFR 552.60 - Supervision of on-post commercial activities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... obtain sales (e.g., soliciting future appointments), is prohibited. Solicitors may contact prospective... cards by retired or Reserve members of the Armed Forces to gain access to military installations to... solicitation by an active duty member of the Armed Forces of another member who is junior in rank or grade, at...

32 CFR 552.60 - Supervision of on-post commercial activities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... obtain sales (e.g., soliciting future appointments), is prohibited. Solicitors may contact prospective... cards by retired or Reserve members of the Armed Forces to gain access to military installations to... solicitation by an active duty member of the Armed Forces of another member who is junior in rank or grade, at...

32 CFR 552.60 - Supervision of on-post commercial activities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... obtain sales (e.g., soliciting future appointments), is prohibited. Solicitors may contact prospective... cards by retired or Reserve members of the Armed Forces to gain access to military installations to... solicitation by an active duty member of the Armed Forces of another member who is junior in rank or grade, at...

Using the MEDiPORT humanoid robot to reduce procedural pain and distress in children with cancer: A pilot randomized controlled trial.

PubMed

Jibb, Lindsay A; Birnie, Kathryn A; Nathan, Paul C; Beran, Tanya N; Hum, Vanessa; Victor, J Charles; Stinson, Jennifer N

2018-06-12

Subcutaneous port needle insertions are painful and distressing for children with cancer. The interactive MEDiPORT robot has been programmed to implement psychological strategies to decrease pain and distress during this procedure. This study assessed the feasibility of a future MEDiPORT trial. The secondary aim was to determine the preliminary effectiveness of MEDiPORT in reducing child pain and distress during subcutaneous port accesses. This 5-month pilot randomized controlled trial used a web-based service to randomize 4- to 9-year-olds with cancer to the MEDiPORT cognitive-behavioral arm (robot using evidence-based cognitive-behavioral interventions) or active distraction arm (robot dancing and singing) while a nurse conducted a needle insertion. We assessed accrual and retention; technical difficulties; outcome measure completion by children, parents, and nurses; time taken to complete the study and clinical procedure; and child-, parent-, and nurse-rated acceptability. Descriptive analyses, with exploratory inferential testing of child pain and distress data, were used to address study aims. Forty children were randomized across study arms. Most (85%) eligible children participated and no children withdrew. Technical difficulties were more common in the cognitive-behavioral arm. Completion times for the study and needle insertion were acceptable and >96% of outcome measure items were completed. Overall, MEDiPORT and the study were acceptable to participants. There was no difference in pain between arms, but distress during the procedure was less pronounced in the active distraction arm. The MEDiPORT study appears feasible to implement as an adequately-powered effectiveness-assessing trial following modifications to the intervention and study protocol. ClinicalTrials.gov NCT02611739. © 2018 Wiley Periodicals, Inc.

A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa

PubMed Central

Tabana, Hanani; Nkonki, Lungiswa; Hongoro, Charles; Doherty, Tanya; Ekström, Anna Mia; Naik, Reshma; Zembe-Mkabile, Wanga; Jackson, Debra; Thorson, Anna

2015-01-01

Introduction There is growing evidence concerning the acceptability and feasibility of home-based HIV testing. However, less is known about the cost-effectiveness of the approach yet it is a critical component to guide decisions about scaling up access to HIV testing. This study examined the cost-effectiveness of a home-based HIV testing intervention in rural South Africa. Methods Two alternatives: clinic and home-based HIV counselling and testing were compared. Costs were analysed from a provider’s perspective for the period of January to December 2010. The outcome, HIV counselling and testing (HCT) uptake was obtained from the Good Start home-based HIV counselling and testing (HBHCT) cluster randomised control trial undertaken in KwaZulu-Natal province. Cost-effectiveness was estimated for a target population of 22,099 versus 23,864 people for intervention and control communities respectively. Average costs were calculated as the cost per client tested, while cost-effectiveness was calculated as the cost per additional client tested through HBHCT. Results Based on effectiveness of 37% in the intervention (HBHCT) arm compared to 16% in control arm, home based testing costs US$29 compared to US$38 per person for clinic HCT. The incremental cost effectiveness per client tested using HBHCT was $19. Conclusions HBHCT was less costly and more effective. Home-based HCT could present a cost-effective alternative for rural ‘hard to reach’ populations depending on affordability by the health system, and should be considered as part of community outreach programs. PMID:26275059

A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.

PubMed

Tabana, Hanani; Nkonki, Lungiswa; Hongoro, Charles; Doherty, Tanya; Ekström, Anna Mia; Naik, Reshma; Zembe-Mkabile, Wanga; Jackson, Debra; Thorson, Anna

2015-01-01

There is growing evidence concerning the acceptability and feasibility of home-based HIV testing. However, less is known about the cost-effectiveness of the approach yet it is a critical component to guide decisions about scaling up access to HIV testing. This study examined the cost-effectiveness of a home-based HIV testing intervention in rural South Africa. Two alternatives: clinic and home-based HIV counselling and testing were compared. Costs were analysed from a provider's perspective for the period of January to December 2010. The outcome, HIV counselling and testing (HCT) uptake was obtained from the Good Start home-based HIV counselling and testing (HBHCT) cluster randomised control trial undertaken in KwaZulu-Natal province. Cost-effectiveness was estimated for a target population of 22,099 versus 23,864 people for intervention and control communities respectively. Average costs were calculated as the cost per client tested, while cost-effectiveness was calculated as the cost per additional client tested through HBHCT. Based on effectiveness of 37% in the intervention (HBHCT) arm compared to 16% in control arm, home based testing costs US$29 compared to US$38 per person for clinic HCT. The incremental cost effectiveness per client tested using HBHCT was $19. HBHCT was less costly and more effective. Home-based HCT could present a cost-effective alternative for rural 'hard to reach' populations depending on affordability by the health system, and should be considered as part of community outreach programs.

STS-79 CREW COMMANDER WILLIAM F. READDY PREPARES TO ENTER ATLANTIS AT PAD 39A FOR TCDT

NASA Technical Reports Server (NTRS)

1996-01-01

At Launch Pad 39A, the astronauts assigned to Space Shuttle Mission STS-79 are wrapping up Terminal Countdown Demonstration Test (TCDT) activities with participation in a simulated countdown. Shown here in the white room of the Orbiter Access Arm is Commander William F. Readdy. Besides the realistic launch day preparation, the TCDT also includes emergency egress training at the pad. The Space Shuttle Atlantis is undergoing preparations for liftoff on the fourth Shuttle-Mir docking flight no earlier than Sept. 12.

49 CFR 234.255 - Gate arm and gate mechanism.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Gate arm and gate mechanism. 234.255 Section 234... Maintenance, Inspection, and Testing Inspections and Tests § 234.255 Gate arm and gate mechanism. (a) Each gate arm and gate mechanism shall be inspected at least once each month. (b) Gate arm movement shall be...

49 CFR 234.255 - Gate arm and gate mechanism.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Gate arm and gate mechanism. 234.255 Section 234... Maintenance, Inspection, and Testing Inspections and Tests § 234.255 Gate arm and gate mechanism. (a) Each gate arm and gate mechanism shall be inspected at least once each month. (b) Gate arm movement shall be...

Genotypic and sex differences in anxiety-like behavior and alcohol-induced anxiolysis in High Drinking in the Dark selected mice.

PubMed

Barkley-Levenson, Amanda M; Crabbe, John C

2015-02-01

Alcohol use disorders and anxiety disorders are highly comorbid in humans. In rodent lines selected for alcohol drinking, differences in anxiety-like behavior are also seen. The High Drinking in the Dark (HDID) lines of mice are selectively bred for drinking to intoxication during limited access to alcohol, and these mice represent a genetic model of risk for binge-like drinking. The present studies investigated whether these selected lines differ from control (HS) mice in basal anxiety behavior or in anxiolytic response to alcohol. We also assessed the genetic correlation between alcohol drinking in the dark (DID) and basal anxiety-like behavior using existing inbred strain data. Mice of both sexes and HDID replicates (HDID-1 and HDID-2) were tested on an elevated zero maze immediately following a DID test. In general, HDID mice showed more time spent in the open arms after drinking alcohol than HS mice, and open-arm time was significantly correlated with blood alcohol concentration. HDID-1 male mice also showed less anxiety-like behavior at baseline (water-drinking controls). In a separate experiment, HDID-1 and HS mice were tested for anxiolytic dose-response to acute alcohol injections. Both genotypes showed increasing time spent in the open arms with increasing alcohol doses, and HDID-1 and female mice had greater open-arm time across all doses. HDID-1 control males showed lower anxiety-like behavior than the HS control males. Inbred strain data analysis also showed no significant genetic relationship between alcohol DID and anxiety. These findings suggest that HDID selection has not produced systematic changes in anxiety-like behavior or sensitivity to alcohol-induced anxiolysis, though there is a tendency in the male mice of the first replicate toward reduced basal anxiety-like behavior. Therefore, anxiety state and sensitivity to alcohol's anxiolytic effects do not appear to contribute significantly to the high drinking behavior of the HDID mice. Copyright © 2015 Elsevier Inc. All rights reserved.

Home-based versus mobile clinic HIV testing and counseling in rural Lesotho: a cluster-randomized trial.

PubMed

Labhardt, Niklaus Daniel; Motlomelo, Masetsibi; Cerutti, Bernard; Pfeiffer, Karolin; Kamele, Mashaete; Hobbins, Michael A; Ehmer, Jochen

2014-12-01

The success of HIV programs relies on widely accessible HIV testing and counseling (HTC) services at health facilities as well as in the community. Home-based HTC (HB-HTC) is a popular community-based approach to reach persons who do not test at health facilities. Data comparing HB-HTC to other community-based HTC approaches are very limited. This trial compares HB-HTC to mobile clinic HTC (MC-HTC). The trial was powered to test the hypothesis of higher HTC uptake in HB-HTC campaigns than in MC-HTC campaigns. Twelve clusters were randomly allocated to HB-HTC or MC-HTC. The six clusters in the HB-HTC group received 30 1-d multi-disease campaigns (five villages per cluster) that delivered services by going door-to-door, whereas the six clusters in MC-HTC group received campaigns involving community gatherings in the 30 villages with subsequent service provision in mobile clinics. Time allocation and human resources were standardized and equal in both groups. All individuals accessing the campaigns with unknown HIV status or whose last HIV test was >12 wk ago and was negative were eligible. All outcomes were assessed at the individual level. Statistical analysis used multivariable logistic regression. Odds ratios and p-values were adjusted for gender, age, and cluster effect. Out of 3,197 participants from the 12 clusters, 2,563 (80.2%) were eligible (HB-HTC: 1,171; MC-HTC: 1,392). The results for the primary outcomes were as follows. Overall HTC uptake was higher in the HB-HTC group than in the MC-HTC group (92.5% versus 86.7%; adjusted odds ratio [aOR]: 2.06; 95% CI: 1.18-3.60; p = 0. 011). Among adolescents and adults ≥ 12 y, HTC uptake did not differ significantly between the two groups; however, in children <12 y, HTC uptake was higher in the HB-HTC arm (87.5% versus 58.7%; aOR: 4.91; 95% CI: 2.41-10.0; p<0.001). Out of those who took up HTC, 114 (4.9%) tested HIV-positive, 39 (3.6%) in the HB-HTC arm and 75 (6.2%) in the MC-HTC arm (aOR: 0.64; 95% CI: 0.48-0.86; p = 0.002). Ten (25.6%) and 19 (25.3%) individuals in the HB-HTC and in the MC-HTC arms, respectively, linked to HIV care within 1 mo after testing positive. Findings for secondary outcomes were as follows: HB-HTC reached more first-time testers, particularly among adolescents and young adults, and had a higher proportion of men among participants. However, after adjusting for clustering, the difference in male participation was not significant anymore. Age distribution among participants and immunological and clinical stages among persons newly diagnosed HIV-positive did not differ significantly between the two groups. Major study limitations included the campaigns' restriction to weekdays and a relatively low HIV prevalence among participants, the latter indicating that both arms may have reached an underexposed population. This study demonstrates that both HB-HTC and MC-HTC can achieve high uptake of HTC. The choice between these two community-based strategies will depend on the objective of the activity: HB-HTC was better in reaching children, individuals who had never tested before, and men, while MC-HTC detected more new HIV infections. The low rate of linkage to care after a positive HIV test warrants future consideration of combining community-based HTC approaches with strategies to improve linkage to care for persons who test HIV-positive. ClinicalTrials.gov NCT01459120. Please see later in the article for the Editors' Summary.

Targeted Muscle Reinnervation for Real-Time Myoelectric Control of Multifunction Artificial Arms

PubMed Central

Kuiken, Todd A.; Li, Guanglin; Lock, Blair A.; Lipschutz, Robert D.; Miller, Laura A.; Stubblefield, Kathy A.; Englehart, Kevin

2011-01-01

Context Improving the function of prosthetic arms remains a challenge, as access to the neural control information for the arm is lost during amputation. We have developed a surgical technique called targeted muscle reinnervation (TMR) which transfers residual arm nerves to alternative muscle sites. After reinnervation, these target muscles produce an electromyogram (EMG) on the surface of the skin that can be measured and used to control prosthetic arms. Objective Assess the performance of TMR upper-limb amputee patients using a pattern-recognition algorithm to decode EMG signals and control prosthetic arm motions. Design Surface EMG signals were recorded on participants and decoded using a pattern-recognition algorithm. The decoding program controlled the movement of a virtual prosthetic arm. Participants were instructed to perform various arm movements, and their abilities to control the virtual prosthetic arm were measured. In addition, TMR patients used the same control system to operate advanced arm prosthesis prototypes. Setting This study was conducted between January 2007 and January 2008 at the Rehabilitation Institute of Chicago. Participants This study included five patients with shoulder disarticulation or transhumeral amputations who received TMR surgery between February 2002 and October 2006. It also included five non-amputee (control) participants. Main Outcome Measure Performance metrics measured during virtual arm movements included motion-selection time, motion-completion time, and motion-completion (or `success') rate. Three of the TMR patients were also able to test advanced arm prostheses. Results TMR patients were able to repeatedly perform 10 different elbow, wrist and hand motions with the virtual prosthetic arm. For TMR patients, the average (standard deviation (SD)) motion-selection and motion-completion times for elbow and wrist movements were 0.22 s (0.06) and 1.29 s (0.15), respectively. These times were 0.06 s and 0.21 s longer than the average times of control participants. For TMR patients, the average (SD) motion-selection and motion-completion times for hand-grasp patterns were 0.38 s (0.12) and 1.54 s (0.27), respectively. TMR patients successfully completed an average (SD) of 96.3% (3.8) of elbow and wrist movements and 86.9% (13.9) of hand movements within 5 s, compared to 100% (0) and 96.7% (4.7) completed by controls. Three of the patients were able to demonstrate the use of this control system in advanced prostheses including motorized shoulders, elbows, wrists and hands. Conclusion These results suggest that reinnervated muscles can produce sufficient EMG information to control advanced artificial arms. PMID:19211469

Self-administration of morphine into the lateral hypothalamus in the mouse.

PubMed

Cazala, P; Darracq, C; Saint-Marc, M

1987-07-28

BALB/c mice were chronically and unilaterally implanted with a guide cannula, the tip of which was positioned 1 mm above the lateral hypothalamus (LH). On each experimental day, a stainless-steel injection cannula was inserted into the LH, and self-administration of morphine or vehicle in this brain area was studied by using a spatial discrimination test in a Y-maze. In a first experiment, we observed that when mice had access to morphine (0.1 microgram by injection) they rapidly discriminated the reinforced arm from the neutral arm of the maze in order to self administer, with increasing frequency, the drug into the LH. In contrast when only vehicle was present, the two arms were no longer discriminated. In a second experiment we compared the effects of 3 doses of morphine (0.1 microgram, 0.05 microgram and 0.025 microgram by injection); optimal discrimination was obtained with the lowest dose used. In a third experiment we observed that subcutaneous injections of naloxone (4 mg/kg) progressively reduced the number of self-administrations of morphine into the LH, a result which suggests that this response is dependent on an opiate receptor mechanism.

A Prototype Robotic Arm for Use by Severely Orthopedically Handicapped Students. Final Report.

ERIC Educational Resources Information Center

Howell, Richard

This 18-month pilot project, which ran from October 1, 1987 to March 31, 1989, developed a prototype robotic arm for educational use by students with severe orthopedic disabilities in the Columbus (Ohio) Public Schools. The developmental effort was intended first, to provide direct access to currently available instructional materials and, second,…

Aniracetam improves radial maze performance in rats.

PubMed

Martin, J R; Cumin, R; Aschwanden, W; Moreau, J L; Jenck, F; Haefely, W E

1992-01-01

The memory enhancing effect of the pyrrolidinone derivative aniracetam was investigated in rats trained in a delayed-response task in an 8-arm radial maze. Oral administration of aniracetam (100, 200, 400, or 800 mg kg-1) 16 h and again 1 h prior to a first trial of exposure to a given configuration of 4 baited arms resulted in a significant improvement in performance during a second trial in the maze given 3 h later in which there was access to all 8 arms but only the other 4 arms were baited. The pattern of baited arms was varied daily. The performance enhancement was greatest for the highest doses. These results extend the demonstration of the cognition enhancing effects of aniracetam to a spatial memory task in rats.

Internet Mindfulness Meditation Intervention for the General Public: Pilot Randomized Controlled Trial

PubMed Central

2016-01-01

Background Mindfulness meditation interventions improve a variety of health conditions and quality of life, are inexpensive, easy to implement, have minimal if any side effects, and engage patients to take an active role in their treatment. However, the group format can be an obstacle for many to take structured meditation programs. Internet Mindfulness Meditation Intervention (IMMI) is a program that could make mindfulness meditation accessible to all people who want and need to receive it. However, the feasibility, acceptability, and ability of IMMI to increase meditation practice have yet to be evaluated. Objectives The primary objectives of this pilot randomized controlled study were to (1) evaluate the feasibility and acceptability of IMMIs in the general population and (2) to evaluate IMMI’s ability to change meditation practice behavior. The secondary objective was to collect preliminary data on health outcomes. Methods Potential participants were recruited from online and offline sources. In a randomized controlled trial, participants were allocated to IMMI or Access to Guided Meditation arm. IMMI included a 1-hour Web-based training session weekly for 6 weeks along with daily home practice guided meditations between sessions. The Access to Guided Meditation arm included a handout on mindfulness meditation and access to the same guided meditation practices that the IMMI participants received, but not the 1-hour Web-based training sessions. The study activities occurred through the participants’ own computer and Internet connection and with research-assistant telephone and email contact. Feasibility and acceptability were measured with enrollment and completion rates and participant satisfaction. The ability of IMMI to modify behavior and increase meditation practice was measured by objective adherence of daily meditation practice via Web-based forms. Self-report questionnaires of quality of life, self-efficacy, depression symptoms, sleep disturbance, perceived stress, and mindfulness were completed before and after the intervention period via Web-based surveys. Results We enrolled 44 adults were enrolled and 31 adults completed all study activities. There were no group differences on demographics or important variables at baseline. Participants rated the IMMI arm higher than the Access to Guided Meditation arm on Client Satisfaction Questionnaire. IMMI was able to increase home practice behavior significantly compared to the Access to Guided Meditation arm: days practiced (P=.05), total minutes (P=.01), and average minutes (P=.05). As expected, there were no significant differences on health outcomes. Conclusions In conclusion, IMMI was found to be feasible and acceptable. The IMMI arm had increased daily meditation practice compared with the Access to Guided Meditation control group. More interaction through staff and/or through built-in email or text reminders may increase daily practice even more. Future studies will examine IMMI’s efficacy at improving health outcomes in the general population and also compare it directly to the well-studied mindfulness-based group interventions to evaluate relative efficacy. Trial Registration Clinicaltrials.gov NCT02655835; http://clinicaltrials.gov/ct2/show/NCT02655835 (Archived by WebCite at http://www.webcitation/ 6jUDuQsG2) PMID:27502759

Essential, Desirable or Optional? Making Distance E-Learning Courses Available to Those without Internet Access

ERIC Educational Resources Information Center

Hancock, Val

2010-01-01

The Open University, an open distance learning institution, is increasingly using a Virtual Learning Environment (VLE) that requires internet access. This paper investigates how the move to a VLE has affected one group of students who do not have internet access--offender learners studying in prison. Members of the armed forces and secure hospital…

Evidence for Conformationa1 Heterogeneity of Fission Protein Fis1 from Saccharomyces cerevisiae†

PubMed Central

Picton, Lora K.; Casares, Salvador; Monahan, Ann C.; Majumdar, Ananya; Hill, R. Blake

2009-01-01

Fission 1 (Fis1) is an evolutionarily conserved, type II integral membrane protein implicated in maintaining the proper morphology of mitochondria and peroxisomes. A concave surface on the cytosolic domain of Fis1 from Saccharomyces cerevisiae is implicated in binding other fission proteins, yet structural studies reveal that this surface is sterically occluded by its N-terminal arm. Here we address the question of whether the N-terminal arm of yeast Fis1 exists in a dynamic equilibrium that would allow access to this functionally important surface. NMR measurements sensitive to dynamics occurring on a wide range of time scales (picoseconds to minutes) were used to assess whether the Fis1 arm is dynamic. Hydrogen–deuterium exchange experiments revealed that the Fis1 arm, α-helix 6, and proximal loops were not protected from solvent exchange, consistent with motions on the second to minute time scale. An engineered cysteine, I85C, located on the concave surface that lies underneath the Fis1 arm, was readily modified by a fluorescent probe, revealing more solvent accessibility of this position than would be predicted from the structure. Chemical denaturation, NMR chemical shift perturbation, and residual dipolar coupling experiments support the idea that the dynamic equilibrium can be shifted on the basis of changing pH and temperature, with the changes primarily localizing to the Fis1 arm and proximal regions. The data as a whole are consistent with the Fis1 arm adopting a primarily “closed” conformational state able to undergo dynamic excursions that reveal the concave surface and therefore may be important for binding other fission factors and for Fis1 function. PMID:19522466

The HAAPI (Home Arm Assistance Progression Initiative) Trial: A Novel Robotics Delivery Approach in Stroke Rehabilitation.

PubMed

Wolf, Steven L; Sahu, Komal; Bay, R Curtis; Buchanan, Sharon; Reiss, Aimee; Linder, Susan; Rosenfeldt, Anson; Alberts, Jay

2015-01-01

Geographical location, socioeconomic status, and logistics surrounding transportation impede access of poststroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP) was incorporated within a home exercise program (HEP) to improve upper-extremity (UE) functional capabilities poststroke. To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months poststroke and characterized as underserved. In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to UE rehabilitation were randomized to either (1) the experimental group, which received combined HEP and HMP for 3 h/d ×5 days ×8 weeks, or (2) the control group, which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl-Meyer Assessment (UE) were primary and secondary outcome measures, respectively, undertaken before and after the interventions. Both groups demonstrated improvement across all UE outcomes. Robotic + HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time. Additional research is necessary to determine the appropriate dosage of HMP and HEP. © The Author(s) 2015.

The HAAPI (Home Arm Assistance Progression Initiative) Trial: - A Novel Robotics Delivery Approach in Stroke Rehabilitation

PubMed Central

Wolf, Steven L.; Sahu, Komal; Bay, R. Curtis; Buchanan, Sharon; Reiss, Aimee; Linder, Susan; Rosenfeldt, Anson; Alberts, Jay

2015-01-01

Background Geographical location, socioeconomic status and logistics surrounding transportation impede access of post-stroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing for the remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP), was incorporated within a home exercise program (HEP) to improve upper extremity functional capabilities post-stroke. Objective To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months post-stroke and characterized as underserved. Methods In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to upper extremity rehabilitation were randomized to the: 1) experimental group which received combined HEP and HMP for 3 hrs/day x 5 days x 8 weeks; or 2) control group which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl Meyer Assessment (upper extremity) were primary and secondary outcome measures respectively, undertaken before and after the interventions. Results Both groups demonstrated improvement across all upper extremity outcomes. Conclusions Robotic+HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time, additional research is necessary to determine appropriate dosage of HMP and HEP. PMID:25782693

KSC-2012-6229

NASA Image and Video Library

2012-11-14

CAPE CANAVERAL, Fla. – The Orion spacecraft crew access arm, or CAA, seal prototype is being checked out at the Launch Equipment Test Facility at NASA's Kennedy Space Center in Florida. The tests will use a mockup of the vehicle Outer Mold Line and CAA white room to test the performance of the seal while simulating vehicle to CAA white room excursions. Orion is the exploration spacecraft designed to carry crews to space beyond low Earth orbit. It will provide emergency abort capability, sustain the crew during the space travel and provide safe re-entry from deep space return velocities. The first unpiloted test flight of the Orion is scheduled to launch in 2014 atop a Delta IV rocket and in 2017 on a Space Launch System rocket. For more information, visit http://www.nasa.gov/orion Photo credit: NASA/Jim Grossmann

KSC-2012-6225

NASA Image and Video Library

2012-11-14

CAPE CANAVERAL, Fla. – The Orion spacecraft crew access arm, or CAA, seal prototype is being checked out at the Launch Equipment Test Facility at NASA's Kennedy Space Center in Florida. The tests will use a mockup of the vehicle Outer Mold Line and CAA white room to test the performance of the seal while simulating vehicle to CAA white room excursions. Orion is the exploration spacecraft designed to carry crews to space beyond low Earth orbit. It will provide emergency abort capability, sustain the crew during the space travel and provide safe re-entry from deep space return velocities. The first unpiloted test flight of the Orion is scheduled to launch in 2014 atop a Delta IV rocket and in 2017 on a Space Launch System rocket. For more information, visit http://www.nasa.gov/orion Photo credit: NASA/Jim Grossmann

KSC-2012-6231

NASA Image and Video Library

2012-11-14

CAPE CANAVERAL, Fla. – The Orion spacecraft crew access arm, or CAA, seal prototype is being checked out at the Launch Equipment Test Facility at NASA's Kennedy Space Center in Florida. The tests will use a mockup of the vehicle Outer Mold Line and CAA white room to test the performance of the seal while simulating vehicle to CAA white room excursions. Orion is the exploration spacecraft designed to carry crews to space beyond low Earth orbit. It will provide emergency abort capability, sustain the crew during the space travel and provide safe re-entry from deep space return velocities. The first unpiloted test flight of the Orion is scheduled to launch in 2014 atop a Delta IV rocket and in 2017 on a Space Launch System rocket. For more information, visit http://www.nasa.gov/orion Photo credit: NASA/Jim Grossmann

KSC-2012-6226

NASA Image and Video Library

2012-11-14

CAPE CANAVERAL, Fla. – The Orion spacecraft crew access arm, or CAA, seal prototype is being checked out at the Launch Equipment Test Facility at NASA's Kennedy Space Center in Florida. The tests will use a mockup of the vehicle Outer Mold Line and CAA white room to test the performance of the seal while simulating vehicle to CAA white room excursions. Orion is the exploration spacecraft designed to carry crews to space beyond low Earth orbit. It will provide emergency abort capability, sustain the crew during the space travel and provide safe re-entry from deep space return velocities. The first unpiloted test flight of the Orion is scheduled to launch in 2014 atop a Delta IV rocket and in 2017 on a Space Launch System rocket. For more information, visit http://www.nasa.gov/orion Photo credit: NASA/Jim Grossmann

Democratizing Neurorehabilitation: How Accessible are Low-Cost Mobile-Gaming Technologies for Self-Rehabilitation of Arm Disability in Stroke?

PubMed Central

Rinne, Paul; Mace, Michael; Nakornchai, Tagore; Zimmerman, Karl; Fayer, Susannah; Sharma, Pankaj; Liardon, Jean-Luc; Burdet, Etienne; Bentley, Paul

2016-01-01

Motor-training software on tablets or smartphones (Apps) offer a low-cost, widely-available solution to supplement arm physiotherapy after stroke. We assessed the proportions of hemiplegic stroke patients who, with their plegic hand, could meaningfully engage with mobile-gaming devices using a range of standard control-methods, as well as by using a novel wireless grip-controller, adapted for neurodisability. We screened all newly-diagnosed hemiplegic stroke patients presenting to a stroke centre over 6 months. Subjects were compared on their ability to control a tablet or smartphone cursor using: finger-swipe, tap, joystick, screen-tilt, and an adapted handgrip. Cursor control was graded as: no movement (0); less than full-range movement (1); full-range movement (2); directed movement (3). In total, we screened 345 patients, of which 87 satisfied recruitment criteria and completed testing. The commonest reason for exclusion was cognitive impairment. Using conventional controls, the proportion of patients able to direct cursor movement was 38–48%; and to move it full-range was 55–67% (controller comparison: p>0.1). By comparison, handgrip enabled directed control in 75%, and full-range movement in 93% (controller comparison: p<0.001). This difference between controllers was most apparent amongst severely-disabled subjects, with 0% achieving directed or full-range control with conventional controls, compared to 58% and 83% achieving these two levels of movement, respectively, with handgrip. In conclusion, hand, or arm, training Apps played on conventional mobile devices are likely to be accessible only to mildly-disabled stroke patients. Technological adaptations such as grip-control can enable more severely affected subjects to engage with self-training software. PMID:27706248

Automated cognitive testing of monkeys in social groups yields results comparable to individual laboratory-based testing.

PubMed

Gazes, Regina Paxton; Brown, Emily Kathryn; Basile, Benjamin M; Hampton, Robert R

2013-05-01

Cognitive abilities likely evolved in response to specific environmental and social challenges and are therefore expected to be specialized for the life history of each species. Specialized cognitive abilities may be most readily engaged under conditions that approximate the natural environment of the species being studied. While naturalistic environments might therefore have advantages over laboratory settings for cognitive research, it is difficult to conduct certain types of cognitive tests in these settings. We implemented methods for automated cognitive testing of monkeys (Macaca mulatta) in large social groups (Field station) and compared the performance to that of laboratory-housed monkeys (Laboratory). The Field station animals shared access to four touch-screen computers in a large naturalistic social group. Each Field station subject had an RFID chip implanted in each arm for computerized identification and individualized assignment of cognitive tests. The Laboratory group was housed and tested in a typical laboratory setting, with individual access to testing computers in their home cages. Monkeys in both groups voluntarily participated at their own pace for food rewards. We evaluated performance in two visual psychophysics tests, a perceptual classification test, a transitive inference test, and a delayed matching-to-sample memory test. Despite the differences in housing, social environment, age, and sex, monkeys in the two groups performed similarly in all tests. Semi-free ranging monkeys living in complex social environments are therefore viable subjects for cognitive testing designed to take advantage of the unique affordances of naturalistic testing environments.

Automated cognitive testing of monkeys in social groups yields results comparable to individual laboratory based testing

PubMed Central

Gazes, Regina Paxton; Brown, Emily Kathryn; Basile, Benjamin M.; Hampton, Robert R.

2013-01-01

Cognitive abilities likely evolved in response to specific environmental and social challenges and are therefore expected to be specialized for the life history of each species. Specialized cognitive abilities may be most readily engaged under conditions that approximate the natural environment of the species being studied. While naturalistic environments might therefore have advantages over laboratory settings for cognitive research, it is difficult to conduct certain types of cognitive tests in these settings. We implemented methods for automated cognitive testing of monkeys (Macaca mulatta) in large social groups (Field station) and compared the performance to that of laboratory housed monkeys (Laboratory). The Field station animals shared access to four touch screen computers in a large naturalistic social group. Each Field station subject had an RFID chip implanted in each arm for computerized identification and individualized assignment of cognitive tests. The Laboratory group was housed and tested in a typical laboratory setting, with individual access to testing computers in their home cages. Monkeys in both groups voluntarily participated at their own pace for food rewards. We evaluated performance in two visual psychophysics tests, a perceptual classification test, a transitive inference test, and a delayed matching to sample memory test. Despite differences in housing, social environment, age, and sex, monkeys in the two groups performed similarly in all tests. Semi-free ranging monkeys living in complex social environments are therefore viable subjects for cognitive testing designed to take advantage of the unique affordances of naturalistic testing environments. PMID:23263675

Correcting for multiple-testing in multi-arm trials: is it necessary and is it done?

PubMed

Wason, James M S; Stecher, Lynne; Mander, Adrian P

2014-09-17

Multi-arm trials enable the evaluation of multiple treatments within a single trial. They provide a way of substantially increasing the efficiency of the clinical development process. However, since multi-arm trials test multiple hypotheses, some regulators require that a statistical correction be made to control the chance of making a type-1 error (false-positive). Several conflicting viewpoints are expressed in the literature regarding the circumstances in which a multiple-testing correction should be used. In this article we discuss these conflicting viewpoints and review the frequency with which correction methods are currently used in practice. We identified all multi-arm clinical trials published in 2012 by four major medical journals. Summary data on several aspects of the trial design were extracted, including whether the trial was exploratory or confirmatory, whether a multiple-testing correction was applied and, if one was used, what type it was. We found that almost half (49%) of published multi-arm trials report using a multiple-testing correction. The percentage that corrected was higher for trials in which the experimental arms included multiple doses or regimens of the same treatments (67%). The percentage that corrected was higher in exploratory than confirmatory trials, although this is explained by a greater proportion of exploratory trials testing multiple doses and regimens of the same treatment. A sizeable proportion of published multi-arm trials do not correct for multiple-testing. Clearer guidance about whether multiple-testing correction is needed for multi-arm trials that test separate treatments against a common control group is required.

Consecutive learning of opposing unimanual motor tasks using the right arm followed by the left arm causes intermanual interference

PubMed Central

Thürer, Benjamin; Stein, Thorsten

2017-01-01

Intermanual transfer (motor memory generalization across arms) and motor memory interference (impairment of retest performance in consecutive motor learning) are well-investigated motor learning phenomena. However, the interplay of these phenomena remains elusive, i.e., whether intermanual interference occurs when two unimanual tasks are consecutively learned using different arms. Here, we examine intermanual interference when subjects consecutively adapt their right and left arm movements to novel dynamics. We considered two force field tasks A and B which were of the same structure but mirrored orientation (B = -A). The first test group (ABA-group) consecutively learned task A using their right arm and task B using their left arm before being retested for task A with their right arm. Another test group (AAA-group) learned only task A in the same right-left-right arm schedule. Control subjects learned task A using their right arm without intermediate left arm learning. All groups were able to adapt their right arm movements to force field A and both test groups showed significant intermanual transfer of this initial learning to the contralateral left arm of 21.9% (ABA-group) and 27.6% (AAA-group). Consecutively, both test groups adapted their left arm movements to force field B (ABA-group) or force field A (AAA-group). For the ABA-group, left arm learning caused significant intermanual interference of the initially learned right arm task (68.3% performance decrease). The performance decrease of the AAA-group (10.2%) did not differ from controls (15.5%). These findings suggest that motor control and learning of right and left arm movements involve partly similar neural networks or underlie a vital interhemispheric connectivity. Moreover, our results suggest a preferred internal task representation in extrinsic Cartesian-based coordinates rather than in intrinsic joint-based coordinates because interference was absent when learning was performed in extrinsically equivalent fashion (AAA-group) but interference occurred when learning was performed in intrinsically equivalent fashion (ABA-group). PMID:28459833

Consecutive learning of opposing unimanual motor tasks using the right arm followed by the left arm causes intermanual interference.

PubMed

Stockinger, Christian; Thürer, Benjamin; Stein, Thorsten

2017-01-01

Intermanual transfer (motor memory generalization across arms) and motor memory interference (impairment of retest performance in consecutive motor learning) are well-investigated motor learning phenomena. However, the interplay of these phenomena remains elusive, i.e., whether intermanual interference occurs when two unimanual tasks are consecutively learned using different arms. Here, we examine intermanual interference when subjects consecutively adapt their right and left arm movements to novel dynamics. We considered two force field tasks A and B which were of the same structure but mirrored orientation (B = -A). The first test group (ABA-group) consecutively learned task A using their right arm and task B using their left arm before being retested for task A with their right arm. Another test group (AAA-group) learned only task A in the same right-left-right arm schedule. Control subjects learned task A using their right arm without intermediate left arm learning. All groups were able to adapt their right arm movements to force field A and both test groups showed significant intermanual transfer of this initial learning to the contralateral left arm of 21.9% (ABA-group) and 27.6% (AAA-group). Consecutively, both test groups adapted their left arm movements to force field B (ABA-group) or force field A (AAA-group). For the ABA-group, left arm learning caused significant intermanual interference of the initially learned right arm task (68.3% performance decrease). The performance decrease of the AAA-group (10.2%) did not differ from controls (15.5%). These findings suggest that motor control and learning of right and left arm movements involve partly similar neural networks or underlie a vital interhemispheric connectivity. Moreover, our results suggest a preferred internal task representation in extrinsic Cartesian-based coordinates rather than in intrinsic joint-based coordinates because interference was absent when learning was performed in extrinsically equivalent fashion (AAA-group) but interference occurred when learning was performed in intrinsically equivalent fashion (ABA-group).

Modular Elastomer Photoresins for Digital Light Processing Additive Manufacturing.

PubMed

Thrasher, Carl J; Schwartz, Johanna J; Boydston, Andrew J

2017-11-15

A series of photoresins suitable for the production of elastomeric objects via digital light processing additive manufacturing are reported. Notably, the printing procedure is readily accessible using only entry-level equipment under ambient conditions using visible light projection. The photoresin formulations were found to be modular in nature, and straightforward adjustments to the resin components enabled access to a range of compositions and mechanical properties. Collectively, the series includes silicones, hydrogels, and hybrids thereof. Printed test specimens displayed maximum elongations of up to 472% under tensile load, a tunable swelling behavior in water, and Shore A hardness values from 13.7 to 33.3. A combination of the resins was used to print a functional multimaterial three-armed pneumatic gripper. These photoresins could be transformative to advanced prototyping applications such as simulated human tissues, stimuli-responsive materials, wearable devices, and soft robotics.

The Effect of a Multi-Level Intervention on the Initiation of Antiretroviral Therapy (ART) among HIV-Infected Men Who Inject Drugs and Were Diagnosed Late in Thai Nguyen, Vietnam

PubMed Central

Zelaya, Carla E.; Le Minh, Nguyen; Lau, Bryan; Latkin, Carl A.; Viet Ha, Tran; Minh Quan, Vu; Mo, Thi Tran; Sripaipan, Teerada; Davis, Wendy W.; Celentano, David D.; Frangakis, Constantine; Go, Vivian F.

2016-01-01

Background In Vietnam, an estimated 256,000 people are living with HIV, and 58% of HIV-infections reported are among people who inject drugs (PWID). While antiretroviral therapy (ART) is widely available in Vietnam, marginalized hard-to-reach male PWID, demonstrate significantly reduced and delayed access to ART. Methods We investigated the effect of a randomized four-arm multi-level intervention trial on ART initiation among male PWID. Our analysis was conducted among a subset of trial participants (n = 136), who were newly diagnosed as HIV-infected, treatment naïve, and eligible for ART (baseline late diagnosis). The trial arms included: 1, standard of care (HIV testing and counseling); 2, structural-level intervention (door-to-door communications and community video screenings); 3, individual-level intervention (counseling plus group support); and 4, individual-level plus structural-level intervention. In a time-to-event analysis, we used a non-parametric approach for competing risks to estimate cumulative incidence function (CIF) for ART initiation (event of interest) by arm and the difference in CIF for each trial arm as compared to Arm 1. Follow-up was conducted at 6, 12, 18 and 24 months. Data collection occurred from 2009 to 2013. Findings By 24-months, 61.0% initiated ART, and 30.9% had died prior to ART initiation. In the first 6 months, participants in arm 4 (individual plus community intervention) had a 28% (95% confidence interval (CI): 6–50%) increased probability of initiating ART. Despite increasing coverage of ART in all arms throughout follow-up, participants in arm 4 retained a 31% (95% CI: 5–56%) increased probability of initiating ART. The individual and community components of the intervention were only effective when delivered together. Conclusions Marginalized, hard-to-reach men, who do not routinely engage in HIV services, and therefore come into care late, may benefit significantly from both individual counseling and group support, in combination with community-focused stigma reduction, when being referred and attempting to initiate urgently needed ART. PMID:27579772

The Effect of a Multi-Level Intervention on the Initiation of Antiretroviral Therapy (ART) among HIV-Infected Men Who Inject Drugs and Were Diagnosed Late in Thai Nguyen, Vietnam.

PubMed

Zelaya, Carla E; Le Minh, Nguyen; Lau, Bryan; Latkin, Carl A; Viet Ha, Tran; Minh Quan, Vu; Mo, Thi Tran; Sripaipan, Teerada; Davis, Wendy W; Celentano, David D; Frangakis, Constantine; Go, Vivian F

2016-01-01

In Vietnam, an estimated 256,000 people are living with HIV, and 58% of HIV-infections reported are among people who inject drugs (PWID). While antiretroviral therapy (ART) is widely available in Vietnam, marginalized hard-to-reach male PWID, demonstrate significantly reduced and delayed access to ART. We investigated the effect of a randomized four-arm multi-level intervention trial on ART initiation among male PWID. Our analysis was conducted among a subset of trial participants (n = 136), who were newly diagnosed as HIV-infected, treatment naïve, and eligible for ART (baseline late diagnosis). The trial arms included: 1, standard of care (HIV testing and counseling); 2, structural-level intervention (door-to-door communications and community video screenings); 3, individual-level intervention (counseling plus group support); and 4, individual-level plus structural-level intervention. In a time-to-event analysis, we used a non-parametric approach for competing risks to estimate cumulative incidence function (CIF) for ART initiation (event of interest) by arm and the difference in CIF for each trial arm as compared to Arm 1. Follow-up was conducted at 6, 12, 18 and 24 months. Data collection occurred from 2009 to 2013. By 24-months, 61.0% initiated ART, and 30.9% had died prior to ART initiation. In the first 6 months, participants in arm 4 (individual plus community intervention) had a 28% (95% confidence interval (CI): 6-50%) increased probability of initiating ART. Despite increasing coverage of ART in all arms throughout follow-up, participants in arm 4 retained a 31% (95% CI: 5-56%) increased probability of initiating ART. The individual and community components of the intervention were only effective when delivered together. Marginalized, hard-to-reach men, who do not routinely engage in HIV services, and therefore come into care late, may benefit significantly from both individual counseling and group support, in combination with community-focused stigma reduction, when being referred and attempting to initiate urgently needed ART.

The Advanced Placement Arms Race and the Reproduction of Educational Inequality

ERIC Educational Resources Information Center

Klugman, Joshua

2013-01-01

Background: Access to Advanced Placement (AP) courses is stratified by class and race. Researchers have identified how schools serving disadvantaged students suffer from various kinds of resource deprivations, concluding that interventions are needed to equalize access to AP courses. On the other hand, the theory of Effectively Maintained…

Forearm versus upper arm grafts for vascular access.

PubMed

Gage, Shawn M; Lawson, Jeffrey H

2017-03-06

Forearm and upper arm arteriovenous grafts perform similarly in terms of patency and complications. Primary patency at 1 year for forearm arteriovenous grafts versus upper arm grafts ranges from 22%-50% versus 22%-42%, and secondary patency at 1 year ranges from 78%-89% versus 52%-67%), respectively. Secondary patency at 2 years, ranges from 30%-64% versus 35%-60% for forearm and upper arteriovenous graft, respectively. Ample pre-operative planning is essential to improved clinical success and the decision to place a graft at one location versus the other should be based solely on previous access history, physical exam, appropriate venous imaging, and other factors that make up the clinical picture. Operative implant strategies and risk of complications are very similar between the two configurations. Postoperative ischemia due to steal syndrome is a potential complication that requires immediate attention. Utilization of the proximal radial or ulnar artery for inflow for the graft can minimize risk of clinically relevant steal syndrome.

Models of anxiety: responses of mice to novelty and open spaces in a 3D maze.

PubMed

Ennaceur, A; Michalikova, S; van Rensburg, R; Chazot, P L

2006-11-01

The present report describes the emotional responses of different strains of mice to exposure to a novel open space model of anxiety using a 3D spatial navigation task. The 3D maze is modification of the radial maze with flexible arms that can be raised above or lowered below the horizontal level of a central platform. To access the arms animals need to cross a bridge linking the arms to the central platform. In this model, mice are exposed to novelty in an unfamiliar open space setting with no safe alternative. Fear from novelty is compounded with the need to explore. The drive to escape and the drive to approach are intermingled making this open space model radically different from the current models of anxiety which provide animals with the choice between safe and anxiogenic spaces. In a series of experiments, we examined the behaviour of different groups of mice from C57, C3H, CD1 and Balb/c strains. In the first experiment, different groups of C57 mice were tested in one of the three arms configurations. In the second experiment, C57 mice were compared to C3H mice. In the third experiment, C57 mice were compared to CD1 and Balb/c mice in the raised arm configuration over three successive sessions. In the fourth experiment, we examined the behaviour of C57 mice in the lowered arm configuration with an open and an enclosed central. In the final experiment, we examined the difference between C57 and C3H mice of both genders. Using several spatio-temporal parameters of the transition responses between central platform, bridges and arms, we have been able to show consistent results demonstrating significant differences between C57 and C3H mice, and between Balb/c and both C57 and CD1 mice. C3H appear more anxious than C57 mice, and Balb/c mice seem more anxious than C57 and CD1 mice. We also observed significant differences between sexes in C3H mice but not in C57 mice. C3H male mice appear more anxious than C3H female mice and than both C57 male and female mice. In the lowered arm configuration with an enclosed central platform, C57 mice took longer time to make a first entry to an arm, made more visits to bridges before first entry to an arm and required longer time between re-entries to arms, spent longer time on the central platform and shorter time on arms compared to mice in the other arm configurations. They also made frequent entries to the centre and bridges compared to mice in the lowered arm with an open central platform. These results demonstrate not only the sensitivity of the parameters of the test but also the consistencies and concordances of the results which make this 3D maze a valuable new tool in the study of the underlying neural mechanisms of anxiety responses in addition to learning and memory, and in assessing the effects of potential anxiolytic drugs. In this report we examine methodological issues related to the design of animal behavioural paradigms and question the value and the construct validity of the current models of human anxiety.

Commerical Crew Astronauts Visit Launch Complex 39A

NASA Image and Video Library

2018-03-27

Commercial Crew Program astronauts, from the left, Suni Williams, Eric Boe, Bob Behnken and Doug Hurley take in the view from the top of Launch Complex 39A at Kennedy Space Center. The astronauts toured the pad for an up-close look at modifications that are in work for the SpaceX Crew Dragon flight tests. Tower modifications included l removal of the space shuttle era rotating service structure. Future integration of the crew access arm will allow for safe crew entry for launch and exit from the spacecraft in the unlikely event a pad abort is required.

Commerical Crew Astronauts Visit Launch Complex 39A

NASA Image and Video Library

2018-03-27

Commercial Crew Program astronauts, from the left Doug Hurley, Eric Boe, Bob Behnken and Suni Williams, pose just outside Launch Complex 39A at NASA's Kennedy Space Center in Florida. The astronauts toured the pad for an up-close look at modifications that are in work for the SpaceX Crew Dragon flight tests. The tower modifications included removal of the space shuttle era rotating service structure. Future integration of the crew access arm will allow for safe crew entry for launch and exit from the spacecraft in the unlikely event a pad abort is required.

Single-site access robot-assisted epicardial mapping with a snake robot: preparation and first clinical experience.

PubMed

Neuzil, Petr; Cerny, Stepan; Kralovec, Stepan; Svanidze, Oleg; Bohuslavek, Jan; Plasil, Petr; Jehlicka, Pavel; Holy, Frantisek; Petru, Jan; Kuenzler, Richard; Sediva, Lucie

2013-06-01

CardioARM, a highly flexible "snakelike" medical robotic system (Medrobotics, Raynham, MA), has been developed to allow physicians to view, access, and perform complex procedures intrapericardially on the beating heart through a single-access port. Transthoracic epicardial catheter mapping and ablation has emerged as a strategy to treat arrhythmias, particularly ventricular arrhythmias, originating from the epicardial surface. The aim of our investigation was to determine whether the CardioARM could be used to diagnose and treat ventricular tachycardia (VT) of epicardial origin. Animal and clinical studies of the CardioARM flexible robot were performed in hybrid surgical-electrophysiology settings. In a porcine model study, single-port pericardial access, navigation, mapping, and ablation were performed in nine animals. The device was then used in a small, single-center feasibility clinical study. Three patients, all with drug-refractory VT and multiple failed endocardial ablation attempts, underwent epicardial mapping with the flexible robot. In all nine animals, navigation, mapping, and ablation were successful without hemodynamic compromise. In the human study, all three patients demonstrated a favorable safety profile, with no major adverse events through a 30-day follow-up. Two cases achieved technical success, in which an electroanatomic map of the epicardial ventricle surface was created; in the third case, blood obscured visualization. These results, although based on a limited number of experimental animals and patients, show promise and suggest that further clinical investigation on the use of the flexible robot in patients requiring epicardial mapping of VT is warranted.

KSC-02pd1741

NASA Image and Video Library

2002-11-15

KENNEDY SPACE CENTER, FLA. -- An ultrasound device is held at the site where the honeycomb shell around Endeavour's robotic arm has been cut to inspect the arm. A scrape of the shell occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

'TXT2BFiT' a mobile phone-based healthy lifestyle program for preventing unhealthy weight gain in young adults: study protocol for a randomized controlled trial.

PubMed

Hebden, Lana; Balestracci, Kate; McGeechan, Kevin; Denney-Wilson, Elizabeth; Harris, Mark; Bauman, Adrian; Allman-Farinelli, Margaret

2013-03-18

Despite international efforts to arrest increasing rates of overweight and obesity, many population strategies have neglected young adults as a target group. Young adults are at high risk for unhealthy weight gain which tends to persist throughout adulthood with associated chronic disease health risks. TXT2BFiT is a nine month two-arm parallel-group randomized controlled trial aimed at improving weight management and weight-related dietary and physical activity behaviors among young adults. Participants are recruited via general practice (primary medical care) clinics in Sydney, New South Wales, Australia. All participants receive a mailed resource outlining national physical activity and dietary guidelines and access to the study website. Additional resources accessible to the intervention arm via the study website include Smartphone mobile applications, printable handouts, an interactive healthy weight tracker chart, and a community blog. The study consists of two phases: (1) Intensive phase (weeks 1 to 12): the control arm receives four short message service (SMS) text messages; the intervention arm receives eight SMS messages/week tailored to their baseline stage-of-change, one Email/week, and personalized coaching calls during weeks 0, 2, 5, 8, and 11; and (2) Maintenance phase (weeks 14 to 36): the intervention arm receives one SMS message/month, one Email/month and booster coaching calls during months 5 and 8. A sample of N = 354 (177 per arm) is required to detect differences in primary outcomes: body weight (kg) and body mass index (kg/m2), and secondary outcomes: physical activity, sitting time, intake of specific foods, beverages and nutrients, stage-of-change, self-efficacy and participant well-being, at three and nine months. Program reach, costs, implementation and participant engagement will also be assessed. This mobile phone based program addresses an important gap in obesity prevention efforts to date. The method of intervention delivery is via platforms that are highly accessible and appropriate for this population group. If effective, further translational research will be required to assess how this program might operate in the broader community. Australian New Zealand Clinical Trials Registry ACTRN12612000924853.

Protocol for population testing of an Internet-based Personalised Decision Support system for colorectal cancer screening

PubMed Central

2010-01-01

Background Australia has a comparatively high incidence of colorectal (bowel) cancer; however, population screening uptake using faecal occult blood test (FOBT) remains low. This study will determine the impact on screening participation of a novel, Internet-based Personalised Decision Support (PDS) package. The PDS is designed to measure attitudes and cognitive concerns and provide people with individually tailored information, in real time, that will assist them with making a decision to screen. The hypothesis is that exposure to (tailored) PDS will result in greater participation in screening than participation following exposure to non-tailored PDS or resulting from the current non-tailored, paper-based approach. Methods/design A randomised parallel trial comprising three arms will be conducted. Men and women aged 50-74 years (N = 3240) will be recruited. They must have access to the Internet; have not had an FOBT within the previous 12 months, or sigmoidoscopy or colonoscopy within the previous 5 years; have had no clinical diagnosis of bowel cancer. Groups 1 and 2 (PDS arms) will access a website and complete a baseline survey measuring decision-to-screen stage, attitudes and cognitive concerns and will receive immediate feedback; Group 1 will receive information 'tailored' to their responses in the baseline survey and group 2 will received 'non-tailored' bowel cancer information. Respondents in both groups will subsequently receive an FOBT kit. Group 3 (usual practice arm) will complete a paper-based version of the baseline survey and respondents will subsequently receive 'non-tailored' paper-based bowel cancer information with accompanying FOBT kit. Following despatch of FOBTs, all respondents will be requested to complete an endpoint survey. Main outcome measures are (1) completion of FOBT and (2) change in decision-to-screen stage. Secondary outcomes include satisfaction with decision and change in attitudinal scores from baseline to endpoint. Analyses will be performed using Chi-square tests, analysis of variance and log binomial generalized linear models as appropriate. Discussion It is necessary to restrict participants to Internet users to provide an appropriately controlled evaluation of PDS. Once efficacy of the approach has been established, it will be important to evaluate effectiveness in the wider at-risk population, and to identify barriers to its implementation in those settings. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12610000095066 PMID:20843369

Validity and Reproducibility of an Incremental Sit-To-Stand Exercise Test for Evaluating Anaerobic Threshold in Young, Healthy Individuals.

PubMed

Nakamura, Keisuke; Ohira, Masayoshi; Yokokawa, Yoshiharu; Nagasawa, Yuya

2015-12-01

Sit-to-stand exercise (STS) is a common activity of daily living. The objectives of the present study were: 1) to assess the validity of aerobic fitness measurements based on anaerobic thresholds (ATs), during incremental sit-to-stand exercise (ISTS) with and without arm support compared with an incremental cycle-ergometer (CE) test; and 2) to examine the reproducibility of the AT measured during the ISTSs. Twenty-six healthy individuals randomly performed the ISTS and CE test. Oxygen uptakes at the AT (AT-VO2) and heart rate at the AT (AT-HR) were determined during the ISTSs and CE test, and repeated-measures analyses of variance and Tukey's post-hoc test were used to evaluate the differences between these variables. Pearson correlation coefficients were used to assess the strength of the relationship between AT-VO2 and AT-HR during the ISTSs and CE test. Data analysis yielded the following correlations: AT-VO2 during the ISTS with arm support and the CE test, r = 0.77 (p < 0.05); AT-VO2 during the ISTS without arm support and the CE test, r = 0.70 (p < 0.05); AT-HR during the ISTS with arm support and the CE test, r = 0.80 (p < 0.05); and AT-HR during the ISTS without arm support and the CE test, r = 0.66 (p < 0.05). The AT-VO2 values during the ISTS with arm support (18.5 ± 1.9 mL·min(-1)·kg(-1)) and the CE test (18.4 ± 1.8 mL·min(-1)·kg(-1)) were significantly higher than those during the ISTS without arm support (16.6 ± 1.8 mL·min(-1)·kg(-1); p < 0.05). The AT-HR values during the ISTS with arm support (126 ± 10 bpm) and the CE test (126 ± 13 bpm) were significantly higher than those during the ISTS without arm support (119 ± 9 bpm; p < 0.05). The ISTS with arm support may provide a cardiopulmonary function load equivalent to the CE test; therefore, it is a potentially valid test for evaluating AT-VO2 and AT-HR in healthy, young adults. Key pointsThe ISTS is a simple test that varies only according to the frequency of standing up, and requires only a small space and a chair.The ISTS with arm support is valid and reproducible, and is a safe test for evaluating AT in healthy young adults.For evaluating the AT, the ISTS may serve as a valid alternative to conventional CPX, using either a cycle ergometer or treadmill, in cases where the latter methods are difficult to implement.

[Validation of the Omron HEM-650 wrist blood pressure device using the British Hypertension Society protocol in emergency patients in Hong Kong].

PubMed

Hung, Kevin KC; Lai, W Y; Cocks, Robert A; Rainer, Timothy H; Graham, Colin A

2015-10-01

Automated wrist cuff blood pressure (BP) devices are more compact and easier to use, particularly when access to the upper arm is restricted, for example in emergencies. We tested the Omron HEM-650 wrist device using the validation criteria of the British Hypertension Society (BHS) protocol in a major emergency department (ED) in Hong Kong. 85 patients had three measurements each by both the Omron HEM-650 wrist device and the mercury sphygmomanometer. The conventional automated BP with arm cuff was also measured using an oscillometric (Colin BP-88S NXT) device for comparison. The Omron HEM-650 achieved a grade B for both systolic and diastolic BP and demonstrated acceptable accuracy and reliability in Chinese patients in the emergency setting. The Omron HEM 650 wrist device can be recommended for use in adult emergency patients. Further research is warranted for its use in pregnant women and critically ill patients.

Cortical Spiking Network Interfaced with Virtual Musculoskeletal Arm and Robotic Arm.

PubMed

Dura-Bernal, Salvador; Zhou, Xianlian; Neymotin, Samuel A; Przekwas, Andrzej; Francis, Joseph T; Lytton, William W

2015-01-01

Embedding computational models in the physical world is a critical step towards constraining their behavior and building practical applications. Here we aim to drive a realistic musculoskeletal arm model using a biomimetic cortical spiking model, and make a robot arm reproduce the same trajectories in real time. Our cortical model consisted of a 3-layered cortex, composed of several hundred spiking model-neurons, which display physiologically realistic dynamics. We interconnected the cortical model to a two-joint musculoskeletal model of a human arm, with realistic anatomical and biomechanical properties. The virtual arm received muscle excitations from the neuronal model, and fed back proprioceptive information, forming a closed-loop system. The cortical model was trained using spike timing-dependent reinforcement learning to drive the virtual arm in a 2D reaching task. Limb position was used to simultaneously control a robot arm using an improved network interface. Virtual arm muscle activations responded to motoneuron firing rates, with virtual arm muscles lengths encoded via population coding in the proprioceptive population. After training, the virtual arm performed reaching movements which were smoother and more realistic than those obtained using a simplistic arm model. This system provided access to both spiking network properties and to arm biophysical properties, including muscle forces. The use of a musculoskeletal virtual arm and the improved control system allowed the robot arm to perform movements which were smoother than those reported in our previous paper using a simplistic arm. This work provides a novel approach consisting of bidirectionally connecting a cortical model to a realistic virtual arm, and using the system output to drive a robotic arm in real time. Our techniques are applicable to the future development of brain neuroprosthetic control systems, and may enable enhanced brain-machine interfaces with the possibility for finer control of limb prosthetics.

The effect of arm sling on balance in patients with hemiplegia.

PubMed

Acar, Merve; Karatas, Gulcin Kaymak

2010-10-01

The aim of this study was to investigate the effect of an arm sling on balance in patients with, hemiplegia following a stroke. Twenty-six patients with hemiplegia (11 men, 15 women) who had, shoulder subluxation were enrolled in the study. Balance was evaluated by the Berg Balance Scale, the, Functional Reach test, and a static balance index which was measured by the Kinesthetic Ability, Trainer 3000. Balance tests were performed twice, with arm sling and without arm sling use. Results of, this study show that the Berg Balance Scores and static balance index ameliorated with arm sling use (p=0.005 and p=0.004, respectively). Likewise, the Functional Reach test was better when performed with an arm sling (p=0.039). In conclusion, arm slings have a beneficial effect on balance in patients, with hemiplegia. An arm sling may be applied for its possible beneficial effect on balance especially in, the early phases of stroke rehabilitation while the upper extremity is still flaccid and arm swing is, reduced. Copyright © 2010 Elsevier B.V. All rights reserved.

The physiotherapeutic context of loss of dominant arm function due to occupational accidents.

PubMed

Kostiukow, Anna; Kaluga, Elżbieta; Samborski, Włodzimierz; Rostkowska, Elżbieta

2016-12-23

The study examines the problem of dominant arm function loss in rural adult patients due to work-related accidents. The types of risks involved in farmyard work include falling from a height, manually moving loads, overturning/accident whilst driving an agricultural tractor, noise and vibration, use of pesticides, and the risk of being cut or injured. The study focuses on adaptation of the non-dominant arm. The main aim of the study was evaluation of visual-motor coordination on the basis of performance of the non-dominant hand in patients after the loss of function of the dominant arm. The research sample consisted of 52 patients with a permanent or temporary loss of function or severely limited function of the dominant arm. The subjects were patients with arm amputations due to various occupational injuries sustained while operating agricultural and construction machinery and forestry equipment, following traumas or complicated medical surgeries of the arm, or due to car accidents. The following tests were applied in the analysis: I) Dufour cross-shaped apparatus test for assessing visual motor-coordination; II) paper-and-pencil tests and the Relay Baton motor fitness test; III) anthropometric measurements; IV) Edinburgh Handedness Inventory; and V) a questionnaire survey. The results of the apparatus and motor tests indicate the same tendency: reaction to stimuli measured on the basis of performance of the non-dominant arm is longer in shorter and older patients. Visual-motor coordination, as measured by the performance of the non-dominant arm, is significantly affected by the subject's body height and arm length.

Impact of a focused nutrition educational intervention coupled with improved access to fresh produce on purchasing behavior and consumption of fruits and vegetables in overweight patients with diabetes mellitus.

PubMed

Weinstein, Eleanor; Galindo, Rodolfo J; Fried, Martin; Rucker, Lisa; Davis, Nichola J

2014-01-01

The purpose of this study was to test the impact of distributing coupons redeemable at farmers markets plus an educational intervention on fruit and vegetable (F&V) purchase and consumption in overweight patients with type 2 diabetes (T2DM). Seventy-eight participants with T2DM being followed at Jacobi Medical Center, a large public hospital in the Bronx, New York, were randomized to receive the standard of care or a 1-hour session focused on benefits of F&V consumption and $6 in coupons. Questionnaires assessed demographics, F&V intake, and farmers market purchasing at baseline and 12 weeks. Clinical parameters were obtained through chart review at baseline and at 12 weeks. Participants were predominantly Latino, females, and low income. At 12 weeks, there was a statistically significant increase in the number of participants in the intervention arm who reported purchasing from a farmers market. In addition, there was a minimal increase in fresh fruit intake in the intervention arm at 12 weeks. Focused education combined with a small economic incentive resulted in an increase in purchasing behavior and fresh fruit intake per day. A more intense behavioral intervention combined with increased access may result in a significant impact on obesity and diabetes, particularly among low-income and racially diverse communities.

Isolated effects of peripheral arm and central body cooling on arm performance.

PubMed

Giesbrecht, G G; Wu, M P; White, M D; Johnston, C E; Bristow, G K

1995-10-01

Whole body cooling impairs manual arm performance. The independent contributions of local (peripheral) and/or whole body (central) cooling are not known. Therefore, a protocol was developed in which the arm and the rest of the body could be independently cooled. Biceps temperature (Tmus), at a depth of 20 mm, and esophageal temperature (Tes) were measured. Six subjects were immersed to the clavicles in a tank (body tank) of water under 3 conditions: 1) cold body-cold arm (CB-CA); 2) warm body-cold arm (WB-CA); and 3) cold body-warm arm (CB-WA). In the latter two conditions, subjects placed their dominant arm in a separate (arm) tank. Water temperature (Tw) in each tank was independently controlled. In conditions requiring cold body and/or cold arm, Tw in the appropriate tanks was 8 degrees C. In conditions requiring warm body and/or warm arm, Tw in the appropriate tanks was adjusted between 29 and 38 degrees C to maintain body/arm temperature at baseline values. A battery of 6 tests, requiring fine or gross motor movements, were performed immediately before immersion and after 15, 45, and 70 minutes of immersion. In CB-CA, Tes decreased from an average of 37.2 to 35.6 degrees C and Tmus decreased from 34.6 to 22.0 degrees C. In WB-CA, Tmus decreased to 18.1 degrees C (Tes = 37.1 degrees C), and in CB-WA, Tes decreased to 35.8 degrees C (Tmus = 34.5 degrees C). By the end of immersion, there were significant decrements (43-85%) in the performance of all tests in CB-CA and WB-CA (p < 0.0002); scores for each test were similar in these two conditions. There was no significant change in scores throughout the CB-WA condition. In both conditions with arm cooling (i.e., WB-CA and CB-CA), Tmus accounted for 85-98% of the variance in all tests. When the core was cooled in the CB-WA condition, Tes was significantly correlated to scores in only two tests (accounted for 90 and 93% of the variance) although the actual effect was small. In the CB-CA condition, partial correlations indicated that Tes accounted for 4-10% of the variance in scores of 4 tests. We conclude that cooling of the body and/or the arm elicits large decrements in finger, hand and arm performance. The decrements are due almost entirely to the local effects of arm tissue cooling.

KSC-2012-6230

NASA Image and Video Library

2012-11-14

CAPE CANAVERAL, Fla. – The Orion spacecraft crew access arm, or CAA, seal prototype is being checked by technicians and engineers at the Launch Equipment Test Facility at NASAs Kennedy Space Center in Florida. The tests will use a mockup of the vehicle Outer Mold Line and CAA white room to assess the performance of the seal while simulating vehicle to CAA white room excursions. Orion is the exploration spacecraft designed to carry crews to space beyond low Earth orbit. It will provide emergency abort capability, sustain the crew during the space travel and provide safe re-entry from deep space return velocities. The first unpiloted test flight of the Orion is scheduled to launch in 2014 atop a Delta IV rocket and in 2017 on a Space Launch System rocket. For more information, visit http://www.nasa.gov/orion Photo credit: NASA/Jim Grossmann

KSC-2012-6228

NASA Image and Video Library

2012-11-14

CAPE CANAVERAL, Fla. – The Orion spacecraft crew access arm, or CAA, seal prototype is being checked by technicians and engineers at the Launch Equipment Test Facility at NASAs Kennedy Space Center in Florida. The tests will use a mockup of the vehicle Outer Mold Line and CAA white room to assess the performance of the seal while simulating vehicle to CAA white room excursions. Orion is the exploration spacecraft designed to carry crews to space beyond low Earth orbit. It will provide emergency abort capability, sustain the crew during the space travel and provide safe re-entry from deep space return velocities. The first unpiloted test flight of the Orion is scheduled to launch in 2014 atop a Delta IV rocket and in 2017 on a Space Launch System rocket. For more information, visit http://www.nasa.gov/orion Photo credit: NASA/Jim Grossmann

Vascular Accesses for Haemodialysis in the Upper Arm Cause Greater Reduction in the Carotid-Brachial Stiffness than Those in the Forearm: Study of Gender Differences

PubMed Central

Bia, Daniel; Cabrera-Fischer, Edmundo I.; Zócalo, Yanina; Galli, Cintia; Graf, Sebastián; Valtuille, Rodolfo; Pérez-Cámpos, Héctor; Saldías, María; Álvarez, Inés; Armentano, Ricardo L.

2012-01-01

Purpose. To evaluate in chronically haemodialysed patients (CHPs), if: (1) the vascular access (VA) position (upper arm or forearm) is associated with differential changes in upper limb arterial stiffness; (2) differences in arterial stiffness exist between genders associated with the VA; (3) the vascular substitute (VS) of choice, in biomechanical terms, depends on the previous VA location and CHP gender. Methods. 38 CHPs (18 males; VA in upper arm: 18) were studied. Left and right carotid-brachial pulse wave velocity (PWVc-b) was measured. In in vitro studies, PWV was obtained in ePTFE prostheses and in several arterial and venous homografts obtained from donors. The biomechanical mismatch (BM) between CHP native vessel (NV) and VS was calculated. Results/Conclusions. PWVc-b in upper limbs with VA was lower than in the intact contralateral limbs (P < 0.05), and differences were higher (P < 0.05) when the VA was performed in the upper arm. Differences between PWVc-b in upper limbs with VA (in the upper arm) with respect to intact upper limbs were higher (P < 0.05) in males. Independently of the region in which the VA was performed, the homograft that ensured the minimal BM was the brachial artery. The BM was highly dependent on gender and the location in the upper limb in which the VA was performed. PMID:22567282

Testing non-inferiority of a new treatment in three-arm clinical trials with binary endpoints.

PubMed

Tang, Nian-Sheng; Yu, Bin; Tang, Man-Lai

2014-12-18

A two-arm non-inferiority trial without a placebo is usually adopted to demonstrate that an experimental treatment is not worse than a reference treatment by a small pre-specified non-inferiority margin due to ethical concerns. Selection of the non-inferiority margin and establishment of assay sensitivity are two major issues in the design, analysis and interpretation for two-arm non-inferiority trials. Alternatively, a three-arm non-inferiority clinical trial including a placebo is usually conducted to assess the assay sensitivity and internal validity of a trial. Recently, some large-sample approaches have been developed to assess the non-inferiority of a new treatment based on the three-arm trial design. However, these methods behave badly with small sample sizes in the three arms. This manuscript aims to develop some reliable small-sample methods to test three-arm non-inferiority. Saddlepoint approximation, exact and approximate unconditional, and bootstrap-resampling methods are developed to calculate p-values of the Wald-type, score and likelihood ratio tests. Simulation studies are conducted to evaluate their performance in terms of type I error rate and power. Our empirical results show that the saddlepoint approximation method generally behaves better than the asymptotic method based on the Wald-type test statistic. For small sample sizes, approximate unconditional and bootstrap-resampling methods based on the score test statistic perform better in the sense that their corresponding type I error rates are generally closer to the prespecified nominal level than those of other test procedures. Both approximate unconditional and bootstrap-resampling test procedures based on the score test statistic are generally recommended for three-arm non-inferiority trials with binary outcomes.

The feasibility, time savings and economic impact of a designated time appointment system at a busy HIV care clinic in Kenya: a randomized controlled trial.

PubMed

Kwena, Zachary A; Njoroge, Betty W; Cohen, Craig R; Oyaro, Patrick; Shikari, Rosemary; Kibaara, Charles K; Bukusi, Elizabeth A

2015-01-01

As efforts are made to reach universal access to ART in Kenya, the problem of congestion at HIV care clinics is likely to worsen. We evaluated the feasibility and the economic benefits of a designated time appointment system as a solution to decongest HIV care clinics. This was an explanatory two-arm open-label randomized controlled trial that enrolled 354 consenting participants during their normal clinic days and followed-up at subsequent clinic appointments for up to nine months. Intervention arm participants were given specific dates and times to arrive at the clinic for their next appointment while those in the control arm were only given the date and had the discretion to decide on the time to arrive as is the standard practice. At follow-up visits, we recorded arrival and departure times and asked the monetary value of work participants engaged in before and after clinic. We conducted multiple imputation to replace missing data in our primary outcome variables to allow for intention-to-treat analysis; and analyzed the data using Mann-Whitney U test. Overall, 72.1% of the intervention participants arrived on time, 13.3% arrived ahead of time and 14.6% arrived past scheduled time. Intervention arm participants spent a median of 65 [interquartile range (IQR), 52-87] minutes at the clinic compared to 197 (IQR, 173-225) minutes for control participants (p<0.01). Furthermore, intervention arm participants were more productively engaged on their clinic days valuing their cumulative work at a median of USD 10.5 (IQR, 60.0-16.8) compared to participants enrolled in the control arm who valued their work at USD 8.3 (IQR, 5.5-12.9; p=0.02). A designated time appointment system is feasible and provides substantial time savings associated with greater economic productivity for HIV patients attending a busy HIV care clinic.

Compendium of Arms Control Verification Proposals.

DTIC Science & Technology

1982-03-01

proposals. This appears to be the case for virtually all kinds of prospective arms control topics from general and complete disarmament to control of specific... virtually anywhere. Unrestricted access would be particularly necessary in the case of states which previously had nuclear weapons. Practically speaking...been transferred out of the area, it would be harder to check on remaining stocks without some intrusive inspection and it would be virtually impossible

Quantifying arm nonuse in individuals poststroke.

PubMed

Han, Cheol E; Kim, Sujin; Chen, Shuya; Lai, Yi-Hsuan; Lee, Jeong-Yoon; Osu, Rieko; Winstein, Carolee J; Schweighofer, Nicolas

2013-06-01

Arm nonuse, defined as the difference between what the individual can do when constrained to use the paretic arm and what the individual does when given a free choice to use either arm, has not yet been quantified in individuals poststroke. (1) To quantify nonuse poststroke and (2) to develop and test a novel, simple, objective, reliable, and valid instrument, the Bilateral Arm Reaching Test (BART), to quantify arm use and nonuse poststroke. First, we quantify nonuse with the Quality of Movement (QOM) subscale of the Actual Amount of Use Test (AAUT) by subtracting the AAUT QOM score in the spontaneous use condition from the AAUT QOM score in a subsequent constrained use condition. Second, we quantify arm use and nonuse with BART by comparing reaching performance to visual targets projected over a 2D horizontal hemi-work space in a spontaneous-use condition (in which participants are free to use either arm at each trial) with reaching performance in a constrained-use condition. All participants (N = 24) with chronic stroke and with mild to moderate impairment exhibited nonuse with the AAUT QOM. Nonuse with BART had excellent test-retest reliability and good external validity. BART is the first instrument that can be used repeatedly and practically in the clinic to quantify the effects of neurorehabilitation on arm use and nonuse and in the laboratory for advancing theoretical knowledge about the recovery of arm use and the development of nonuse and "learned nonuse" after stroke.

Multi-access laser communications transceiver system

NASA Technical Reports Server (NTRS)

Ross, Monte (Inventor); Lokerson, Donald C. (Inventor); Fitzmaurice, Michael W. (Inventor); Meyer, Daniel D. (Inventor)

1993-01-01

A satellite system for optical communications such as a multi-access laser transceiver system. Up to six low Earth orbiting satellites send satellite data to a geosynchronous satellite. The data is relayed to a ground station at the Earth's surface. The earth pointing geosynchronous satellite terminal has no gimbal but has a separate tracking mechanism for tracking each low Earth orbiting satellite. The tracking mechanism has a ring assembly rotatable about an axis coaxial with the axis of the field of view of the geosynchronous satellite and a pivotable arm mounted for pivotal movement on the ring assembly. An optical pickup mechanism at the end of each arm is positioned for optical communication with one of the orbiting satellites by rotation of the ring.

Development of a facility using robotics for testing automation of inertial instruments

NASA Technical Reports Server (NTRS)

Greig, Joy Y.; Lamont, Gary B.; Biezad, Daniel J.; Lewantowicz, Zdsislaw H.; Greig, Joy Y.

1987-01-01

The Integrated Robotics System Simulation (ROBSIM) was used to evaluate the performance of the PUMA 560 arm as applied to testing of inertial sensors. Results of this effort were used in the design and development of a feasibility test environment using a PUMA 560 arm. The implemented facility demonstrated the ability to perform conventional static inertial instrument tests (rotation and tumble). The facility included an efficient data acquisitions capability along with a precision test servomechanism function resulting in various data presentations which are included in the paper. Analysis of inertial instrument testing accuracy, repeatability and noise characteristics are provided for the PUMA 560 as well as for other possible commercial arm configurations. Another integral aspect of the effort was an in-depth economic analysis and comparison of robot arm testing versus use of contemporary precision test equipment.

Thickness and air gap measurement of assembled IR objectives

NASA Astrophysics Data System (ADS)

Lueerss, B.; Langehanenberg, P.

2015-05-01

A growing number of applications like surveillance, thermography, or automotive demand for infrared imaging systems. Their imaging performance is significantly influenced by the alignment of the individual lens elements. Besides the lateral orientation of lenses, the air spacing between the lenses is a crucial parameter. Because of restricted mechanical accessibility within an assembled objective, a non-contact technique is required for the testing of these parameters. So far commercial measurement systems were not available for testing of IR objectives since many materials used for infrared imaging are non-transparent at wavelengths below 2 μm. We herewith present a time-domain low coherent interferometer capable of measuring any kind of infrared material (e.g., Ge, Si, etc.) as well as VIS materials. The fiber-optic set-up is based on a Michelson-Interferometer in which the light from a broadband super-luminescent diode is split into a reference arm with a variable optical delay and a measurement arm where the sample is placed. On a photo detector, the reflected signals from both arms are superimposed and recorded as a function of the variable optical path. Whenever the group delay difference is zero, a coherence peak occurs and the relative lens' surface distances are derived from the optical delay. In order to penetrate IR materials, the instrument operates at 2.2 μm. The set-up allows the contactless determination of thicknesses and air gaps inside of assembled infrared objective lenses with accuracy in the micron range. It therefore is a tool for the precise manufacturing or quality control.

Thickness and air gap measurement of assembled IR objectives

NASA Astrophysics Data System (ADS)

Lueerss, B.; Langehanenberg, P.

2015-10-01

A growing number of applications like surveillance, thermography, or automotive demand for infrared imaging systems. Their imaging performance is significantly influenced by the alignment of the individual lenses. Besides the lateral orientation of lenses, the air spacing between the lenses is a crucial parameter. Because of restricted mechanical accessibility within an assembled objective, a non-contact technique is required for the testing of these parameters. So far, commercial measurement systems were not available for testing of IR objectives since most materials used for infrared imaging are non-transparent at wavelengths below 2 μm. We herewith present a time-domain low coherent interferometer capable of measuring any kind of infrared material (e.g., Ge, Si, etc.) as well as VIS materials. The set-up is based on a Michelson interferometer in which the light from a broadband superluminescent diode is split into a reference arm with a variable optical delay and a measurement arm where the sample is placed. On a detector, the reflected signals from both arms are superimposed and recorded as a function of the variable optical path. Whenever the group delay difference is zero, a coherence peak occurs and the relative distances of the lens surfaces are derived from the optical delay. In order to penetrate IR materials, the instrument operates at 2.2 μm. Together with an LWIR autocollimator, this technique allows for the determination of centering errors, lens thicknesses and air spacings of assembled IR objective lenses with a micron accuracy. It is therefore a tool for precision manufacturing and quality control.

[Aerodynamic characteristics of crewman's arms during windblast].

PubMed

Zhang, Yun-ran; Wu, Gui-rong

2003-10-01

To study the aerodynamic characteristics of crewman's arms with or without protective devices in the status with raised legs or not. The experiments were performed in an FL-24 transonic and supersonic wind tunnel, over Mach number range of 0.4-2.0, with 5 degrees-30 degrees angles of attack, 0 degrees - 90 degrees sideslip angles and Re number of (0.93-3.1) x 10(6). The test model was a 1/5-scale crewman/ejection seat combination. The aerodynamic characteristics of the various sections of crewman's arms were studied and analyzed. The results showed that 1) The effect of raised leg on the aerodynamic characteristics of the crewman's arms was very evident, and was related to the status of leg raising; 2) The sideslip considerably increased aerodynamic loads on the crewman's arms, in particular when beta=50 degrees the loads was severe in the test; 3) The tested protective devices was valid, the effectiveness of wind deflector in protecting crewman's arms was evident; 4) A formula for calculating aerodynamic force acting on crewman's arms was presented. 1)The tested protective devices was valid, and the effectiveness of wind deflector in protecting crewman's arms was evident; 2) An aerodynamic basis for the development of crewman windblast protective device was presented; 3)The calculation formula presented is useful in estimating aerodynamic forces of crewman's arms.

The Effects of Cache Modification on Food Caching and Retrieval Behavior by Rats

ERIC Educational Resources Information Center

McKenzie, T.L.B.; Bird, L.R.; Roberts, W.A.

2005-01-01

Rats cached pieces of cheese on four different arms of an eight-arm radial maze. On a retrieval test given 45min later, rats learned to return to arms where food was cached before arms where food had not been cached. Tests were then performed in which cache sites on one side of the maze were always modified (pilfered or degraded), but cache sites…

Accuracy Analysis and Validation of the Mars Science Laboratory (MSL) Robotic Arm

NASA Technical Reports Server (NTRS)

Collins, Curtis L.; Robinson, Matthew L.

2013-01-01

The Mars Science Laboratory (MSL) Curiosity Rover is currently exploring the surface of Mars with a suite of tools and instruments mounted to the end of a five degree-of-freedom robotic arm. To verify and meet a set of end-to-end system level accuracy requirements, a detailed positioning uncertainty model of the arm was developed and exercised over the arm operational workspace. Error sources at each link in the arm kinematic chain were estimated and their effects propagated to the tool frames.A rigorous test and measurement program was developed and implemented to collect data to characterize and calibrate the kinematic and stiffness parameters of the arm. Numerous absolute and relative accuracy and repeatability requirements were validated with a combination of analysis and test data extrapolated to the Mars gravity and thermal environment. Initial results of arm accuracy and repeatability on Mars demonstrate the effectiveness of the modeling and test program as the rover continues to explore the foothills of Mount Sharp.

ACT Test

MedlinePlus

... Sample Required? A blood sample drawn from a vein in your arm Test Preparation Needed? None Looking ... is obtained by inserting a needle into a vein in the arm. Is any test preparation needed ...

A Unified Approach for Reporting ARM Measurement Uncertainties Technical Report: Updated in 2016

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

Sisterson, Douglas

The U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Climate Research Facility is observationally based, and quantifying the uncertainty of its measurements is critically important. With over 300 widely differing instruments providing over 2,500 datastreams, concise expression of measurement uncertainty is quite challenging. ARM currently provides data and supporting metadata (information about the data or data quality) to its users through several sources. Because the continued success of the ARM Facility depends on the known quality of its measurements, ARM relies on Instrument Mentors and the ARM Data Quality Office to ensure, assess, and report measurement quality. Therefore, anmore » easily accessible, well-articulated estimate of ARM measurement uncertainty is needed. This report is a continuation of the work presented by Campos and Sisterson (2015) and provides additional uncertainty information from instruments not available in their report. As before, a total measurement uncertainty has been calculated as a function of the instrument uncertainty (calibration factors), the field uncertainty (environmental factors), and the retrieval uncertainty (algorithm factors). This study will not expand on methods for computing these uncertainties. As before, it will focus on the practical identification, characterization, and inventory of the measurement uncertainties already available to the ARM community through the ARM Instrument Mentors and their ARM instrument handbooks. This study continues the first steps towards reporting ARM measurement uncertainty as: (1) identifying how the uncertainty of individual ARM measurements is currently expressed, (2) identifying a consistent approach to measurement uncertainty, and then (3) reclassifying ARM instrument measurement uncertainties in a common framework.« less

A Model Evaluation Data Set for the Tropical ARM Sites

DOE Data Explorer

Jakob, Christian

2008-01-15

This data set has been derived from various ARM and external data sources with the main aim of providing modelers easy access to quality controlled data for model evaluation. The data set contains highly aggregated (in time) data from a number of sources at the tropical ARM sites at Manus and Nauru. It spans the years of 1999 and 2000. The data set contains information on downward surface radiation; surface meteorology, including precipitation; atmospheric water vapor and cloud liquid water content; hydrometeor cover as a function of height; and cloud cover, cloud optical thickness and cloud top pressure information provided by the International Satellite Cloud Climatology Project (ISCCP).

The Relation of Arm Exercise Peak Heart Rate to Stress Test Results and Outcome.

PubMed

Xian, Hong; Liu, Weijian; Marshall, Cynthia; Chandiramani, Pooja; Bainter, Emily; Martin, Wade H

2016-09-01

Arm exercise is an alternative to pharmacologic stress testing for >50% of patients unable to perform treadmill exercise, but no data exist regarding the effect of attained peak arm exercise heart rate on test sensitivity. Thus, the purpose of this investigation was to characterize the relationship of peak arm exercise heart rate responses to abnormal stress test findings, coronary revascularization, and mortality in patients unable to perform leg exercise. From 1997 until 2002, arm cycle ergometer stress tests were performed in 443 consecutive veterans age 64.1 yr (11.0 yr) (mean (SD)), of whom 253 also underwent myocardial perfusion imaging (MPI). Patients were categorized by frequency distributions of quartiles of percentage age-predicted peak heart rate (APPHR), heart rate reserve (HRR), and peak heart rate-systolic blood pressure product (PRPP). Exercise-induced ST-segment depression, abnormal MPI findings, coronary revascularization, and 12.0-yr (1.3 yr) Kaplan-Meier all-cause and cardiovascular mortality plots were then characterized by quartiles of APPHR, HRR, and PRPP. A reduced frequency of abnormal arm exercise ECG results was associated only with the lowest quartile of APPHR (≤69%) and HRR (≤43%), whereas higher frequency of abnormal MPI findings exhibited an inverse relationship trend with lower APPHR (P = 0.10) and HRR (P = 0.12). There was a strong inverse association of APPHR, HRR, and PRPP with all-cause (all P ≤ 0.01) and cardiovascular (P < 0.05) mortality. The frequency of coronary revascularization was unrelated to APPHR or HRR. Arm exercise ECG stress test sensitivity is only reduced at ≤69% APPHR or ≤43% HRR, whereas arm exercise MPI sensitivity and referral for coronary revascularization after arm exercise stress testing are not adversely affected by even a severely blunted peak heart rate. However, both all-cause mortality and cardiovascular mortality are strongly and inversely related to APPHR and HRR.

Using a tailored health information technology- driven intervention to improve health literacy and medication adherence in a Pakistani population with vascular disease (Talking Rx) - study protocol for a randomized controlled trial.

PubMed

Kamal, Ayeesha Kamran; Muqeet, Abdul; Farhat, Kashfa; Khalid, Wardah; Jamil, Anum; Gowani, Ambreen; Muhammad, Aliya Amin; Zaidi, Fabiha; Khan, Danyal; Elahi, Touseef; Sharif, Shahrukh; Raz, Sibtain; Zafar, Taha; Bokhari, Syedah Saira; Rahman, Nasir; Sultan, Fateh Ali Tipoo; Sayani, Saleem; Virani, Salim S

2016-03-05

Vascular disease, manifesting as myocardial infarction and stroke, is a major cause of morbidity and mortality, especially in low- and middle-income countries. Current estimates are that only one in six patients have good adherence to medications and very few have sufficient health literacy. Our aim is to explore the effectiveness and acceptability of Prescription Interactive Voice Response (IVR) Talking Prescriptions (Talking Rx) and SMS reminders in increasing medication adherence and health literacy in Pakistani patients with vascular disease. This is a randomized, controlled, single center trial. Adult participants, with access to a cell phone and a history of vascular disease, taking multiple risk-modifying medications (inclusive of anti-platelets and statins) will be selected from cerebrovascular and cardiovascular clinics. They will be randomized in a 1:1 ratio via a block design to the intervention or the control arm with both groups having access to a helpline number to address their queries in addition to standard of care as per institutional guidelines. Participants in the intervention group will also have access to Interactive Voice Response (IVR) technology tailored to their respective prescriptions in the native language (Urdu) and will have the ability to hear information about their medication dosage, correct use, side effects, mechanism of action and how and why they should use their medication, as many times as they like. Participants in the intervention arm will also receive scheduled SMS messages reminding them to take their medications. The primary outcome measure will be the comparison of the difference in adherence to anti-platelet and statin medication between baseline and at 3-month follow-up in each group measured by the Morisky Medication Adherence Scale. To ascertain the impact of our intervention on health literacy, we will also compare a local content-validated and modified version of Test of Health Literacy in Adults (TOFHLA) between the intervention and the control arm. We estimate that a sample size of 86 participants in each arm will be able to detect a difference of 1 point on the MMAS with a power of 90 % and significance level of 5 %. Accounting for an attrition rate of 15 %, we plan to enroll 100 participants in each arm (total study population = 200). We hypothesize that a linguistically tailored health IT intervention based on IVR and SMS will be associated with an improvement in adherence (to anti-platelet and lipid-lowering medications) and an improvement in health literacy in Pakistani patients with vascular disease. This innovative study will provide early data for the feasibility of the use of IT based prescriptions in an lower middle incorme country setting with limited numeracy and literacy skills. Clinical Trials.gov: NCT02354040 - 2 February 2015.

Gangs in El Salvador

DTIC Science & Technology

2013-03-01

job.6 3 In cities the familiarity with the handling of arms and armed combat were the only tools. Some of them were incorporated into...April 17, 2012. 40 Douglas Moreno, “Buscan apoyo para prevención de violencia en El Salvador,” June 22, 2012, http://hoylosangeles.com/news/2012/jun/22...buscan-apoyo-para-prevencion-de- violencia - en-el-sa/, (accessed December 10, 2012). 41 Cámara de Comercio e Industria de El Salvador “Propuesta

Release from proactive interference in rat spatial working memory.

PubMed

Roberts, William A; MacDonald, Hayden; Brown, Lyn; Macpherson, Krista

2017-09-01

A three-phase procedure was used to produce proactive interference (PI) in one trial on an eight-arm radial maze. Rats were forced to enter four arms for reward on an initial interference phase, to then enter the four remaining arms on a target phase, and to then choose among all eight arms on a retention test, with only the arms not visited in the target phase containing reward. Control trials involved only the target phase and the retention test. Lower accuracy was found on PI trials than on control trials, but performance on PI trials significantly exceeded chance, showing some retention of target memories. Changes in temporal and reward variables between the interference, target, and retention test phases showed release from PI, but changes in context and pattern of arm entry did not. It is suggested that the release from PI paradigm can be used to understand spatial memory encoding in rats and other species.

A Cluster Randomised Trial Introducing Rapid Diagnostic Tests into Registered Drug Shops in Uganda: Impact on Appropriate Treatment of Malaria

PubMed Central

Mbonye, Anthony K.; Magnussen, Pascal; Lal, Sham; Hansen, Kristian S.; Cundill, Bonnie; Chandler, Clare; Clarke, Siân E.

2015-01-01

Background Inappropriate treatment of malaria is widely reported particularly in areas where there is poor access to health facilities and self-treatment of fevers with anti-malarial drugs bought in shops is the most common form of care-seeking. The main objective of the study was to examine the impact of introducing rapid diagnostic tests for malaria (mRDTs) in registered drug shops in Uganda, with the aim to increase appropriate treatment of malaria with artemisinin-based combination therapy (ACT) in patients seeking treatment for fever in drug shops. Methods A cluster-randomized trial of introducing mRDTs in registered drug shops was implemented in 20 geographical clusters of drug shops in Mukono district, central Uganda. Ten clusters were randomly allocated to the intervention (diagnostic confirmation of malaria by mRDT followed by ACT) and ten clusters to the control arm (presumptive treatment of fevers with ACT). Treatment decisions by providers were validated by microscopy on a reference blood slide collected at the time of consultation. The primary outcome was the proportion of febrile patients receiving appropriate treatment with ACT defined as: malaria patients with microscopically-confirmed presence of parasites in a peripheral blood smear receiving ACT or rectal artesunate, and patients with no malaria parasites not given ACT. Findings A total of 15,517 eligible patients (8672 intervention and 6845 control) received treatment for fever between January-December 2011. The proportion of febrile patients who received appropriate ACT treatment was 72·9% versus 33·7% in the control arm; a difference of 36·1% (95% CI: 21·3 – 50·9), p<0·001. The majority of patients with fever in the intervention arm accepted to purchase an mRDT (97·8%), of whom 58·5% tested mRDT-positive. Drug shop vendors adhered to the mRDT results, reducing over-treatment of malaria by 72·6% (95% CI: 46·7– 98·4), p<0·001) compared to drug shop vendors using presumptive diagnosis (control arm). Conclusion Diagnostic testing with mRDTs compared to presumptive treatment of fevers implemented in registered drug shops substantially improved appropriate treatment of malaria with ACT. Trial Registration ClinicalTrials.gov NCT01194557. PMID:26200467

A Cluster Randomised Trial Introducing Rapid Diagnostic Tests into Registered Drug Shops in Uganda: Impact on Appropriate Treatment of Malaria.

PubMed

Mbonye, Anthony K; Magnussen, Pascal; Lal, Sham; Hansen, Kristian S; Cundill, Bonnie; Chandler, Clare; Clarke, Siân E

2015-01-01

Inappropriate treatment of malaria is widely reported particularly in areas where there is poor access to health facilities and self-treatment of fevers with anti-malarial drugs bought in shops is the most common form of care-seeking. The main objective of the study was to examine the impact of introducing rapid diagnostic tests for malaria (mRDTs) in registered drug shops in Uganda, with the aim to increase appropriate treatment of malaria with artemisinin-based combination therapy (ACT) in patients seeking treatment for fever in drug shops. A cluster-randomized trial of introducing mRDTs in registered drug shops was implemented in 20 geographical clusters of drug shops in Mukono district, central Uganda. Ten clusters were randomly allocated to the intervention (diagnostic confirmation of malaria by mRDT followed by ACT) and ten clusters to the control arm (presumptive treatment of fevers with ACT). Treatment decisions by providers were validated by microscopy on a reference blood slide collected at the time of consultation. The primary outcome was the proportion of febrile patients receiving appropriate treatment with ACT defined as: malaria patients with microscopically-confirmed presence of parasites in a peripheral blood smear receiving ACT or rectal artesunate, and patients with no malaria parasites not given ACT. A total of 15,517 eligible patients (8672 intervention and 6845 control) received treatment for fever between January-December 2011. The proportion of febrile patients who received appropriate ACT treatment was 72·9% versus 33·7% in the control arm; a difference of 36·1% (95% CI: 21·3 - 50·9), p<0·001. The majority of patients with fever in the intervention arm accepted to purchase an mRDT (97·8%), of whom 58·5% tested mRDT-positive. Drug shop vendors adhered to the mRDT results, reducing over-treatment of malaria by 72·6% (95% CI: 46·7- 98·4), p<0·001) compared to drug shop vendors using presumptive diagnosis (control arm). Diagnostic testing with mRDTs compared to presumptive treatment of fevers implemented in registered drug shops substantially improved appropriate treatment of malaria with ACT. ClinicalTrials.gov NCT01194557.

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

Grip strength and body composition in Turkana pastoralist children and adolescents.

PubMed

Little, Michael A

2017-03-01

In an earlier study, age changes and sex differences in grip strength were documented for adult Turkana pastoralists of Kenya (Little and Johnson, 1986). The objective here is to characterize age changes and sex differences in grip strength of Turkana children and adolescents in the context of arm lean tissue composition, and in comparison with other African, African-American, and non-Western populations. Anthropometric measurements, derived body composition values, and grip strength measures (maximum voluntary contraction) were taken on a sample of 232 nomadic Turkana pastoralist children (94 boys and 138 girls) aged 3 to 21 years. Relationships were tested between grip strength (in Newtons) and mid-upper arm (brachium) lean tissue cross-sectional areas. Comparisons were made among several different ethnic groups. Turkana children and adolescents had low arm muscle (derived lean tissue) and grip strength values when compared with U.S. NHANES percentile references. Girls' percentile rankings were greater than boys' percentile rankings for muscle and for grip strength. Both boys and girls were intermediate when compared with other non-Western populations and U.S. strength grip reference values. Correlations between grip strength and arm lean tissue areas were highly significant for both boys and girls. The greater relative muscle size and grip strength values of late adolescent girls compared to boys is consistent with an earlier study of adults. The difference is likely to result from greater physical subsistence activity and greater access to food in girls than in boys. Several suggestions are given to explain why Turkana youths have relatively small muscle sizes. © 2016 Wiley Periodicals, Inc.

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems

PubMed Central

Blana, Dimitra; Hincapie, Juan G.; Chadwick, Edward K.; Kirsch, Robert F.

2008-01-01

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs:motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model-calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems. PMID:18420213

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems.

PubMed

Blana, Dimitra; Hincapie, Juan G; Chadwick, Edward K; Kirsch, Robert F

2008-01-01

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs: motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems.

Cortical Spiking Network Interfaced with Virtual Musculoskeletal Arm and Robotic Arm

PubMed Central

Dura-Bernal, Salvador; Zhou, Xianlian; Neymotin, Samuel A.; Przekwas, Andrzej; Francis, Joseph T.; Lytton, William W.

2015-01-01

Embedding computational models in the physical world is a critical step towards constraining their behavior and building practical applications. Here we aim to drive a realistic musculoskeletal arm model using a biomimetic cortical spiking model, and make a robot arm reproduce the same trajectories in real time. Our cortical model consisted of a 3-layered cortex, composed of several hundred spiking model-neurons, which display physiologically realistic dynamics. We interconnected the cortical model to a two-joint musculoskeletal model of a human arm, with realistic anatomical and biomechanical properties. The virtual arm received muscle excitations from the neuronal model, and fed back proprioceptive information, forming a closed-loop system. The cortical model was trained using spike timing-dependent reinforcement learning to drive the virtual arm in a 2D reaching task. Limb position was used to simultaneously control a robot arm using an improved network interface. Virtual arm muscle activations responded to motoneuron firing rates, with virtual arm muscles lengths encoded via population coding in the proprioceptive population. After training, the virtual arm performed reaching movements which were smoother and more realistic than those obtained using a simplistic arm model. This system provided access to both spiking network properties and to arm biophysical properties, including muscle forces. The use of a musculoskeletal virtual arm and the improved control system allowed the robot arm to perform movements which were smoother than those reported in our previous paper using a simplistic arm. This work provides a novel approach consisting of bidirectionally connecting a cortical model to a realistic virtual arm, and using the system output to drive a robotic arm in real time. Our techniques are applicable to the future development of brain neuroprosthetic control systems, and may enable enhanced brain-machine interfaces with the possibility for finer control of limb prosthetics. PMID:26635598

Effectiveness of Provider and Community Interventions to Improve Treatment of Uncomplicated Malaria in Nigeria: A Cluster Randomized Controlled Trial.

PubMed

Onwujekwe, Obinna; Mangham-Jefferies, Lindsay; Cundill, Bonnie; Alexander, Neal; Langham, Julia; Ibe, Ogochukwu; Uzochukwu, Benjamin; Wiseman, Virginia

2015-01-01

The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT). Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs) with basic instruction (control); RDTs with provider training (provider arm); and RDTs with provider training plus a school-based community intervention (provider-school arm). The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93%) of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm) were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36): stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26) in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19) in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47). Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines. ClinicalTrials.gov NCT01350752.

A highly articulated robotic surgical system for minimally invasive surgery.

PubMed

Ota, Takeyoshi; Degani, Amir; Schwartzman, David; Zubiate, Brett; McGarvey, Jeremy; Choset, Howie; Zenati, Marco A

2009-04-01

We developed a novel, highly articulated robotic surgical system (CardioARM) to enable minimally invasive intrapericardial therapeutic delivery through a subxiphoid approach. We performed preliminary proof of concept studies in a porcine preparation by performing epicardial ablation. CardioARM is a robotic surgical system having an articulated design to provide unlimited but controllable flexibility. The CardioARM consists of serially connected, rigid cyclindrical links housing flexible working ports through which catheter-based tools for therapy and imaging can be advanced. The CardioARM is controlled by a computer-driven, user interface, which is operated outside the operative field. In six experimental subjects, the CardioARM was introduced percutaneously through a subxiphoid access. A commercial 5-French radiofrequency ablation catheter was introduced through the working port, which was then used to guide deployment. In all subjects, regional ("linear") left atrial ablation was successfully achieved without complications. Based on these preliminary studies, we believe that the CardioARM promises to enable deployment of a number of epicardium-based therapies. Improvements in imaging techniques will likely facilitate increasingly complex procedures.

Genetic mapping of a novel recessive allele for non-glaucousness in wild diploid wheat Aegilops tauschii: implications for the evolution of common wheat.

PubMed

Nishijima, Ryo; Tanaka, Chisa; Yoshida, Kentaro; Takumi, Shigeo

2018-04-01

Cuticular wax on the aerial surface of plants has a protective function against many environmental stresses. The bluish-whitish appearance of wheat leaves and stems is called glaucousness. Most modern cultivars of polyploid wheat species exhibit the glaucous phenotype, while in a wild wheat progenitor, Ae. tauschii, both glaucous and non-glaucous accessions exist. Iw2, a wax inhibitor locus on the short arm of chromosome 2D, is the main contributor to this phenotypic variation in Ae. tauschii, and the glaucous/non-glaucous phenotype of Ae. tauschii is usually inherited by synthetic hexaploid wheat. However, a few synthetic lines show the glaucous phenotype although the parental Ae. tauschii accessions are non-glaucous. Molecular marker genotypes indicate that the exceptional non-glaucous Ae. tauschii accessions share the same genotype in the Iw2 chromosomal region as glaucous accessions, suggesting that these accessions have a different causal locus for their phenotype. This locus was assigned to the long arm of chromosome 3D using an F 2 mapping population and designated W4, a novel glaucous locus in Ae. tauschii. The dominant W4 allele confers glaucousness, consistent with phenotypic observation of Ae. tauschii accessions and the derived synthetic lines. These results implied that glaucous accessions of Ae. tauschii with the W2W2iw2iw2W4W4 genotype could have been the D-genome donor of common wheat.

Use of an eight-arm radial water maze to assess working and reference memory following neonatal brain injury.

PubMed

Penley, Stephanie C; Gaudet, Cynthia M; Threlkeld, Steven W

2013-12-04

Working and reference memory are commonly assessed using the land based radial arm maze. However, this paradigm requires pretraining, food deprivation, and may introduce scent cue confounds. The eight-arm radial water maze is designed to evaluate reference and working memory performance simultaneously by requiring subjects to use extra-maze cues to locate escape platforms and remedies the limitations observed in land based radial arm maze designs. Specifically, subjects are required to avoid the arms previously used for escape during each testing day (working memory) as well as avoid the fixed arms, which never contain escape platforms (reference memory). Re-entries into arms that have already been used for escape during a testing session (and thus the escape platform has been removed) and re-entries into reference memory arms are indicative of working memory deficits. Alternatively, first entries into reference memory arms are indicative of reference memory deficits. We used this maze to compare performance of rats with neonatal brain injury and sham controls following induction of hypoxia-ischemia and show significant deficits in both working and reference memory after eleven days of testing. This protocol could be easily modified to examine many other models of learning impairment.

Awareness of and memory for arm weakness during intracarotid sodium amytal testing.

PubMed

Carpenter, K; Berti, A; Oxbury, S; Molyneux, A J; Bisiach, E; Oxbury, J M

1995-02-01

The traditional association between anosognosia for hemiplegia and the right hemisphere was investigated in 31 patients with unilateral temporal lobe pathology during intracarotid sodium amytal testing (ISA) before epilepsy surgery. Recall of arm weakness was examined by questioning at the end of the test, when memory for items presented during the hemiplegia was also examined. Significantly more patients were amnesic for left arm weakness than for right. Amnesia for right arm weakness (and speech arrest) was significantly associated with pathology in the temporal lobe on the non-injected side and with impaired recognition of the memory items. Amnesia for left arm weakness was independent of both. Examination of cases where injection was contralateral to a hemisphere without pathology, and which showed normal memory capacity under ISA conditions, revealed that 87% recalled right arm weakness, but only 22% recalled left arm weakness. Awareness of arm weakness during left hemiplegia was examined in nine patients. Five of them were not aware of the weakness. Three of the four others could not subsequently recall it. By inference from the generally unimpaired recall of right arm weakness, following left hemisphere inactivation by amytal, an intact right hemisphere is capable of both recognizing right arm weakness and mediating its subsequent recall. In contrast, the left hemisphere was aware of left arm weakness only in approximately 50% of cases and even when there had been awareness usually could not mediate its subsequent recall. The suggestion is made that the right hemisphere may have a specific mnestic function for arm weakness, and presumably for hemiplegia, additional to the gnostic function.

Creating a Reinforcement Learning Controller for Functional Electrical Stimulation of a Human Arm*

PubMed Central

Thomas, Philip S.; Branicky, Michael; van den Bogert, Antonie; Jagodnik, Kathleen

2010-01-01

Clinical tests have shown that the dynamics of a human arm, controlled using Functional Electrical Stimulation (FES), can vary significantly between and during trials. In this paper, we study the application of Reinforcement Learning to create a controller that can adapt to these changing dynamics of a human arm. Development and tests were done in simulation using a two-dimensional arm model and Hill-based muscle dynamics. An actor-critic architecture is used with artificial neural networks for both the actor and the critic. We begin by training it using a Proportional Derivative (PD) controller as a supervisor. We then make clinically relevant changes to the dynamics of the arm and test the actor-critic’s ability to adapt without supervision in a reasonable number of episodes. PMID:22081795

The Effect of the Assessment of Recruit Motivation and Strength (ARMS) Program on Army Accessions and Attrition

DTIC Science & Technology

2011-01-01

implementation of the ARMS program occurred in three phases. In 2005, the Army authorized six MEPS (Atlanta, Buffalo, Chicago, Sacramento, San Anto - nio, and...Nashville 0.054 28.5 1.8 0.803 0.298 1,316 Butte 0.052 34.1 2.2 0.800 0.450 482 Anchorage 0.077 32.2 2.6 0.800 0.600 324 Minneapolis 0.077 38.4 2.1 0.786

Reorganizing Geographic Combatant Command Headquarters for Joint Force 2020

DTIC Science & Technology

2013-05-01

Corps General James N. Mattis , U.S. Central Command Commander, before the House Armed Services Committee on March 7, 2012, about the posture of U.S...Prentice Hall, 2002. Legal Organization of Defense. http://www.ndu.edu/library/pbrc/36L52.pdf (accessed January 21, 2013). 99 Mattis , James N...Statement of U.S. Marine Corps General James N. Mattis , U.S. Central Command Commander, before the House Armed Services Committee on March 7, 2012

KSC-03pd0077

NASA Image and Video Library

2003-01-15

KENNEDY SPACE CENTER, FLA. -- The late afternoon sun highlights the external tank and solid rocket booster on Space Shuttle Columbia after rollback of the Rotating Service Structure on Launch Pad 39A. Visible are the orbiter access arm with the White Room extended to Columbia's cockpit, and at the top, the gaseous oxygen vent arm and cap, called the "beanie cap." Columbia is scheduled for launch Jan. 16 at 10:39 a.m. EST on mission STS-107, a research mission.

KSC-03pd0074

NASA Image and Video Library

2003-01-15

KENNEDY SPACE CENTER, FLA. -- The late afternoon sun highlights the external tank and solid rocket booster on Space Shuttle Columbia after rollback of the Rotating Service Structure on Launch Pad 39A. Visible are the orbiter access arm with the White Room extended to Columbia's cockpit, and at the top, the gaseous oxygen vent arm and cap, called the "beanie cap." Columbia is scheduled for launch Jan. 16 at 10:39 a.m. EST on mission STS-107, a research mission.

QuantiFERON-TB Gold In-Tube as a Confirmatory Test for Tuberculin Skin Test in Tuberculosis Contact Tracing: A Noninferiority Clinical Trial.

PubMed

Muñoz, Laura; Santin, Miguel; Alcaide, Fernando; Ruíz-Serrano, Maria Jesús; Gijón, Paloma; Bermúdez, Elena; Domínguez-Castellano, Angel; Navarro, María Dolores; Ramírez, Encarnación; Pérez-Escolano, Elvira; López-Prieto, María Dolores; Gutiérrez-Rodriguez, José; Anibarro, Luis; Calviño, Laura; Trigo, Matilde; Cifuentes, Carmen; García-Gasalla, Mercedes; Payeras, Antoni; Gasch, Oriol; Espasa, Mateu; Agüero, Ramon; Ferrer, Diego; Casas, Xavier; González-Cuevas, Araceli; García-Zamalloa, Alberto; Bikuña, Edurne; Lecuona, María; Galindo, Rosa; Ramírez-Lapausa, Marta; Carrillo, Raquel

2018-01-18

Screening strategies based on interferon-γ release assays in tuberculosis contact tracing may reduce the need for preventive therapy without increasing subsequent active disease. We conducted an open-label, randomized trial to test the noninferiority of a 2-step strategy with the tuberculin skin test (TST) followed by QuantiFERON-TB Gold In-Tube (QFT-GIT) as a confirmatory test (the TST/QFT arm) to the standard TST-alone strategy (TST arm) for targeting preventive therapy in household contacts of patients with tuberculosis. Participants were followed for 24 months after randomization. The primary endpoint was the development of tuberculosis, with a noninferiority margin of 1.5 percentage points. A total of 871 contacts were randomized. Four contacts in the TST arm and 2 in the TST/QFT arm developed tuberculosis. In the modified intention-to-treat analysis, this accounted for 0.99% in the TST arm and 0.51% in the TST/QFT arm (-0.48% difference; 97.5% confidence interval [CI], -1.86% to 0.90%); in the per-protocol analysis, the corresponding rates were 1.67% and 0.82% in the TST and TST/QFT arms, respectively (-0.85% difference; 97.5% CI, -3.14% to 1.43%). Of the 792 contacts analyzed, 65.3% in the TST arm and 42.2% in the TST/QFT arm were diagnosed with tuberculosis infection (23.1% difference; 95% CI, 16.4% to 30.0%). In low-incidence settings, screening household contacts with the TST and using QFT-GIT as a confirmatory test is not inferior to TST-alone for preventing active tuberculosis, allowing a safe reduction of preventive treatments. NCT01223534. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

KSC-06pd0484

NASA Image and Video Library

2006-03-14

KENNEDY SPACE CENTER, FLA. - Inside the Orbiter Processing Facility bay 3 at NASA's Kennedy Space Center, workers lower Discovery's robotic arm onto a flat bed in a work area. The arm was removed from Discovery's payload bay. The arm was removed due to damage found on the arm after it was accidentally bumped by a bridge bucket in the payload bay. Ultrasound inspections revealed a small crack, measuring 1.25 inches by 0.015 inch deep. The arm will be sent back to the vendor for repair. The bucket was being used by technicians cleaning the area and was in the process of being stowed. A bridge bucket is a personnel transport device that is suspended from an overhead bridge that moves back and forth above the shuttle's mid-body. It allows workers to access the payload bay area without walking or standing on the payload bay floor or on the fixed platforms. Space Shuttle Discovery is scheduled for launch on mission STS-121 during a launch planning window of July 1-19. Photo credit: NASA/Kim Shiflett

Astronaut Sherwood Spring on RMS checks joints on the ACCESS device

NASA Image and Video Library

1985-11-27

Astronaut Sherwood C. Spring, anchored to the foot restraint on the remote manipulator system (RMS) arm, checks joints on the tower-like Assembly Concept for Construction of Erectable Space Structures (ACCESS) device extending from the payload bay as the Atlantis flies over white clouds and blue ocean waters. The Gulf of Mexico waters form the backdrop for the scene.

Improving detection and initial management of gestational diabetes through the primary level of care in Morocco: protocol for a cluster randomized controlled trial.

PubMed

Utz, Bettina; Assarag, Bouchra; Essolbi, Amina; Barkat, Amina; El Ansari, Nawal; Fakhir, Bouchra; Delamou, Alexandre; De Brouwere, Vincent

2017-06-19

Morocco is facing a growing prevalence of diabetes and according to latest figures of the World Health Organization, already 12.4% of the population are affected. A similar prevalence has been reported for gestational diabetes (GDM) and although it is not yet high on the national agenda, immediate and long-term complications threaten the health of mothers and future generations. A situational analysis on GDM conducted in 2015 revealed difficulties in access to screening and delays in receiving appropriate care. This implementation study has as objective to evaluate a decentralized GDM detection and management approach through the primary level of care and assess its potential for scaling up. We will conduct a hybrid effectiveness-implementation research using a cluster randomized controlled trial design in two districts of Morocco. Using the health center as unit of randomization we randomly selected 20 health centers with 10 serving as intervention and 10 as control facilities. In the intervention arm, providers will screen pregnant women attending antenatal care for GDM by capillary glucose testing during antenatal care. Women tested positive will receive nutritional counselling and will be followed up through the health center. In the control facilities, screening and initial management of GDM will follow standard practice. Primary outcome will be birthweight with weight gain during pregnancy, average glucose levels and pregnancy outcomes including mode of delivery, presence or absence of obstetric or newborn complications and the prevalence of GDM at health center level as secondary outcomes. Furthermore we will assess the quality of life /care experienced by the women in both arms. Qualitative methods will be applied to evaluate the feasibility of the intervention at primary level and its adoption by the health care providers. In Morocco, gestational diabetes screening and its initial management is fragmented and coupled with difficulties in access and treatment delays. Implementation of a strategy that enables detection, management and follow-up of affected women at primary health care level is expected to positively impact on access to care and medical outcomes. The trial has been registered on clininicaltrials.gov ; identifier NCT02979756 ; retrospectively registered 22 November 2016.

KSC-02pd0391

NASA Image and Video Library

2002-04-03

KENNEDY SPACE CENTER, FLA. -- With the Rotating Service Structure rolled back, Space Shuttle Atlantis stands ready for launch on mission STS-110. The Orbiter Access Arm extends from the Fixed Service Structure (FSS) to the crew compartment hatch, through which the STS-110 crew will enter Atlantis. The RSS provides protected access to the orbiter for changeout and servicing of payloads at the pad. The structure has access platforms at five levels to provide access to the payload bay. The FSS provides access to the orbiter and the RSS. . Mission STS-110 is scheduled to launch April 4 on its 11-day mission to the International Space Station

Self-reported physical activity and preaccession fitness testing in U.S. Army applicants.

PubMed

Gubata, Marlene E; Cowan, David N; Bedno, Sheryl A; Urban, Nadia; Niebuhr, David W

2011-08-01

The Assessment of Recruit Motivation and Strength (ARMS) study evaluated a physical fitness screening test for Army applicants before basic training. This report examines applicants' self-reported physical activity as a predictor of objective fitness measured by ARMS. In 2006, the ARMS study administered a fitness test and physical activity survey to Army applicants during their medical evaluation, using multiple logistic regression for comparison. Among both men and women, "qualified" and "exceeds-body-fat" subjects who met American College of Sports Medicine adult physical activity guidelines were more likely to pass the fitness test. Overall, subjects who met physical activity recommendations, watched less television, and played on sports teams had a higher odds of passing the ARMS test after adjustment for age, race, and smoking status. This study demonstrates that self-reported physical activity was associated with physical fitness and may be used to identify those at risk of failing a preaccession fitness test.

Blood glucose concentrations of arm and finger during dynamic glucose conditions.

PubMed

Szuts, Ete Z; Lock, J Paul; Malomo, Kenneth J; Anagnostopoulos, Althea

2002-01-01

We set out to determine the physiological difference between the capillary blood of the arm and finger with the greatest possible accuracy using the HemoCue B-glucose analyzer on subjects undergoing a meal tolerance test (MTT) or oral glucose tolerance test (OGTT). MTT study was performed on 50 subjects who drank a liquid meal (Ensure, 40 g of carbohydrates) and who were tested on the arm and finger every 30 min for up to 4 h. OGTT study was performed on 12 subjects who drank a 100-g glucose solution (Glucola) and were tested on the arm and finger every 15 min during the first hour and thereafter every 30 min for up to 3 h. Average percent glucose difference between arm and finger reached a maximal value about 1 h following glucose load, with arm glucose being about 5% lower than that of finger. At other times, average differences were less than this. At the greatest rate of glucose change (>2 mg/dL-min), mean percent bias was found to be about 6%. Despite these measurable differences, when arm results were plotted on the Clarke error grid against finger values, >97% of the data were within zone A (rest in zone B). Thus, physiological differences between arm and finger were clinically insignificant. Our studies with HemoCue confirmed the existence of measurable physiological glucose differences between arm and finger following a glucose challenge, but these differences were found to be clinically insignificant even in those subjects in whom they were measurable.

Technical Note: Confirming the prescribed angle of CT localizer radiographs and c-arm projection acquisitions

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

Szczykutowicz, Timothy P., E-mail: tszczykutowicz@uwhealth.org; Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin 53705; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706

2016-02-15

Purpose: Accurate CT radiograph angle is not usually important in diagnostic CT. However, there are applications in radiation oncology and interventional radiology in which the orientation of the x-ray source and detector with respect to the patient is clinically important. The authors present a method for measuring the accuracy of the tube/detector assembly with respect to the prescribed tube/detector position for CT localizer, fluoroscopic, and general radiograph imaging using diagnostic, mobile, and c-arm based CT systems. Methods: A mathematical expression relating the x-ray projection of two metal BBs is related to gantry angle. Measurement of the BBs at a prescribedmore » gantry (i.e., c-arm) angle can be obtained and using this relation the prescribed versus actual gantry angle compared. No special service mode or proprietary information is required, only access to projection images is required. Projection images are available in CT via CT localizer radiographs and in the interventional setting via fluorography. Results: The technique was demonstrated on two systems, a mobile CT scanner and a diagnostic CT scanner. The results confirmed a known issue with the mobile scanner and accurately described the CT localizer angle of the diagnostic system tested. Conclusions: This method can be used to quantify gantry angle, which is important when projection images are used for procedure guidance, such as in brachytherapy and interventional radiology applications.« less

Employees with Myasthenia Gravis

MedlinePlus

... of Disabilities Publications Resources Home | Accommodation and Compliance Series: Employees with Myasthenia Gravis By Linda Carter Batiste, ... rest breaks Fine Motor Impairment: Implement ergonomic workstation design Provide alternative computer and telephone access Provide arm ...

Implementation of the Computerized Adaptive Version of the Armed Services Vocational Aptitude Battery.

ERIC Educational Resources Information Center

Curran, Linda T.; Jordan, Linda A.

In the summer of 1996, the U.S. Armed Services will implement the computerized adaptive testing version of the Armed Services Vocational Aptitude Battery (CAT-ASVAB). When conversion is completed at the 65 targeted military entrance processing stations, about half the applicants will take this test version. This paper describes the efforts that…

The Implementation and Testing of a Robotic Arm on an Autonomous Vehicle

DTIC Science & Technology

2007-12-01

FIGURES Figure 1. BigFoot . .............................................................................................................2 Figure 2...Arm. ............................................................31 Figure 29. BigFoot launched a shaped charge model on the suspected IED...work with BigFoot . I would also like to thank you to LTCD Kirk Volland for his assistance in the implementation and testing of a robotic arm. I thank

Hand dominance in intravenous drug using patients does not affect peripheral venous access sites identified by ultrasound.

PubMed

Kaban, Nicole L; Avitabile, Nicholas C; Siadecki, Sebastian D; Saul, Turandot

2016-06-01

The peripheral veins in the arms and forearms of patients with a history of intravenous (IV) drug use may be sclerosed, calcified, or collapsed due to damage from previous injections. These patients may consequently require alternative, more invasive types of vascular access including central venous or intraosseous catheters. We investigated the relationship between hand dominance and the presence of patent upper extremity (UE) veins specifically in patients with a history of IV drug-use. We predicted that injection into the non-dominant UE would occur with a higher frequency than the dominant UE, leading to fewer damaged veins in the dominant UE. If hand dominance affects which upper extremity has more patent veins, providers could focus their first vascular access attempt on the dominant upper extremity. Adult patients were approached for enrollment if they provided a history of IV drug use into one of their upper extremities. Each upper extremity was examined with a high frequency linear transducer in 3 areas: the antecubital crease, forearm and the proximal arm. The number of fully compressible veins ≥1.8 mm in diameter was recorded for each location. The mean vein difference between the numbers of veins in the dominant versus the non-dominant UE was -1.5789. At a .05 significance level, there was insufficient evidence to suggest the number of compressible veins between patients' dominant and non-dominant arms was significantly different (P = .0872.) The number of compressible veins visualized with ultrasound was not greater in the dominant upper extremity as expected. Practitioners may gain more information about potential peripheral venous access sites by asking patients their previous injection practice patterns. Copyright © 2016 Elsevier Inc. All rights reserved.

Predicting hand function in older adults: evaluations of grip strength, arm curl strength, and manual dexterity.

PubMed

Liu, Chiung-Ju; Marie, Deana; Fredrick, Aaron; Bertram, Jessica; Utley, Kristen; Fess, Elaine Ewing

2017-08-01

Hand function is critical for independence in activities of daily living for older adults. The purpose of this study was to examine how grip strength, arm curl strength, and manual dexterous coordination contributed to time-based versus self-report assessment of hand function in community-dwelling older adults. Adults aged ≥60 years without low vision or neurological disorders were recruited. Purdue Pegboard Test, Jamar hand dynamometer, 30-second arm curl test, Jebsen-Taylor Hand Function Test, and the Late-Life Function and Disability Instrument were administered to assess manual dexterous coordination, grip strength, arm curl strength, time-based hand function, and self-report of hand function, respectively. Eighty-four adults (mean age = 72 years) completed the study. Hierarchical multiple regressions show that older adults with better arm curl strength (β = -.25, p < .01) and manual dexterous coordination (β = -.52, p < .01) performed better on the time-based hand function test. In comparison, older adults with better grip strength (β = .40, p < .01), arm curl strength (β = .23, p < .05), and manual dexterous coordination (β = .23, p < .05) were associated with better self-report of upper extremity function. The relationship between grip strength and hand function may be test-specific. Grip strength becomes a significant factor when the test requires grip strength to successfully complete the test tasks. Arm curl strength independently contributed to hand function in both time-based and self-report assessments, indicating that strength of extrinsic muscles of the hand are essential for hand function.

105KE Basin Area Radiation Monitor System (ARMS) Acceptance Test Procedure

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

KINKEL, C.C.

1999-12-14

This procedure is intended for the Area Radiation Monitoring System, ARMS, that is replacing the existing Programmable Input-Output Processing System, PIOPS, radiation monitoring system in the 105KE basin. The new system will be referred to as the 105KE ARMS, 105KE Area Radiation Monitoring System. This ATP will ensure calibration integrity of the 105KE radiation detector loops. Also, this ATP will test and document the display, printing, alarm output, alarm acknowledgement, upscale check, and security functions. This ATP test is to be performed after completion of the 105KE ARMS installation. The alarm outputs of the 105KE ARMS will be connected tomore » the basin detector alarms, basin annunciator system, and security Alarm Monitoring System, AMS, located in the 200 area Central Alarm Station (CAS).« less

Application of the Actor-Critic Architecture to Functional Electrical Stimulation Control of a Human Arm

PubMed Central

Thomas, Philip; Branicky, Michael; van den Bogert, Antonie; Jagodnik, Kathleen

2010-01-01

Clinical tests have shown that the dynamics of a human arm, controlled using Functional Electrical Stimulation (FES), can vary significantly between and during trials. In this paper, we study the application of the actor-critic architecture, with neural networks for the both the actor and the critic, as a controller that can adapt to these changing dynamics of a human arm. Development and tests were done in simulation using a planar arm model and Hill-based muscle dynamics. We begin by training it using a Proportional Derivative (PD) controller as a supervisor. We then make clinically relevant changes to the dynamics of the arm and test the actor-critic’s ability to adapt without supervision in a reasonable number of episodes. Finally, we devise methods for achieving both rapid learning and long-term stability. PMID:20689654

Application of the Actor-Critic Architecture to Functional Electrical Stimulation Control of a Human Arm.

PubMed

Thomas, Philip; Branicky, Michael; van den Bogert, Antonie; Jagodnik, Kathleen

2009-01-01

Clinical tests have shown that the dynamics of a human arm, controlled using Functional Electrical Stimulation (FES), can vary significantly between and during trials. In this paper, we study the application of the actor-critic architecture, with neural networks for the both the actor and the critic, as a controller that can adapt to these changing dynamics of a human arm. Development and tests were done in simulation using a planar arm model and Hill-based muscle dynamics. We begin by training it using a Proportional Derivative (PD) controller as a supervisor. We then make clinically relevant changes to the dynamics of the arm and test the actor-critic's ability to adapt without supervision in a reasonable number of episodes. Finally, we devise methods for achieving both rapid learning and long-term stability.

Development of an Arm Phantom for Testing Non-Invasive Blood Pressure Monitors

NASA Astrophysics Data System (ADS)

Anderson-Jackson, LaTecia D.

Approximately one in every three adults age 20 older are diagnosed with high blood pressure or hypertension. It is estimated that hypertension affects 78 million people in the United States, is equally prevalent in both men and woman (Crabtree, Stuart-Shor, & McAllister, 2013). In the United States, around 78% of people suffering from hypertension are aware of their condition, with only 68% using hypertensive medications to control their blood pressure (Writing Group et al., 2010). Clinically, blood pressure measurements may lack accuracy, which can be attributed to various factors, including device limitations, cuff mis-sizing and misplacement, white-coat effect, masked hypertension, and lifestyle factors. The development of an arm phantom to simulate physiologic properties of a human arm and arterial BP waveforms may allow us to better assess the accuracy of non-invasive blood pressure (NIBP) monitors. The objective of this study are to: (1) Develop an arm phantom to replicate physiological properties of the human arm, and (2) Incorporate the arm phantom into a mock circulatory flow loop to simulate different physiological blood pressure readings on the bench. A tissue mimicking material, styrene-ethylene-butylene-styrene (SEBS), a co-block polymer was used to develop the arm phantom for in-vitro testing. To determine the optimal mechanical properties for the arm phantom, individual arm components were isolated and tested. A protocol was developed to evaluate various components for optimal arm phantom development. Mechanical testing was conducted on 10%, 15%, and 20% SEBS gel samples for modulus of elasticity measurements in order to simulate physiological properties of the human arm. As a result of the SEBS polymer being a new material for this application, this investigation will contribute to resolving the limitations that occurred during experimentation. In this study, we demonstrated that although SEBS polymer may be an ideal material to use for simulating tissue, further research on the material properties should be conducted.

KSC-2012-6227

NASA Image and Video Library

2012-11-14

CAPE CANAVERAL, Fla. – The Orion spacecraft crew access arm, or CAA, seal prototype is being checked out at the Launch Equipment Test Facility at NASA's Kennedy Space Center in Florida. Monitoring the activity, from the left are Kent Bachelor, Stinger Ghaffarian Technologies lead, Kelli Maloney, NASA lead and Clayton Gvasse, Nelson Engineering lead. The tests will use a mockup of the vehicle Outer Mold Line and CAA white room to test the performance of the seal while simulating vehicle to CAA white room excursions. Orion is the exploration spacecraft designed to carry crews to space beyond low Earth orbit. It will provide emergency abort capability, sustain the crew during the space travel and provide safe re-entry from deep space return velocities. The first unpiloted test flight of the Orion is scheduled to launch in 2014 atop a Delta IV rocket and in 2017 on a Space Launch System rocket. For more information, visit http://www.nasa.gov/orion Photo credit: NASA/Jim Grossmann

Preparing America for Deep Space Exploration Episode 16: Exploration On The Move

NASA Image and Video Library

2018-02-22

Preparing America for Deep Space Exploration Episode 16: Exploration On The Move NASA is pressing full steam ahead toward sending humans farther than ever before. Take a look at the work being done by teams across the nation for NASA’s Deep Space Exploration System, including the Space Launch System, Orion, and Exploration Ground Systems programs, as they continue to propel human spaceflight into the next generation. Highlights from the fourth quarter of 2017 included Orion parachute drop tests at the Yuma Proving Ground in Arizona; the EM-1 Crew Module move from Cleanroom to Workstation at Kennedy Space Center; Crew Training, Launch Pad Evacuation Scenario, and Crew Module Vibration and Legibility Testing at NASA’s Johnson Space Center; RS-25 Rocket Engine Testing at Stennis Space Center; Core Stage Engine Section arrival, Core Stage Pathfinder; LH2 Qualification Tank; Core Stage Intertank Umbilical lift at Mobile Launcher; Crew Access Arm move to Mobile Launcher; Water Flow Test at Launch Complex 39-B.

Cardio-Respiratory and Perceived Exertion Responses to Different Cranking Rates during Maximal Arm Ergometry.

ERIC Educational Resources Information Center

Israel, Richard G.; And Others

This study compared cardio-respiratory and perceived exertion responses for four cranking rates (50, 60, 70 and 80 rpm) during a continuous maximal arm ergometry protocol in order to determine the most efficient cranking rate for maximal testing. Fifteen male volunteers from 18-30 years of age performed a continuous arm ergometry stress test in…

A prognostic scoring system for arm exercise stress testing.

PubMed

Xie, Yan; Xian, Hong; Chandiramani, Pooja; Bainter, Emily; Wan, Leping; Martin, Wade H

2016-01-01

Arm exercise stress testing may be an equivalent or better predictor of mortality outcome than pharmacological stress imaging for the ≥50% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals. In this retrospective observational cohort study, arm exercise ECG stress tests were performed in 443 consecutive veterans aged 64.1 (11.1) years. (mean (SD)) between 1997 and 2002. From multivariate Cox models, arm exercise scores were developed for prediction of 5-year and 12-year all-cause and cardiovascular mortality and 5-year cardiovascular mortality or myocardial infarction (MI). Arm exercise capacity in resting metabolic equivalents (METs), 1 min heart rate recovery (HRR) and ST segment depression ≥1 mm were the stress test variables independently associated with all-cause and cardiovascular mortality by step-wise Cox analysis (all p<0.01). A score based on the relation HRR (bpm)+7.3×METs-10.5×ST depression (0=no; 1=yes) prognosticated 5-year cardiovascular mortality with a C-statistic of 0.81 before and 0.88 after adjustment for significant demographic and clinical covariates. Arm exercise scores for the other outcome end points yielded C-statistic values of 0.77-0.79 before and 0.82-0.86 after adjustment for significant covariates versus 0.64-0.72 for best fit pharmacological myocardial perfusion imaging models in a cohort of 1730 veterans who were evaluated over the same time period. Arm exercise scores, analogous to the Duke Treadmill Score, have good power for prediction of mortality or MI in patients who cannot perform leg exercise.

Robot-Assisted Training of Arm and Hand Movement Shows Functional Improvements for Incomplete Cervical Spinal Cord Injury.

PubMed

Francisco, Gerard E; Yozbatiran, Nuray; Berliner, Jeffrey; OʼMalley, Marcia K; Pehlivan, Ali Utku; Kadivar, Zahra; Fitle, Kyle; Boake, Corwin

2017-10-01

The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia. Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later. After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed. Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.

Memory systems in the rat: effects of reward probability, context, and congruency between working and reference memory.

PubMed

Roberts, William A; Guitar, Nicole A; Marsh, Heidi L; MacDonald, Hayden

2016-05-01

The interaction of working and reference memory was studied in rats on an eight-arm radial maze. In two experiments, rats were trained to perform working memory and reference memory tasks. On working memory trials, they were allowed to enter four randomly chosen arms for reward in a study phase and then had to choose the unentered arms for reward in a test phase. On reference memory trials, they had to learn to visit the same four arms on the maze on every trial for reward. Retention was tested on working memory trials in which the interval between the study and test phase was 15 s, 15 min, or 30 min. At each retention interval, tests were performed in which the correct WM arms were either congruent or incongruent with the correct RM arms. Both experiments showed that congruency interacted with retention interval, yielding more forgetting at 30 min on incongruent trials than on congruent trials. The effect of reference memory strength on the congruency effect was examined in Experiment 1, and the effect of associating different contexts with working and reference memory on the congruency effect was studied in Experiment 2.

Global Perspectives in the Mathematics Classroom.

ERIC Educational Resources Information Center

Hudson, Brian

1990-01-01

Discusses the use of world problems in mathematics curriculum. Provides a topic on (1) life expectancy and the percentage of the population with access to safe drinking water and (2) the global arms race. (YP)

The Computerized Adaptive Testing System Development Project.

ERIC Educational Resources Information Center

McBride, James R.; Sympson, J. B.

The Computerized Adaptive Testing (CAT) project is a joint Armed Services coordinated effort to develop and evaluate a system for automated, adaptive administration of the Armed Services Vocational Aptitude Battery (ASVAB). The CAT is a system for administering personnel tests that differs from conventional test administration in two major…

Design considerations for an astronaut monorail system for large space structures and the structural characterization of its positioning arm

NASA Astrophysics Data System (ADS)

Watson, Judith J.

1992-08-01

An astronaut monorail system (AMS) is presented as a vehicle to transport and position EVA astronauts along large space truss structures. The AMS is proposed specifically as an alternative to the crew and equipment transfer aid for Space Station Freedom. Design considerations for the AMS were discussed and a reference configuration was selected for the study. Equations were developed to characterize the stiffness and frequency behavior of the AMS positioning arm. Experimental data showed that these equations gave a fairly accurate representation of the stiffness and frequency behavior of the arm. A study was presented to show trends for the arm behavior based on varying parameters of the stiffness and frequency equations. An ergonomics study was conducted to provide boundary conditions for tolerable frequency and deflection to be used in developing a design concept for the positioning arm. The feasibility of the AMS positioning arm was examined using equations and working curves developed in this study. It was found that a positioning arm of a length to reach all interior points of the space station truss structure could not be designed to satisfy frequency and deflection constraints. By relaxing the design requirements and the ergonomic boundaries, an arm could be designed which would provide a stable work platform for the EVA astronaut and give him access to over 75 percent of the truss interior.

Analysis of Multi-Arm Caliper Data for the U.S. Strategic Petroleum Reserve

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

Roberts, Barry L.

The U.S. Strategic Petroleum Reserve (SPR) has an increasing reliance on mul t i - arm caliper surveys to assess the integrity of casing for cavern access wells and to determine priorities for casing remediation. Multi - arm caliper (MAC) surveys provide a view of well casing deformation by reporting radial measurements of the inner cas ing wall as the tool is drawn through the casing. Over the last several years the SPR has collected a large number of modern MAC surveys. In total, these surveys account for over 100 million individual measurements. The surveys were collected using diff eringmore » survey vendors and survey hardware. This has resulted in a collection of disparate data sets which confound attempts to make well - to - well or time - dependent evaluations. In addition, the vendor supplied MAC interpretations often involve variables wh ich are not well defined or which may not be applicable to casings for cavern access wells. These factors reduce the usability of these detailed data sets. In order to address this issue and provide an independent analysis of multi - arm caliper survey data, Sandia National Labs has developed processing techniques and analysis variables which allow for the comparison of MAC survey data regardless of the source of the survey data. These techniques use the raw radial arm information and newly developed analysis variables to assess the casing status and provide a means for well - to - well and time - dependent analyses. Well - to - well and t ime - dependent investigation of the MAC survey data provide s information to prioritize well remediation activities and identify wells with integrity issues. This paper presents the challenges in using disparate MAC survey data, techniques developed to address these challenges and some o f the insights gained from these new techniques.« less

Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: a randomized controlled trial.

PubMed

Kelvin, Elizabeth A; George, Gavin; Mwai, Eva; Nyaga, Eston; Mantell, Joanne E; Romo, Matthew L; Odhiambo, Jacob O; Starbuck, Lila; Govender, Kaymarlin

2018-01-01

We conducted a randomized controlled trial among 305 truck drivers from two North Star Alliance roadside wellness clinics in Kenya to see if offering HIV testing choices would increase HIV testing uptake. Participants were randomized to be offered (1) a provider-administered rapid blood (finger-prick) HIV test (i.e., standard of care [SOC]) or (2) a Choice between SOC or a self-administered oral rapid HIV test with provider supervision in the clinic. Participants in the Choice arm who refused HIV testing in the clinic were offered a test kit for home use with phone-based posttest counseling. We compared HIV test uptake using the Mantel Haenszel odds ratio (OR) adjusting for clinic. Those in the Choice arm had higher odds of HIV test uptake than those in the SOC arm (OR = 1.5), but the difference was not statistically significant (p = 0.189). When adding the option to take an HIV test kit for home use, the Choice arm had significantly greater odds of testing uptake (OR = 2.8, p = 0.002). Of those in the Choice arm who tested, 26.9% selected the SOC test, 64.6% chose supervised self-testing in the clinic, and 8.5% took a test kit for home use. Participants varied in the HIV test they selected when given choices. Importantly, when participants who refused HIV testing in the clinic were offered a test kit for home use, an additional 8.5% tested. Offering truck drivers a variety of HIV testing choices may increase HIV testing uptake in this key population.

Arm-specific cleavage and mutation during reverse transcription of 2΄,5΄-branched RNA by Moloney murine leukemia virus reverse transcriptase

PubMed Central

Döring, Jessica

2017-01-01

Abstract Branchpoint nucleotides of intron lariats induce pausing of DNA synthesis by reverse transcriptases (RTs), but it is not known yet how they direct RT RNase H activity on branched RNA (bRNA). Here, we report the effects of the two arms of bRNA on branchpoint-directed RNA cleavage and mutation produced by Moloney murine leukemia virus (M-MLV) RT during DNA polymerization. We constructed a long-chained bRNA template by splinted-ligation. The bRNA oligonucleotide is chimeric and contains DNA to identify RNA cleavage products by probe hybridization. Unique sequences surrounding the branchpoint facilitate monitoring of bRNA purification by terminal-restriction fragment length polymorphism analysis. We evaluate the M-MLV RT-generated cleavage and mutational patterns. We find that cleavage of bRNA and misprocessing of the branched nucleotide proceed arm-specifically. Bypass of the branchpoint from the 2΄-arm causes single-mismatch errors, whereas bypass from the 3΄-arm leads to deletion mutations. The non-template arm is cleaved when reverse transcription is primed from the 3΄-arm but not from the 2΄-arm. This suggests that RTs flip ∼180° at branchpoints and RNases H cleave the non-template arm depending on its accessibility. Our observed interplay between M-MLV RT and bRNA would be compatible with a bRNA-mediated control of retroviral and related retrotransposon replication. PMID:28160599

Comparison of the American Optical Vision Tester and the Armed Forces Far Visual Acuity Test. B-6-133-13

DTIC Science & Technology

1954-01-01

THE AMERICAN OPTICAL VISION TESTER AND THE ARMED FORCES FAR VISUAL ACUITY TEST Comparisons were made of the visual acuity scores of 100 enlisted men on ...the American Optical Vision Tester (with Sloan plates) and on the Armed Forces Far Visual Acuity test. Order of presentation was: AO-left eye, AO...right eye, AFFVAT-left, AFVTAT-right. Correlation coefficients between AO and AFFVAT were around .89. Dispersion of acuity scores was about the same on

Feasibility of Developing a Human Simulator for CBRN IPE Testing

DTIC Science & Technology

2007-08-01

side to side, calisthenic arm movements, running in place, pumping a tire pump, and walking in place. For testing high efficiency (HE) PAPRs, the head...not be appropriate for mouth movement to cause abnormal bulges or depressions in the simulator’s cheek. The arms should be able to mimic calisthenic ...Exercises FIT TEST Exercise NIOSH NIOSH HE PAPR OSHA(" LRPL Head: Up/Down x - x x Head: Side/Side x - x x Calisthenic Arm Movements x - - - Running in

C-arm rotation encoding with accelerometers.

PubMed

Grzeda, Victor; Fichtinger, Gabor

2010-07-01

Fluoroscopic C-arms are being incorporated in computer-assisted interventions in increasing number. For these applications to work, the relative poses of imaging must be known. To find the pose, tracking methods such as optical cameras, electromagnetic trackers, and radiographic fiducials have been used-all hampered by significant shortcomings. We propose to recover the rotational pose of the C-arm using the angle-sensing ability of accelerometers, by exploiting the capability of the accelerometer to measure tilt angles. By affixing the accelerometer to a C-arm, the accelerometer tracks the C-arm pose during rotations of the C-arm. To demonstrate this concept, a C-arm analogue was constructed with a webcam device affixed to the C-arm model to mimic X-ray imaging. Then, measuring the offset between the accelerometer angle readings to the webcam pose angle, an angle correction equation (ACE) was created to properly tracking the C-arm rotational pose. Several tests were performed on the webcam C-arm model using the ACEs to tracking the primary and secondary angle rotations of the model. We evaluated the capability of linear and polynomial ACEs to tracking the webcam C-arm pose angle for different rotational scenarios. The test results showed that the accelerometer could track the pose of the webcam C-arm model with an accuracy of less than 1.0 degree. The accelerometer was successful in sensing the C-arm's rotation with clinically adequate accuracy in the C-arm webcam model.

Field guide to the Mesozoic accretionary complex along Turnagain Arm and Kachemak Bay, south-central Alaska

USGS Publications Warehouse

Bradley, Dwight C.; Kusky, Timothy M.; Karl, Susan M.; Haeussler, Peter J.

1997-01-01

Turnagain Arm, just east of Anchorage, provides a readily accessible, world-class cross section through a Mesozoic accretionary wedge. Nearly continuous exposures along the Seward Highway, the Alaska Railroad, and the shoreline of Turnagain Arm display the two main constituent units of the Chugach terrane: the McHugh Complex and Valdez Group. In this paper we describe seven bedrock geology stops along Turnagain Arm, and two others in the Chugach Mountains just to the north (Stops 1-7 and 9), which will be visited as part of the May, 1997 field trip of the Alaska Geological Society. Outcrops along Turnagain Arm have already been described in two excellent guidebook articles (Clark, 1981; Winkler and others 1984), both of which remain as useful and valid today as when first published. Since the early 1980's, studies along Turnagain Arm have addressed radiolarian ages of chert and conodont ages of limestone in the McHugh Complex (Nelson and others, 1986, 1987); geochemistry of basalt in the McHugh Complex (Nelson and Blome, 1991); post-accretion brittle faulting (Bradley and Kusky, 1990; Kusky and others, 1997); and the age and tectonic setting of gold mineralization (Haeussler and others, 1995). Highlights of these newer findings will described both in the text below, and in the stop descriptions.Superb exposures along the southeastern shore of Kachemak Bay show several other features of the McHugh Complex that are either absent or less convincing along Turnagain Arm. While none of these outcrops can be reached via the main road network, they are still reasonably accessible - all are within an hour by motorboat from Homer, seas permitting. Here, we describe seven outcrops along the shore of Kachemak Bay that we studied between 1989 and 1993 during geologic mapping of the Seldovia 1:250,000- scale quadrangle. These outcrops (Stops 61-67) will not be part of the 1997 itinerary, but are included here tor the benefit of those who may wish to visit them later.

Reliability and feasibility of physical fitness tests in female fibromyalgia patients.

PubMed

Carbonell-Baeza, A; Álvarez-Gallardo, I C; Segura-Jiménez, V; Castro-Piñero, J; Ruiz, J R; Delgado-Fernández, M; Aparicio, V A

2015-02-01

The aim of the present study was to determine the reliability and feasibility of physical fitness tests in female fibromyalgia patients. 100 female fibromyalgia patients (aged 50.6±8.6 years) performed the following tests twice (7 days interval test-retest): chair sit and reach, back scratch, handgrip strength, arm curl, chair stand, 8 feet up and go, and 6-min walk. Significant differences between test and retest were found in the arm curl (mean difference: 1.25±2.16 repetitions, Cohen d=0.251), chair stand (0.99±1.7 repetitions, Cohen d=0.254) and 8 feet up and go (-0.38±1.09 s, Cohen d=0.111) tests. Intraclass correlation coefficients (ICC) range from 0.92 in the arm curl test to 0.96 in the back scratch test. The feasibility of the tests (patients able to complete the test) ranged from 89% in the arm curl test to 100% in the handgrip strength test. Therefore, the reliability and feasibility of the physical fitness tests examined is acceptable for female fibromyalgia patients. © Georg Thieme Verlag KG Stuttgart · New York.

Standardisation of information submitted to an endpoint committee for cause of death assignment in a cancer screening trial – lessons learnt from CAP (Cluster randomised triAl of PSA testing for Prostate cancer).

PubMed

Williams, Naomi J; Hill, Elizabeth M; Ng, Siaw Yein; Martin, Richard M; Metcalfe, Chris; Donovan, Jenny L; Evans, Simon; Hughes, Laura J; Davies, Charlotte F; Hamdy, Freddie C; Neal, David E; Turner, Emma L

2015-01-23

In cancer screening trials where the primary outcome is target cancer-specific mortality, the unbiased determination of underlying cause of death (UCD) is crucial. To minimise bias, the UCD should be independently verified by expert reviewers, blinded to death certificate data and trial arm. We investigated whether standardising the information submitted for UCD assignment in a population-based randomised controlled trial of prostate-specific antigen (PSA) testing for prostate cancer reduced the reviewers' ability to correctly guess the trial arm. Over 550 General Practitioner (GP) practices (>415,000 men aged 50-69 years) were cluster-randomised to PSA testing (intervention arm) or the National Health Service (NHS) prostate cancer risk management programme (control arm) between 2001 and 2007. Assignment of UCD was by independent reviews of researcher-written clinical vignettes that masked trial arm and death certificate information. A period of time after the process began (the initial phase), we analysed whether the reviewers could correctly identify trial arm from the vignettes, and the reasons for their choice. This feedback led to further standardisation of information (second phase), after which we re-assessed the extent of correct identification of trial arm. 1099 assessments of 509 vignettes were completed by January 2014. In the initial phase (n = 510 assessments), reviewers were unsure of trial arm in 33% of intervention and 30% of control arm assessments and were influenced by symptoms at diagnosis, PSA test result and study-specific criteria. In the second phase (n = 589), the respective proportions of uncertainty were 45% and 48%. The percentage of cases whereby reviewers were unable to determine the trial arm was greater following the standardisation of information provided in the vignettes. The chances of a correct guess and an incorrect guess were equalised in each arm, following further standardisation. It is possible to mask trial arm from cause of death reviewers, by using their feedback to standardise the information submitted to them. ISRCTN92187251.

Improving distress in dialysis (iDiD): a feasibility two-arm parallel randomised controlled trial of an online cognitive behavioural therapy intervention with and without therapist-led telephone support for psychological distress in patients undergoing haemodialysis

PubMed Central

Hudson, Joanna L; Moss-Morris, Rona; Game, David; Carroll, Amy; McCrone, Paul; Hotopf, Matthew; Yardley, Lucy; Chilcot, Joseph

2016-01-01

Introduction Psychological distress is common in end-stage kidney disease (ESKD) and is associated with poorer health outcomes. Cognitive behavioural therapy (CBT) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions. Access to skilled therapists competent in managing the competing mental and physical health demands of ESKD is limited. Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-resourced services. This study examines the feasibility and acceptability of implementing a two-arm parallel randomised controlled trial of online CBT with (intervention arm) and without (control arm) therapist support to improve psychological distress in patients undergoing haemodialysis. Methods Patients will be screened for depression and anxiety while attending for their haemodialysis treatments. We aim to recruit 60 adult patients undergoing haemodialysis who meet criteria for mild to moderately severe symptoms of depression and/or anxiety. Patients will be randomised individually (using a 1:1 computerised sequence ratio) to either online CBT with therapist telephone support (intervention arm), or online CBT with no therapist (control arm). Outcomes include feasibility and acceptability descriptive data on rates of recruitment, randomisation, retention and treatment adherence. Self-report outcomes include measures of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), quality of life (Euro-QoL), service use (client service receipt inventory) and illness cognitions (brief illness perception questionnaire). A qualitative process evaluation will also be conducted. The statistician will be blinded to treatment allocation. Ethics and dissemination A National Health Service (NHS) research ethics committee approved the study. Data from this study will provide essential information for the design and testing of further interventions to ameliorate distress in patients undergoing dialysis. Any amendments to the protocol will be submitted to the NHS committee and study sponsor. Trial registration number NCT023528702; Pre-results. PMID:27072573

Improving distress in dialysis (iDiD): a feasibility two-arm parallel randomised controlled trial of an online cognitive behavioural therapy intervention with and without therapist-led telephone support for psychological distress in patients undergoing haemodialysis.

PubMed

Hudson, Joanna L; Moss-Morris, Rona; Game, David; Carroll, Amy; McCrone, Paul; Hotopf, Matthew; Yardley, Lucy; Chilcot, Joseph

2016-04-12

Psychological distress is common in end-stage kidney disease (ESKD) and is associated with poorer health outcomes. Cognitive behavioural therapy (CBT) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions. Access to skilled therapists competent in managing the competing mental and physical health demands of ESKD is limited. Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-resourced services. This study examines the feasibility and acceptability of implementing a two-arm parallel randomised controlled trial of online CBT with (intervention arm) and without (control arm) therapist support to improve psychological distress in patients undergoing haemodialysis. Patients will be screened for depression and anxiety while attending for their haemodialysis treatments. We aim to recruit 60 adult patients undergoing haemodialysis who meet criteria for mild to moderately severe symptoms of depression and/or anxiety. Patients will be randomised individually (using a 1:1 computerised sequence ratio) to either online CBT with therapist telephone support (intervention arm), or online CBT with no therapist (control arm). Outcomes include feasibility and acceptability descriptive data on rates of recruitment, randomisation, retention and treatment adherence. Self-report outcomes include measures of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), quality of life (Euro-QoL), service use (client service receipt inventory) and illness cognitions (brief illness perception questionnaire). A qualitative process evaluation will also be conducted. The statistician will be blinded to treatment allocation. A National Health Service (NHS) research ethics committee approved the study. Data from this study will provide essential information for the design and testing of further interventions to ameliorate distress in patients undergoing dialysis. Any amendments to the protocol will be submitted to the NHS committee and study sponsor. NCT023528702; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) - A randomized controlled trial.

PubMed

Finkelstein, Eric A; Tham, Kwang-Wei; Haaland, Benjamin A; Sahasranaman, Aarti

2017-07-01

The prevalence of overweight and obesity has more than doubled in the past three decades, leading to rising rates of non-communicable diseases. This study tests whether adding a payment/rewards (term reward) program to an existing evidence-based weight loss program can increase weight loss and weight loss maintenance. We conducted a parallel-group randomized controlled trial from October 2012 to October 2015 with 161 overweight or obese individuals randomized to either control or reward arm in a 1:2 ratio. Control and reward arm participants received a four month weight loss program at the LIFE (Lifestyle Improvement and Fitness Enhancement) Centre at Singapore General Hospital. Those in the reward arm paid a fee of S$165.00 (1US$ = 1.35S$) to access a program that provided rewards of up to S$660 for meeting weight loss and physical activity goals. Participants could choose to receive rewards as guaranteed cash payments or a lottery ticket with a 1 in 10 chance of winning but with the same expected value. The primary outcome was weight loss at months 4, 8, and 12. 161 participants were randomized to control (n = 54) or reward (n = 107) arms. Average weight loss was more than twice as great in the reward arm compared to the control arm at month 4 when the program concluded (3.4 kg vs 1.4 kg, p < 0.01), month 8 when rewards concluded (3.3 kg vs 1.8 kg, p < 0.05), and at month 12 (2.3 kg vs 0.8 kg, p < 0.05). These results reveal that a payment/rewards program can be used to improve weight loss and weight loss maintenance when combined with an evidence-based weight loss program. Future efforts should attempt to replicate this approach and identify how to cost effectively expand these programs to maximize their reach. This study is registered at www.clinicaltrials.gov (Identifier: NCT01533454). Copyright © 2017 Elsevier Ltd. All rights reserved.

10 CFR 430.24 - Units to be tested.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the method includes an ARM/simulation adjustment factor(s), determine the value(s) of the factors(s... process. (v) If request for approval is for an updated ARM, manufacturers must identify modifications made to the ARM since the last submittal, including any ARM/simulation adjustment factor(s) added since...

Primary cervical cancer screening with HPV testing compared with liquid-based cytology: results of round 1 of a randomised controlled trial -- the HPV FOCAL Study.

PubMed

Ogilvie, G S; Krajden, M; van Niekerk, D J; Martin, R E; Ehlen, T G; Ceballos, K; Smith, L W; Kan, L; Cook, D A; Peacock, S; Stuart, G C E; Franco, E L; Coldman, A J

2012-12-04

Round 1 data of human papillomavirus (HPV) FOCAL, a three-arm, randomised trial, which aims to establish the efficacy of HPV DNA testing as a primary screen for cervical cancer, are presented. The three arms are: Control arm - liquid based cytology with atypical squamous cells of unknown significance (ASC-US) triage with hrHPV testing; Intervention Arm - hrHPV at entry with liquid-based cytology (LBC) triage of hrHPV positives, with exit screen at 4 years; Safety check arm - hrHPV at entry with LBC triage of hrHPV positives with exit screen at 2 years. A total of 6154 women were randomised to the control arm and 12 494 to the HPV arms (intervention and safety check). In the HPV arm, the baseline cervical intraepithelial neoplasia (CIN)2+ and CIN3+ rate was 9.2/1000 (95%CI; 7.4, 10.9) and 4.8/1000 (95%CI; 3.6, 6.1), which increased to 16.1/1000 (95%CI 13.2, 18.9) for CIN2+ and to 8.0/1000 (95%CI; 5.9, 10.0) for CIN3+ after subsequent screening of HPV-DNA-positive/cytology-negative women. Detection rate in the control arm remained unchanged after subsequent screening of ASC-US-positive/hrHPV DNA-negative women at 11.0/1000 for CIN2+ and 5.0/1000 for CIN3+. After subsequent screening of women who were either hrHPV positive/cytology negative or ASC-US positive/HPV negative, women randomised to the HPV arms had increased CIN2+ detection compared with women randomised to the cytology arm.

Cardiovascular mortality prediction in veterans with arm exercise vs pharmacologic myocardial perfusion imaging.

PubMed

Martin, Wade H; Xian, Hong; Chandiramani, Pooja; Bainter, Emily; Klein, Andrew J P

2015-08-01

No data exist comparing outcome prediction from arm exercise vs pharmacologic myocardial perfusion imaging (MPI) stress test variables in patients unable to perform treadmill exercise. In this retrospective study, 2,173 consecutive lower extremity disabled veterans aged 65.4 ± 11.0years (mean ± SD) underwent either pharmacologic MPI (1730 patients) or arm exercise stress tests (443 patients) with MPI (n = 253) or electrocardiography alone (n = 190) between 1997 and 2002. Cox multivariate regression models and reclassification analysis by integrated discrimination improvement (IDI) were used to characterize stress test and MPI predictors of cardiovascular mortality at ≥10-year follow-up after inclusion of significant demographic, clinical, and other variables. Cardiovascular death occurred in 561 pharmacologic MPI and 102 arm exercise participants. Multivariate-adjusted cardiovascular mortality was predicted by arm exercise resting metabolic equivalents (hazard ratio [HR] 0.52, 95% CI 0.39-0.69, P < .001), 1-minute heart rate recovery (HR 0.61, 95% CI 0.44-0.86, P < .001), and pharmacologic and arm exercise delta (peak-rest) heart rate (both P < .001). Only an abnormal arm exercise MPI prognosticated cardiovascular death by multivariate Cox analysis (HR 1.98, 95% CI 1.04-3.77, P < .05). Arm exercise MPI defect number, type, and size provided IDI over covariates for prediction of cardiovascular mortality (IDI = 0.074-0.097). Only pharmacologic defect size prognosticated cardiovascular mortality (IDI = 0.022). Arm exercise capacity, heart rate recovery, and pharmacologic and arm exercise heart rate responses are robust predictors of cardiovascular mortality. Arm exercise MPI results are equivalent and possibly superior to pharmacologic MPI for cardiovascular mortality prediction in patients unable to perform treadmill exercise. Published by Elsevier Inc.

OxMaR: open source free software for online minimization and randomization for clinical trials.

PubMed

O'Callaghan, Christopher A

2014-01-01

Minimization is a valuable method for allocating participants between the control and experimental arms of clinical studies. The use of minimization reduces differences that might arise by chance between the study arms in the distribution of patient characteristics such as gender, ethnicity and age. However, unlike randomization, minimization requires real time assessment of each new participant with respect to the preceding distribution of relevant participant characteristics within the different arms of the study. For multi-site studies, this necessitates centralized computational analysis that is shared between all study locations. Unfortunately, there is no suitable freely available open source or free software that can be used for this purpose. OxMaR was developed to enable researchers in any location to use minimization for patient allocation and to access the minimization algorithm using any device that can connect to the internet such as a desktop computer, tablet or mobile phone. The software is complete in itself and requires no special packages or libraries to be installed. It is simple to set up and run over the internet using online facilities which are very low cost or even free to the user. Importantly, it provides real time information on allocation to the study lead or administrator and generates real time distributed backups with each allocation. OxMaR can readily be modified and customised and can also be used for standard randomization. It has been extensively tested and has been used successfully in a low budget multi-centre study. Hitherto, the logistical difficulties involved in minimization have precluded its use in many small studies and this software should allow more widespread use of minimization which should lead to studies with better matched control and experimental arms. OxMaR should be particularly valuable in low resource settings.

Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients through Medical home Evaluation and reDesign (TOPMED) study

PubMed Central

Dorr, David A.; Anastas, Tracy; Ramsey, Katrina; Wagner, Jesse; Sachdeva, Bhavaya; Michaels, LeAnn; Fagnan, Lyle

2016-01-01

Background Health reform programs like the Patient-Centered Medical Home (PCMH) are intended to improve the Triple Aim. Previous studies on PCMHs have shown mixed effects, but High Value Elements (HVEs) are expected to improve the Triple Aim. Objective To understand whether focusing on high value elements (HVEs) would improve patient experience with care. Methods Eight clinics were cluster-randomized in a year-long trial. Both arms received practice facilitation, IT-based reporting, and financial incentives. Intervention practices were encouraged to choose HVEs for QI goals. To assess patient experience, 1,597 Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys were sent pre- and post-trial to a stratified random sample of patients. Difference in difference multivariate analysis was used to compare patient responses from intervention and control practices, adjusting for confounders. Results The response rate was 43% (n=686). Non-respondent analysis showed no difference between arms, although differences were seen by risk status and age. The overall difference in difference was 2.8%, favoring the intervention. The intervention performed better in 9 of 11 composites. The intervention performed significantly better in Follow-up on test results (p=.091) and Patients’ rating of the provider (p=.091), while the control performed better in Access to care (p=.093). Both arms also had decreases, including 4 of 11 composites for the intervention, and 8 of 11 for the control. Discussion Practices that targeted HVEs showed significantly more improvement in patient experience of care. However, contemporaneous trends may have affected results, leading to declines in patient experience in both arms. PMID:27116107

Protocol for the process evaluation of interventions combining performance-based financing with health equity in Burkina Faso.

PubMed

Ridde, Valéry; Turcotte-Tremblay, Anne-Marie; Souares, Aurélia; Lohmann, Julia; Zombré, David; Koulidiati, Jean Louis; Yaogo, Maurice; Hien, Hervé; Hunt, Matthew; Zongo, Sylvie; De Allegri, Manuela

2014-10-12

The low quality of healthcare and the presence of user fees in Burkina Faso contribute to low utilization of healthcare and elevated levels of mortality. To improve access to high-quality healthcare and equity, national authorities are testing different intervention arms that combine performance-based financing with community-based health insurance and pro-poor targeting. There is a need to evaluate the implementation of these unique approaches. We developed a research protocol to analyze the conditions that led to the emergence of these intervention arms, the fidelity between the activities initially planned and those conducted, the implementation and adaptation processes, the sustainability of the interventions, the possibilities for scaling them up, and their ethical implications. The study adopts a longitudinal multiple case study design with several embedded levels of analyses. To represent the diversity of contexts where the intervention arms are carried out, we will select three districts. Within districts, we will select both primary healthcare centers (n =18) representing different intervention arms and the district or regional hospital (n =3). We will select contrasted cases in relation to their initial performance (good, fair, poor). Over a period of 18 months, we will use quantitative and qualitative data collection and analytical tools to study these cases including in-depth interviews, participatory observation, research diaries, and questionnaires. We will give more weight to qualitative methods compared to quantitative methods. Performance-based financing is expanding rapidly across low- and middle-income countries. The results of this study will enable researchers and decision makers to gain a better understanding of the factors that can influence the implementation and the sustainability of complex interventions aiming to increase healthcare quality as well as equity.

The need for preoperative baseline arm measurement to accurately quantify breast cancer-related lymphedema.

PubMed

Sun, Fangdi; Skolny, Melissa N; Swaroop, Meyha N; Rawal, Bhupendra; Catalano, Paul J; Brunelle, Cheryl L; Miller, Cynthia L; Taghian, Alphonse G

2016-06-01

Breast cancer-related lymphedema (BCRL) is a feared outcome of breast cancer treatment, yet the push for early screening is hampered by a lack of standardized quantification. We sought to determine the necessity of preoperative baseline in accounting for temporal changes of upper extremity volume. 1028 women with unilateral breast cancer were prospectively screened for lymphedema by perometry. Thresholds were defined: relative volume change (RVC) ≥10 % for clinically significant lymphedema and ≥5 % including subclinical lymphedema. The first postoperative measurement (pseudo-baseline) simulated the case of no baseline. McNemar's test and binomial logistic regression models were used to analyze BCRL misdiagnoses. Preoperatively, 28.3 and 2.9 % of patients had arm asymmetry of ≥5 and 10 %, respectively. Without baseline, 41.6 % of patients were underdiagnosed and 40.1 % overdiagnosed at RVC ≥ 5 %, increasing to 50.0 and 54.8 % at RVC ≥ 10 %. Increased pseudo-baseline asymmetry, increased weight change between baselines, hormonal therapy, dominant use of contralateral arm, and not receiving axillary lymph node dissection (ALND) were associated with increased risk of underdiagnosis at RVC ≥ 5 %; not receiving regional lymph node radiation was significant at RVC ≥ 10 %. Increased pseudo-baseline asymmetry, not receiving ALND, and dominant use of ipsilateral arm were associated with overdiagnosis at RVC ≥ 5 %; increased pseudo-baseline asymmetry and not receiving ALND were significant at RVC ≥ 10 %. The use of a postoperative proxy even early after treatment results in poor sensitivity for identifying BCRL. Providers with access to patients before surgery should consider the consequent need for proper baseline, with specific strategy tailored by institution.

Arm cranking versus wheelchair propulsion for testing aerobic fitness in children with spina bifida who are wheelchair dependent.

PubMed

Bloemen, Manon A T; de Groot, Janke F; Backx, Frank J G; Westerveld, Rosalyne A; Takken, Tim

2015-05-01

To determine the best test performance and feasibility using a Graded Arm Cranking Test vs a Graded Wheelchair Propulsion Test in young people with spina bifida who use a wheelchair, and to determine the reliability of the best test. Validity and reliability study. Young people with spina bifida who use a wheelchair. Physiological responses were measured during a Graded Arm Cranking Test and a Graded Wheelchair Propulsion Test using a heart rate monitor and calibrated mobile gas analysis system (Cortex Metamax). For validity, peak oxygen uptake (VO2peak) and peak heart rate (HRpeak) were compared using paired t-tests. For reliability, the intra-class correlation coefficients, standard error of measurement, and standard detectable change were calculated. VO2peak and HRpeak were higher during wheelchair propulsion compared with arm cranking (23.1 vs 19.5 ml/kg/min, p = 0.11; 165 vs 150 beats/min, p < 0.05). Reliability of wheelchair propulsion showed high intra-class correlation coefficients (ICCs) for both VO2peak (ICC = 0.93) and HRpeak (ICC = 0.90). This pilot study shows higher HRpeak and a tendency to higher VO2peak in young people with spina bifida who are using a wheelchair when tested during wheelchair propulsion compared with arm cranking. Wheelchair propulsion showed good reliability. We recommend performing a wheelchair propulsion test for aerobic fitness testing in this population.

Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

PubMed

Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

2013-10-01

Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

KSC-2009-4535

NASA Image and Video Library

2009-08-07

CAPE CANAVERAL, Fla. – STS-128 Mission Specialist Patrick Forrester is the White Room on NASA Kennedy Space Center's Launch Pad 39A getting ready to enter space shuttle Discovery. The White Room is at the end of the orbiter access arm and provides entry into the shuttle. Mission crew members are at Kennedy to take part in the terminal countdown demonstration test, or TCDT, which culminates in a simulated launch countdown inside the shuttle. On the STS-128 mission, Discovery will deliver 33,000 pounds of equipment to the station, including science and storage racks, a freezer to store research samples, a new sleeping compartment and the COLBERT treadmill. Launch is targeted for late August. Photo credit: NASA/Jim Grossmann

KSC-01pp0075

NASA Image and Video Library

2001-01-05

In the White Room, STS-98 Mission Specialist Thomas Jones gets help with his launch and entry suit before entering Atlantis for a simulated launch countdown. The White Room is an environmental chamber at the end of the orbiter access arm that mates with the orbiter to allow personnel to enter the orbiter’s crew compartment. The STS-98 crew is taking part in Terminal Countdown Demonstration Test activities, which also include emergency egress training at the pad. STS-98 is the seventh construction flight to the International Space Station, carrying as payload the U.S. Lab Destiny, a key element in the construction of the ISS. Launch of STS-98 is scheduled for Jan. 19 at 2:11 a.m. EST

KSC-2009-4533

NASA Image and Video Library

2009-08-07

CAPE CANAVERAL, Fla. – STS-128 Pilot Kevin Ford is the White Room on NASA Kennedy Space Center's Launch Pad 39A getting ready to enter space shuttle Discovery. The White Room is at the end of the orbiter access arm and provides entry into the shuttle. Mission crew members are at Kennedy to take part in the terminal countdown demonstration test, or TCDT, which culminates in a simulated launch countdown inside the shuttle. On the STS-128 mission, Discovery will deliver 33,000 pounds of equipment to the station, including science and storage racks, a freezer to store research samples, a new sleeping compartment and the COLBERT treadmill. Launch is targeted for late August. Photo credit: NASA/Jim Grossmann

KSC-07pd1990

NASA Image and Video Library

2007-07-19

KENNEDY SPACE CENTER, Fla. --In the White Room on Launch Pad 39A, STS-118 Mission Specialist Rick Mastracchio is eager to enter Space Shuttle Endeavour for a simulated launch countdown, the culmination of terminal countdown demonstration test activities. The White Room is situated at the end of the orbiter access arm and provides entry into the orbiter. TCDT activities also include M-113 training, payload familiarization and emergency egress training at the pad. The mission is the 22nd flight to the International Space Station and Space Shuttle Endeavour will carry a payload including the S5 truss, a SPACEHAB module and external stowage platform 3. STS-118 is targeted for launch on Aug. 7. Photo credit: NASA/Amanda Diller

KSC-01pp0076

NASA Image and Video Library

2001-01-05

In the White Room, STS-98 Pilot Mark Polansky gets help with his launch and entry suit before entering Atlantis for a simulated launch countdown. The White Room is an environmental chamber at the end of the orbiter access arm that mates with the orbiter to allow personnel to enter the orbiter’s crew compartment. The STS-98 crew is taking part in Terminal Countdown Demonstration Test activities, which also include emergency egress training at the pad. STS-98 is the seventh construction flight to the International Space Station, carrying as payload the U.S. Lab Destiny, a key element in the construction of the ISS. Launch of STS-98 is scheduled for Jan. 19 at 2:11 a.m. EST

KSC-01pp0074

NASA Image and Video Library

2001-01-05

In the White Room, STS-98 Mission Specialists Robert Curbeam and Marsha Ivins pose for a photo before entering Atlantis for a simulated launch countdown. The White Room is an environmental chamber at the end of the orbiter access arm that mates with the orbiter to allow personnel to enter the orbiter’s crew compartment. The STS-98 crew is taking part in Terminal Countdown Demonstration Test activities, which also include emergency egress training at the pad. STS-98 is the seventh construction flight to the International Space Station, carrying as payload the U.S. Lab Destiny, a key element in the construction of the ISS. Launch of STS-98 is scheduled for Jan. 19 at 2:11 a.m. EST

KSC-2009-4538

NASA Image and Video Library

2009-08-07

CAPE CANAVERAL, Fla. – In the White Room on NASA Kennedy Space Center's Launch Pad 39A, STS-128 Commander Rick Sturckow is helped with his harness before entering space shuttle Discovery. The White Room is at the end of the orbiter access arm and provides entry into the shuttle. The crew is at Kennedy to take part in the terminal countdown demonstration test, or TCDT, which includes equipment familiarization, emergency exit training and a simulated countdown. On the STS-128 mission, Discovery will deliver 33,000 pounds of equipment to the station, including science and storage racks, a freezer to store research samples, a new sleeping compartment and the COLBERT treadmill. Launch is targeted for late August. Photo credit: NASA/Kim Shiflett

Effect of HIV self-testing on the number of sexual partners among female sex workers in Zambia

PubMed Central

Oldenburg, Catherine E.; Chanda, Michael M.; Ortblad, Katrina F.; Mwale, Magdalene; Chongo, Steven; Kamungoma, Nyambe; Kanchele, Catherine; Fullem, Andrew; Moe, Caitlin; Barresi, Leah G.; Harling, Guy D.; Bärnighausen, Till

2018-01-01

Objectives: To assess the effect of two health system approaches to distribute HIV self-tests on the number of female sex workers’ client and nonclient sexual partners. Design: Cluster randomized controlled trial. Methods: Peer educators recruited 965 participants. Peer educator–participant groups were randomized 1 : 1 : 1 to one of three arms: delivery of HIV self-tests directly from a peer educator, free facility-based delivery of HIV self-tests in exchange for coupons, or referral to standard-of-care HIV testing. Participants in all three arms completed four peer educator intervention sessions, which included counseling and condom distribution. Participants were asked the average number of client partners they had per night at baseline, 1 and 4 months, and the number of nonclient partners they had in the past 12 months (at baseline) and in the past month (at 1 month and 4 months). Results: At 4 months, participants reported significantly fewer clients per night in the direct delivery arm (mean difference −0.78 clients, 95% CI −1.28 to −0.28, P = 0.002) and the coupon arm (−0.71, 95% CI −1.21 to −0.21, P = 0.005) compared with standard of care. Similarly, they reported fewer nonclient partners in the direct delivery arm (−3.19, 95% CI −5.18 to −1.21, P = 0.002) and in the coupon arm (−1.84, 95% CI −3.81 to 0.14, P = 0.07) arm compared with standard of care. Conclusion: Expansion of HIV self-testing may have positive behavioral effects enhancing other HIV prevention efforts among female sex workers in Zambia. Trial Registration: ClinicalTrials.gov NCT02827240. PMID:29494424

C-arm cone beam computed tomography needle path overlay for fluoroscopic guided vertebroplasty.

PubMed

Tam, Alda L; Mohamed, Ashraf; Pfister, Marcus; Chinndurai, Ponraj; Rohm, Esther; Hall, Andrew F; Wallace, Michael J

2010-05-01

Retrospective review. To report our early clinical experience using C-arm cone beam computed tomography (C-arm CBCT) with fluoroscopic overlay for needle guidance during vertebroplasty. C-arm CBCT is advanced three-dimensional (3-D) imaging technology that is currently available on state-of-the-art flat panel based angiography systems. The imaging information provided by C-arm CBCT allows for the acquisition and reconstruction of "CT-like" images in flat panel based angiography/interventional suites. As part of the evolution of this technology, enhancements allowing the overlay of cross-sectional imaging information can now be integrated with real time fluoroscopy. We report our early clinical experience with C-arm CBCT with fluoroscopic overlay for needle guidance during vertebroplasty. This is a retrospective review of 10 consecutive oncology patients who underwent vertebroplasty of 13 vertebral levels using C-arm CBCT with fluoroscopic overlay for needle guidance from November 2007 to December 2008. Procedural data including vertebral level, approach (transpedicular vs. extrapedicular), access (bilateral vs. unilateral) and complications were recorded. Technical success with the overlay technology was assessed based on accuracy which consisted of 4 measured parameters: distance from target to needle tip, distance from planned path to needle tip, distance from midline to needle tip, and distance from the anterior 1/3 of the vertebral body to needle tip. Success within each parameter required that the distance between the needle tip and parameter being evaluated be no more than 5 mm on multiplanar CBCT or fluoroscopy. Imaging data for 12 vertebral levels was available for review. All vertebral levels were treated using unilateral access and 9 levels were treated with an extrapedicular approach. Technical success rates were 92% for both distance from planned path and distance from midline to final needle tip, 100% when distance from needle tip to the anterior 1/3 border of the vertebral body was measured, and 75% when distance from target to needle tip was measured. There were no major complications. Minor complications consisted of 3 cases (25%) of cement extravasation. C-arm CBCT with needle path overlay for fluoroscopic guided vertebroplasty is feasible and allows for reliable unilateral therapy of both lumbar and thoracic vertebral bodies. Extrapedicular approaches were performed safely and with good accuracy of reaching the targets.

EPIC Calibration/Validation Experiment Field Campaign Report

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

Koch, Steven E; Chilson, Phillip; Argrow, Brian

A field exercise involving several different kinds of Unmanned Aerial Systems (UAS) and supporting instrumentation systems provided by DOE/ARM and NOAA/NSSL was conducted at the ARM SGP site in Lamont, Oklahoma on 29-30 October 2016. This campaign was part of a larger National Oceanic and Atmospheric Administration (NOAA) UAS Program Office program awarded to the National Severe Storms Laboratory (NSSL). named Environmental Profiling and Initiation of Convection (EPIC). The EPIC Field Campaign (Test and Calibration/Validation) proposed to ARM was a test or “dry-run” for a follow-up campaign to be requested for spring/summer 2017. The EPIC project addresses NOAA’s objective tomore » “evaluate options for UAS profiling of the lower atmosphere with applications for severe weather.” The project goal is to demonstrate that fixed-wing and rotary-wing small UAS have the combined potential to provide a unique observing system capable of providing detailed profiles of temperature, moisture, and winds within the atmospheric boundary layer (ABL) to help determine the potential for severe weather development. Specific project objectives are: 1) to develop small UAS capable of acquiring needed wind and thermodynamic profiles and transects of the ABL using one fixed-wing UAS operating in tandem with two different fixed rotary-wing UAS pairs; 2) adapt and test miniaturized, high-precision, and fast-response atmospheric sensors with high accuracy in strong winds characteristic of the pre-convective ABL in Oklahoma; 3) conduct targeted short-duration experiments at the ARM Southern Great Plains site in northern Oklahoma concurrently with a second site to be chosen in “real-time” from the Oklahoma Mesonet in coordination with the (National Weather Service (NWS)-Norman Forecast Office; and 4) gain valuable experience in pursuit of NOAA’s goals for determining the value of airborne, mobile observing systems for monitoring rapidly evolving high-impact severe weather conditions not observed with current operational systems. OU operated three UAS at the Lamont SGP site – the OU CopterSonde, the OU Iris, and the Meteomatics Meteodrone – under a blanket Federal Aviation Administration (FAA) Certificate of Authorization (COA) allowing flights up to 400 feet above ground level (AGL). The mission for the rotary-wing UAS involved four aircraft, three from the ARM Lamont site and one from an Oklahoma Mesonet site located at Medford, involving a vertical ascent to an altitude of 400 ft (130 m) AGL at ~ 30 minute intervals for ~ 5 hours duration on each of the two experiment days. This operation was conducted in close coordination with NSSL-launched rawinsonde balloons at the two sites, and operation of a fixed-wing UAS from the University of Colorado called the TTwistor that flew mission flight legs between the Lamont site and Medford. The NSSL operation at Medford (outside of ARM) also involved use of their Collaborative Lower Atmosphere Mobile Profiling System (CLAMPS) ground-based remote-sensing system for measuring atmospheric profiles of temperature, moisture, and winds with atmospheric emitted radiance interferometer (AERI), microwave radiometer, and Doppler wind lidar systems. The ARM Facility supported the project by providing access to their instrumented tower data at Lamont (at three levels), as well as AERI and Doppler wind lidar data obtained from systems quite similar to those used by CLAMPS. These non-UAS data from both ARM and NSSL provided the observations used to validate the experimental UAS observations.« less

Properties of intermodal transfer after dual visuo- and auditory-motor adaptation.

PubMed

Schmitz, Gerd; Bock, Otmar L

2017-10-01

Previous work documented that sensorimotor adaptation transfers between sensory modalities: When subjects adapt with one arm to a visuomotor distortion while responding to visual targets, they also appear to be adapted when they are subsequently tested with auditory targets. Vice versa, when they adapt to an auditory-motor distortion while pointing to auditory targets, they appear to be adapted when they are subsequently tested with visual targets. Therefore, it was concluded that visuomotor as well as auditory-motor adaptation use the same adaptation mechanism. Furthermore, it has been proposed that sensory information from the trained modality is weighted larger than sensory information from an untrained one, because transfer between sensory modalities is incomplete. The present study tested these hypotheses for dual arm adaptation. One arm adapted to an auditory-motor distortion and the other either to an opposite directed auditory-motor or visuomotor distortion. We found that both arms adapted significantly. However, compared to reference data on single arm adaptation, adaptation in the dominant arm was reduced indicating interference from the non-dominant to the dominant arm. We further found that arm-specific aftereffects of adaptation, which reflect recalibration of sensorimotor transformation rules, were stronger or equally strong when targets were presented in the previously adapted compared to the non-adapted sensory modality, even when one arm adapted visually and the other auditorily. The findings are discussed with respect to a recently published schematic model on sensorimotor adaptation. Copyright © 2017 Elsevier B.V. All rights reserved.

The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial

PubMed Central

Rocco, Michael V.; Lockridge, Robert S.; Beck, Gerald J.; Eggers, Paul W.; Gassman, Jennifer J.; Greene, Tom; Larive, Brett; Chan, Christopher T.; Chertow, Glenn M.; Copland, Michael; Hoy, Christopher D.; Lindsay, Robert M.; Levin, Nathan W.; Ornt, Daniel B.; Pierratos, Andreas; Pipkin, Mary F.; Rajagopalan, Sanjay; Stokes, John B.; Unruh, Mark L.; Star, Robert A.; Kliger, Alan S.

2013-01-01

Prior small studies have shown multiple benefits of frequent nocturnal hemodialysis compared to conventional three times per week treatments. To study this further, we randomized 87 patients to three times per week conventional hemodialysis or to nocturnal hemodialysis six times per week, all with single-use high-flux dialyzers. The 45 patients in the frequent nocturnal arm had a 1.82-fold higher mean weekly stdKt/Vurea, a 1.74-fold higher average number of treatments per week, and a 2.45-fold higher average weekly treatment time than the 42 patients in the conventional arm. We did not find a significant effect of nocturnal hemodialysis for either of the two coprimary outcomes (death or left ventricular mass (measured by MRI) with a hazard ratio of 0.68, or of death or RAND Physical Health Composite with a hazard ratio of 0.91). Possible explanations for the left ventricular mass result include limited sample size and patient characteristics. Secondary outcomes included cognitive performance, self-reported depression, laboratory markers of nutrition, mineral metabolism and anemia, blood pressure and rates of hospitalization, and vascular access interventions. Patients in the nocturnal arm had improved control of hyperphosphatemia and hypertension, but no significant benefit among the other main secondary outcomes. There was a trend for increased vascular access events in the nocturnal arm. Thus, we were unable to demonstrate a definitive benefit of more frequent nocturnal hemodialysis for either coprimary outcome. PMID:21775973

Mirror therapy for patients with severe arm paresis after stroke--a randomized controlled trial.

PubMed

Thieme, Holm; Bayn, Maria; Wurg, Marco; Zange, Christian; Pohl, Marcus; Behrens, Johann

2013-04-01

To evaluate the effects of individual or group mirror therapy on sensorimotor function, activities of daily living, quality of life and visuospatial neglect in patients with a severe arm paresis after stroke. Randomized controlled trial. Inpatient rehabilitation centre. Sixty patients with a severe paresis of the arm within three months after stroke. Three groups: (1) individual mirror therapy, (2) group mirror therapy and (3) control intervention with restricted view on the affected arm. Motor function on impairment (Fugl-Meyer Test) and activity level (Action Research Arm Test), independence in activities of daily living (Barthel Index), quality of life (Stroke Impact Scale) and visuospatial neglect (Star Cancellation Test). After five weeks, no significant group differences for motor function were found (P > 0.05). Pre-post differences for the Action Research Arm Test and Fugl-Meyer Test: individual mirror therapy: 3.4 (7.1) and 3.2 (3.8), group mirror therapy: 1.1 (3.1) and 5.1 (10.0) and control therapy: 2.8 (6.7) and 5.2 (8.7). However, a significant effect on visuospatial neglect for patients in the individual mirror therapy compared to control group could be shown (P < 0.01). Furthermore, it was possible to integrate a mirror therapy group intervention for severely affected patients after stroke. This study showed no effect on sensorimotor function of the arm, activities of daily living and quality of life of mirror therapy compared to a control intervention after stroke. However, a positive effect on visuospatial neglect was indicated.

Reporting of analyses from randomized controlled trials with multiple arms: a systematic review.

PubMed

Baron, Gabriel; Perrodeau, Elodie; Boutron, Isabelle; Ravaud, Philippe

2013-03-27

Multiple-arm randomized trials can be more complex in their design, data analysis, and result reporting than two-arm trials. We conducted a systematic review to assess the reporting of analyses in reports of randomized controlled trials (RCTs) with multiple arms. The literature in the MEDLINE database was searched for reports of RCTs with multiple arms published in 2009 in the core clinical journals. Two reviewers extracted data using a standardized extraction form. In total, 298 reports were identified. Descriptions of the baseline characteristics and outcomes per group were missing in 45 reports (15.1%) and 48 reports (16.1%), respectively. More than half of the articles (n = 171, 57.4%) reported that a planned global test comparison was used (that is, assessment of the global differences between all groups), but 67 (39.2%) of these 171 articles did not report details of the planned analysis. Of the 116 articles reporting a global comparison test, 12 (10.3%) did not report the analysis as planned. In all, 60% of publications (n = 180) described planned pairwise test comparisons (that is, assessment of the difference between two groups), but 20 of these 180 articles (11.1%) did not report the pairwise test comparisons. Of the 204 articles reporting pairwise test comparisons, the comparisons were not planned for 44 (21.6%) of them. Less than half the reports (n = 137; 46%) provided baseline and outcome data per arm and reported the analysis as planned. Our findings highlight discrepancies between the planning and reporting of analyses in reports of multiple-arm trials.

New Approach to Sea Level Monitoring Tested at Shemya, Alaska

NASA Astrophysics Data System (ADS)

Urban, G. W.; Medbery, A. H.; Burgy, M. C.

2003-12-01

Due to the prohibitive installation cost to replace a storm damaged stilling well type tide gauge at Earickson Air Force Station on Shemya Island, Alaska, an alternative sea-level gauge was sought by the West Coast and Alaska Tsunami Warning Center (WCATWC). An Omart-Vega radar system was chosen as the alternative, since it had low power needs, did not require a stilling well and its design included observation of rough surface liquids. The Omart-Vega radar system works by emitting a 5 gHz radar wave which reflects off the water surface and then back to the unit at a specified rate. This information is then telemetered directly to a computer which records the sample. Although the cost of the Vega system (3500USD) was similar to that of the stilling well unit (2500USD), the comparison of the installation costs of the two different units was an issue. To install the stilling well system, two certified under-water welding divers were required at a cost of 40K-USD or more. In comparison, the installation of the Vega system simply required an arm constructed so as to hang and support the Vega unit off the pier at Shemya. This arm assembly would also house the unit to protect it from surf and weather. The arm was designed in-house and built by a local metal contractor for less than 500USD. This portable unit was sent to Shemya via C-130 aircraft. The arm assembly and housed radar tide gauge was installed by one person. The circuitry to run the Vega was developed and tested at the WCATWC. Software was designed and tested there as well, although the software was written by Omart at no cost to the Warning Center. The circuitry allows for direct remote reconfiguration from Palmer to the radar system. The Vega is accessed by software directly from the WCATWC computer to sample the water level at numerous settable sample rates, which include one second, five second, fifteen second, and thirty second. After nearly one year of operation at Earickson, which included many major storms, the radar unit is proving to be a reliable substitute for the previous stilling well type gauge.

The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans.

PubMed

Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels; Larsen, Filip J; Schiffer, Tomas A; Willis, Sarah J; Gelabert-Rebato, Miriam; Perez-Valera, Mario; Boushel, Robert; Calbet, Jose A L; Holmberg, Hans-Christer

2016-01-01

To elucidate the mechanisms underlying the differences in adaptation of arm and leg muscles to sprint training, over a period of 11 days 16 untrained men performed six sessions of 4-6 × 30-s all-out sprints (SIT) with the legs and arms, separately, with a 1-h interval of recovery. Limb-specific VO 2 peak, sprint performance (two 30-s Wingate tests with 4-min recovery), muscle efficiency and time-trial performance (TT, 5-min all-out) were assessed and biopsies from the m. vastus lateralis and m. triceps brachii taken before and after training. VO 2 peak and Wmax increased 3-11% after training, with a more pronounced change in the arms ( P < 0.05). Gross efficiency improved for the arms (+8.8%, P < 0.05), but not the legs (-0.6%). Wingate peak and mean power outputs improved similarly for the arms and legs, as did TT performance. After training, VO 2 during the two Wingate tests was increased by 52 and 6% for the arms and legs, respectively ( P < 0.001). In the case of the arms, VO 2 was higher during the first than second Wingate test (64 vs. 44%, P < 0.05). During the TT, relative exercise intensity, HR, VO 2 , VCO 2 , V E , and V t were all lower during arm-cranking than leg-pedaling, and oxidation of fat was minimal, remaining so after training. Despite the higher relative intensity, fat oxidation was 70% greater during leg-pedaling ( P = 0.017). The aerobic energy contribution in the legs was larger than for the arms during the Wingate tests, although VO 2 for the arms was enhanced more by training, reducing the O 2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple regression analysis demonstrated that the variables that predict TT performance differ for the arms and legs. The primary mechanism of adaptation to SIT by both the arms and legs is enhancement of aerobic energy production. However, with their higher proportion of fast muscle fibers, the arms exhibit greater plasticity.

The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

PubMed Central

Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels; Larsen, Filip J.; Schiffer, Tomas A.; Willis, Sarah J.; Gelabert-Rebato, Miriam; Perez-Valera, Mario; Boushel, Robert; Calbet, Jose A. L.; Holmberg, Hans-Christer

2016-01-01

To elucidate the mechanisms underlying the differences in adaptation of arm and leg muscles to sprint training, over a period of 11 days 16 untrained men performed six sessions of 4–6 × 30-s all-out sprints (SIT) with the legs and arms, separately, with a 1-h interval of recovery. Limb-specific VO2peak, sprint performance (two 30-s Wingate tests with 4-min recovery), muscle efficiency and time-trial performance (TT, 5-min all-out) were assessed and biopsies from the m. vastus lateralis and m. triceps brachii taken before and after training. VO2peak and Wmax increased 3–11% after training, with a more pronounced change in the arms (P < 0.05). Gross efficiency improved for the arms (+8.8%, P < 0.05), but not the legs (−0.6%). Wingate peak and mean power outputs improved similarly for the arms and legs, as did TT performance. After training, VO2 during the two Wingate tests was increased by 52 and 6% for the arms and legs, respectively (P < 0.001). In the case of the arms, VO2 was higher during the first than second Wingate test (64 vs. 44%, P < 0.05). During the TT, relative exercise intensity, HR, VO2, VCO2, VE, and Vt were all lower during arm-cranking than leg-pedaling, and oxidation of fat was minimal, remaining so after training. Despite the higher relative intensity, fat oxidation was 70% greater during leg-pedaling (P = 0.017). The aerobic energy contribution in the legs was larger than for the arms during the Wingate tests, although VO2 for the arms was enhanced more by training, reducing the O2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple regression analysis demonstrated that the variables that predict TT performance differ for the arms and legs. The primary mechanism of adaptation to SIT by both the arms and legs is enhancement of aerobic energy production. However, with their higher proportion of fast muscle fibers, the arms exhibit greater plasticity. PMID:27746738

Comparing young people's experience of technology-delivered v. face-to-face mindfulness and relaxation: two-armed qualitative focus group study.

PubMed

Tunney, Conall; Cooney, Patricia; Coyle, David; O'Reilly, Gary

2017-04-01

Background The current popularity of mindfulness-based practices has coincided with the increase in access to mobile technology. This has led to many mindfulness apps and programs becoming available, some specifically for children. However, little is known about the experience of engaging with mindfulness through these mediums. Aims To explore children's experience of mindfulness delivered both face-to-face and through a computer game to highlight any differences or similarities. Method A two-armed qualitative focus groups design was used to explore children's experiences. The first arm offered mindfulness exercises in a traditional face-to-face setting with guided meditations. The second arm offered mindfulness exercises through a computer game avatar. Results Themes of relaxation, engagement, awareness, thinking, practice and directing attention emerged from both arms of focus groups. Subthematic codes highlight key differences as well as similarities in the experience of mindfulness. Conclusions These results indicate that mindfulness delivered via technology can offer a rich experience. © The Royal College of Psychiatrists 2017.

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Thorax without arm. 572.196 Section 572.196... Test Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Thorax without arm. 572.196 Section 572.196... Test Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 234.219 - Gate arm lights and light cable.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Gate arm lights and light cable. 234.219 Section... Maintenance, Inspection, and Testing Maintenance Standards § 234.219 Gate arm lights and light cable. Each gate arm light shall be maintained in such condition to be properly visible to approaching highway...

49 CFR 234.219 - Gate arm lights and light cable.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Gate arm lights and light cable. 234.219 Section... Maintenance, Inspection, and Testing Maintenance Standards § 234.219 Gate arm lights and light cable. Each gate arm light shall be maintained in such condition to be properly visible to approaching highway...

Providing Home-Based HIV Testing and Counseling for Transgender Youth (Project Moxie): Protocol for a Pilot Randomized Controlled Trial.

PubMed

Stephenson, Rob; Metheny, Nicholas; Sharma, Akshay; Sullivan, Stephen; Riley, Erin

2017-11-28

Transgender and gender nonconforming people experience some of the highest human immunodeficiency virus (HIV) rates in the United States, and experience many structural and behavioral barriers that may limit their engagement in HIV testing, prevention, and care. Evidence suggests that transgender and gender nonconforming youth (TY) are especially vulnerable to acquiring HIV, yet there is little research on TY and few services are targeted towards HIV testing, prevention, and care for this population. Telehealth presents an opportunity to mitigate some structural barriers that TY experience in accessing HIV testing, allowing TY to engage in HIV testing and counseling in a safe and nonjudgmental space of their choosing. Project Moxie is an HIV prevention intervention that pairs the use of HIV self-testing with remote video-based counseling and support from a trained, gender-affirming counselor. This study aims to offer a more positive HIV testing and counseling experience, with the goal of improving HIV testing frequency. Project Moxie involves a pilot randomized controlled trial (RCT) of 200 TY aged 15-24 years, who are randomized on a 1:1 basis to control or intervention arms. The aim is to examine whether the addition of counseling provided via telehealth, coupled with home-based HIV testing, can create gains in routine HIV testing among TY over a six-month follow-up period. This study implements a prospective pilot RCT of 200 TY recruited online. Participants in the control arm will receive one HIV self-testing kit and will be asked to report their results via the study's website. Participants in the experimental arm will receive one HIV self-testing kit and will test with a remotely-located counselor during a prescheduled video-counseling session. Participants are assessed at baseline, and at three and six months posttesting. Project Moxie was launched in June 2017 and recruitment is ongoing. As of August 21, 2017, the study had enrolled 130 eligible participants. Combining home-based HIV testing and video-based counseling allows TY, an often stigmatized and marginalized population, to test for HIV in a safe and nonjudgmental setting of their choosing. This approach creates an opportunity to reduce the high rate of HIV among TY through engagement in care, support, and linkage to the HIV treatment cascade for those who test positive. ClinicalTrials.gov NCT03185975; https://clinicaltrials.gov/ct2/show/NCT03185975 (Archived by WebCite at http://www.webcitation.org/6vIjHJ93s). ©Rob Stephenson, Nicholas Metheny, Akshay Sharma, Stephen Sullivan, Erin Riley. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.11.2017.

Archetype relational mapping - a practical openEHR persistence solution.

PubMed

Wang, Li; Min, Lingtong; Wang, Rui; Lu, Xudong; Duan, Huilong

2015-11-05

One of the primary obstacles to the widespread adoption of openEHR methodology is the lack of practical persistence solutions for future-proof electronic health record (EHR) systems as described by the openEHR specifications. This paper presents an archetype relational mapping (ARM) persistence solution for the archetype-based EHR systems to support healthcare delivery in the clinical environment. First, the data requirements of the EHR systems are analysed and organized into archetype-friendly concepts. The Clinical Knowledge Manager (CKM) is queried for matching archetypes; when necessary, new archetypes are developed to reflect concepts that are not encompassed by existing archetypes. Next, a template is designed for each archetype to apply constraints related to the local EHR context. Finally, a set of rules is designed to map the archetypes to data tables and provide data persistence based on the relational database. A comparison study was conducted to investigate the differences among the conventional database of an EHR system from a tertiary Class A hospital in China, the generated ARM database, and the Node + Path database. Five data-retrieving tests were designed based on clinical workflow to retrieve exams and laboratory tests. Additionally, two patient-searching tests were designed to identify patients who satisfy certain criteria. The ARM database achieved better performance than the conventional database in three of the five data-retrieving tests, but was less efficient in the remaining two tests. The time difference of query executions conducted by the ARM database and the conventional database is less than 130 %. The ARM database was approximately 6-50 times more efficient than the conventional database in the patient-searching tests, while the Node + Path database requires far more time than the other two databases to execute both the data-retrieving and the patient-searching tests. The ARM approach is capable of generating relational databases using archetypes and templates for archetype-based EHR systems, thus successfully adapting to changes in data requirements. ARM performance is similar to that of conventionally-designed EHR systems, and can be applied in a practical clinical environment. System components such as ARM can greatly facilitate the adoption of openEHR architecture within EHR systems.

A Unified Approach for Reporting ARM Measurement Uncertainties Technical Report

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

Campos, E; Sisterson, Douglas

The U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Climate Research Facility is observationally based, and quantifying the uncertainty of its measurements is critically important. With over 300 widely differing instruments providing over 2,500 datastreams, concise expression of measurement uncertainty is quite challenging. The ARM Facility currently provides data and supporting metadata (information about the data or data quality) to its users through a number of sources. Because the continued success of the ARM Facility depends on the known quality of its measurements, the Facility relies on instrument mentors and the ARM Data Quality Office (DQO) to ensure, assess,more » and report measurement quality. Therefore, an easily accessible, well-articulated estimate of ARM measurement uncertainty is needed. Note that some of the instrument observations require mathematical algorithms (retrievals) to convert a measured engineering variable into a useful geophysical measurement. While those types of retrieval measurements are identified, this study does not address particular methods for retrieval uncertainty. As well, the ARM Facility also provides engineered data products, or value-added products (VAPs), based on multiple instrument measurements. This study does not include uncertainty estimates for those data products. We propose here that a total measurement uncertainty should be calculated as a function of the instrument uncertainty (calibration factors), the field uncertainty (environmental factors), and the retrieval uncertainty (algorithm factors). The study will not expand on methods for computing these uncertainties. Instead, it will focus on the practical identification, characterization, and inventory of the measurement uncertainties already available in the ARM community through the ARM instrument mentors and their ARM instrument handbooks. As a result, this study will address the first steps towards reporting ARM measurement uncertainty: 1) identifying how the uncertainty of individual ARM measurements is currently expressed, 2) identifying a consistent approach to measurement uncertainty, and then 3) reclassifying ARM instrument measurement uncertainties in a common framework.« less

Use of malaria rapid diagnostic tests by community health workers in Afghanistan: cluster randomised trial.

PubMed

Leslie, Toby; Rowland, Mark; Mikhail, Amy; Cundill, Bonnie; Willey, Barbara; Alokozai, Asif; Mayan, Ismail; Hasanzai, Anwar; Baktash, Sayed Habibullah; Mohammed, Nader; Wood, Molly; Rahimi, Habib-U-Rahman; Laurent, Baptiste; Buhler, Cyril; Whitty, Christopher J M

2017-07-07

The World Health Organisation (WHO) recommends parasitological diagnosis of malaria before treatment, but use of malaria rapid diagnostic tests (mRDTs) by community health workers (CHWs) has not been fully tested within health services in south and central Asia. mRDTs could allow CHWs to diagnose malaria accurately, improving treatment of febrile illness. A cluster randomised trial in community health services was undertaken in Afghanistan. The primary outcome was the proportion of suspected malaria cases correctly treated for polymerase chain reaction (PCR)-confirmed malaria and PCR negative cases receiving no antimalarial drugs measured at the level of the patient. CHWs from 22 clusters (clinics) received standard training on clinical diagnosis and treatment of malaria; 11 clusters randomised to the intervention arm received additional training and were provided with mRDTs. CHWs enrolled cases of suspected malaria, and the mRDT results and treatments were compared to blind-read PCR diagnosis. In total, 256 CHWs enrolled 2400 patients with 2154 (89.8%) evaluated. In the intervention arm, 75.3% (828/1099) were treated appropriately vs. 17.5% (185/1055) in the control arm (cluster adjusted risk ratio: 3.72, 95% confidence interval 2.40-5.77; p < 0.001). In the control arm, 85.9% (164/191) with confirmed Plasmodium vivax received chloroquine compared to 45.1% (70/155) in the intervention arm (p < 0.001). Overuse of chloroquine in the control arm resulted in 87.6% (813/928) of those with no malaria (PCR negative) being treated vs. 10.0% (95/947) in the intervention arm, p < 0.001. In the intervention arm, 71.4% (30/42) of patients with P. falciparum did not receive artemisinin-based combination therapy, partly because operational sensitivity of the RDTs was low (53.2%, 38.1-67.9). There was high concordance between recorded RDT result and CHW prescription decisions: 826/950 (87.0%) with a negative test were not prescribed an antimalarial. Co-trimoxazole was prescribed to 62.7% of malaria negative patients in the intervention arm and 15.0% in the control arm. While introducing mRDT reduced overuse of antimalarials, this action came with risks that need to be considered before use at scale: an appreciable proportion of malaria cases will be missed by those using current mRDTs. Higher sensitivity tests could be used to detect all cases. Overtreatment with antimalarial drugs in the control arm was replaced with increased antibiotic prescription in the intervention arm, resulting in a probable overuse of antibiotics. ClinicalTrials.gov, NCT01403350 . Prospectively registered.

A studentized permutation test for three-arm trials in the 'gold standard' design.

PubMed

Mütze, Tobias; Konietschke, Frank; Munk, Axel; Friede, Tim

2017-03-15

The 'gold standard' design for three-arm trials refers to trials with an active control and a placebo control in addition to the experimental treatment group. This trial design is recommended when being ethically justifiable and it allows the simultaneous comparison of experimental treatment, active control, and placebo. Parametric testing methods have been studied plentifully over the past years. However, these methods often tend to be liberal or conservative when distributional assumptions are not met particularly with small sample sizes. In this article, we introduce a studentized permutation test for testing non-inferiority and superiority of the experimental treatment compared with the active control in three-arm trials in the 'gold standard' design. The performance of the studentized permutation test for finite sample sizes is assessed in a Monte Carlo simulation study under various parameter constellations. Emphasis is put on whether the studentized permutation test meets the target significance level. For comparison purposes, commonly used Wald-type tests, which do not make any distributional assumptions, are included in the simulation study. The simulation study shows that the presented studentized permutation test for assessing non-inferiority in three-arm trials in the 'gold standard' design outperforms its competitors, for instance the test based on a quasi-Poisson model, for count data. The methods discussed in this paper are implemented in the R package ThreeArmedTrials which is available on the comprehensive R archive network (CRAN). Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Images of war: using satellite images for human rights monitoring in Turkish Kurdistan.

PubMed

de Vos, Hugo; Jongerden, Joost; van Etten, Jacob

2008-09-01

In areas of war and armed conflict it is difficult to get trustworthy and coherent information. Civil society and human rights groups often face problems of dealing with fragmented witness reports, disinformation of war propaganda, and difficult direct access to these areas. Turkish Kurdistan was used as a case study of armed conflict to evaluate the potential use of satellite images for verification of witness reports collected by human rights groups. The Turkish army was reported to be burning forests, fields and villages as a strategy in the conflict against guerrilla uprising. This paper concludes that satellite images are useful to validate witness reports of forest fires. Even though the use of this technology for human rights groups will depend on some feasibility factors such as prices, access and expertise, the images proved to be key for analysis of spatial aspects of conflict and valuable for reconstructing a more trustworthy picture.

Calorie restriction inhibits relapse behaviour and preference for alcohol within a two-bottle free choice paradigm in the alcohol preferring (iP) rat.

PubMed

Guccione, Lisa; Djouma, Elvan; Penman, Jim; Paolini, Antonio G

2013-02-17

Among its many beneficial effects, calorie restriction (CR) has also been found to reduce anxiety related behavior in the rodent. With heightened levels of stress and anxiety implicated as a key precipitating factor of relapse and alcohol addiction, it was found that a 25% CR in addition to inducing anxiolytic effects also had the capacity to reduce intake of alcohol and inhibit relapse within a model of operant self-administration. The aim of this study was to investigate if a 25% CR would also display similar effects in a two-bottle free choice paradigm, whereby 24 h ad libitum access to both 10% ethanol and water is provided. All animals were initially tested on the elevated plus maze (EPM) and open field test prior to commencing the two-bottle free choice paradigm. Differences between control and CR25% animals demonstrated the anxiolytic effects of CR, with the CR25% group displaying greater percentage of open arm/total arm duration and open arm/total arm entries in the EPM. During the acquisition phase of the two-bottle free choice paradigm, CR25% animals showed a reduced intake of 10% ethanol in ml/kg, in comparison to the control group. Whilst control animals displayed a strong preference for 10% ethanol, the CR25% group consumed both 10% ethanol and water equally with no differences found in total fluid intake between groups. Similarly this was also the case following forced deprivation. In addition to reduced intake and lack of preference for 10% ethanol, CR 25% animals unlike controls failed to display a typical alcohol deprivation effect following abstinence. Taken collectively the results of this study suggest that CR may act as a protective factor against addiction and relapse in the alcohol preferring (iP) rat. In addition, given CR25% animals did not display a preference for 10% ethanol, results also suggest that CR may be altering the hedonic impact of ethanol within this group. Copyright © 2012 Elsevier Inc. All rights reserved.

Sociolinguistic and Measurement Considerations for Construction of Armed Services Selection Batteries.

DTIC Science & Technology

1977-12-01

The objective of this study is to identify potential sources of linguistics bias in Armed Forces aptitude tests. General aspects of a sociolinguistic ...conclusion summarizes specific considerations that should be given to sociolinguistic aspects of aptitude tests and suggests ways in which this anlaysis may be followed up by test designers and test interpreters. (Author)

Evaluation Plan for the Computerized Adaptive Vocational Aptitude Battery.

ERIC Educational Resources Information Center

Green, Bert F.; And Others

The United States Armed Services are planning to introduce computerized adaptive testing (CAT) into the Armed Services Vocational Aptitude Battery (ASVAB), which is a major part of the present personnel assessment procedures. Adaptive testing will improve efficiency greatly by assessing each candidate's answers as the test progresses and posing…

Design and pilot evaluation of competitive and cooperative exercise games for arm rehabilitation at home.

PubMed

Gorsic, Maja; Novak, Domen

2016-08-01

People with chronic arm impairment should exercise intensely at home after completing their clinical rehabilitation program, but frequently lack motivation. To address this issue, we present a home rehabilitation system that motivates patients by allowing them to perform arm exercises together with friends or relatives in competitive and cooperative games. Inertial sensors are used to track the patient's arm and control the game. The system was tested with seven adults with arm impairment as well as their friends or spouses. They tested four exercise games (single-player, competitive and two different cooperative games) for 3 minutes each. Of the 7 participants, 4 preferred the competitive game, 2 preferred a cooperative game, and 1 preferred to exercise alone. Competition also increased exercise intensity (measured using inertial sensors) compared to exercising alone. Though preliminary, these results indicate that competitive exercise games could improve arm rehabilitation at home for survivors of neurological and orthopedic injuries.

Sprinkle Test by Phoenix Robotic Arm Movie

NASA Image and Video Library

2008-06-10

NASA Phoenix Mars Lander used its Robotic Arm during the mission 15th Martian day since landing June 9, 2008 to test a prinkle method for delivering small samples of soil to instruments on the lander deck.

Innovative public–private partnership to target subsidised antimalarials: a study protocol for a cluster randomised controlled trial to evaluate a community intervention in Western Kenya

PubMed Central

Laktabai, Jeremiah; Lesser, Adriane; Platt, Alyssa; Maffioli, Elisa; Mohanan, Manoj; Menya, Diana; Prudhomme O'Meara, Wendy; Turner, Elizabeth L

2017-01-01

Introduction There are concerns of inappropriate use of subsidised antimalarials due to the large number of fevers treated in the informal sector with minimal access to diagnostic testing. Targeting antimalarial subsidies to confirmed malaria cases can lead to appropriate, effective therapy. There is evidence that community health volunteers (CHVs) can be trained to safely and correctly use rapid diagnostic tests (RDTs). This study seeks to evaluate the public health impact of targeted antimalarial subsidies delivered through a partnership between CHVs and the private retail sector. Methods and analysis We are conducting a stratified cluster-randomised controlled trial in Western Kenya where 32 community units were randomly assigned to the intervention or control (usual care) arm. In the intervention arm, CHVs offer free RDT testing to febrile individuals and, conditional on a positive test result, a voucher to purchase a WHO-qualified artemisinin combination therapy (ACT) at a reduced fixed price in the retail sector. Study outcomes in individuals with a febrile illness in the previous 4 weeks will be ascertained through population-based cross-sectional household surveys at four time points: baseline, 6, 12 and 18 months postbaseline. The primary outcome is the proportion of fevers that receives a malaria test from any source (CHV or health facility). The main secondary outcome is the proportion of ACTs used by people with a malaria-positive test. Other secondary outcomes include: the proportion of ACTs used by people without a test and adherence to test results. Ethics and dissemination The protocol has been approved by the National Institutes of Health, the Moi University School of Medicine Institutional Research and Ethics Committee and the Duke University Medical Center Institutional Review Board. Findings will be reported on clinicalstrials.gov, in peer-reviewed publications and through stakeholder meetings including those with the Kenyan Ministry of Health. Trial registration number Pre-results, NCT02461628. PMID:28320794

Subclavian Vein Versus Arm Vein for Totally Implantable Central Venous Port for Patients with Head and Neck Cancer: A Retrospective Comparative Analysis

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

Akahane, Akio, E-mail: a.akahane@gmail.com; Sone, Miyuki; Ehara, Shigeru

2011-12-15

Purpose: This study was designed to compare central venous ports (CVP) from two different routes of venous access-the subclavian vein and arm vein-in terms of safety for patients with head and neck cancer (HNC). Methods: Patients with HNC who underwent image-guided implantations of CVPs were retrospectively evaluated. All CVPs were implanted under local anesthesia. Primary outcome measurements were rates and types of adverse events (AEs). Secondary outcomes included technical success and rate and reason of CVP removal. Results: A total of 162 patients (subclavian port group, 47; arm port group, 115) were included in this study. Technical success was achievedmore » in all patients. The median follow-up period was 94 (range, 1-891) days. Two patients in the subclavian port group experienced periprocedural complications. Postprocedural AEs were observed in 8.5 and 22.6% of the subclavian port and arm port group patients, respectively (P = 0.044). Phlebitis and system occlusions were observed only in the arm port group. The rate of infection was not significantly different between the two groups. The CVP was removed in 34 and 39.1% of the subclavian port and arm port patients, respectively. Conclusions: Both subclavian and arm CVPs are feasible in patients with HNC. AEs were more frequent in the arm port group; thus, the arm port is not recommended as the first choice for patients with HNC. However, further experience is needed to improve the placement technique and the maintenance of CVPs and a prospective analysis is warranted.« less

An overview and categorization of dynamic arm supports for people with decreased arm function.

PubMed

Van der Heide, Loek A; van Ninhuijs, Bob; Bergsma, Arjen; Gelderblom, Gert Jan; van der Pijl, Dick J; de Witte, Luc P

2014-08-01

Assistive devices that augment arm function were already introduced during the polio era. Devices are still being developed, but a review has not been performed thus far. To create an overview and categorize assistive devices facilitating arm function in activities of daily living for people with decreased arm function. Literature review. A systematic review in three scientific literature databases. Conference proceedings, assistive technology databases, and references were searched and experts consulted. This resulted in a database of dynamic arm supports. Product information was added, and the devices were categorized. A total of 104 dynamic arm supports were found. These could be categorized as nonactuated devices (N = 39), passively actuated devices (N = 24), actively actuated devices (N = 34), or devices using the functional electrical stimulation principle (N = 7). Functionality analysis resulted in second-level categorization: tremor suppression, facilitation of anti-gravity movement, and assistance of specific joint motion. All devices could be ordered in a categorization of low complexity. Many have been developed; most have disappeared and have been succeeded by similar devices. Limitations of the devices found mainly concern interfacing and the range of motion facilitated. Future devices could make use of whatever residual strength is available in the users' arm for control. The provided overview of devices in this article and the classification developed is relevant for practitioners seeking assistive solutions for their clients as it makes the range of developed solutions both accessible and comprehensible. © The International Society for Prosthetics and Orthotics 2013.

KSC-03pd0075

NASA Image and Video Library

2003-01-15

KENNEDY SPACE CENTER, FLA. -- After rollback of the Rotating Service Structure on Launch Pad 39A, the top of Space Shuttle Columbia's external tank and solid rocket booster are bathed in sunlight. Shadows from the Fixed Service Structure stretch across the Shuttle and landscape. Visible are the orbiter access arm with the White Room extended to Columbia's cockpit, and at the top, the gaseous oxygen vent arm and cap, called the "beanie cap." Columbia is scheduled for launch Jan. 16 at 10:39 a.m. EST on mission STS-107, a research mission.

A corner store intervention to improve access to fruits and vegetables in two Latino communities.

PubMed

Albert, Stephanie L; Langellier, Brent A; Sharif, Mienah Z; Chan-Golston, Alec M; Prelip, Michael L; Elena Garcia, Rosa; Glik, Deborah C; Belin, Thomas R; Brookmeyer, Ron; Ortega, Alexander N

2017-08-01

Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities. A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions. Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA. Store patrons were interviewed before (n550) and after (n407) the intervention. Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V. Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued.

A corner store intervention to improve access to fruits and vegetables in two Latino communities

PubMed Central

Albert, Stephanie L; Langellier, Brent A; Sharif, Mienah Z; Chan-Golston, Alec M; Prelip, Michael L; Garcia, Rosa Elena; Glik, Deborah C; Belin, Thomas R; Brookmeyer, Ron; Ortega, Alexander N

2017-01-01

Objective Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities. Design A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions. Setting Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA. Subjects Store patrons were interviewed before (n 550) and after (n 407) the intervention. Results Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V. Conclusions Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued. PMID:28578744

Neural control of rhythmic arm cycling after stroke

PubMed Central

Loadman, Pamela M.; Hundza, Sandra R.

2012-01-01

Disordered reflex activity and alterations in the neural control of walking have been observed after stroke. In addition to impairments in leg movement that affect locomotor ability after stroke, significant impairments are also seen in the arms. Altered neural control in the upper limb can often lead to altered tone and spasticity resulting in impaired coordination and flexion contractures. We sought to address the extent to which the neural control of movement is disordered after stroke by examining the modulation pattern of cutaneous reflexes in arm muscles during arm cycling. Twenty-five stroke participants who were at least 6 mo postinfarction and clinically stable, performed rhythmic arm cycling while cutaneous reflexes were evoked with trains (5 × 1.0-ms pulses at 300 Hz) of constant-current electrical stimulation to the superficial radial (SR) nerve at the wrist. Both the more (MA) and less affected (LA) arms were stimulated in separate trials. Bilateral electromyography (EMG) activity was recorded from muscles acting at the shoulder, elbow, and wrist. Analysis was conducted on averaged reflexes in 12 equidistant phases of the movement cycle. Phase-modulated cutaneous reflexes were present, but altered, in both MA and LA arms after stroke. Notably, the pattern was “blunted” in the MA arm in stroke compared with control participants. Differences between stroke and control were progressively more evident moving from shoulder to wrist. The results suggest that a reduced pattern of cutaneous reflex modulation persists during rhythmic arm movement after stroke. The overall implication of this result is that the putative spinal contributions to rhythmic human arm movement remain accessible after stroke, which has translational implications for rehabilitation. PMID:22572949

Household point of care CD4 testing and isoniazid preventive therapy initiation in a household TB contact tracing programme in two districts of South Africa.

PubMed

Page-Shipp, Liesl; Lewis, James J; Velen, Kavindhran; Senoge, Sedikanelo; Zishiri, Elizabeth; Popane, Flora; Chihota, Violet N; Clark, Dave; Churchyard, Gavin J; Charalambous, Salome

2018-01-01

In South Africa, TB household contact tracing provides an opportunity for increased TB and HIV case finding. We aimed to determine the effect of two new potential interventions for TB contact tracing programmes: Point of Care CD4 (PoC CD4) on HIV linkage to care and household Isoniazid Preventive Therapy (IPT) provision on uptake and retention of IPT. A pragmatic, three-arm, cluster-randomized trial was undertaken. TB Household contacts were randomised to 3 arms: 1) Standard of Care TB and HIV testing (SOC); 2) SOC with POC CD4 for those testing HIV positive; 3) SOC with POC CD4 and IPT for eligible household members. Linkage to care within 90 days was assessed either through patient visits (at 10 weeks and 6 months) or via telephonic contact. 2,243 index TB patients and 3,012 contacts (64,3% female, median age 30 years) were enrolled. On self-report, 26(1.2%) were currently receiving TB treatment and 1816 (60.3%) reported a prior HIV test. HIV testing uptake was 34.7% in the SoC arm, 40.2% in the PoC CD4 arm (RR1.16, CI 0.99-1.36, p-value = 0.060) and 39.9% in the PoC CD4 + HH-IPT arm (RR = 1.15, CI 0.99-1.35, p-value = 0.075). Linkage to care within 3 months was 30.8% in the SoC arm and 42.1% in the POC CD4 arms (RR 1.37; CI: 0.68-2.76, p-value = 0.382). 20/21 contacts (95.2%) initiated IPT in the PoC CD4 + HH-IPT arm, compared to 3/20 (15.0%) in the PoC CD4 arm (p = 0.004; p-value from Fisher's exact test < 0.001). Among 3,008 contacts screened for tuberculosis, 15 (3.4%) had bacteriologically confirmed TB with an overall yield of TB of 0.5% (95% CI: 0.3%, 0.8%). Household PoC CD4 testing and IPT initiation is feasible. There was only weak evidence that PoCCD4 led to a small increase in HCT uptake and no evidence for an increase in linkage-to-care. IPT initiation and completion was increased by the household intervention. Although feasible, these interventions had low impact due to the low uptake of HIV testing in households.

Prescribing water-based exercise from treadmill and arm ergometry in cardiac patients.

PubMed

Fernhall, B; Manfredi, T G; Congdon, K

1992-01-01

This study investigated the appropriateness of prescribing upright water-based exercise from treadmill and arm ergometry in uncomplicated, trained patients with cardiovascular disease (CVD) who were accustomed to water-based activities. Ten male patients with established CVD (mean age 59.4 +/- 8.7 yr) underwent maximal treadmill and arm ergometry in randomized counterbalanced order (half of the patients completed the treadmill test first and the other half completed the arm ergometer test first). Electrocardiographic (ECG), rating of perceived exertion (RPE), and oxygen uptake (VO2) measurements were made during both tests. Patients performed upright water-based exercise at 60, 70, and 80% of their maximal treadmill heart rate for 6 min at each intensity in a heated pool with a water temperature of 28-30 degrees C. They also performed an easy tethered swim, defined as performing at a comfortable exercise intensity, eliciting a heart rate of 86% of the treadmill maximum. VO2 and RPE were collected for all water-based exercise. To compare the RPE and VO2 between water-based, treadmill, and arm ergometry exercise, individual regression equations were constructed between heart rate, VO2, and RPE for both treadmill and arm ergometry tests. VO2 and RPE were then compared at the same heart rates between the three exercise modes. At 60% intensity, treadmill exercise exhibited a higher VO2 than water-based and arm ergometry exercise (P less than 0.05) but similar RPE. At 70%, treadmill exercise still yielded higher VO2, but also lower RPE than (P less than 0.05) and arm ergometry exercise (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Pre-training in a radial arm maze abolished anxiety and impaired habituation in C57BL6/J mice treated with dizocilpine.

PubMed

Abuhamdah, R M; Hussain, M D; Chazot, P L; Ennaceur, A

2016-10-01

Familiarity can imply a reduction of fear and anxiety, which may render learning and memory performance insensitive to NMDA receptor antagonism. Our previous study indicates that MK-801 (dizocilpine), NMDA antagonist, increased anxiety and prevented the acquisition of a spatial memory task. Here, we examined whether MK-801 will produce anxiety in mice that were familiar with the test environment. Male C57BL/6J mice were exposed, one session a day for 7days, to a 3D maze, which consisted of nine arms attached to upward inclined bridges radiating from a nonagonal platform. In this maze, high anxiety mice avoid the arms in the first sessions. One group of mice received saline (SAL) while a second group received MK-801 (MKD1), both on day one. A third group received saline in the first 3 sessions, and MK 801 in subsequent sessions (MKD4). Saline and MK-801 (0.1mg/kg) were administered intraperitoneally 30min before the test. MKD4 mice demonstrated an increase in bridge and arm visits, and reached arm/bridge entries ratio close to 1 in session 5. SAL mice also crossed frequently onto the arms, and reached a comparable ratio, but this was achieved with a lower number of arm visits. MKD1 mice demonstrated a reduced number of arm visits in each session compared to SAL and MKD4 mice. Dizocilpine produced anxiety in mice treated from day 1 of the test, but not in those treated from day 4. It also impaired habituation in animals familiar with the test environment; it produced sustained non-habituating hyperactivity. Copyright © 2016 Elsevier Inc. All rights reserved.

When action is not enough: tool-use reveals tactile-dependent access to Body Schema.

PubMed

Cardinali, L; Brozzoli, C; Urquizar, C; Salemme, R; Roy, A C; Farnè, A

2011-11-01

Proper motor control of our own body implies a reliable representation of body parts. This information is supposed to be stored in the Body Schema (BS), a body representation that appears separate from a more perceptual body representation, the Body Image (BI). The dissociation between BS for action and BI for perception, originally based on neuropsychological evidence, has recently become the focus of behavioural studies in physiological conditions. By inducing the rubber hand illusion in healthy participants, Kammers et al. (2009) showed perceptual changes attributable to the BI to which the BS, as indexed via motor tasks, was immune. To more definitively support the existence of dissociable body representations in physiological conditions, here we tested for the opposite dissociation, namely, whether a tool-use paradigm would induce a functional update of the BS (via a motor localization task) without affecting the BI (via a perceptual localization task). Healthy subjects were required to localize three anatomical landmarks on their right arm, before and after using the same arm to control a tool. In addition to this classical task-dependency approach, we assessed whether preferential access to the BS could also depend upon the way positional information about forearm targets is provided, to subsequently execute the same task. To this aim, participants performed either verbally or tactually driven versions of the motor and perceptual localization tasks. Results showed that both the motor and perceptual tasks were sensitive to the update of the forearm representation, but only when the localization task (perceptual or motor) was driven by a tactile input. This pattern reveals that the motor output is not sufficient per se, but has to be coupled with tactually mediated information to guarantee access to the BS. These findings shade a new light on the action-perception models of body representations and underlie how functional plasticity may be a useful tool to clarify their operational definition. Copyright © 2011 Elsevier Ltd. All rights reserved.

A Compendium of the Physiological Demands of the 32 Critical Physically Demanding Tasks of Combat Arms Soldiers

DTIC Science & Technology

As part of the U.S. Army Physical Demands Study (which led to the development of the Occupational Physical Assessment Test (OPAT)), 32 physically ...demanding tasks were identified as being critical to combat arms soldiers. In order to identify the most physically demanding of those tests, data were...comprehensive reference of the physiological demands of the critical physically demanding tasks of combat arms Soldiers.

Curiosity Mars Rover Flexes its Robotic Arm

NASA Image and Video Library

2010-09-16

Test operators in a clean room at NASA Jet Propulsion Laboratory monitor some of the first motions by the robotic arm on the Mars rover Curiosity after installation in August 2010. The arm is shown in a partially extended position.

Protective effects of Tualang honey on bone structure in experimental postmenopausal rats

PubMed Central

Zaid, Siti Sarah Mohamad; Sulaiman, Siti Amrah; Othman, Nor Hayati; Soelaiman, Ima-Nirwana; Shuid, Ahmad Nazrun; Mohamad, Norazlina; Muhamad, Norliza

2012-01-01

OBJECTIVE: The objective of this study was to evaluate the effects of Tualang honey on trabecular structure and compare these effects with those of calcium supplementation in ovariectomized rats. METHODS: Forty female, Sprague-Dawley rats were randomly divided into five groups (n = 8): four controls and one test arm. The control arm comprised a baseline control, sham-operated control, ovariectomized control, and ovariectomized calcium-treated rats (receiving 1% calcium in drinking water ad libitum). The test arm was composed of ovariectomized, Tualang honey-treated rats (received 0.2 g/kg body weight of Tualang honey). Both the sham-operated control and ovariectomized control groups received vehicle treatment (deionized water), and the baseline control group was sacrificed without treatment. RESULTS: All rats were orally gavaged daily for six weeks after day one post-surgery. The bone structural analysis of rats in the test arm group showed a significant increase in the bone volume per tissue volume (BV/TV), trabecular thickness (Tb.Th) and trabecular number (Tb.N) and a significant decrease in inter-trabecular space (Tb.Sp) compared with the ovariectomized control group. The trabecular thickness (Tb.Th) in the test arm group was significantly higher compared with the ovariectomized-calcium treated group, and the inter-trabecular space (Tb.Sp) in the test arm group was significantly narrower compared with the ovariectomized-calcium treated group. CONCLUSION: In conclusion, ovariectomized rats that received Tualang honey showed more improvements in trabecular bone structure than the rats that received calcium. PMID:22892923

Protective effects of Tualang honey on bone structure in experimental postmenopausal rats.

PubMed

Zaid, Siti Sarah Mohamad; Sulaiman, Siti Amrah; Othman, Nor Hayati; Soelaiman, Ima-Nirwana; Shuid, Ahmad Nazrun; Mohamad, Norazlina; Muhamad, Norliza

2012-07-01

The objective of this study was to evaluate the effects of Tualang honey on trabecular structure and compare these effects with those of calcium supplementation in ovariectomized rats. Forty female, Sprague-Dawley rats were randomly divided into five groups (n =8): four controls and one test arm. The control arm comprised a baseline control, sham-operated control, ovariectomized control, and ovariectomized calcium-treated rats (receiving 1% calcium in drinking water ad libitum). The test arm was composed of ovariectomized, Tualang honey-treated rats (received 0.2 g/kg body weight of Tualang honey). Both the sham-operated control and ovariectomized control groups received vehicle treatment (deionized water), and the baseline control group was sacrificed without treatment. All rats were orally gavaged daily for six weeks after day one post-surgery. The bone structural analysis of rats in the test arm group showed a significant increase in the bone volume per tissue volume (BV/TV), trabecular thickness (Tb.Th) and trabecular number (Tb.N) and a significant decrease in inter-trabecular space (Tb.Sp) compared with the ovariectomized control group. The trabecular thickness (Tb.Th) in the test arm group was significantly higher compared with the ovariectomized-calcium treated group, and the inter-trabecular space (Tb.Sp) in the test arm group was significantly narrower compared with the ovariectomized-calcium treated group. In conclusion, ovariectomized rats that received Tualang honey showed more improvements in trabecular bone structure than the rats that received calcium.

Interface evaluation for soft robotic manipulators

NASA Astrophysics Data System (ADS)

Moore, Kristin S.; Rodes, William M.; Csencsits, Matthew A.; Kwoka, Martha J.; Gomer, Joshua A.; Pagano, Christopher C.

2006-05-01

The results of two usability experiments evaluating an interface for the operation of OctArm, a biologically inspired robotic arm modeled after an octopus tentacle, are reported. Due to the many degrees-of-freedom (DOF) for the operator to control, such 'continuum' robotic limbs provide unique challenges for human operators because they do not map intuitively. Two modes have been developed to control the arm and reduce the DOF under the explicit direction of the operator. In coupled velocity (CV) mode, a joystick controls changes in arm curvature. In end-effector (EE) mode, a joystick controls the arm by moving the position of an endpoint along a straight line. In Experiment 1, participants used the two modes to grasp objects placed at different locations in a virtual reality modeling language (VRML). Objective measures of performance and subjective preferences were recorded. Results revealed lower grasp times and a subjective preference for the CV mode. Recommendations for improving the interface included providing additional feedback and implementation of an error recovery function. In Experiment 2, only the CV mode was tested with improved training of participants and several changes to the interface. The error recovery function was implemented, allowing participants to reverse through previously attained positions. The mean time to complete the trials in the second usability test was reduced by more than 4 minutes compared with the first usability test, confirming the interface changes improved performance. The results of these tests will be incorporated into future versions of the arm and improve future usability tests.

The Management of Ethnic-Cultural Diversity in Western Armed Forces

DTIC Science & Technology

2012-03-20

192-201. 12 Bruce A. Brant, ―Vanguard of Social Change?‖ Military Review, no. 73 (February 1993): 12-19. 13 Histoire du monde Home Page, http...11, 2008. http://inde.aujourdhuilemonde.com/les-separatistes-gorkhas-entament-un-blocus- general?page=7 (accessed January 25, 2012). 15 ― Histoire ...du monde Home Page, http://www.histoiredumonde.net/Gurkhas.html (accessed January 25, 2012). 16 Histoire du monde Home Page, http

Improving access to medicines for non-communicable diseases in rural India: a mixed methods study protocol using quasi-experimental design.

PubMed

Prashanth, N S; Elias, Maya Annie; Pati, Manoj Kumar; Aivalli, Praveenkumar; Munegowda, C M; Bhanuprakash, Srinath; Sadhana, S M; Criel, Bart; Bigdeli, Maryam; Devadasan, Narayanan

2016-08-22

India has the distinction of financing its healthcare mainly through out-of-pocket expenses by individual families contributing to catastrophic health expenditure and impoverishment. Nearly 70 % of the expenditure is on medicines purchased at private pharmacies. Patients with chronic ailments are especially affected, as they often need lifelong medicines. Over the past years in India, there have been several efforts to improve drug availability at government primary health centres. In this study, we aim to understand health system factors that affect utilisation and access to generic medicines for people with non-communicable diseases. This study aims to understand if (and how) a package of interventions targeting primary health centres and community participation platforms affect utilisation and access to generic medicines for people with non-communicable diseases in the current district context in India. This study will employ a quasi-experimental design and a qualitative theory-driven approach. PHCs will be randomly assigned to one of three arms of the intervention. In one arm, PHCs will receive inputs to optimise service delivery for non-communicable diseases, while the second arm will receive an additional package of interventions to strengthen community participation platforms for improving non-communicable disease care. The third arm will be the control. We will conduct household and facility surveys, before and after the intervention and will estimate the effect of the intervention by difference-in-difference analysis. Sample size for measuring effects was calculated based on obtaining at least 30 households for each primary health centre spread across three distance-based clusters. Primary outcomes include availability and utilisation of medicines at primary health centres and out-of-pocket expenditure for medicines by non-communicable disease households. Focus group discussions with patients and in-depth interviews with health workers will also be conducted. Qualitative and process documentation data will be used to explain how the intervention could have worked. By taking into consideration several health system building blocks and trying to understand how they interact, our study aims to generate evidence for health planners on how to optimise health services to improve access to medicines. Protocol registered on Clinical Trials Registry of India with registration identifier number CTRI/2015/03/005640 on 17(th) March 2015.

Robot arm apparatus

DOEpatents

Nachbar, Henry D.

1992-12-01

A robot arm apparatus is provided for inspecting and/or maintaining an interior of a steam generator which has an outside wall and a port for accessing the interior of the steam generator. The robot arm apparatus includes a flexible movable conduit for conveying inspection and/or maintenance apparatus from outside the steam generator to the interior of the steam generator. The flexible conduit has a terminal working end which is translated into and around the interior of the steam generator. Three motors located outside the steam generator are employed for moving the terminal working end inside the steam generator in "x", "y", and "z" directions, respectively. Commonly conducted inspection and maintenance operations include visual inspection for damaged areas, water jet lancing for cleaning sludge deposits, core boring for obtaining sludge deposits, and scrubbing of internal parts.

Robot arm apparatus

DOEpatents

Nachbar, Henry D.

1992-01-01

A robot arm apparatus is provided for inspecting and/or maintaining an interior of a steam generator which has an outside wall and a port for accessing the interior of the steam generator. The robot arm apparatus includes a flexible movable conduit for conveying inspection and/or maintenance apparatus from outside the steam generator to the interior of the steam generator. The flexible conduit has a terminal working end which is translated into and around the interior of the steam generator. Three motors located outside the steam generator are employed for moving the terminal working end inside the steam generator in "x", "y", and "z" directions, respectively. Commonly conducted inspection and maintenance operations include visual inspection for damaged areas, water jet lancing for cleaning sludge deposits, core boring for obtaining sludge deposits, and scrubbing of internal parts.

Dietary Intake Influences Adult Fertility and Offspring Fitness in Zebrafish.

PubMed

Newman, Trent; Jhinku, Noel; Meier, Michael; Horsfield, Julia

2016-01-01

The burden of malnutrition, including both over- and undernutrition, is a major public health concern. Here we used a zebrafish model of diet-induced obesity to analyze the impact of dietary intake on fertility and the phenotype of the next generation. Over an eight-week period, one group received 60 mg of food each day (60 mg arm), while another received 5 mg (5 mg arm). At the end of the diet, the body mass index of the 60 mg arm was 1.5 fold greater than the 5 mg arm. The intervention also had a marked impact on fertility; breeding success and egg production in the 60 mg arm were increased 2.1- and 6.2-fold compared to the 5 mg arm, respectively. Transcriptome analysis of eggs revealed that transcripts involved in metabolic biological processes differed according to dietary intake. The progeny from the differentially fed fish were more likely to survive when the parents had access to more food. An intergenerational crossover study revealed that while parental diet did not influence weight gain in the offspring, the progeny of well-fed parents had increased levels of physical activity when exposed again to high nutrient availability. We conclude that dietary intake has an important influence on fertility and the subsequent fitness of offspring, even prior to breeding.

Dietary Intake Influences Adult Fertility and Offspring Fitness in Zebrafish

PubMed Central

Jhinku, Noel; Meier, Michael; Horsfield, Julia

2016-01-01

The burden of malnutrition, including both over- and undernutrition, is a major public health concern. Here we used a zebrafish model of diet-induced obesity to analyze the impact of dietary intake on fertility and the phenotype of the next generation. Over an eight-week period, one group received 60 mg of food each day (60 mg arm), while another received 5 mg (5 mg arm). At the end of the diet, the body mass index of the 60 mg arm was 1.5 fold greater than the 5 mg arm. The intervention also had a marked impact on fertility; breeding success and egg production in the 60 mg arm were increased 2.1- and 6.2-fold compared to the 5 mg arm, respectively. Transcriptome analysis of eggs revealed that transcripts involved in metabolic biological processes differed according to dietary intake. The progeny from the differentially fed fish were more likely to survive when the parents had access to more food. An intergenerational crossover study revealed that while parental diet did not influence weight gain in the offspring, the progeny of well-fed parents had increased levels of physical activity when exposed again to high nutrient availability. We conclude that dietary intake has an important influence on fertility and the subsequent fitness of offspring, even prior to breeding. PMID:27870856

Single-arm phase II trial design under parametric cure models.

PubMed

Wu, Jianrong

2015-01-01

The current practice of designing single-arm phase II survival trials is limited under the exponential model. Trial design under the exponential model may not be appropriate when a portion of patients are cured. There is no literature available for designing single-arm phase II trials under the parametric cure model. In this paper, a test statistic is proposed, and a sample size formula is derived for designing single-arm phase II trials under a class of parametric cure models. Extensive simulations showed that the proposed test and sample size formula perform very well under different scenarios. Copyright © 2015 John Wiley & Sons, Ltd.

Cervical cancer screening through human papillomavirus testing in community health campaigns versus health facilities in rural western Kenya.

PubMed

Huchko, Megan J; Ibrahim, Saduma; Blat, Cinthia; Cohen, Craig R; Smith, Jennifer S; Hiatt, Robert A; Bukusi, Elizabeth

2018-04-01

To determine the effectiveness of community health campaigns (CHCs) as a strategy for human papillomavirus (HPV)-based cervical cancer screening in rural western Kenya. Between January and November 2016, a cluster-randomized trial was carried out in 12 communities in western Kenya to investigate high-risk HPV testing offered via self-collection to women aged 25-65 years in CHCs versus government health facilities. Outcome measures were the total number of women accessing cervical cancer screening and the proportion of HPV-positive women accessing treatment. In total, 4944 women underwent HPV-based cervical cancer screening in CHCs (n=2898) or health facilities (n=2046). Screening uptake as a proportion of total eligible women in the population was greater in communities assigned to CHCs (60.0% vs 37.0%, P<0.001). Rates of treatment acquisition were low in both arms (CHCs 39.2%; health facilities 31.5%; P=0.408). Cervical cancer screening using HPV testing of self-collected samples reached a larger proportion of women when offered through periodic CHCs compared with health facilities. The community-based model is a promising strategy for cervical cancer prevention. Lessons learned from this trial can be used to identify ways of maximizing the impact of such strategies through greater community participation and improved linkage to treatment. ClinicalTrials.gov registration: NCT02124252. © 2017 International Federation of Gynecology and Obstetrics.

KSC-06pd0479

NASA Image and Video Library

2006-03-14

KENNEDY SPACE CENTER, FLA. - Inside the Orbiter Processing Facility bay 3 at NASA's Kennedy Space Center, workers attach an overhead crane to Discovery's robotic arm in the payload bay. The arm is being removed due to damage found on the arm after it was accidentally bumped by a bridge bucket in the payload bay. Ultrasound inspections revealed a small crack, measuring 1.25 inches by 0.015 inch deep. The arm will be sent back to the vendor for repair. The bucket was being used by technicians cleaning the area and was in the process of being stowed. A bridge bucket is a personnel transport device that is suspended from an overhead bridge that moves back and forth above the shuttle's mid-body. It allows workers to access the payload bay area without walking or standing on the payload bay floor or on the fixed platforms. Space Shuttle Discovery is scheduled for launch on mission STS-121 during a launch planning window of July 1-19. Photo credit: NASA/Kim Shiflett

Cost-effectiveness analysis of introducing malaria diagnostic testing in drug shops: A cluster-randomised trial in Uganda.

PubMed

Hansen, Kristian Schultz; Clarke, Siân E; Lal, Sham; Magnussen, Pascal; Mbonye, Anthony K

2017-01-01

Private sector drug shops are an important source of malaria treatment in Africa, yet diagnosis without parasitological testing is common among these providers. Accurate rapid diagnostic tests for malaria (mRDTs) require limited training and present an opportunity to increase access to correct diagnosis. The present study was a cost-effectiveness analysis of the introduction of mRDTs in Ugandan drug shops. Drug shop vendors were trained to perform and sell subsidised mRDTs and artemisinin-based combination therapies (ACTs) in the intervention arm while vendors offered ACTs following presumptive diagnosis of malaria in the control arm. The effect on the proportion of customers with fever 'appropriately treated of malaria with ACT' was captured during a randomised trial in drug shops in Mukono District, Uganda. Health sector costs included: training of drug shop vendors, community sensitisation, supervision and provision of mRDTs and ACTs to drug shops. Household costs of treatment-seeking were captured in a representative sample of drug shop customers. The introduction of mRDTs in drug shops was associated with a large improvement of diagnosis and treatment of malaria, resulting in low incremental costs for the health sector at US$0.55 per patient appropriately treated of malaria. High expenditure on non-ACT drugs by households contributed to higher incremental societal costs of US$3.83. Sensitivity analysis showed that mRDTs would become less cost-effective compared to presumptive diagnosis with increasing malaria prevalence and lower adherence to negative mRDT results. mRDTs in drug shops improved the targeting of ACTs to malaria patients and are likely to be considered cost-effective compared to presumptive diagnosis, although the increased costs borne by households when the test result is negative are a concern.

Cost-effectiveness analysis of introducing malaria diagnostic testing in drug shops: A cluster-randomised trial in Uganda

PubMed Central

Hansen, Kristian Schultz; Clarke, Siân E.; Lal, Sham; Magnussen, Pascal; Mbonye, Anthony K.

2017-01-01

Background Private sector drug shops are an important source of malaria treatment in Africa, yet diagnosis without parasitological testing is common among these providers. Accurate rapid diagnostic tests for malaria (mRDTs) require limited training and present an opportunity to increase access to correct diagnosis. The present study was a cost-effectiveness analysis of the introduction of mRDTs in Ugandan drug shops. Methods Drug shop vendors were trained to perform and sell subsidised mRDTs and artemisinin-based combination therapies (ACTs) in the intervention arm while vendors offered ACTs following presumptive diagnosis of malaria in the control arm. The effect on the proportion of customers with fever ‘appropriately treated of malaria with ACT’ was captured during a randomised trial in drug shops in Mukono District, Uganda. Health sector costs included: training of drug shop vendors, community sensitisation, supervision and provision of mRDTs and ACTs to drug shops. Household costs of treatment-seeking were captured in a representative sample of drug shop customers. Findings The introduction of mRDTs in drug shops was associated with a large improvement of diagnosis and treatment of malaria, resulting in low incremental costs for the health sector at US$0.55 per patient appropriately treated of malaria. High expenditure on non-ACT drugs by households contributed to higher incremental societal costs of US$3.83. Sensitivity analysis showed that mRDTs would become less cost-effective compared to presumptive diagnosis with increasing malaria prevalence and lower adherence to negative mRDT results. Conclusion mRDTs in drug shops improved the targeting of ACTs to malaria patients and are likely to be considered cost-effective compared to presumptive diagnosis, although the increased costs borne by households when the test result is negative are a concern. PMID:29244829

Robots testing robots: ALAN-Arm, a humanoid arm for the testing of robotic rehabilitation systems.

PubMed

Brookes, Jack; Kuznecovs, Maksims; Kanakis, Menelaos; Grigals, Arturs; Narvidas, Mazvydas; Gallagher, Justin; Levesley, Martin

2017-07-01

Robotics is increasing in popularity as a method of providing rich, personalized and cost-effective physiotherapy to individuals with some degree of upper limb paralysis, such as those who have suffered a stroke. These robotic rehabilitation systems are often high powered, and exoskeletal systems can attach to the person in a restrictive manner. Therefore, ensuring the mechanical safety of these devices before they come in contact with individuals is a priority. Additionally, rehabilitation systems may use novel sensor systems to measure current arm position. Used to capture and assess patient movements, these first need to be verified for accuracy by an external system. We present the ALAN-Arm, a humanoid robotic arm designed to be used for both accuracy benchmarking and safety testing of robotic rehabilitation systems. The system can be attached to a rehabilitation device and then replay generated or human movement trajectories, as well as autonomously play rehabilitation games or activities. Tests of the ALAN-Arm indicated it could recreate the path of a generated slow movement path with a maximum error of 14.2mm (mean = 5.8mm) and perform cyclic movements up to 0.6Hz with low gain (<1.5dB). Replaying human data trajectories showed the ability to largely preserve human movement characteristics with slightly higher path length and lower normalised jerk.

KSC-06pd2490

NASA Image and Video Library

2006-11-09

KENNEDY SPACE CENTER, FLA. -- Space Shuttle Discovery and the mobile launcher platform sit on Launch Pad 39B for mission STS-116. The shuttle's external tank is capped by the oxygen vent hood (at top). Below it is the orbiter access arm which swings out from the fixed service structure to the orbiter crew compartment hatch to allow personnel to enter the crew compartment. The outer end of the access arm ends in an environmental chamber (white room) that mates with the orbiter and holds six persons. The arm remains in the extended position until seven minutes 24 seconds before launch to provide emergency egress for the flight crew. At right, the U.S. flag flies at half-staff in accordance with special Presidential Proclamation No. 3044, due to the death of Senior Border Patrol Agent David N. Webb. The rollout of Discovery from the Vehicle Assembly Building began at 12:29 a.m. The shuttle was harddown on the pad at 9:03 a.m. The mission is No. 20 to the International Space Station and construction flight 12A.1. The mission payload is the SPACEHAB module, the P5 integrated truss structure and other key components. The launch window for mission STS-116 opens Dec. 7. Photo credit: NASA/George Shelton

The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance

PubMed Central

2013-01-01

Background Robotic arm therapy devices that incorporate actuated assistance can enhance arm recovery, motivate patients to practice, and allow therapists to deliver semi-autonomous training. However, because such devices are often complex and actively apply forces, they have not achieved widespread use in rehabilitation clinics or at home. This paper describes the design and pilot testing of a simple, mechanically passive device that provides robot-like assistance for active arm training using the principle of mechanical resonance. Methods The Resonating Arm Exerciser (RAE) consists of a lever that attaches to the push rim of a wheelchair, a forearm support, and an elastic band that stores energy. Patients push and pull on the lever to roll the wheelchair back and forth by about 20 cm around a neutral position. We performed two separate pilot studies of the device. In the first, we tested whether the predicted resonant properties of RAE amplified a user’s arm mobility by comparing his or her active range of motion (AROM) in the device achieved during a single, sustained push and pull to the AROM achieved during rocking. In a second pilot study designed to test the therapeutic potential of the device, eight participants with chronic stroke (35 ± 24 months since injury) and a mean, stable, initial upper extremity Fugl-Meyer (FM) score of 17 ± 8 / 66 exercised with RAE for eight 45 minute sessions over three weeks. The primary outcome measure was the average AROM measured with a tilt sensor during a one minute test, and the secondary outcome measures were the FM score and the visual analog scale for arm pain. Results In the first pilot study, we found people with a severe motor impairment after stroke intuitively found the resonant frequency of the chair, and the mechanical resonance of RAE amplified their arm AROM by a factor of about 2. In the second pilot study, AROM increased by 66% ± 20% (p = 0.003). The mean FM score increase was 8.5 ± 4 pts (p = 0.009). Subjects did not report discomfort or an increase in arm pain with rocking. Improvements were sustained at three months. Conclusions These results demonstrate that a simple mechanical device that snaps onto a manual wheelchair can use resonance to assist arm training, and that such training shows potential for safely increasing arm movement ability for people with severe chronic hemiparetic stroke. PMID:23597303

The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance.

PubMed

Zondervan, Daniel K; Palafox, Lorena; Hernandez, Jorge; Reinkensmeyer, David J

2013-04-18

Robotic arm therapy devices that incorporate actuated assistance can enhance arm recovery, motivate patients to practice, and allow therapists to deliver semi-autonomous training. However, because such devices are often complex and actively apply forces, they have not achieved widespread use in rehabilitation clinics or at home. This paper describes the design and pilot testing of a simple, mechanically passive device that provides robot-like assistance for active arm training using the principle of mechanical resonance. The Resonating Arm Exerciser (RAE) consists of a lever that attaches to the push rim of a wheelchair, a forearm support, and an elastic band that stores energy. Patients push and pull on the lever to roll the wheelchair back and forth by about 20 cm around a neutral position. We performed two separate pilot studies of the device. In the first, we tested whether the predicted resonant properties of RAE amplified a user's arm mobility by comparing his or her active range of motion (AROM) in the device achieved during a single, sustained push and pull to the AROM achieved during rocking. In a second pilot study designed to test the therapeutic potential of the device, eight participants with chronic stroke (35 ± 24 months since injury) and a mean, stable, initial upper extremity Fugl-Meyer (FM) score of 17 ± 8 / 66 exercised with RAE for eight 45 minute sessions over three weeks. The primary outcome measure was the average AROM measured with a tilt sensor during a one minute test, and the secondary outcome measures were the FM score and the visual analog scale for arm pain. In the first pilot study, we found people with a severe motor impairment after stroke intuitively found the resonant frequency of the chair, and the mechanical resonance of RAE amplified their arm AROM by a factor of about 2. In the second pilot study, AROM increased by 66% ± 20% (p = 0.003). The mean FM score increase was 8.5 ± 4 pts (p = 0.009). Subjects did not report discomfort or an increase in arm pain with rocking. Improvements were sustained at three months. These results demonstrate that a simple mechanical device that snaps onto a manual wheelchair can use resonance to assist arm training, and that such training shows potential for safely increasing arm movement ability for people with severe chronic hemiparetic stroke.

Effects of comfort food on food intake, anxiety-like behavior and the stress response in rats.

PubMed

Ortolani, D; Oyama, L M; Ferrari, E M; Melo, L L; Spadari-Bratfisch, R C

2011-07-06

It has been suggested that access to high caloric food attenuates stress response. The present paper investigates whether access to commercial chow enriched with glucose and fat, here referred to as comfort food alters behavioral, metabolic, and hormonal parameters of rats submitted to three daily sessions of foot-shock stress. Food intake, anxiety-like behaviors, and serum levels of insulin, leptin, corticosterone, glucose and triglycerides were determined. The rats submitted to stress decreased the intake of commercial chow, but kept unaltered the intake of comfort food. During the elevated plus maze (EPM) test, stressed rats increased the number of head dipping, entries into the open arms, as well as the time spent there, and decreased the number of stretched-attend posture and risk assessment. These effects of stress were independent of the type of food consumed. Non-stressed rats ingesting comfort food decreased risk assessment as well. Stress and comfort food increased time spent in the center of the open field and delayed the first crossing to a new quadrant. Stress increased the plasma level of glucose and insulin, and reduced triglycerides, although consumption of comfort food increases glucose, triglyceride and leptin levels; no effect on leptin level was associated to stress. The stress induced increase in serum corticosterone was attenuated when rats had access to comfort food. It was concluded that foot-shock stress has an anorexigenic effect that is independent of leptin and prevented upon access to comfort food. Foot-shock stress also has an anxiolytic effect that is potentiated by the ingestion of comfort food and that is evidenced by both EPM and open field tests. Copyright © 2011 Elsevier Inc. All rights reserved.

A biometric access personal optical storage device

NASA Astrophysics Data System (ADS)

Davies, David H.; Ray, Steve; Gurkowski, Mark; Lee, Lane

2007-01-01

A portable USB2.0 personal storage device that uses built-in encryption and allows data access through biometric scanning of a finger print is described. Biometric image derived templates are stored on the removable 32 mm write once (WO) media. The encrypted templates travel with the disc and allow access to the data providing the biometric feature (e.g. the finger itself) is present. The device also allows for export and import of the templates under secure key exchange protocols. The storage system is built around the small form factor optical engine that uses a tilt arm rotary actuator and front surface media.

Spatiotemporal gait changes with use of an arm swing cueing device in people with Parkinson's disease.

PubMed

Thompson, Elizabeth; Agada, Peter; Wright, W Geoffrey; Reimann, Hendrik; Jeka, John

2017-10-01

Impaired arm swing is a common motor symptom of Parkinson's disease (PD), and correlates with other gait impairments and increased risk of falls. Studies suggest that arm swing is not merely a passive consequence of trunk rotation during walking, but an active component of gait. Thus, techniques to enhance arm swing may improve gait characteristics. There is currently no portable device to measure arm swing and deliver immediate cues for larger movement. Here we test report pilot testing of such a device, ArmSense (patented), using a crossover repeated-measures design. Twelve people with PD walked in a video-recorded gym space at self-selected comfortable and fast speeds. After baseline, cues were given either visually using taped targets on the floor to increase step length or through vibrations at the wrist using ArmSense to increase arm swing amplitude. Uncued walking then followed, to assess retention. Subjects successfully reached cueing targets on >95% of steps. At a comfortable pace, step length increased during both visual cueing and ArmSense cueing. However, we observed increased medial-lateral trunk sway with visual cueing, possibly suggesting decreased gait stability. In contrast, no statistically significant changes in trunk sway were observed with ArmSense cues compared to baseline walking. At a fast pace, changes in gait parameters were less systematic. Even though ArmSense cues only specified changes in arm swing amplitude, we observed changes in multiple gait parameters, reflecting the active role arm swing plays in gait and suggesting a new therapeutic path to improve mobility in people with PD. Copyright © 2017 Elsevier B.V. All rights reserved.

76 FR 40707 - 36(b)(1) Arms Sales Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-11

... training and training equipment, support equipment, U.S. Government and contractor engineering, logistics... training equipment, support equipment, U.S. Government and contractor engineering, logistics, and technical... access to SSEE Increment F services via standard Service Oriented Architecture (SOA) interfaces via...

Main outcomes of an RCT to pilot test reporting and feedback to foster research integrity climates in the VA.

PubMed

Martinson, Brian C; Mohr, David C; Charns, Martin P; Nelson, David; Hagel-Campbell, Emily; Bangerter, Ann; Bloomfield, Hanna E; Owen, Richard; Thrush, Carol R

2017-01-01

Assessing the integrity of research climates and sharing such information with research leaders may support research best practices. We report here results of a pilot trial testing the effectiveness of a reporting and feedback intervention using the Survey of Organizational Research Climate (SOuRCe). We randomized 41 Veterans Health Administration (VA) facilities to a phone-based intervention designed to help research leaders understand their survey results (enhanced arm) or to an intervention in which results were simply distributed to research leaders (basic arm). Primary outcomes were (1) whether leaders took action, (2) whether actions taken were consistent with the feedback received, and (3) whether responses differed by receptivity to quality improvement input. Research leaders from 25 of 42 (59%) VA facilities consented to participate in the study intervention and follow-up, of which 14 were at facilities randomized to the enhanced arm. We completed follow-up interviews with 21 of the 25 leaders (88%), 12 from enhanced arm facilities. While not statistically significant, the proportion of leaders reporting taking some action in response to the feedback was twice as high in the enhanced arm than in the basic arm (67% vs. 33%, p = .20). While also not statistically significant, a higher proportion of actions taken among facilities in the enhanced arm were responsive to the survey results than in the basic arm (42% vs. 22%, p = .64). Enhanced feedback of survey results appears to be a promising intervention that may increase the likelihood of responsive action to improve organizational climates. Due to the small sample size of this pilot study, even large percentage-point differences between study arms are not statistically distinguishable. This hypothesis should be tested in a larger trial.

Design and testing of a model CELSS chamber robot

NASA Astrophysics Data System (ADS)

Davis, Mark; Dezego, Shawn; Jones, Kinzy; Kewley, Christopher; Langlais, Mike; McCarthy, John; Penny, Damon; Bonner, Tom; Funderburke, C. Ashley; Hailey, Ruth

1994-08-01

A robot system for use in an enclosed environment was designed and tested. The conceptual design will be used to assist in research performed by the Controlled Ecological Life Support System (CELSS) project. Design specifications include maximum load capacity, operation at specified environmental conditions, low maintenance, and safety. The robot system must not be hazardous to the sealed environment, and be capable of stowing and deploying within a minimum area of the CELSS chamber facility. This design consists of a telescoping robot arm that slides vertically on a shaft positioned in the center of the CELSS chamber. The telescoping robot arm consists of a series of links which can be fully extended to a length equal to the radius of the working envelope of the CELSS chamber. The vertical motion of the robot arm is achieved through the use of a combination ball screw/ball spline actuator system. The robot arm rotates cylindrically about the vertical axis through use of a turntable bearing attached to a central mounting structure fitted to the actuator shaft. The shaft is installed in an overhead rail system allowing the entire structure to be stowed and deployed within the CELSS chamber. The overhead rail system is located above the chamber's upper lamps and extends to the center of the CELSS chamber. The mounting interface of the actuator shaft and rail system allows the entire actuator shaft to be detached and removed from the CELSS chamber. When the actuator shaft is deployed, it is held fixed at the bottom of the chamber by placing a square knob on the bottom of the shaft into a recessed square fitting in the bottom of the chamber floor. A support boot ensures the rigidity of the shaft. Three student teams combined into one group designed a model of the CELSS chamber robot that they could build. They investigated materials, availability, and strength in their design. After the model arm and stand were built, the class performed pre-tests on the entire system. A stability pre-test was used to determine whether the model robot arm would tip over on the stand when it was fully extended. Results showed the stand tipped when 50 Newtons were applied horizontally to the top of the vertical shaft while the arm was fully extended.

Design and testing of a model CELSS chamber robot

NASA Technical Reports Server (NTRS)

Davis, Mark; Dezego, Shawn; Jones, Kinzy; Kewley, Christopher; Langlais, Mike; Mccarthy, John; Penny, Damon; Bonner, Tom; Funderburke, C. Ashley; Hailey, Ruth

1994-01-01

A robot system for use in an enclosed environment was designed and tested. The conceptual design will be used to assist in research performed by the Controlled Ecological Life Support System (CELSS) project. Design specifications include maximum load capacity, operation at specified environmental conditions, low maintenance, and safety. The robot system must not be hazardous to the sealed environment, and be capable of stowing and deploying within a minimum area of the CELSS chamber facility. This design consists of a telescoping robot arm that slides vertically on a shaft positioned in the center of the CELSS chamber. The telescoping robot arm consists of a series of links which can be fully extended to a length equal to the radius of the working envelope of the CELSS chamber. The vertical motion of the robot arm is achieved through the use of a combination ball screw/ball spline actuator system. The robot arm rotates cylindrically about the vertical axis through use of a turntable bearing attached to a central mounting structure fitted to the actuator shaft. The shaft is installed in an overhead rail system allowing the entire structure to be stowed and deployed within the CELSS chamber. The overhead rail system is located above the chamber's upper lamps and extends to the center of the CELSS chamber. The mounting interface of the actuator shaft and rail system allows the entire actuator shaft to be detached and removed from the CELSS chamber. When the actuator shaft is deployed, it is held fixed at the bottom of the chamber by placing a square knob on the bottom of the shaft into a recessed square fitting in the bottom of the chamber floor. A support boot ensures the rigidity of the shaft. Three student teams combined into one group designed a model of the CELSS chamber robot that they could build. They investigated materials, availability, and strength in their design. After the model arm and stand were built, the class performed pre-tests on the entire system. A stability pre-test was used to determine whether the model robot arm would tip over on the stand when it was fully extended. Results showed the stand tipped when 50 Newtons were applied horizontally to the top of the vertical shaft while the arm was fully extended. This proved that it was stable. Another pre-test was the actuator slip test used to determine if there is an adequate coefficient of friction between the actuator drive wheels and drive cable to enable the actuator to fully extend and retract the arm. This pre-test revealed that the coefficient of friction was not large enough to prevent slippage. Sandpaper was glued to the drive wheel and this eliminated the slippage problem. The class preformed a fit test in the CELSS chamber to ensure that the completed robot arm is capable of reaching the entire working envelope. The robot was centered in the chamber and the arm was fully extended to the sides of the chamber. The arm was also able to retract to clear the drain pipes separating the upper and lower plant trays.

Estimation of brachial artery volume flow by duplex ultrasound imaging predicts dialysis access maturation.

PubMed

Ko, Sae Hee; Bandyk, Dennis F; Hodgkiss-Harlow, Kelley D; Barleben, Andrew; Lane, John

2015-06-01

This study validated duplex ultrasound measurement of brachial artery volume flow (VF) as predictor of dialysis access flow maturation and successful hemodialysis. Duplex ultrasound was used to image upper extremity dialysis access anatomy and estimate access VF within 1 to 2 weeks of the procedure. Correlation of brachial artery VF with dialysis access conduit VF was performed using a standardized duplex testing protocol in 75 patients. The hemodynamic data were used to develop brachial artery flow velocity criteria (peak systolic velocity and end-diastolic velocity) predictive of three VF categories: low (<600 mL/min), acceptable (600-800 mL/min), or high (>800 mL/min). Brachial artery VF was then measured in 148 patients after a primary (n = 86) or revised (n = 62) upper extremity dialysis access procedure, and the VF category correlated with access maturation or need for revision before hemodialysis usage. Access maturation was conferred when brachial artery VF was >600 mL/min and conduit imaging indicated successful cannulation based on anatomic criteria of conduit diameter >5 mm and skin depth <6 mm. Measurements of VF from the brachial artery and access conduit demonstrated a high degree of correlation (R(2) = 0.805) for autogenous vein (n = 45; R(2) = 0.87) and bridge graft (n = 30; R(2) = 0.78) dialysis accesses. Access VF of >800 mL/min was predicted when the brachial artery lumen diameter was >4.5 mm, peak systolic velocity was >150 cm/s, and the diastolic-to-systolic velocity ratio was >0.4. Brachial artery velocity spectra indicating VF <800 mL/min was associated (P < .0001) with failure of access maturation. Revision was required in 15 of 21 (71%) accesses with a VF of <600 mL/min, 4 of 40 accesses (10%) with aVF of 600 to 800 mL/min, and 2 of 87 accesses (2.3%) with an initial VF of >800 mL/min. Duplex testing to estimate brachial artery VF and assess the conduit for ease of cannulation can be performed in 5 minutes during the initial postoperative vascular clinic evaluation. Estimation of brachial artery VF using the duplex ultrasound, termed the "Fast, 5-min Dialysis Duplex Scan," facilitates patient evaluation after new or revised upper extremity dialysis access procedures. Brachial artery VF correlates with access VF measurements and has the advantage of being easier to perform and applicable for forearm and also arm dialysis access. When brachial artery velocity spectra criteria confirm a VF >800 mL/min, flow maturation and successful hemodialysis are predicted if anatomic criteria for conduit cannulation are also present. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The People with Asperger syndrome and anxiety disorders (PAsSA) trial: a pilot multicentre, single-blind randomised trial of group cognitive-behavioural therapy.

PubMed

Langdon, Peter E; Murphy, Glynis H; Shepstone, Lee; Wilson, Edward C F; Fowler, David; Heavens, David; Malovic, Aida; Russell, Alexandra; Rose, Alice; Mullineaux, Louise

2016-03-01

There is a growing interest in using cognitive-behavioural therapy (CBT) with people who have Asperger syndrome and comorbid mental health problems. To examine whether modified group CBT for clinically significant anxiety in an Asperger syndrome population is feasible and likely to be efficacious. Using a randomised assessor-blind trial, 52 individuals with Asperger syndrome were randomised into a treatment arm or a waiting-list control arm. After 24 weeks, those in the waiting-list control arm received treatment, while those initially randomised to treatment were followed up for 24 weeks. The conversion rate for this trial was high (1.6:1), while attrition was 13%. After 24 weeks, there was no significant difference between those randomised to the treatment arm compared with those randomised to the waiting-list control arm on the primary outcome measure, the Hamilton Rating Scale for Anxiety. Trials of psychological therapies with this population are feasible. Larger definitive trials are now needed. None. © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.

Interethnic differences at the thermometric response to cold test: functional disorders of blood circulation in hand fingers and exposure to hand-arm vibration.

PubMed

Riolfi, A; Princivalle, A; Romeo, L; Caramaschi, P; Perbellini, L

2008-02-01

To report some notable aspects regarding thermometric response to cold test in black African subjects compared with Caucasians: both groups comprised persons exposed to hand-arm vibration and controls. An overall sample of 48 workers was examined in order to study their blood circulation in hand fingers: a control group of 12 healthy Caucasian workers never exposed before to hand-arm vibration; 12 Caucasian workers exposed for several years to vibrating tools and affected by occupational Raynaud's phenomenon; 12 healthy black African workers exposed to hand-arm vibration for almost 3 years; and 12 healthy black African workers never exposed to hand-arm vibration. Computerized skin thermometry was performed and thermometric curves were analyzed according to thermometric interpretation criteria such as the area-over-curve (AOC), the fifth minute of recovery/baseline temperature ratio (5REC/BT) and the temperature at the tenth minute of recovery (10REC) after cold test. Thermometric parameters in Caucasian subjects confirmed the basis of the existing literature in controls (basal finger temperature higher than 32 degrees C and complete recovery to the initial temperature after the cold test) and also in patients with Raynaud's phenomenon (basal temperature often lower than control subjects and slow recovery of finger temperature after cold test). Statistically significant difference was found between healthy Caucasians and healthy black subjects in all the parameters tested: healthy black subjects showed values of AOC and 10REC suggesting almost constantly lower finger temperatures during the thermometry test. Black people, both exposed and non-exposed to hand-arm vibration showed thermometric parameters suggesting poor blood microcirculation, which seems even poorer than in Caucasian people complaining Raynaud's phenomenon. Our chronothermometric tests suggest some significant interethnic differences in peripheral microcirculation, which seems rather poor in black African subjects in comparison with Caucasians.

Activity in prelimbic cortex is required for adjusting the anxiety response level during the elevated plus-maze retest.

PubMed

Stern, C A J; Do Monte, F H M; Gazarini, L; Carobrez, A P; Bertoglio, L J

2010-09-29

The prelimbic (PL) subregion of medial prefrontal cortex has been implicated in anxiety regulation. It is unknown, however, whether PL cortex also serves to fine-tuning the level of anxiety-related behavior exhibited on the next exposure to the same potentially threatening situation. To address this, we infused cobalt (1.0 mM) to temporarily inactivate the PL cortex during testing, post-testing or retesting in the elevated plus-maze (EPM). This protocol was chosen because it allowed us to concurrently investigate anxiety and the process of aversive learning and memory. PL cortex inactivation during the EPM testing increased the exploration of open-arms, substantiating its role in anxiety. PL cortex inactivation during the EPM retesting counteracted the further avoidance to open-arms exhibited by rats. Interestingly, as evidenced by min-by-min analysis, the cobalt-treated group behaved on EPM retesting as did the vehicle-treated group on EPM testing. This result may imply that activity in PL cortex is necessary for retrieving previously learned information that adjusts the anxiety response level on EPM retesting. Alternatively, a simple reduction in anxiety could explain the cobalt-induced increase in retest open-arms exploration. Neither test nor post-test PL cortex inactivation affected the further avoidance to open-arms observed on EPM retesting. To extend the investigation of PL cortex role in the regulation of open-arms avoidance, we infused other drugs prior to testing or retesting in the EPM. Antagonism of PL cortex adrenergic beta-1 receptors with atenolol (10 nmol), cholinergic muscarinic receptors with scopolamine (20 nmol) or glutamatergic N-methyl-d-aspartic acid (NMDA) receptors with AP5 (6.0 nmol) interfered with the level of open-arms exploration on testing, but not on retesting. Copyright 2010 IBRO. Published by Elsevier Ltd. All rights reserved.

Dynamic balance control in elders: gait initiation assessment as a screening tool

NASA Technical Reports Server (NTRS)

Chang, H.; Krebs, D. E.; Wall, C. C. (Principal Investigator)

1999-01-01

OBJECTIVE: To determine whether measurements of center of gravity-center of pressure separation (CG-CP moment arm) during gait initiation can differentiate healthy from disabled subjects with sufficient specificity and sensitivity to be useful as a screening test for dynamic balance in elderly patients. SUBJECTS: Three groups of elderly subjects (age, 74.97+/-6.56 yrs): healthy elders (HE, n = 21), disabled elders (DE, n = 20), and elders with vestibular hypofunction (VH, n = 18). DESIGN: Cross-sectional, intact-groups research design. Peak CG-CP moment arm measures how far the subject will tolerate the whole-body CG to deviate from the ground reaction force's CP; it represents dynamic balance control. Screening test cutoff points at 16 to 18 cm peak CG-CP moment arm predicted group membership. RESULTS: The magnitude of peak CG-CP moment arm was significantly greater in HE than in DE and VH subjects (p<.01) and was not different between the DE and VH groups. The peak CG-CP moment arm occurred at the end of single stance phase in all groups. As a screening test, the peak moment arm has greater than 50% sensitivity and specificity to discriminate the HE group from the DE and VH groups with peak CG-CP moment arm cutoff points between 16 and 18 cm. CONCLUSIONS: Examining dynamic balance through the use of the CG-CP moment arm during single stance in gait initiation discriminates between nondisabled and disabled older persons and warrants further investigation as a potential tool to identify people with balance dysfunction.

Aegilops tauschii Accessions with Geographically Diverse Origin Show Differences in Chromosome Organization and Polymorphism of Molecular Markers Linked to Leaf Rust and Powdery Mildew Resistance Genes.

PubMed

Majka, Maciej; Kwiatek, Michał T; Majka, Joanna; Wiśniewska, Halina

2017-01-01

Aegilops tauschii (2n = 2x = 14) is a diploid wild species which is reported as a donor of the D-genome of cultivated bread wheat. The main goal of this study was to examine the differences and similarities in chromosomes organization among accessions of Ae. tauschii with geographically diversed origin, which is believed as a potential source of genes, especially determining resistance to fungal diseases (i.e., leaf rust and powdery mildew) for breeding of cereals. We established and compared the fluorescence in situ hybridization patterns of 21 accessions of Ae. tauschii using various repetitive sequences mainly from the BAC library of wheat cultivar Chinese Spring. Results obtained for Ae. tauschii chromosomes revealed many similarities between analyzed accessions, however, some hybridization patterns were specific for accessions, which become from cognate regions of the World. The most noticeable differences were observed for accessions from China which were characterized by presence of distinct signals of pTa-535 in the interstitial region of chromosome 3D, less intensity of pTa-86 signals in chromosome 2D, as well as lack of additional signals of pTa-86 in chromosomes 1D, 5D, or 6D. Ae. tauschii of Chinese origin appeared homogeneous and separate from landraces that originated in western Asia. Ae. tauschii chromosomes showed similar hybridization patterns to wheat D-genome chromosomes, but some differences were also observed among both species. What is more, we identified reciprocal translocation between short arm of chromosome 1D and long arm of chromosome 7D in accession with Iranian origin. High polymorphism between analyzed accessions and extensive allelic variation were revealed using molecular markers associated with resistance genes. Majority of the markers localized in chromosomes 1D and 2D showed the diversity of banding patterns between accessions. Obtained results imply, that there is a moderate or high level of polymorphism in the genome of Ae . tauschii determined by a geographical origin, which we proved by cytogenetic and molecular markers analysis. Therefore, selected accessions might constitute an accessible source of variation for improvement of Triticeae species like wheat and triticale.

The effects of mirror therapy on arm and hand function in subacute stroke in patients.

PubMed

Radajewska, Alina; Opara, Józef A; Kucio, Cezary; Błaszczyszyn, Monika; Mehlich, Krzysztof; Szczygiel, Jarosław

2013-09-01

The aim of this study was to evaluate the effect of mirror therapy on arm and hand function in subacute stroke in patients. The study included 60 hemiparetic right-handed patients after ischemic stroke 8-10 weeks after onset. They underwent stationary comprehensive rehabilitation in the rehabilitation centre. They were divided into two randomly assigned groups: mirror (n=30) and control (n=30). For both groups, two subgroups were created: one that included patients with right arm paresis (n=15) and the other that included patients with left arm paresis (n=15). The mirror group received an additional intervention: training with a mirror for 5 days/week, 2 sessions/day, for 21 days. Each single session lasted for 15 min. The control group (n=30) underwent a conventional rehabilitation program without mirror therapy. To evaluate self-care in performing activities of daily living, the Functional Index 'Repty' was used. To evaluate hand and arm function, the Frenchay Arm Test and the Motor Status Score were used. Measurements were performed twice: before and after 21 days of applied rehabilitation. No significant improvement in hand and arm function in both subgroups in Frenchay Arm Test and Motor Status Score scales was observed. However, there was a significant improvement in self-care of activities of daily living in the right arm paresis subgroup in the mirror group measured using the Functional Index 'Repty'. Mirror therapy improves self-care of activities of daily living for patients with right arm paresis after stroke.

Mechanisms underlying interlimb transfer of visuomotor rotations

PubMed Central

Wang, Jinsung; Sainburg, Robert L.

2013-01-01

We previously reported that opposite arm training improved the initial direction of dominant arm movements, whereas it only improved the final position accuracy of non-dominant arm movements. We now ask whether each controller accesses common, or separate, short-term memory resources. To address this question, we investigated interlimb transfer of learning for visuomotor rotations that were directed oppositely [clockwise (CW)/counterclockwise (CCW)] for the two arms. We expected that if information obtained by initial training was stored in the same short-term memory space for both arms, opposite arm training of a CW rotation would interfere with subsequent adaptation to a CCW rotation. All subjects first adapted to a 30° rotation (CW) in the visual display during reaching movements. Following this, they adapted to a 30° rotation in the opposite direction (CCW) with the other arm. In contrast to our previous findings for interlimb transfer of same direction rotations (CCW/CCW), no effects of opposite arm adaptation were indicated in the initial trials performed. This indicates that interlimb transfer is not obligatory, and suggests that short-term memory resources for the two limbs are independent. Through single trial analysis, we found that the direction and final position errors of the first trial of movement, following opposite arm training, were always the same as those of naive performance. This was true whether the opposite arm was trained with the same or the opposing rotation. When trained with the same rotation, transfer of learning did not occur until the second trial. These findings suggest that the selective use of opposite arm information is dependent on the first trial to probe current movement conditions. Interestingly, the final extent of adaptation appeared to be reduced by opposite arm training of opposing rotations. Thus, the extent of adaptation, but not initial information transfer, appears obligatorily affected by prior opposite arm adaptation. According to our findings, it is plausible that the initiation and the final extent of adaptation involve two independent neural processes. Theoretical implications of these findings are discussed. PMID:12677333

Diagnostic disagreement between tests of evacuatory function: a prospective study of 100 constipated patients.

PubMed

Palit, S; Thin, N; Knowles, C H; Lunniss, P J; Bharucha, A E; Scott, S M

2016-10-01

Evacuatory dysfunction (ED) is a common cause of constipation and may be sub-classified on the basis of specialist tests. Such tests may guide treatment e.g., biofeedback therapy for 'functional' defecatory disorders (FDD). However, there is no gold standard, and prior studies have not prospectively and systematically compared all tests that are used to diagnose forms of ED. One hundred consecutive patients fulfilling Rome III criteria for functional constipation underwent four tests: expulsion of a rectal balloon distended to 50 mL (BE50 ) or until patients experienced the desire to defecate (BEDDV ), evacuation proctography (EP) and anorectal manometry. Yields and agreements between tests for the diagnosis of ED and FDD were assessed. Positive diagnostic yields for ED were: BEDDV 18%, BE50 31%, EP 38% and anorectal manometry (ARM) 68%. Agreement was substantial between the two balloon tests (k = 0.66), only fair between proctography and BE50 (k = 0.27), poor between manometry and proctography (k = 0.01), and there was no agreement between the balloon tests and manometry (k = -0.07 for both BE50 and BEDDV ). For the diagnosis of FDD, there was only fair agreement between ARM and EP (k = 0.23), ARM ± BE50 and EP (k = 0.18), ARM and EP ± BE50 (k = 0.30) and ARM ± BE50 and EP ± BE50 (k = 0.23). There is considerable disagreement between the results of various tests used to diagnose ED and FDD. This highlights the need for a reappraisal of both diagnostic criteria, and what represents the 'gold standard' investigation. © 2016 John Wiley & Sons Ltd.

Characterization of Peripheral Activity States and Cortical Local Field Potentials of Mice in an Elevated Plus Maze Test.

PubMed

Okonogi, Toya; Nakayama, Ryota; Sasaki, Takuya; Ikegaya, Yuji

2018-01-01

Elevated plus maze (EPM) tests have been used to assess animal anxiety levels. Little information is known regarding how physiological activity patterns of the brain-body system are altered during EPM tests. Herein, we monitored cortical local field potentials (LFPs), electrocardiograms (ECGs), electromyograms (EMGs), and respiratory signals in individual mice that were repeatedly exposed to EPM tests. On average, mouse heart rates were higher in open arms. In closed arms, the mice occasionally showed decreased heart and respiratory rates lasting for several seconds or minutes, characterized as low-peripheral activity states of peripheral signals. The low-activity states were observed only when the animals were in closed arms, and the frequencies of the states increased as the testing days proceeded. During the low-activity states, the delta and theta powers of cortical LFPs were significantly increased and decreased, respectively. These results demonstrate that cortical oscillations crucially depend on whether an animal exhibits low-activity states in peripheral organs rather than the EPM arm in which the animal is located. These results suggest that combining behavioral tests with physiological makers enables a more accurate evaluation of rodent mental states.

Reliability and comparison of trunk and pelvis angles, arm distance and center of pressure in the seated functional reach test with and without foot support in children.

PubMed

Radtka, Sandra; Zayac, Jacqueline; Goldberg, Krystyna; Long, Michael; Ixanov, Rustem

2017-03-01

This study determined test-retest reliability of trunk and pelvis joint angles, arm distance and center of pressure (COP) excursion for the seated functional reach test (FRT) and compared these variables during the seated FRT with and without foot support. Fifteen typically developing children (age 9.3±4.1years) participated. Trunk and pelvis joint angles, arm distance, and COP excursion were collected on two days using three-dimensional motion analysis and a force plate while subjects reached maximally with and without foot support in the anterior, anterior/lateral, lateral, posterior/lateral directions. Age, weight, height, trunk and arm lengths were correlated (p<0.01) with maximum arm distance reached. Maximum arm distance, trunk and pelvis joint angles, and COP with and without foot support were not significant (p<0.05) for the two test periods. Excellent reliability (ICCs>0.75) was found for maximum arm distance reached in all four directions in the seated FRT with and without foot support. Most trunk and pelvis joint angles and COP excursions during maximum reach in all four directions showed excellent to fair reliability (ICCs>0.40-0.75). Reaching with foot support in all directions was significantly greater (p<0.05) than without foot support; however, most COP excursions and trunk and pelvic angles were not significantly different. Findings support the addition of anterior/lateral and posterior/lateral reaching directions in the seated FRT. Trunk and pelvis movement analysis is important to examine in the seated FRT to determine the specific movement strategies needed for maximum reaching without loss of balance. Copyright © 2017 Elsevier B.V. All rights reserved.

Gaming and Conventional Exercises for Improvement of Arm Function After Stroke: A Randomized Controlled Pilot Study.

PubMed

Kottink, Anke I R; Prange, Gerdienke B; Krabben, Thijs; Rietman, Johan S; Buurke, Jaap H

2014-06-01

The use of new technologies in rehabilitation, such as virtual reality and/or computerized gaming exercises, may be useful to enable patients to practice intensively in a motivating way. The objective of the present randomized controlled pilot study was to compare the effect of reach training using a target group specific-designed rehabilitation game to time-matched standardized conventional reach training on arm function after stroke. Twenty chronic stroke patients were randomized to either the rehabilitation game group or the conventional training group. Both groups received three arm training sessions of 30 minutes each week, during a period of 6 weeks. Arm (the upper extremity part of Fugl-Meyer [FM] assessment) and hand (the Action Research Arm [ARA] test) functions were tested 1 week before (T0) and 1 week after (T1) training. A follow-up measurement was performed at 1 month after T1 (T2). ARA and FM scores improved significantly within both groups. Post hoc comparisons revealed significant increases in test scores between T0 and T1 and between T0 and T2 for both ARA and FM, but not for changes from T1 to T2. There were no significant differences between both groups for either clinical test. The present randomized controlled pilot study showed that both arm and hand function improved as much after training with a rehabilitation game as after time-matched conventional training.

A prospective pilot study to evaluate an animated home-based physical exercise program as a treatment option for patients with rheumatoid arthritis.

PubMed

Zernicke, Jan; Kedor, Claudia; Müller, Angela; Burmester, Gerd-Rüdiger; Reißhauer, Anett; Feist, Eugen

2016-08-18

Physical exercises and physiotherapy are of great importance for maintenance of joint function in patients with rheumatoid arthritis (RA). However, many RA patients complain about problems to receive prescriptions or have a lack of access to physiotherapy. Recent reports have shown positive effects of the Wii game console on physical and psychosocial conditions of patients with other underlying diseases. The primary objectives of this prospective controlled pilot study were to investigate feasibility and patients' assessment using an animated home-based exercise program. This pilot study was conducted as a single-center, cross-over trial with two treatment arms over 24 weeks. Eligibility criteria included patients with RA reaching low disease activity under therapy with a biological disease modifying anti-rheumatic drug (bDMARD). After detailed instruction, 15 patients started with a conventional home-based physical exercise program and 15 patients began with a predefined animated exercise program by using the Wii game console for 12 weeks. Afterwards, patients were crossed-over to the other treatment arm for another period of 12 weeks. Multi-methodical assessments were performed by qualitative analysis of the interview-data as well as statistical analysis of functional tests and patient reported outcomes (PRO's). Evaluation of the interviews indicated feasibility and usefulness of the chosen animated home-based exercise program. Forefoot disabilities were identified as a main limiting factor for performing some of the animated exercises. After 12 weeks, both treatment arms showed improvement of functional tests without significant differences between groups: Overall muscle strength improved for a mean value of 10 Newton (+12 %) and the mean 6-min walk test (6-MWT) distance increased for 28 meters (+5 %). This study showed that an animated home-based exercise program by using a Wii game console was feasible and beneficial for RA patients. Compared to standard physical home exercises, similar effects were observed indicating that such an animated program might be an alternative supportive option for RA patients. ClinicalTrials.gov ID: NCT02658370 (19-Jan-2016).

Intermanual transfer in training with an upper-limb myoelectric prosthesis simulator: a mechanistic, randomized, pretest-posttest study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2013-01-01

Intermanual transfer may improve prosthetic handling and acceptance if used in training soon after an amputation. The purpose of this study was to determine whether intermanual transfer effects can be detected after training with a myoelectric upper-limb prosthesis simulator. A mechanistic, randomized, pretest-posttest design was used. A total of 48 right-handed participants (25 women, 23 men) who were able-bodied were randomly assigned to an experimental group or a control group. The experimental group performed a training program of 5 days' duration using the prosthesis simulator. To determine the improvement in skill, a test was administered before, immediately after, and 6 days after training. The control group only performed the tests. Training was performed with the unaffected arm, and tests were performed with the affected arm (the affected arm simulating an amputated limb). Half of the participants were tested with the dominant arm and half with the nondominant arm. Initiation time was defined as the time from starting signal until start of the movement, movement time was defined as the time from the beginning of the movement until completion of the task, and force control was defined as the maximal applied force on a deformable object. The movement time decreased significantly more in the experimental group (F₂,₉₂=7.42, P=.001, η²(G)=.028) when compared with the control group. This finding is indicative of faster handling of the prosthesis. No statistically significant differences were found between groups with regard to initiation time and force control. We did not find a difference in intermanual transfer between the dominant and nondominant arms. The training utilized participants who were able-bodied in a laboratory setting and focused only on transradial amputations. Intermanual transfer was present in the affected arm after training the unaffected arm with a myoelectric prosthesis simulator, and this effect did not depend on laterality. This effect may improve rehabilitation of patients with an upper-limb amputation.

Microgravity experiments on the effect of internal flow on solidification of Fe-Cr-Ni stainless steels.

PubMed

Hanlon, Alaina B; Matson, Douglas M; Hyers, Robert W

2006-09-01

A new hypothesis has been developed to explain the effect of internal fluid flow on the lifetime of a metastable phase in solidifying Fe-Cr-Ni alloys. The hypothesis shows excellent agreement with available experimental results, but microgravity experiments are required for complete validation. Certain Fe-Cr-Ni stainless steel alloys solidify from an undercooled melt by a two-step process in which the metastable ferrite phase forms first followed by the stable austenite phase. Recent experiments using containerless processing techniques have shown that the lifetime of the metastable phase is strongly influenced by flow within the molten sample. Simulations using a commercial computational fluid dynamics (CFD) package, FIDAP, were performed to determine the time required for collision of dendrites and compared to experimental delay time. If the convective velocities are strong enough to bend the primary arms, then the secondary arms of adjacent dendrites can touch. The points of collision form low-angle boundaries and result in high-energy sites that can serve as nuclei for the transformation to the stable phase. It has been determined that the convective velocities in electrostatic levitation (ESL) are not strong enough to cause collision. However, in ground-based electromagnetic levitation (EML), the convective velocities are strong enough to cause the dendrites to deflect so that the secondary arms of adjacent dendrites collide. There is quantitative agreement between the numerically determined time to collision and the experimentally observed delay time in EML. The strong internal velocity due to convection within the EML samples is the reason for the observed difference in delay times between ESL and EML. Microgravity testing is essential because the significant change in nucleation behavior occurs between the ranges accessible by ground-based ESL and EML. Testing in microgravity using EML will permit a large range of internal convective velocities including those that are inaccessible in 1 g.

Health care workers in danger zones: a special report on safety and security in a changing environment.

PubMed

Redwood-Campbell, Lynda J; Sekhar, Sharonya N; Persaud, Christine R

2014-10-01

Violence against humanitarian health care workers and facilities in situations of armed conflict is a serious humanitarian problem. Targeting health care workers and destroying or looting medical facilities directly or indirectly impacts the delivery of emergency and life-saving medical assistance, often at a time when it is most needed. Attacks may be intentional or unintentional and can take a range of forms from road blockades and check points which delay or block transport, to the direct targeting of hospitals, attacks against medical personnel, suppliers, patients, and armed entry into health facilities. Lack of access to vital health care services weakens the entire health system and exacerbates existing vulnerabilities, particularly among communities of women, children, the elderly, and the disabled, or anyone else in need of urgent or chronic care. Health care workers, especially local workers, are often the target. This report reviews the work being spearheaded by the Red Cross and Red Crescent Movement on the Health Care in Danger initiative, which aims to strengthen the protections for health care workers and facilities in armed conflicts and ensure safe access for patients. This includes a review of internal reports generated from the expert workshops on a number of topics as well as a number of public sources documenting innovative coping mechanisms adopted by National Red Cross and Red Crescent Societies. The work of other organizations is also briefly examined. This is followed by a review of security mechanisms within the humanitarian sector to ensure the safety and security of health care personnel operating in armed conflicts. From the existing literature, a number of gaps have been identified with current security frameworks that need to be addressed to improve the safety of health care workers and ensure the protection and access of vulnerable populations requiring assistance. A way forward for policy, research, and practice is proposed for consideration. While there is work being done to improve conditions for health care personnel and patients, there need to be concerted actions to stigmatize attacks against workers, facilities, and patients to protect the neutrality of the medical mission.

The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in Polio survivors: a randomised controlled trial.

PubMed

Murray, D; Hardiman, O; Campion, A; Vance, R; Horgan, F; Meldrum, D

2017-07-01

To investigate the effect of an eight-week home-based arm ergometry aerobic exercise programme on physical fitness, fatigue, activity and quality of life in Polio Survivors. An assessor blinded randomised controlled trial. Home-based exercise. Fifty-five Polio survivors randomised to exercise or control groups. Home-based arm ergometry at an intensity of 50%-70% maximum heart rate, compared with usual physiotherapy care. The Six-minute Arm Test, Fatigue Severity Scale, Physical Activity Scale for Individuals with Physical Disabilities and SF-36. Assessments were completed at baseline and at eight weeks. There was no significant difference in the primary outcome, exercising heart rate during the Six-minute Arm Test, between the groups at follow-up [97.6 (SD10.1) compared to 102.4 (SD13.7) beats per minute ( P=0.20)]. Blood pressure was significantly lower in the intervention group at follow-up [systolic blood pressure 132(18.6)mmHg compared to 144.1(14.6)mmHg ( P=0.002)]. There were no between group differences in the Fatigue Severity Scale ( P=0.25) or Physical Activity Scale for Individuals with Physical Disabilities ( P=0.49), with a small difference in SF-36 physical component score ( P=0.04). This home-based arm ergometry programme successfully facilitated aerobic exercise in Polio Survivors, but did not result in a significant change in physical fitness, measured by the Six-minute Arm Test.

System For Research On Multiple-Arm Robots

NASA Technical Reports Server (NTRS)

Backes, Paul G.; Hayati, Samad; Tso, Kam S.; Hayward, Vincent

1991-01-01

Kali system of computer programs and equipment provides environment for research on distributed programming and distributed control of coordinated-multiple-arm robots. Suitable for telerobotics research involving sensing and execution of low level tasks. Software and configuration of hardware designed flexible so system modified easily to test various concepts in control and programming of robots, including multiple-arm control, redundant-arm control, shared control, traded control, force control, force/position hybrid control, design and integration of sensors, teleoperation, task-space description and control, methods of adaptive control, control of flexible arms, and human factors.

The Need and Opportunity for an Integrated Research, Development and Testing Station in the Alaskan High Arctic

NASA Astrophysics Data System (ADS)

Hardesty, J. O.; Ivey, M.; Helsel, F.; Dexheimer, D.; Cahill, C. F.; Bendure, A.; Lucero, D. A.; Roesler, E. L.

2016-12-01

This presentation will make the case for development of a permanent integrated research and testing station at Oliktok Point, Alaska; taking advantage of existing assets and infrastructure, controlled airspace, an active UAS program and local partnerships. Arctic research stations provide critical monitoring and research on climate change for conditions and trends in the Arctic. The US Chair of the Arctic Council has increased awareness of gaps in our understanding of Artic systems, scarce monitoring, lack of infrastructure and readiness for emergency response. Less sea ice brings competition for commercial shipping and resource extraction. Search and rescue, pollution mitigation and safe navigation need real-time, wide-area monitoring to respond to events. Multi-national responses for international traffic will drive a greater security presence to protect citizens and sovereign interests. To address research and technology gaps, there is a national need for a High Arctic Station with an approach that partners stakeholders from science, safety and security to develop comprehensive solutions. The Station should offer year-round use, logistic support and access to varied ecological settings; phased adaptation to changing needs; and support testing of technologies such as multiple autonomous platforms, renewable energies and microgrids, and sensors in Arctic settings. We propose an Arctic Station at Oliktok Point, Alaska. Combined with the Toolik Field Station and Barrow Environmental Observatory, they form a US network of Arctic Stations. An Oliktok Point Station can provide complementary and unique assets that include: ocean access, and coastal and terrestrial systems; road access; controlled airspaces on land and ocean; nearby air facilities, medical and logistic support; atmospheric observations from an adjacent ARM facility; connections to Barrow and Toolik; fiber-optic communications; University of Alaska Fairbanks UAS Test Facility partnership; and an airstrip and hangar for UAS. World-class Arctic research requires year-round access and facilities. The US currently conducts most Arctic research at stations outside the US. A US Arctic Station network enables monitoring that is specific to the US Arctic, to predict and understand impacts that affect people, communities and the planet.

Performance Evaluation of a Mobile Touchscreen Interface for Assistive Robotic Manipulators: A Pilot Study.

PubMed

Chung, Cheng-Shiu; Ka, Hyun W; Wang, Hongu; Ding, Dan; Kelleher, Annmarie; Cooper, Rory A

2017-01-01

Background: Assistive robotic manipulators (ARMs) have been developed to provide enhanced assistance and independence in performance of daily activities among people with spinal cord injury when a caregiver is not on site. However, the current commercial ARM user interfaces (UIs) may be difficult to learn and control. A touchscreen mobile UI was developed to overcome these challenges. Objective: The object of this study was to evaluate the performance between 2 ARM UIs, touchscreen and the original joystick, using an ARM evaluation tool (ARMET). Methods: This is a pilot study of people with upper extremity impairments ( N = 8). Participants were trained on 2 UIs, and then they chose one to use when performing 3 tasks on the ARMET: flipping a toggle switch, pushing down a door handle, and turning a knob. Task completion time, mean velocity, and open interviews were the main outcome measurements. Results: Among 8 novice participants, 7 chose the touchscreen UI and 1 chose the joystick UI. All participants could complete the ARMET tasks independently. Use of the touchscreen UI resulted in enhanced ARMET performance (higher mean moving speed and faster task completion). Conclusions: Mobile ARM UIs demonstrated easier learning experience, less physical effort, and better ARMET performance. The improved performance, the accessibility, and lower physical effort suggested that the touchscreen UI might be an efficient tool for the ARM users.

A Randomized Trial of Displaying Paid Price Information on Imaging Study and Procedure Ordering Rates.

PubMed

Chien, Alyna T; Lehmann, Lisa Soleymani; Hatfield, Laura A; Koplan, Kate E; Petty, Carter R; Sinaiko, Anna D; Rosenthal, Meredith B; Sequist, Thomas D

2017-04-01

Prior studies have demonstrated how price transparency lowers the test-ordering rates of trainees in hospitals, and physician-targeted price transparency efforts have been viewed as a promising cost-controlling strategy. To examine the effect of displaying paid-price information on test-ordering rates for common imaging studies and procedures within an accountable care organization (ACO). Block randomized controlled trial for 1 year. A total of 1205 fully licensed clinicians (728 primary care, 477 specialists). Starting January 2014, clinicians in the Control arm received no price display; those in the intervention arms received Single or Paired Internal/External Median Prices in the test-ordering screen of their electronic health record. Internal prices were the amounts paid by insurers for the ACO's services; external paid prices were the amounts paid by insurers for the same services when delivered by unaffiliated providers. Ordering rates (orders per 100 face-to-face encounters with adult patients): overall, designated to be completed internally within the ACO, considered "inappropriate" (e.g., MRI for simple headache), and thought to be "appropriate" (e.g., screening colonoscopy). We found no significant difference in overall ordering rates across the Control, Single Median Price, or Paired Internal/External Median Prices study arms. For every 100 encounters, clinicians in the Control arm ordered 15.0 (SD 31.1) tests, those in the Single Median Price arm ordered 15.0 (SD 16.2) tests, and those in the Paired Prices arms ordered 15.7 (SD 20.5) tests (one-way ANOVA p-value 0.88). There was no difference in ordering rates for tests designated to be completed internally or considered to be inappropriate or appropriate. Displaying paid-price information did not alter how frequently primary care and specialist clinicians ordered imaging studies and procedures within an ACO. Those with a particular interest in removing waste from the health care system may want to consider a variety of contextual factors that can affect physician-targeted price transparency.

A Media Mix Test of Paid Radio Advertising for Armed Services Recruitment. Volume II.

DTIC Science & Technology

1976-05-01

This was a test of the effectiveness of paid radio recruiting advertising . The four active military services (Army, Navy, Air Force, Marine Corps...service, awareness and knowledge of specific programs and benefits offered by individual services and awareness of armed forces advertising . (Author)

A Media MIX Test of Paid Radio Advertising for Armed Services Recruitment. Volume 3. Addendum.

DTIC Science & Technology

1976-07-01

This was a test of the effectiveness of paid radio recruiting advertising . The four active military services (Army, Navy, Air Force, Marine Corps...service, awareness and knowledge of specific programs and benefits offered by individual services and awareness of armed forces advertising . (Author)

HOW TO PASS ARMED FORCES TESTS.

ERIC Educational Resources Information Center

Cowles Education Corp., New York, NY.

FOLLOWING THE CONTENT OF THE ARMED FORCES EXAMINATIONS, THIS BOOK IS PROGRAMED WITH STEP-BY-STEP DIRECTIONS, TESTS, AND CORRECT ANSWERS AND SOLUTIONS. THE CANDIDATE CAN SIMULATE TAKING THE ACTUAL EXAMS BY ANSWERING THE AUTHENTIC QUESTIONS AND PROBLEMS, MARKING THE ANSWER SHEET, AND EVALUATING HIS OWN APTITUDE BY COMPARING HIS ANSWERS WITH THE…

6. MOBILE LAUNCHER SIDE 4, SHOWING MILK STOOL AND LUT. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. MOBILE LAUNCHER SIDE 4, SHOWING MILK STOOL AND LUT. PROTRUSION ON UPPER RIGHT HAND SIDE OF LUT IS SWING ARM NINE WHICH PROVIDED ACCESS TO CAPSULE OF LAUNCH VEHICLE WHILE ON LAUNCHER. - Mobile Launcher One, Kennedy Space Center, Titusville, Brevard County, FL

Building Trust and Capacity: Disarmament, Demobilization, and Reintegration to Transition Pro-Government Non-State Armed Groups

DTIC Science & Technology

2009-05-11

de Pau. “Cambodia.” Escola de Cultura de Pau, http://www.escolapau.org/img/ programas /desarme/mapa/camboyai.pdf (accessed March 20, 2009). 69...Escola de Cultura de Pau. “Eritrea.” Escola de Cultura de Pau, http://www.escolapau.org/img/ programas /desarme/mapa/eritreai.pdf (accessed March 20...government authorized the formation and support of “rondas” or Comites de auto defensa (Committees of Self Defense) as the government fought the

Skylab rescue space vehicle flight readiness test

NASA Technical Reports Server (NTRS)

Jevitt, S. J.

1973-01-01

A Skylab Rescue Space Vehicle flight readiness test is described which ensures that space vehicle systems are in a state of flight readiness and are compatible with associated ground support equipment. The functions of propellant loading, umbilical ejection, ignition, holddown arm release, liftoff, and service arm and tail service mast retraction are simulated. The test outline is presented along with a list of references, intercommunications information, operations interface control chart, and flight test.

Swing arm profilometer: analytical solutions of misalignment errors for testing axisymmetric optics

NASA Astrophysics Data System (ADS)

Xiong, Ling; Luo, Xiao; Liu, Zhenyu; Wang, Xiaokun; Hu, Haixiang; Zhang, Feng; Zheng, Ligong; Zhang, Xuejun

2016-07-01

The swing arm profilometer (SAP) has been playing a very important role in testing large aspheric optics. As one of most significant error sources that affects the test accuracy, misalignment error leads to low-order errors such as aspherical aberrations and coma apart from power. In order to analyze the effect of misalignment errors, the relation between alignment parameters and test results of axisymmetric optics is presented. Analytical solutions of SAP system errors from tested mirror misalignment, arm length L deviation, tilt-angle θ deviation, air-table spin error, and air-table misalignment are derived, respectively; and misalignment tolerance is given to guide surface measurement. In addition, experiments on a 2-m diameter parabolic mirror are demonstrated to verify the model; according to the error budget, we achieve the SAP test for low-order errors except power with accuracy of 0.1 μm root-mean-square.

Treatment of Glioma Using neuroArm Surgical System

PubMed Central

2016-01-01

The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases. neuroArm is equipped with force sensors at the end-effector allowing quantification of tool-tissue interaction forces and transmits force of dissection to the surgeon sited at a remote workstation that includes a haptic interface. Interaction forces between the tool tips and the brain tissue were measured for each procedure, and the peak forces were quantified. Results showed maximum and minimum peak force values of 2.89 N (anaplastic astrocytoma, WHO grade III) and 0.50 N (anaplastic oligodendroglioma, WHO grade III), respectively, with the mean of peak forces varying from case to case, depending on type of the glioma. Mean values of the peak forces varied in range of 1.27 N (anaplastic astrocytoma, WHO grade III) to 1.89 N (glioblastoma with oligodendroglial component, WHO grade IV). In some cases, ANOVA test failed to reject the null hypothesis of equality in means of the peak forces measured. However, we could not find a relationship between forces exerted to the pathological tissue and its size, type, or location. PMID:27314044

Promotion of early pediatric hearing detection through patient navigation: A randomized controlled clinical trial.

PubMed

Bush, Matthew L; Taylor, Zachary R; Noblitt, Bryce; Shackleford, Taylor; Gal, Thomas J; Shinn, Jennifer B; Creel, Liza M; Lester, Cathy; Westgate, Philip M; Jacobs, Julie A; Studts, Christina R

2017-11-01

To assess the efficacy of a patient navigator intervention to decrease nonadherence to obtain audiological testing following failed screening, compared to those receiving the standard of care. Using a randomized controlled design, guardian-infant dyads, in which the infants had abnormal newborn hearing screening, were recruited within the first week after birth. All participants were referred for definitive audiological diagnostic testing. Dyads were randomized into a patient navigator study arm or standard of care arm. The primary outcome was the percentage of patients with follow-up nonadherence to obtain diagnostic testing. Secondary outcomes were parental knowledge of infant hearing testing recommendations and barriers in obtaining follow-up testing. Sixty-one dyads were enrolled in the study (patient navigator arm = 27, standard of care arm = 34). The percentage of participants nonadherent to diagnostic follow-up during the first 6 months after birth was significantly lower in the patient navigator arm compared with the standard of care arm (7.4% vs. 38.2%) (P = .005). The timing of initial follow-up was significantly lower in the navigator arm compared with the standard of care arm (67.9 days after birth vs. 105.9 days, P = .010). Patient navigation increased baseline knowledge regarding infant hearing loss diagnosis recommendations compared with the standard of care (P = .004). Patient navigation decreases nonadherence rates following abnormal infant hearing screening and improves knowledge of follow-up recommendations. This intervention has the potential to improve the timeliness of delivery of infant hearing healthcare; future research is needed to assess the cost and feasibility of larger scale implementation. 1b. Laryngoscope, 127:S1-S13, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Data management and scientific integration within the Atmospheric Radiation Measurement Program

NASA Technical Reports Server (NTRS)

Gracio, Deborah K.; Hatfield, Larry D.; Yates, Kenneth R.; Voyles, Jimmy W.; Tichler, Joyce L.; Cederwall, Richard T.; Laufersweiler, Mark J.; Leach, Martin J.; Singley, Paul

1995-01-01

The Atmospheric Radiation Measurement (ARM) Program has been developed by the U.S. Department of Energy with the goal to improve the predictive capabilities of General Circulation Models (GCM's) in their treatment of clouds and radiative transfer effects. To achieve this goal, three experimental testbeds were designed for the deployment of instruments that will collect atmospheric data used to drive the GCM's. Each site, known as a Cloud and Radiation Testbed (CART), consists of a highly available, redundant data system for the collection of data from a variety of instrumentation. The first CART site was deployed in April 1992 in the Southern Great Plains (SGP), Lamont, Oklahoma, with the other two sites to follow in September 1995 in the Tropical Western Pacific and in 1997 on the North Slope of Alaska. Approximately 400 MB of data are transferred per day via the Internet from the SGP site to the ARM Experiment Center at Pacific Northwest Laboratory in Richland, Washington. The Experiment Center is central to the ARM data path and provides for the collection, processing, analysis, and delivery of ARM data. Data are received from the CART sites from a variety of instrumentation, observational systems, amd external data sources. The Experiment Center processes these data streams on a continuous basis to provide derived data products to the ARM Science Team in near real-time while providing a three-month running archive of data. A primary requirement of the ARM Program is to preserve and protect all data produced or acquired. This function is performed at Oak Ridge National Laboratory where leading edge technology is employed for the long-term storage of ARM data. The ARM Archive provides access to data for participation outside of the ARM Program. The ARM Program involves a collaborative effort by teams from various DOE National Laboratories, providing multi-disciplinary areas of expertise. This paper will discuss the collaborative methods in which the ARM teams translate the scientific goals of the Program into data products. By combining atmospheric scientists, systems engineers, and software engineers, the ARM Program has successfully designed and developed an environment where advances in understanding the parameterizations of GCM's can be made.

The Children and Parents in Focus project: a population-based cluster-randomised controlled trial to prevent behavioural and emotional problems in children.

PubMed

Salari, Raziye; Fabian, Helena; Prinz, Ron; Lucas, Steven; Feldman, Inna; Fairchild, Amanda; Sarkadi, Anna

2013-10-16

There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context. The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013-2017). Outcomes will be measured annually. The primary outcome will be children's behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents' behaviour and parents' general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children's mental health, parent's mental health and health-related quality of life. This study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden. ISRCTN16513449.

A method for removing arm backscatter from EPID images

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

King, Brian W.; Greer, Peter B.; School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, New South Wales 2308

2013-07-15

Purpose: To develop a method for removing the support arm backscatter from images acquired using current Varian electronic portal imaging devices (EPIDs).Methods: The effect of arm backscatter on EPID images was modeled using a kernel convolution method. The parameters of the model were optimized by comparing on-arm images to off-arm images. The model was used to develop a method to remove the effect of backscatter from measured EPID images. The performance of the backscatter removal method was tested by comparing backscatter corrected on-arm images to measured off-arm images for 17 rectangular fields of different sizes and locations on the imager.more » The method was also tested using on- and off-arm images from 42 intensity modulated radiotherapy (IMRT) fields.Results: Images generated by the backscatter removal method gave consistently better agreement with off-arm images than images without backscatter correction. For the 17 rectangular fields studied, the root mean square difference of in-plane profiles compared to off-arm profiles was reduced from 1.19% (standard deviation 0.59%) on average without backscatter removal to 0.38% (standard deviation 0.18%) when using the backscatter removal method. When comparing to the off-arm images from the 42 IMRT fields, the mean {gamma} and percentage of pixels with {gamma} < 1 were improved by the backscatter removal method in all but one of the images studied. The mean {gamma} value (1%, 1 mm) for the IMRT fields studied was reduced from 0.80 to 0.57 by using the backscatter removal method, while the mean {gamma} pass rate was increased from 72.2% to 84.6%.Conclusions: A backscatter removal method has been developed to estimate the image acquired by the EPID without any arm backscatter from an image acquired in the presence of arm backscatter. The method has been shown to produce consistently reliable results for a wide range of field sizes and jaw configurations.« less

Repeatability and Validity of the Combined Arm-Leg (Cruiser) Ergometer

ERIC Educational Resources Information Center

Simmelink, Elisabeth K.; Wempe, Johan B.; Geertzen, Jan H. B.; Dekker, Rienk

2009-01-01

The measurement of physical fitness of lower limb amputees is difficult, as the commonly used ergometer tests have limitations. A combined arm-leg (Cruiser) ergometer might be valuable. The aim of this study was to establish the repeatability and validity of the combined arm-leg (Cruiser) ergometer. Thirty healthy volunteers carried out three…

Upper Arm Central Venous Port Implantation: A 6-Year Single Institutional Retrospective Analysis and Pictorial Essay of Procedures for Insertion

PubMed Central

Shiono, Masatoshi; Takahashi, Shin; Kakudo, Yuichi; Takahashi, Masanobu; Shimodaira, Hideki; Kato, Shunsuke; Ishioka, Chikashi

2014-01-01

Background The requirement of central venous (CV) port implantation is increasing with the increase in the number of cancer patients and advancement in chemotherapy. In our division, medical oncologists have implanted all CV ports to save time and consultation costs to other departments. Recently, upper arm implantation has become the first choice as a safe and comfortable method in our unit. Here we report our experience and discuss the procedure and its potential advantages. Methods All CV port implantations (n = 599) performed in our unit from January 2006 to December 2011 were analyzed. Procedural success and complication rates between subclavian and upper arm groups were compared. Results Both groups had similar patient characteristics. Upper arm CV port and subclavian implantations were equivalently successful and safe. Although we only retrospectively analyzed data from a single center, the upper arm group had a significantly lower overall postprocedural complication rate than the subclavian group. No pneumothorax risk, less risk of arterial puncture by ultrasound, feasibility of stopping potential arterial bleeding, and prevention of accidental arterial cannulation by targeting the characteristic solitary basilic vein were the identified advantages of upper arm CV port implantation. In addition to the aforementioned advantages, there is no risk of “pinch-off syndrome,” possibly less patient fear of manipulation, no scars on the neck and chest, easier accessibility, and compatibility with the “peripherally inserted central catheter” technique. Conclusions Upper arm implantation may benefit clinicians and patients with respect to safety and comfort. We also introduce our methods for upper arm CV port implantation with the videos. PMID:24614412

The Influences of Arm Resist Motion on a CAR Crash Test Using Hybrid III Dummy with Human-Like Arm

NASA Astrophysics Data System (ADS)

Kim, Yongchul; Youm, Youngil; Bae, Hanil; Choi, Hyeonki

Safety of the occupant during the crash is very essential design element. Many researches have been investigated in reducing the fatal injury of occupant. They are focusing on the development of a dummy in order to obtain the real human-like motion. However, they have not considered the arm resist motion during the car accident. In this study, we would like to suggest the importance of the reactive force of the arm in a car crash. The influences of reactive force acting on the human upper extremity were investigated using the impedance experimental method with lumped mass model of hand system and a Hybrid III dummy with human-like arm. Impedance parameters (e.g. inertia, spring constant and damping coefficient) of the elbow joint in maximum activation level were measured by free oscillation test using single axis robot. The results showed that without seat belt, the reactive force of human arm reduced the head, chest, and femur injury, and the flexion moment of the neck is higher than that of the conventional dummy.

Economic analysis: randomized placebo-controlled clinical trial of erlotinib in advanced non-small cell lung cancer.

PubMed

Bradbury, Penelope A; Tu, Dongsheng; Seymour, Lesley; Isogai, Pierre K; Zhu, Liting; Ng, Raymond; Mittmann, Nicole; Tsao, Ming-Sound; Evans, William K; Shepherd, Frances A; Leighl, Natasha B

2010-03-03

The NCIC Clinical Trials Group conducted the BR.21 trial, a randomized placebo-controlled trial of erlotinib (an epidermal growth factor receptor tyrosine kinase inhibitor) in patients with previously treated advanced non-small cell lung cancer. This trial accrued patients between August 14, 2001, and January 31, 2003, and found that overall survival and quality of life were improved in the erlotinib arm than in the placebo arm. However, funding restrictions limit access to erlotinib in many countries. We undertook an economic analysis of erlotinib treatment in this trial and explored different molecular and clinical predictors of outcome to determine the cost-effectiveness of treating various populations with erlotinib. Resource utilization was determined from individual patient data in the BR.21 trial database. The trial recruited 731 patients (488 in the erlotinib arm and 243 in the placebo arm). Costs arising from erlotinib treatment, diagnostic tests, outpatient visits, acute hospitalization, adverse events, lung cancer-related concomitant medications, transfusions, and radiation therapy were captured. The incremental cost-effectiveness ratio was calculated as the ratio of incremental cost (in 2007 Canadian dollars) to incremental effectiveness (life-years gained). In exploratory analyses, we evaluated the benefits of treatment in selected subgroups to determine the impact on the incremental cost-effectiveness ratio. The incremental cost-effectiveness ratio for erlotinib treatment in the BR.21 trial population was $94,638 per life-year gained (95% confidence interval = $52,359 to $429,148). The major drivers of cost-effectiveness included the magnitude of survival benefit and erlotinib cost. Subgroup analyses revealed that erlotinib may be more cost-effective in never-smokers or patients with high EGFR gene copy number. With an incremental cost-effectiveness ratio of $94 638 per life-year gained, erlotinib treatment for patients with previously treated advanced non-small cell lung cancer is marginally cost-effective. The use of molecular predictors of benefit for targeted agents may help identify more or less cost-effective subgroups for treatment.

Structural model of dodecameric heat-shock protein Hsp21: Flexible N-terminal arms interact with client proteins while C-terminal tails maintain the dodecamer and chaperone activity.

PubMed

Rutsdottir, Gudrun; Härmark, Johan; Weide, Yoran; Hebert, Hans; Rasmussen, Morten I; Wernersson, Sven; Respondek, Michal; Akke, Mikael; Højrup, Peter; Koeck, Philip J B; Söderberg, Christopher A G; Emanuelsson, Cecilia

2017-05-12

Small heat-shock proteins (sHsps) prevent aggregation of thermosensitive client proteins in a first line of defense against cellular stress. The mechanisms by which they perform this function have been hard to define due to limited structural information; currently, there is only one high-resolution structure of a plant sHsp published, that of the cytosolic Hsp16.9. We took interest in Hsp21, a chloroplast-localized sHsp crucial for plant stress resistance, which has even longer N-terminal arms than Hsp16.9, with a functionally important and conserved methionine-rich motif. To provide a framework for investigating structure-function relationships of Hsp21 and understanding these sequence variations, we developed a structural model of Hsp21 based on homology modeling, cryo-EM, cross-linking mass spectrometry, NMR, and small-angle X-ray scattering. Our data suggest a dodecameric arrangement of two trimer-of-dimer discs stabilized by the C-terminal tails, possibly through tail-to-tail interactions between the discs, mediated through extended I X V X I motifs. Our model further suggests that six N-terminal arms are located on the outside of the dodecamer, accessible for interaction with client proteins, and distinct from previous undefined or inwardly facing arms. To test the importance of the I X V X I motif, we created the point mutant V181A, which, as expected, disrupts the Hsp21 dodecamer and decreases chaperone activity. Finally, our data emphasize that sHsp chaperone efficiency depends on oligomerization and that client interactions can occur both with and without oligomer dissociation. These results provide a generalizable workflow to explore sHsps, expand our understanding of sHsp structural motifs, and provide a testable Hsp21 structure model to inform future investigations. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

KSC-99padig047

NASA Image and Video Library

1999-12-17

After sunup, which is obscured by a cloud-filled sky, Space Shuttle Discovery waits atop the mobile launcher platform for launch of mission STS-103. At the top is seen the external tank gaseous oxygen vent arm system with the vent hood (commonly called the "beanie cap") poised above the external tank. The retractable arm and the beanie cap are designed to vent gaseous oxygen vapors away from the Space Shuttle. The arm truss section is 65 feet long and the diameter of the vent hood is 13 feet. Extending toward the cabin of the orbiter below is the orbiter access arm, with the environmental chamber (called the White Room) at the end. Through this chamber the crew enters the orbiter. The STS-103 mission, to service the Hubble Space Telescope, is scheduled for launch Dec. 17 at 8:47 p.m. EST. Mission objectives include replacing gyroscopes and an old computer, installing another solid state recorder, and replacing damaged insulation in the telescope. The mission is expected to last about 8 days and 21 hours. Discovery is expected to land at KSC Sunday, Dec. 26, at about 6:25 p.m. EST

Controlling the trajectories of bubble trains at a microfluidic junction

NASA Astrophysics Data System (ADS)

Parthiban, Pravien; Khan, Saif

2011-11-01

The increasing number of applications facilitated by digital microfluidic flows has resulted in a sustained interest in not only understanding the diverse, interesting and often complex dynamics associated with such flows in microchannel networks but also in developing facile strategies to control them. We find that there are readily accessible flow speeds wherein resistance to flow in microchannels decreases with an increase in the number of confined bubbles present, and exploit this intriguing phenomenon to sort all bubble of a train exclusively into one of the arms of a nominally symmetric microfluidic loop. We also demonstrate how the arm into which the train filters into can be chosen by applying a temporary external stimulus by means of an additional flow of the continuous liquid into one the arms of the loop. Furthermore, we show how by tuning the magnitude and period of this temporary stimulus we can switch controllably, the traffic of bubbles between both arms of the loop even when the loop is asymmetric. The results of this work should aid in developing viable methods to regulate traffic of digital flows in microfluidic networks.

Evaluation of a functional hand orthosis combined with electrical stimulation adjunct to arm-hand rehabilitation in subacute stroke patients with a severely to moderately affected hand function.

PubMed

Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2018-01-09

To investigate the usability and effectiveness of a functional hand orthosis, combined with electrical stimulation adjunct to therapy-as-usual, on functional use of the moderately/severely impaired hand in sub-acute stroke patients. Single case experiment (A-B-A'-design) involving eight sub-acute stroke patients. The functional hand orthosis and electrical stimulation were used for six weeks, four days/week, 45'/day. Action_Research_Arm_Test, Intrinsic_Motivation_Inventory. At group level, patients improved 19.2 points (median value) (interquartile range: [8.8, 29.5] points) on the Action_Research_Arm_Test (p = 0.001). After correcting for spontaneous recovery and/or therapy-as-usual effects Action_Research_Arm_Test scores still improved significantly (median: 17.2 points; interquartile range: [5.1, 29.2] points) (p = 0.002). At individual level, six patients had improved as to arm-hand skill performance at follow-up (p < = 0.010). In one patient, arm-hand skill performance improvement did not attain statistical significance. In another patient, no arm-hand skill performance improvement was observed. Average Intrinsic_Motivation_Inventory sub-scores were between 4.6 and 6.3 (maximum: 7), except for 'perceived pressure/tension' (3.3). Sub-acute stroke patients who display only little/modest improvement on their capacity to perform daily activities, seem to benefit from training with a dynamic arm orthosis in combination with electrical stimulation. Patients' perceived intrinsic motivation and sense of self-regulation was high. Implications for rehabilitation Arm-hand training featuring the dynamic hand orthosis in combination with electrical stimulation shows a shift from no dexterity to dexterity. As to the users' experience regarding the dynamic hand orthosis, patients perceive a high-intrinsic motivation and sense of self-regulation. Combining the orthosis with electrical stimulation creates opportunities for a nonfunctional hand towards task-oriented training.

KSC-2014-3668

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. The swing arm is undergoing a test to confirm that it is operating correcting. During the test, the arm was swung out and closer to the Vertical Integration Facility at the pad. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

Aeroelastic instability stoppers for wind tunnel models

NASA Technical Reports Server (NTRS)

Doggett, R. V., Jr.; Ricketts, R. H. (Inventor)

1981-01-01

A mechanism for constraining models or sections thereof, was wind tunnel tested, deployed at the onset of aeroelastic instability, to forestall destructive vibrations in the model is described. The mechanism includes a pair of arms pivoted to the tunnel wall and straddling the model. Rollers on the ends of the arms contact the model, and are pulled together against the model by a spring stretched between the arms. An actuator mechanism swings the arms into place and back as desired.

STS-95 Space Shuttle Discovery rollout to Launch Pad 39B

NASA Technical Reports Server (NTRS)

1998-01-01

As daylight creeps over the horizon, STS-95 Space Shuttle Discovery, on the Mobile Launch Platform, arrives at Launch Complex Pad 39B after a 4.2-mile trip taking approximately 6 hours. At the left is the 'white room,' attached to the orbiter access arm. The white room is an environmental chamber that mates with the orbiter and holds six persons. At the launch pad, the orbiter, external tank and solid rocket boosters will undergo final preparations for the launch, scheduled to lift off Oct. 29. The mission includes research payloads such as the Spartan solar- observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Individual differences in the elevated plus-maze and the forced swim test.

PubMed

Estanislau, Celio; Ramos, Anna Carolina; Ferraresi, Paula Daniele; Costa, Naiara Fernanda; de Carvalho, Heloisa Maria Cotta Pires; Batistela, Silmara

2011-01-01

The elevated plus-maze is an apparatus composed of enclosed and open (elevated) arms and time spent in the open arms by a rat can be increased/decreased by anxiolytic/anxiogenic agents. In the forced swim test, floating behavior is used as an index of behavioral despair and can be decreased by antidepressant agents. As the comorbidity between anxiety and depression is a remarkable issue in human behavioral disorders, a possible relationship between the behaviors seen in the cited tests is of great relevance. In the present study, fifty-four male rats (Rattus norvegicus) were submitted to a plus-maze session and to a 2-day forced swim protocol. According to their time in the open arms, they were divided into three groups: Low Open, Medium Open and High Open. Some plus-maze measures were found to be coherent with time in the open arms and are suggested to also be reliable anxiety indexes. In the forced swim test, the Low Open group showed decreases in floating duration from forced swim Session 1 to Session 2, an alteration opposite to that observed in the other groups (particularly, the Medium Open group). The Low Open group also showed increases in floating latency, again in sharp contrast with the alteration found in the other groups. Accordingly, positive and negative correlation were found between time in the open arms and floating duration and latency, respectively. Results are compared to previous studies and mediation of the effect by reactivity to aversive stimulation or alterations induced by open arm exposure is discussed. Copyright © 2010 Elsevier B.V. All rights reserved.

Study designs for determining and comparing sensitivities of disease screening tests.

PubMed

Prorok, Philip C; Kramer, Barnett S; Miller, Anthony B

2015-12-01

To investigate the capability of various study designs to determine the sensitivity of a disease screening test. Quantities that can be calculated from these designs were derived and examined for their relationship to true sensitivity (the ability to detect unrecognized disease that would surface clinically in the absence of screening) and overdiagnosis. To examine the sensitivity of one test, the single cohort design, in which all participants receive the test, is particularly weak, providing only an upper bound on the true sensitivity, and yields no information about overdiagnosis. A randomized design, with one control arm and participants tested in the other, that includes sufficient post-screening follow-up, allows calculation of bounds on, and an approximation to, true sensitivity and also determination of overdiagnosis. Without follow-up, bounds on the true sensitivity can be calculated. To compare two tests, the single cohort paired design in which all participants receive both tests is precarious. The three arm randomized design with post screening follow-up is preferred, yielding an approximation to the true sensitivity, bounds on the true sensitivity, and the extent of overdiagnosis of each test. Without post screening follow-up, bounds on the true sensitivities can be calculated. When an unscreened control arm is not possible, the two-arm randomized design is recommended. Individual test sensitivities cannot be determined, but with sufficient post-screening follow-up, an order relationship can be established, as can the difference in overdiagnosis between the two tests. © The Author(s) 2015.

Determinants of macular pigment optical density and its relation to age-related maculopathy: results from the Muenster Aging and Retina Study (MARS).

PubMed

Dietzel, Martha; Zeimer, Meike; Heimes, Britta; Claes, Birte; Pauleikhoff, Daniel; Hense, Hans-Werner

2011-06-01

The controversial protective effect of macular pigment (MP), consisting of lutein (L) and zeaxantin (Z), in age-related maculopathy (ARM) and its late-stage, age-related macular degeneration (AMD) is discussed. Determinants of MP optical density (MPOD) and its relation to ARM were investigated. MPOD was accessed at eccentricities of 0.5° and 2.0° from the fovea in 369 participants in the 2.6-year follow-up examination of the prospective Muenster Aging and Retina Study using dual-wavelength analysis of autofluorescence images. ARM was graded from standardized fundus photographs according to the International Classification System. MPOD at 0.5° and 2.0° between pairs and within single eyes was strongly correlated (P < 0.001). Smoking and body mass index showed moderately inverse associations with MPOD at 2.0°, and age was positively related to MPOD at both eccentricities. Serum L, measured at the baseline examination, was significantly associated with MPOD measured at follow-up. Likewise, use of L/Z-containing supplements raised MPOD. Crude mean MPOD increased with ascending stage of ARM. However, adjustment for influential factors and exclusion of L supplement users removed differences of mean MPOD between ARM stages. Considering further the accompanying eye, study eyes with ARM had significantly higher MPOD when the contralateral eye had AMD. MPOD levels showed a high degree of intraindividual concordance and interindividual variability. Long-standing serum L levels, and in particular L supplementation, were the strongest determinants of MPOD. The hypothetical inverse association between MPOD and ARM stage was not confirmed.

Short video interventions to reduce mental health stigma: a multi-centre randomised controlled trial in nursing high schools.

PubMed

Winkler, Petr; Janoušková, Miroslava; Kožený, Jiří; Pasz, Jiří; Mladá, Karolína; Weissová, Aneta; Tušková, Eva; Evans-Lacko, Sara

2017-12-01

We aimed to assess whether short video interventions could reduce stigma among nursing students. A multi-centre, randomised controlled trial was conducted. Participating schools were randomly selected and randomly assigned to receive: (1) an informational leaflet, (2) a short video intervention or (3) a seminar involving direct contact with a service user. The Community Attitudes towards Mental Illness (CAMI) and Reported and Intended Behaviour Scale (RIBS) were selected as primary outcome measures. SPANOVA models were built and Cohen's d calculated to assess the overall effects in each of the trial arms. Compared to the baseline, effect sizes immediately after the intervention were small in the flyer arm (CAMI: d = 0.25; RIBS: d = 0.07), medium in the seminar arm (CAMI: d = 0.61; RIBS: d = 0.58), and medium in the video arm (CAMI: d = 0.49 RIBS: d = 0.26; n = 237). Effect sizes at the follow-up were vanishing in the flyer arm (CAMI: d = 0.05; RIBS: d = 0.04), medium in the seminar arm (CAMI: d = 0.43; RIBS: d = 0.26; n = 254), and small in the video arm (CAMI: d = 0.22 RIBS: d = 0.21; n = 237). Seminar had the strongest and relatively stable effect on students' attitudes and intended behaviour, but the effect of short video interventions was also considerable and stable over time. Since short effective video interventions are relatively cheap, conveniently accessible and easy to disseminate globally, we recommend them for further research and development.

[Spanish translation and cross-cultural adaptation of the ARMS-scale for measuring medication adherence in polypathological patients].

PubMed

González-Bueno, Javier; Calvo-Cidoncha, Elena; Sevilla-Sánchez, Daniel; Espaulella-Panicot, Joan; Codina-Jané, Carles; Santos-Ramos, Bernardo

2017-10-01

Translate the ARMS scale into Spanish ensuring cross-cultural equivalence for measuring medication adherence in polypathological patients. Translation, cross-cultural adaptation and pilot testing. Secondary hospital. (i)Forward and blind-back translations followed by cross-cultural adaptation through qualitative methodology to ensure conceptual, semantic and content equivalence between the original scale and the Spanish version. (ii)Pilot testing in non-institutionalized polypathological patients to assess the instrument for clarity. The Spanish version of the ARMS scale has been obtained. Overall scores from translators involved in forward and blind-back translations were consistent with a low difficulty for assuring conceptual equivalence between both languages. Pilot testing (cognitive debriefing) in a sample of 40 non-institutionalized polypathological patients admitted to an internal medicine department of a secondary hospital showed an excellent clarity. The ARMS-e scale is a Spanish-adapted version of the ARMS scale, suitable for measuring adherence in polypathological patients. Its structure enables a multidimensional approach of the lack of adherence allowing the implementation of individualized interventions guided by the barriers detected in every patient. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Incorporating robotic-assisted telerehabilitation in a home program to improve arm function following stroke.

PubMed

Linder, Susan M; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Rosenfeldt, Anson B; Clark, Cindy; Wolf, Steven L; Alberts, Jay L

2013-09-01

After stroke, many individuals lack resources to receive the intensive rehabilitation that is thought to improve upper extremity motor function. This case study describes the application of a telerehabilitation intervention using a portable robotic device combined with a home exercise program (HEP) designed to improve upper extremity function. The participant was a 54-year-old man, 22 weeks following right medullary pyramidal ischemic infarct. At baseline, he exhibited residual paresis of the left upper extremity, resulting in impaired motor control consistent with a flexion synergistic pattern, scoring 22 of 66 on the Fugl-Meyer Assessment. The participant completed 85 total hours of training (38 hours of robotic device and 47 hours of HEP) over the 8-week intervention period. The participant demonstrated an improvement of 26 points on the Action Research Arm Test, 5 points on the Functional Ability Scale portion of the Wolf Motor Function Test, and 20 points on the Fugl-Meyer Assessment, all of which surpassed the minimal clinically important difference. Of the 17 tasks of the Wolf Motor Function Test, he demonstrated improvement on 11 of the 15 time-based tasks and both strength measures. The participant reported an overall improvement in his recovery from stroke on the Stroke Impact Scale quality-of-life questionnaire from 40 of 100 to 65 of 100. His score on the Center for Epidemiologic Studies Depression Scale improved by 19 points. This case demonstrates that robotic-assisted therapy paired with an HEP can be successfully delivered within a home environment to a person with stroke. Robotic-assisted therapy may be a feasible and efficacious adjunct to an HEP program to elicit substantial improvements in upper extremity motor function, especially in those persons with stroke who lack access to stroke rehabilitation centers.

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23): a study protocol.

PubMed

Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe; Christensen, Jette; Johansen, Tonje; Hariri, Jalil; Christiansen, Sanne; Rygaard, Carsten; Lynge, Elsebeth

2018-05-26

The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could therefore be offered less intensive screening. Primary HPV testing is more sensitive than cytology, allowing for a longer screening interval. The aim of Trial23 is to investigate if primary HPV testing with cytology triage of HPV positive samples is a reasonable screening scheme for women offered HPV vaccination as girls. Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study including intention-to-treat and per-protocol analyses. The potential effect of primary HPV screening with a 6-year interval will be calculated from the observed data. The study protocol has been submitted to the ethical committee and deemed a method study. All women are screened according to routine guidelines. The study will contribute new evidence on the future screening of HPV vaccinated birth cohorts of women. All results will be published in open-access journal. NCT03049553; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Design and preliminary recruitment results of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP).

PubMed

Turner, E L; Metcalfe, C; Donovan, J L; Noble, S; Sterne, J A C; Lane, J A; Avery, K N; Down, L; Walsh, E; Davis, M; Ben-Shlomo, Y; Oliver, S E; Evans, S; Brindle, P; Williams, N J; Hughes, L J; Hill, E M; Davies, C; Ng, S Y; Neal, D E; Hamdy, F C; Martin, R M

2014-06-10

Screening for prostate cancer continues to generate controversy because of concerns about over-diagnosis and unnecessary treatment. We describe the rationale, design and recruitment of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP) trial, a UK-wide cluster randomised controlled trial investigating the effectiveness and cost-effectiveness of prostate-specific antigen (PSA) testing. Seven hundred and eighty-five general practitioner (GP) practices in England and Wales were randomised to a population-based PSA testing or standard care and then approached for consent to participate. In the intervention arm, men aged 50-69 years were invited to undergo PSA testing, and those diagnosed with localised prostate cancer were invited into a treatment trial. Control arm practices undertook standard UK management. All men were flagged with the Health and Social Care Information Centre for deaths and cancer registrations. The primary outcome is prostate cancer mortality at a median 10-year-follow-up. Among randomised practices, 271 (68%) in the intervention arm (198,114 men) and 302 (78%) in the control arm (221,929 men) consented to participate, meeting pre-specified power requirements. There was little evidence of differences between trial arms in measured baseline characteristics of the consenting GP practices (or men within those practices). The CAP trial successfully met its recruitment targets and will make an important contribution to international understanding of PSA-based prostate cancer screening.

Strategic stalemate: Nuclear weapons and arms control in American politics

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

Krepon, M.

1984-01-01

This book presents a concise analysis of the American debate over arms control measures from the atmospheric test ban treaty of 1963 to the present. The author demonstrates the continuity of positions held by the participants throughout. There are two ''camps:'' those who stress security through military means and those who believe above all in arms control or disarmament. The camps in turn, contain ''operationalists,'' who pursue arms control but with differing emphases, and ''ideologues,'' who reject arms control in favor of superiority, at one end of the spectrum, or in favor of disarmament, at the other end.

The People with Asperger syndrome and anxiety disorders (PAsSA) trial: a pilot multicentre, single-blind randomised trial of group cognitive–behavioural therapy

PubMed Central

Murphy, Glynis H.; Shepstone, Lee; Wilson, Edward C.F.; Fowler, David; Heavens, David; Malovic, Aida; Russell, Alexandra; Rose, Alice; Mullineaux, Louise

2016-01-01

Background There is a growing interest in using cognitive–behavioural therapy (CBT) with people who have Asperger syndrome and comorbid mental health problems. Aims To examine whether modified group CBT for clinically significant anxiety in an Asperger syndrome population is feasible and likely to be efficacious. Method Using a randomised assessor-blind trial, 52 individuals with Asperger syndrome were randomised into a treatment arm or a waiting-list control arm. After 24 weeks, those in the waiting-list control arm received treatment, while those initially randomised to treatment were followed up for 24 weeks. Results The conversion rate for this trial was high (1.6:1), while attrition was 13%. After 24 weeks, there was no significant difference between those randomised to the treatment arm compared with those randomised to the waiting-list control arm on the primary outcome measure, the Hamilton Rating Scale for Anxiety. Conclusions Trials of psychological therapies with this population are feasible. Larger definitive trials are now needed. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence. PMID:27703772

Gorbachev’s Arms Control Strategy.

DTIC Science & Technology

1987-01-22

on- site inspection for verifying nuclear tests as well as for dismantling missiles on Soviet territory. Clearlv Gorbachev wants an arms , -4- control...bring its seismological test equipment to what he called the "holy of holies", the area adjoining the Soviet proving ground near Semipalatinsk to offer...prenotification and observation of military exercises including on- site inspection on Soviet territory. But on the big issues--- nuclear testing , strategic weapons

Design and analysis of three-arm trials with negative binomially distributed endpoints.

PubMed

Mütze, Tobias; Munk, Axel; Friede, Tim

2016-02-20

A three-arm clinical trial design with an experimental treatment, an active control, and a placebo control, commonly referred to as the gold standard design, enables testing of non-inferiority or superiority of the experimental treatment compared with the active control. In this paper, we propose methods for designing and analyzing three-arm trials with negative binomially distributed endpoints. In particular, we develop a Wald-type test with a restricted maximum-likelihood variance estimator for testing non-inferiority or superiority. For this test, sample size and power formulas as well as optimal sample size allocations will be derived. The performance of the proposed test will be assessed in an extensive simulation study with regard to type I error rate, power, sample size, and sample size allocation. For the purpose of comparison, Wald-type statistics with a sample variance estimator and an unrestricted maximum-likelihood estimator are included in the simulation study. We found that the proposed Wald-type test with a restricted variance estimator performed well across the considered scenarios and is therefore recommended for application in clinical trials. The methods proposed are motivated and illustrated by a recent clinical trial in multiple sclerosis. The R package ThreeArmedTrials, which implements the methods discussed in this paper, is available on CRAN. Copyright © 2015 John Wiley & Sons, Ltd.

Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial.

PubMed

Ronco, Guglielmo; Segnan, Nereo; Giorgi-Rossi, Paolo; Zappa, Marco; Casadei, Gian Piero; Carozzi, Francesca; Dalla Palma, Paolo; Del Mistro, Annarosa; Folicaldi, Stefania; Gillio-Tos, Anna; Nardo, Gaetano; Naldoni, Carlo; Schincaglia, Patrizia; Zorzi, Manuel; Confortini, Massimo; Cuzick, Jack

2006-06-07

Although testing for human papillomavirus (HPV) has higher sensitivity and lower specificity than cytology alone for detecting cervical intraepithelial neoplasia (CIN), studies comparing conventional and liquid-based cytology have had conflicting results. In the first phase of a two-phase multicenter randomized controlled trial, women aged 35-60 years in the conventional arm (n = 16,658) were screened using conventional cytology, and women in the experimental arm (n = 16,706) had liquid-based cytology and were tested for high-risk HPV types using the Hybrid Capture 2 assay. Women in the conventional arm were referred to colposcopy with atypical cells of undetermined significance (ASCUS) or higher and those in the experimental arm were referred with ASCUS or higher cytology or with a positive (> or = 1 pg/mL) HPV test. Sensitivity and positive predictive value (PPV) for detection of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) were calculated. The screening methods and referral criterion applied in the experimental arm had higher sensitivity than that in the conventional arm (relative sensitivity = 1.47; 95% confidence interval [CI] = 1.03 to 2.09) but a lower PPV (relative PPV = 0.40; 95% CI = 0.23 to 0.66). With HPV testing alone at > or = 1 pg/mL and at > or = 2 pg/mL, the gain in sensitivity compared with the conventional arm remained similar (relative sensitivity = 1.43, 95% CI = 1.00 to 2.04 and relative sensitivity = 1.41, 95% CI = 0.98 to 2.01, respectively) but PPV progressively improved (relative PPV = 0.58, 95% CI = 0.33 to 0.98 and relative PPV = 0.75, 95% CI = 0.45 and 1.27, respectively). Referral based on liquid-based cytology alone did not increase sensitivity compared with conventional cytology (relative sensitivity = 1.06; 95% CI = 0.72 to 1.55) but reduced PPV (relative PPV = 0.57; 95% CI = 0.39 to 0.82). HPV testing alone was more sensitive than conventional cytology among women 35-60 years old. Adding liquid-based cytology improved sensitivity only marginally but increased false-positives. HPV testing using Hybrid Capture 2 with a 2 pg/mL cutoff may be more appropriate than a 1 pg/mL cutoff for primary cervical cancer screening.

ARM/GCSS/SPARC TWP-ICE CRM Intercomparison Study

NASA Technical Reports Server (NTRS)

Fridlind, Ann; Ackerman, Andrew; Petch, Jon; Field, Paul; Hill, Adrian; McFarquhar, Greg; Xie, Shaocheng; Zhang, Minghua

2010-01-01

Specifications are provided for running a cloud-resolving model (CRM) and submitting results in a standardized format for inclusion in a n intercomparison study and archiving for public access. The simulated case study is based on measurements obtained during the 2006 Tropical Warm Pool - International Cloud Experiment (TWP-ICE) led by the U. S. department of Energy Atmospheric Radiation Measurement (ARM) program. The modeling intercomparison study is based on objectives developed in concert with the Stratospheric Processes And their Role in Climate (SPARC) program and the GEWEX cloud system study (GCSS) program. The Global Energy and Water Cycle Experiment (GEWEX) is a core project of the World Climate Research PRogramme (WCRP).

Adaptive Control Strategies for Flexible Robotic Arm

NASA Technical Reports Server (NTRS)

Bialasiewicz, Jan T.

1996-01-01

The control problem of a flexible robotic arm has been investigated. The control strategies that have been developed have a wide application in approaching the general control problem of flexible space structures. The following control strategies have been developed and evaluated: neural self-tuning control algorithm, neural-network-based fuzzy logic control algorithm, and adaptive pole assignment algorithm. All of the above algorithms have been tested through computer simulation. In addition, the hardware implementation of a computer control system that controls the tip position of a flexible arm clamped on a rigid hub mounted directly on the vertical shaft of a dc motor, has been developed. An adaptive pole assignment algorithm has been applied to suppress vibrations of the described physical model of flexible robotic arm and has been successfully tested using this testbed.

Expectations, effect and experiences of an easily accessible self-management intervention for people with chronic pain: study protocol for a randomised controlled trial with embedded qualitative study.

PubMed

Nøst, Torunn Hatlen; Steinsbekk, Aslak; Bratås, Ola; Grønning, Kjersti

2016-07-18

People struggling with chronic pain may benefit from different types of non-pharmacological interventions such as self-management courses. Self-management courses aim to increase participants' skills and knowledge in managing chronic conditions. Community health-care services in Norway have increasingly established Healthy Life Centres (HLCs) to offer easily accessible interventions to people in need of support to better handle a life with chronic illness. The aim of this trial is to investigate the expectations, effect and experience of an easily accessible, group-based self-management course delivered at a HLC for people with chronic pain. This is an open pragmatic two-armed randomised controlled trial with an embedded qualitative study. The intervention is a self-management course comprising education, discussions, exchange of experiences between the participants, and physical movement exercises. The control group is offered a drop-in outdoor physical activity. The intervention period is 6 weeks. The primary outcome is patient activation measured by the patient activation measure (PAM). The secondary outcomes include measures of self-efficacy, pain and quality of life. Data will be collected at baseline, and after 3, 6 and 12 months. Using a mixed linear model, the number needed in each arm to achieve a power of 80 % becomes 55. To allow for dropout, the aim is to include 120 participants. Analysis will be done using mixed linear models. In the embedded qualitative study, we will perform semi-structured face-to-face interviews with a sample from both trial arms before randomisation and after 3 and 12 months. The topics elaborated will be motivation for participation and experiences with the activity related to possible changes in managing and coping with chronic pain. There is need for more knowledge on interventions delivering self-care support in an easily accessible way that aim to reach those in need of this kind of health service. This trial will produce important knowledge on the effect and the experiences of participants in such an easily accessible self-management course delivered in Norwegian public primary care. ClinicalTrials.gov: NCT02531282 . Registered on 21 August 2015.

Pandora’s Box: Lethally-Armed Ground Robots in Operations in Iraq and Afghanistan

DTIC Science & Technology

2010-10-27

Others debate whether Isaac Asimov ‟s famous Three Laws of Robotics (featured in his book I, Robot and the movie of the same name) could be applied in...http://www.tgdaily.com/hardware-features/43441-engineers-rewrite- asimovs -three- laws (accessed 7 September 2010).

National Guard and Reserve Access to Counsel Act

THOMAS, 113th Congress

Sen. Klobuchar, Amy [D-MN

2014-09-17

Senate - 09/17/2014 Read twice and referred to the Committee on Armed Services. (All Actions) Notes: For further action, see H.R.3979, which became Public Law 113-291 on 12/19/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

The Prospects for Security Sector Reform in Tunisia: A Year After the Revolution

DTIC Science & Technology

2012-09-01

included.86 This single, easily accessible, and searchable resource for all laws and amendments pertaining to the secu- rity sector greatly enhances ...Reform of the Peni - tentiary System,” Geneva Centre for the Democratic Control of Armed Forces, DCAF-Tunisie, October 5, 2011, available from dcaf

Mechanisms of Injury and Countermeasures for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

NASA Technical Reports Server (NTRS)

Jones, Jeff; Hoffman, Ron; Harvey, Craig; Bowen, C. K.; Hudy, C. E.; Tuxhorn, Jennifer; Gernhardt, Mike; Scheuring, Richard A.

2007-01-01

The goal of this study is to determine the role that moisture plays in the injury to the fingers and fingernails during EVA training operations in the Neutral Buoyancy Laboratory. Current Extravehicular Mobility Unit (EMU, with a PLSS) as configured in the NBL was used for all testing and a vent tube was extended down a single arm of the crewmember during the test; vent tube was moved between left and right arm to serve as experimental condition being investigated and the other arm served as control condition.

Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of the SPORTSMART pilot randomised controlled trial

PubMed Central

Jackson, Louise J; Roberts, Tracy E; Fuller, Sebastian S; Sutcliffe, Lorna J; Saunders, John M; Copas, Andrew J; Mercer, Catherine H; Cassell, Jackie A; Estcourt, Claudia S

2015-01-01

Background The objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains. Methods A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively. Results There was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm. Conclusions Costs and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated. PMID:25512670

Beam rider for an Articulated Robot Manipulator (ARM) accurate positioning of long flexible manipulators

NASA Technical Reports Server (NTRS)

Malachowski, M. J.

1990-01-01

Laser beam positioning and beam rider modules were incorporated into the long hollow flexible segment of an articulated robot manipulator (ARM). Using a single laser beam, the system determined the position of the distal ARM endtip, with millimetric precision, in six degrees of freedom, at distances of up to 10 meters. Preliminary designs, using space rated technology for the critical systems, of a two segmented physical ARM, with a single and a dual degree of freedom articulation, were developed, prototyped, and tested. To control the positioning of the physical ARM, an indirect adaptive controller, which used the mismatch between the position of the laser beam under static and dynamic conditions, was devised. To predict the behavior of the system and test the concept, a computer simulation model was constructed. A hierarchical artificially intelligent real time ADA operating system program structure was created. The software was designed for implementation on a dedicated VME bus based Intel 80386 administered parallel processing multi-tasking computer system.

Reliability of the Straight-Arm Hang for Testing Muscular Endurance among Children 2 to 5.

ERIC Educational Resources Information Center

Gabbard, Carl; And Others

1979-01-01

The straight-arm hang as a reliable testing instrument for young children is investigated with results indicating that it is a reliable indicator for four- and five-year-old children. Questionable results may occur if utilized for younger subjects and further investigation is recommended for six-to-nine-year-old subjects. (JD)

Constraining early and interacting dark energy with gravitational wave standard sirens: the potential of the eLISA mission

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

Caprini, Chiara; Tamanini, Nicola, E-mail: chiara.caprini@cea.fr, E-mail: nicola.tamanini@cea.fr

We perform a forecast analysis of the capability of the eLISA space-based interferometer to constrain models of early and interacting dark energy using gravitational wave standard sirens. We employ simulated catalogues of standard sirens given by merging massive black hole binaries visible by eLISA, with an electromagnetic counterpart detectable by future telescopes. We consider three-arms mission designs with arm length of 1, 2 and 5 million km, 5 years of mission duration and the best-level low frequency noise as recently tested by the LISA Pathfinder. Standard sirens with eLISA give access to an intermediate range of redshift 1 ∼< zmore » ∼< 8, and can therefore provide competitive constraints on models where the onset of the deviation from ΛCDM (i.e. the epoch when early dark energy starts to be non-negligible, or when the interaction with dark matter begins) occurs relatively late, at z ∼< 6. If instead early or interacting dark energy is relevant already in the pre-recombination era, current cosmological probes (especially the cosmic microwave background) are more efficient than eLISA in constraining these models, except possibly in the interacting dark energy model if the energy exchange is proportional to the energy density of dark energy.« less

Acceleration of fluoro-CT reconstruction for a mobile C-Arm on GPU and FPGA hardware: a simulation study

NASA Astrophysics Data System (ADS)

Xue, Xinwei; Cheryauka, Arvi; Tubbs, David

2006-03-01

CT imaging in interventional and minimally-invasive surgery requires high-performance computing solutions that meet operational room demands, healthcare business requirements, and the constraints of a mobile C-arm system. The computational requirements of clinical procedures using CT-like data are increasing rapidly, mainly due to the need for rapid access to medical imagery during critical surgical procedures. The highly parallel nature of Radon transform and CT algorithms enables embedded computing solutions utilizing a parallel processing architecture to realize a significant gain of computational intensity with comparable hardware and program coding/testing expenses. In this paper, using a sample 2D and 3D CT problem, we explore the programming challenges and the potential benefits of embedded computing using commodity hardware components. The accuracy and performance results obtained on three computational platforms: a single CPU, a single GPU, and a solution based on FPGA technology have been analyzed. We have shown that hardware-accelerated CT image reconstruction can be achieved with similar levels of noise and clarity of feature when compared to program execution on a CPU, but gaining a performance increase at one or more orders of magnitude faster. 3D cone-beam or helical CT reconstruction and a variety of volumetric image processing applications will benefit from similar accelerations.

Bill seeks discharge of all HIV-positive military personnel.

PubMed

1995-06-02

Legislation, introduced in Congress and sponsored by Rep. Robert Dornan, R-Calif., would give an honorary discharge within six months to any military service member who tests positive for HIV antibodies. Those discharged would be assured access to veterans' health services. The existing military policy bars entry to recruits who test positive during fitness exams, but service members who become infected during their military careers are allowed to remain on duty as long as they are physically able. Dornan and other Republicans contend that having service members who are HIV-positive reduces the nation's military readiness. However, military officials do not advocate the legislation and say it is not needed. Dornan has failed in the past to force HIV-positive service members out of the military. However, with the Republican House, Democrats believe Dornan stands a good chance of passing the bill. The Pentagon's most recent figures show that 1,214 of the 1.6 million members of the armed forces are HIV-positive.

DEVELOPMENT OF IMPROVED TECHNIQUES FOR SATELLITE REMOTE SENSING OF CLOUDS AND RADIATION USING ARM DATA, FINAL REPORT

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

Minnis, Patrick

2013-06-28

During the period, March 1997 – February 2006, the Principal Investigator and his research team co-authored 47 peer-reviewed papers and presented, at least, 138 papers at conferences, meetings, and workshops that were supported either in whole or in part by this agreement. We developed a state-of-the-art satellite cloud processing system that generates cloud properties over the Atmospheric Radiation (ARM) surface sites and surrounding domains in near-real time and outputs the results on the world wide web in image and digital formats. When the products are quality controlled, they are sent to the ARM archive for further dissemination. These products andmore » raw satellite images can be accessed at http://cloudsgate2.larc.nasa.gov/cgi-bin/site/showdoc?docid=4&cmd=field-experiment-homepage&exp=ARM and are used by many in the ARM science community. The algorithms used in this system to generate cloud properties were validated and improved by the research conducted under this agreement. The team supported, at least, 11 ARM-related or supported field experiments by providing near-real time satellite imagery, cloud products, model results, and interactive analyses for mission planning, execution, and post-experiment scientific analyses. Comparisons of cloud properties derived from satellite, aircraft, and surface measurements were used to evaluate uncertainties in the cloud properties. Multiple-angle satellite retrievals were used to determine the influence of cloud structural and microphysical properties on the exiting radiation field.« less

Network of movement and proximity sensors for monitoring upper-extremity motor activity after stroke: proof of principle.

PubMed

Sokal, Brad; Uswatte, Gitendra; Barman, Joydip; Brewer, Michael; Byrom, Ezekiel; Latten, Jessica; Joseph, Jeethu; Serafim, Camila; Ghaffari, Touraj; Sarkar, Nilanjan

2014-03-01

To test the convergent validity of an objective method, Sensor-Enabled Radio-frequency Identification System for Monitoring Arm Activity (SERSMAA), that distinguishes between functional and nonfunctional activity. Cross-sectional study. Laboratory. Participants (N=25) were ≥0.2 years poststroke (median, 9) with a wide range of severity of upper-extremity hemiparesis. Not applicable. After stroke, laboratory tests of the motor capacity of the more-affected arm poorly predict spontaneous use of that arm in daily life. However, available subjective methods for measuring everyday arm use are vulnerable to self-report biases, whereas available objective methods only provide information on the amount of activity without regard to its relation with function. The SERSMAA consists of a proximity-sensor receiver on the more-affected arm and multiple units placed on objects. Functional activity is signaled when the more-affected arm is close to an object that is moved. Participants were videotaped during a laboratory simulation of an everyday activity, that is, setting a table with cups, bowls, and plates instrumented with transmitters. Observers independently coded the videos in 2-second blocks with a validated system for classifying more-affected arm activity. There was a strong correlation (r=.87, P<.001) between time that the more-affected arm was used for handling objects according to the SERSMAA and functional activity according to the observers. The convergent validity of SERSMAA for measuring more-affected arm functional activity after stroke was supported in a simulation of everyday activity. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Test Operations Procedure (TOP) 03-2-504A Safety Evaluation of Small Arms and Medium Caliber Weapons

DTIC Science & Technology

2013-05-29

Assessment HHAR Health Hazard Assessment Report HERO Hazards of Electromagnetic Radiation to Ordnance in. inch J Joule km/hr kilometers per hour...help standardize testing and to specify tests commonly used to identify and assess safety hazards associated with the use of small arms. The...19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39-18

Effect of integrated capacity-building interventions on malaria case management by health professionals in Uganda: a mixed design study with pre/post and cluster randomized trial components.

PubMed

Mbonye, Martin Kayitale; Burnett, Sarah M; Burua, Aldomoro; Colebunders, Robert; Crozier, Ian; Kinoti, Stephen N; Ronald, Allan; Naikoba, Sarah; Rubashembusya, Timothy; Van Geertruyden, Jean-Pierre; Willis, Kelly S; Weaver, Marcia R

2014-01-01

The Integrated Infectious Diseases Capacity Building Evaluation (IDCAP) designed two interventions: Integrated Management of Infectious Disease (IMID) training program and On-Site Support (OSS). We evaluated their effects on 23 facility performance indicators, including malaria case management. IMID, a three-week training with two follow-up booster courses, was for two mid- level practitioners, primarily clinical officers and registered nurses, from 36 primary care facilities. OSS was two days of training and continuous quality improvement activities for nine months at 18 facilities, to which all health workers were invited to participate. Facilities were randomized as clusters 1∶1 to parallel OSS "arm A" or control "arm B". Outpatient data on four malaria case management indicators were collected for 14 months. Analysis compared changes before and during the interventions within arms (relative risk = RR). The effect of OSS was measured with the difference in changes across arms (ratio of RR = RRR). The proportion of patients with suspected malaria for whom a diagnostic test result for malaria was recorded decreased in arm B (adjusted RR (aRR) = 0.97; 99%CI: 0.82,1.14) during IMID, but increased 25% in arm A (aRR = 1.25; 99%CI:0.94, 1.65) during IMID and OSS relative to baseline; (aRRR = 1.28; 99%CI:0.93, 1.78). The estimated proportion of patients that received an appropriate antimalarial among those prescribed any antimalarial increased in arm B (aRR = 1.09; 99%CI: 0.87, 1.36) and arm A (aRR = 1.50; 99%CI: 1.04, 2.17); (aRRR = 1.38; 99%CI: 0.89, 2.13). The proportion of patients with a negative diagnostic test result for malaria prescribed an antimalarial decreased in arm B (aRR = 0.96; 99%CI: 0.84, 1.10) and arm A (aRR = 0.67; 99%CI: 0.46, 0.97); (aRRR = 0.70; 99%CI: 0.48, 1.00). The proportion of patients with a positive diagnostic test result for malaria prescribed an antibiotic did not change significantly in either arm. The combination of IMID and OSS was associated with statistically significant improvements in malaria case management.

Evaluation of generic medical information accessed via mobile phones at the point of care in resource-limited settings

PubMed Central

Goldbach, Hayley; Chang, Aileen Y; Kyer, Andrea; Ketshogileng, Dineo; Taylor, Lynne; Chandra, Amit; Dacso, Matthew; Kung, Shiang-Ju; Rijken, Taatske; Fontelo, Paul; Littman-Quinn, Ryan; Seymour, Anne K; Kovarik, Carrie L

2014-01-01

Objective Many mobile phone resources have been developed to increase access to health education in the developing world, yet few studies have compared these resources or quantified their performance in a resource-limited setting. This study aims to compare the performance of resident physicians in answering clinical scenarios using PubMed abstracts accessed via the PubMed for Handhelds (PubMed4Hh) website versus medical/drug reference applications (Medical Apps) accessed via software on the mobile phone. Methods A two-arm comparative study with crossover design was conducted. Subjects, who were resident physicians at the University of Botswana, completed eight scenarios, each with multi-part questions. The primary outcome was a grade for each question. The primary independent variable was the intervention arm and other independent variables included residency and question. Results Within each question type there were significant differences in ‘percentage correct’ between Medical Apps and PubMed4Hh for three of the six types of questions: drug-related, diagnosis/definitions, and treatment/management. Within each of these question types, Medical Apps had a higher percentage of fully correct responses than PubMed4Hh (63% vs 13%, 33% vs 12%, and 41% vs 13%, respectively). PubMed4Hh performed better for epidemiologic questions. Conclusions While mobile access to primary literature remains important and serves an information niche, mobile applications with condensed content may be more appropriate for point-of-care information needs. Further research is required to examine the specific information needs of clinicians in resource-limited settings and to evaluate the appropriateness of current resources in bridging location- and context-specific information gaps. PMID:23535665

Arteriovenous Hybrid Graft with Outflow in the Proximal Axillary Vein.

PubMed

Murga, Allen G; Chiriano, Jason; Kiang, Sharon C; Patel, Sheela; Bianchi, Christian; Abou-Zamzam, Ahmed M; Teruya, Theodore H

2017-07-01

The patency of long-term hemodialysis access in end-stage renal disease patients remains a significant challenge. Often these patients are affected with limited venous outflow options, requiring limb abandonment, and creation of new access in the contralateral arm. Vascular surgeons are familiar with the exposure of the proximal axillary artery via an infraclavicular incision. The axillary vein is easily exposed through this technique. The use of the hybrid Gore graft can make the venous anastomosis easier. A hybrid graft with its venous outflow placed in the proximal axillary vein can extend the options of upper extremity access procedures. We reviewed our early experience with this technique. A review of dialysis procedures at the Loma Linda VA was performed. All patients undergoing placement of arteriovenous grafts utilizing the Gore hybrid placed into the proximal axillary vein for outflow were identified. Outcomes in terms of primary and secondary patency rates were determined. Eight patients had placement of an arteriovenous hybrid graft in the proximal axillary vein via an infraclavicular incision. All patients had exhausted other options for hemodialysis access in the ipsilateral upper extremity. All grafts were used successfully for dialysis. The mean primary and secondary patency rates at 6 months were 37.5% and 62.5%, respectively. One patient developed steal syndrome, requiring proximalization of the graft. Seven out of the 8 patients required secondary procedures including thrombectomy (n = 16) and angioplasty (n = 17). Placement of a hybrid graft in the proximal axillary vein is an effective and suitable option for patients who have exhausted arteriovenous access sites in the arm. This procedure can easily be performed in an outpatient setting with a low complication rate and allowing for preservation of the contralateral upper extremity for future use. Published by Elsevier Inc.

A randomized controlled trial of Human Papillomavirus (HPV) testing for cervical cancer screening: trial design and preliminary results (HPV FOCAL Trial)

PubMed Central

2010-01-01

Background In the HPV FOCAL trial, we will establish the efficacy of hr-HPV DNA testing as a stand-alone screening test followed by liquid based cytology (LBC) triage of hr-HPV-positive women compared to LBC followed by hr-HPV triage with ≥ CIN3 as the outcome. Methods/Design HPV-FOCAL is a randomized, controlled, three-armed study over a four year period conducted in British Columbia. It will recruit 33,000 women aged 25-65 through the province's population based cervical cancer screening program. Control arm: LBC at entry and two years, and combined LBC and hr-HPV at four years among those with initial negative results and hr-HPV triage of ASCUS cases; Two Year Safety Check arm: hr-HPV at entry and LBC at two years in those with initial negative results with LBC triage of hr-HPV positives; Four Year Intervention Arm: hr-HPV at entry and combined hr-HPV and LBC at four years among those with initial negative results with LBC triage of hr-HPV positive cases Discussion To date, 6150 participants have a completed sample and epidemiologic questionnaire. Of the 2019 women enrolled in the control arm, 1908 (94.5%) were cytology negative. Women aged 25-29 had the highest rates of HSIL (1.4%). In the safety arm 92.2% of women were hr-HPV negative, with the highest rate of hr-HPV positivity found in 25-29 year old women (23.5%). Similar results were obtained in the intervention arm HPV FOCAL is the first randomized trial in North America to examine hr-HPV testing as the primary screen for cervical cancer within a population-based cervical cancer screening program. Trial Registration International Standard Randomised Controlled Trial Number Register, ISRCTN79347302 PMID:20334685

Kinematics of preferred and non-preferred handballing in Australian football.

PubMed

Parrington, Lucy; Ball, Kevin; MacMahon, Clare

2015-01-01

In Australian football (AF), handballing proficiently with both the preferred and non-preferred arm is important at elite levels; yet, little information is available for handballing on the non-preferred arm. This study compared preferred and non-preferred arm handballing techniques. Optotrak Certus (100 Hz) collected three-dimensional data for 19 elite AF players performing handballs with the preferred and non-preferred arms. Position data, range of motion (ROM), and linear and angular velocities were collected and compared between preferred and non-preferred arms using dependent t-tests. The preferred arm exhibited significantly greater forearm and humerus ROM and angular velocity and significantly greater shoulder angular velocity at ball contact compared to the non-preferred arm. In addition, the preferred arm produced a significantly greater range of lateral bend and maximum lower-trunk speed, maximum strike-side hip speed and hand speed at ball contact than the non-preferred arm. The non-preferred arm exhibited a significantly greater shoulder angle and lower- and upper-trunk orientation angle, but significantly lower support-elbow angle, trunk ROM, and trunk rotation velocity compared to the preferred arm. Reduced ROM and angular velocities found in non-preferred arm handballs indicates a reduction in the degrees of freedom and a less developed skill. Findings have implication for development of handballing on the non-preferred arm.

Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda.

PubMed

Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham; Clarke, Siân E

2017-06-01

In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision, allowances for CHWs and provision of mRDTs and ACTs. The opportunity costs of time utilised by CHWs were estimated based on self-reporting. Household costs of subsequent treatment-seeking at public health centres and private health providers were captured in a sample of households. mRDTs performed by CHWs was associated with large improvements in appropriate treatment of malaria in both transmission settings. This resulted in low incremental costs for the health sector at US$3.0 per appropriately treated child in the moderate-to-high transmission area. Higher incremental costs at US$13.3 were found in the low transmission area due to lower utilisation of CHW services and higher programme costs. Incremental costs from a societal perspective were marginally higher. The use of mRDTs by CHWs improved the targeting of ACTs to children with malaria and was likely to be considered a cost-effective intervention compared to a presumptive diagnosis in the moderate-to-high transmission area. In contrast to this, in the low transmission area with low attendance, RDT use by CHWs was not a low cost intervention. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda

PubMed Central

Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham; Clarke, Siân E

2017-01-01

Abstract In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever ‘appropriately treated for malaria with ACT’ were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision, allowances for CHWs and provision of mRDTs and ACTs. The opportunity costs of time utilised by CHWs were estimated based on self-reporting. Household costs of subsequent treatment-seeking at public health centres and private health providers were captured in a sample of households. mRDTs performed by CHWs was associated with large improvements in appropriate treatment of malaria in both transmission settings. This resulted in low incremental costs for the health sector at US$3.0 per appropriately treated child in the moderate-to-high transmission area. Higher incremental costs at US$13.3 were found in the low transmission area due to lower utilisation of CHW services and higher programme costs. Incremental costs from a societal perspective were marginally higher. The use of mRDTs by CHWs improved the targeting of ACTs to children with malaria and was likely to be considered a cost-effective intervention compared to a presumptive diagnosis in the moderate-to-high transmission area. In contrast to this, in the low transmission area with low attendance, RDT use by CHWs was not a low cost intervention. PMID:28453718

75 FR 22384 - Ball Bearings and Parts Thereof From France, Germany, Italy, Japan, and the United Kingdom...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-28

... orders cover all the subject bearings and parts thereof (inner race, outer race, cage, rollers, balls... producer, i.e., sales were made at arm's-length prices. See 19 CFR 351.403(c). We excluded from our... arm's-length prices. To test whether these sales were made at arm's-length prices, we compared the...

Patterns of Transfer of Adaptation Among Body Segments

NASA Technical Reports Server (NTRS)

Seidler, R. D.; Bloomberg, J. J.; Stelmach, George E.

2000-01-01

Two experiments were conducted in order to determine the patterns of transfer of visuomotor adaptation between arm and head pointing. An altered gain of display of pointing movements was used to induce a conflict between visual and somatosensory representations. Two subject groups participated in Experiment One: group 1 adapted shoulder pointing movements, and group 2 adapted wrist pointing movements to a 0.5 gain of display. Following the adaptation regimen, subjects performed a transfer test in which the shoulder group performed wrist movements and the wrist group performed shoulder movements. The results demonstrated that both groups displayed typical adaptation curves, initially undershooting the target followed by a return to baseline performance. Transfer tests revealed that both groups had high transfer of the acquired adaptation to the other joint. Experiment Two followed a similar design except that group 1 adapted head pointing movements and group 2 adapted arm pointing movements. The arm adaptation had high transfer to head pointing while the head adaptation had very little transfer to arm pointing. These results imply that, while the arm segments may share a common target representation for goal-directed actions, individual but functionally dependent target representations may exist for the control of head and arm movements.

Design of the arm-wrestling robot's force acquisition system based on Qt

NASA Astrophysics Data System (ADS)

Huo, Zhixiang; Chen, Feng; Wang, Yongtao

2017-03-01

As a collection of entertainment and medical rehabilitation in a robot, the research on the arm-wrestling robot is of great significance. In order to achieve the collection of the arm-wrestling robot's force signals, the design and implementation of arm-wrestling robot's force acquisition system is introduced in this paper. The system is based on MP4221 data acquisition card and is programmed by Qt. It runs successfully in collecting the analog signals on PC. The interface of the system is simple and the real-time performance is good. The result of the test shows the feasibility in arm-wrestling robot.

An adaptive controller for enhancing operator performance during teleoperation

NASA Technical Reports Server (NTRS)

Carignan, Craig R.; Tarrant, Janice M.; Mosier, Gary E.

1989-01-01

An adaptive controller is developed for adjusting robot arm parameters while manipulating payloads of unknown mass and inertia. The controller is tested experimentally in a master/slave configuration where the adaptive slave arm is commanded via human operator inputs from a master. Kinematically similar six-joint master and slave arms are used with the last three joints locked for simplification. After a brief initial adaptation period for the unloaded arm, the slave arm retrieves different size payloads and maneuvers them about the workspace. Comparisons are then drawn with similar tasks where the adaptation is turned off. Several simplifications of the controller dynamics are also addressed and experimentally verified.

Dealing with Sexual Assault, Challenges, and Insights

DTIC Science & Technology

2015-02-11

Services Committee. H.R. 1593 – Sexual Assault Training Oversight and Prevention Act or STOP Act (17 April 2013). https://www.congress.gov/bill/113th...congress/house-bill/ 1593 ?q=%7B%22search%22%3A%5B%22H.R. 1593 %22%5D%7D (accessed 17 October 2014). U.S. Senate Arms Services Committee. S.47 Bill...www.congress.gov/bill/113thcongress/housebill/ 1593 ?q=%7B%22 search%22%3A%5B%22H.R. 1593 %22%5D%7D (accessed 17 October 2014). Winerip, Michael

Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis.

PubMed

Tellis, V A; Kohlberg, W I; Bhat, D J; Driscoll, B; Veith, F J

1979-01-01

In a retrospective study of 66 PTFE arteriovenous fistulae and 71 BCH arteriovenous fistulae for dialysis access, PTFE had a higher patency rate than BCH at 12 months (62.4 versus 32.5%). PTFE was easier to work with and easier to handle in the face of infection. The lateral upper arm approach to placement of the PTFE graft is desirable in patients who have had multiple previous access procedures because this area is usually free from scarring, is distant from neurovascular structures, and provides a greater length of graft for needle punctures.

Effects of training with a passive hand orthosis and games at home in chronic stroke: a pilot randomised controlled trial.

PubMed

Nijenhuis, Sharon M; Prange-Lasonder, Gerdienke B; Stienen, Arno Ha; Rietman, Johan S; Buurke, Jaap H

2017-02-01

To compare user acceptance and arm and hand function changes after technology-supported training at home with conventional exercises in chronic stroke. Secondly, to investigate the relation between training duration and clinical changes. A randomised controlled trial. Training at home, evaluation at research institute. Twenty chronic stroke patients with severely to mildly impaired arm and hand function. Participants were randomly assigned to six weeks (30 minutes per day, six days a week) of self-administered home-based arm and hand training using either a passive dynamic wrist and hand orthosis combined with computerised gaming exercises (experimental group) or prescribed conventional exercises from an exercise book (control group). Main outcome measures are the training duration for user acceptance and the Action Research Arm Test for arm and hand function. Secondary outcomes are the Intrinsic Motivation Inventory, Fugl-Meyer assessment, Motor Activity Log, Stroke Impact Scale and grip strength. The control group reported a higher training duration (189 versus 118 minutes per week, P = 0.025). Perceived motivation was positive and equal between groups ( P = 0.935). No differences in clinical outcomes over training between groups were found (P ⩾ 0.165). Changes in Box and Block Test correlated positively with training duration ( P = 0.001). Both interventions were accepted. An additional benefit of technology-supported arm and hand training over conventional arm and hand exercises at home was not demonstrated. Training duration in itself is a major contributor to arm and hand function improvements.

Improving Latino disaster preparedness using social networks.

PubMed

Eisenman, David P; Glik, Deborah; Gonzalez, Lupe; Maranon, Richard; Zhou, Qiong; Tseng, Chi-Hong; Asch, Steven M

2009-12-01

Culturally targeted, informal social networking approaches to improving disaster preparedness have not been empirically tested. In partnership with community health promoters and the Los Angeles County Department of Public Health, this study tested a disaster preparedness program for Latino households. This study had a community-based, randomized, longitudinal cohort design with two groups and was conducted during February-October 2007. Assessments were made at baseline and 3 months. Analyses were carried out January-October 2008. Community-based study of 231 Latinos living in Los Angeles County. Participants were randomly assigned to attending platicas (small-group discussions led by a health promoter/promotora de salud) or receiving "media" (a culturally tailored mailer). A total of 187 (81.0%) completed the 3-month follow-up. A self-reported disaster preparedness checklist was used. Among participants who did not have emergency water pre-intervention, 93.3% of those in the platica arm had it at follow-up, compared to 66.7% in the media arm (p=0.003). Among participants who did not have food pre-intervention, 91.7% in the platica arm reported it at follow-up, compared to 60.6% in the media arm (p=0.013). Finally, among participants who did not have a family communication plan pre-intervention, 70.4% in the platica arm reported one at follow-up, compared to 42.3% in the media arm (p=0.002). Although both arms improved in stockpiling water and food and creating a communication plan, the platica arm showed greater improvement than the media group.

Spinal ultrasound in patients with anorectal malformations: is this the end of an era?

PubMed

Scottoni, Federico; Iacobelli, Barbara Daniela; Zaccara, Antonio Maria; Totonelli, Giorgia; Schingo, Antonio Maria Salvatore; Bagolan, Pietro

2014-08-01

Even if lumbar magnetic resonance imaging (MRI) is considered the gold standard in the diagnosis of occult spinal dysraphism (SD) in patients with anorectal malformations (ARMs), spinal ultrasound (US) performed up to 5 months of life have been largely used as a screening test. The aim of the present study was to evaluate the accuracy in terms of sensibility and specificity of neonatal US to detect occult SD in patients with ARMs. Retrospective analysis of all patients treated for ARMs between 1999 and 2013 at our institution who underwent both spinal US (up to 5 months of life) and MRI. Sensibility and specificity have been calculated for US based on MRI results. Of 244 patients treated for ARMs at our institution, 82 (34 females, 48 males) underwent both the imaging studies and have been included in this study. ARMs types were: anal stenosis (7), recto-vestibular fistula (19), recto-perineal fistula (3) and cloaca (5) in female and imperforate anus (7) recto-perineal fistula (14), recto-urethral fistula (22), recto-vesical fistula (5) in males. Forty-seven patients (57, 3 % of total, 18 females, 29 males) had some occult SD (tethered spinal cord, spinal lipoma, syringomyelia) at MRI. Only 7 (14, 8 %) patients of those with spinal anomalies at MRI had pathological US studies. In our population, sensibility and specificity of US for diagnosis of occult SD were, respectively, 14, 8 and 100 %. Since it is well known that a screening test must have a high sensibility, our data suggest that spinal ultrasound is not suitable as a screening test for occult spinal dysraphism in patients with ARMs. Furthermore, we strongly advise against the use of US as a screening test for spinal dysraphism to prevent a false sense of security in physician and patients' families.

Methodological issues with adaptation of clinical trial design.

PubMed

Hung, H M James; Wang, Sue-Jane; O'Neill, Robert T

2006-01-01

Adaptation of clinical trial design generates many issues that have not been resolved for practical applications, though statistical methodology has advanced greatly. This paper focuses on some methodological issues. In one type of adaptation such as sample size re-estimation, only the postulated value of a parameter for planning the trial size may be altered. In another type, the originally intended hypothesis for testing may be modified using the internal data accumulated at an interim time of the trial, such as changing the primary endpoint and dropping a treatment arm. For sample size re-estimation, we make a contrast between an adaptive test weighting the two-stage test statistics with the statistical information given by the original design and the original sample mean test with a properly corrected critical value. We point out the difficulty in planning a confirmatory trial based on the crude information generated by exploratory trials. In regards to selecting a primary endpoint, we argue that the selection process that allows switching from one endpoint to the other with the internal data of the trial is not very likely to gain a power advantage over the simple process of selecting one from the two endpoints by testing them with an equal split of alpha (Bonferroni adjustment). For dropping a treatment arm, distributing the remaining sample size of the discontinued arm to other treatment arms can substantially improve the statistical power of identifying a superior treatment arm in the design. A common difficult methodological issue is that of how to select an adaptation rule in the trial planning stage. Pre-specification of the adaptation rule is important for the practicality consideration. Changing the originally intended hypothesis for testing with the internal data generates great concerns to clinical trial researchers.

Piping inspection instrument carriage with precise and repeatable position control and location determination

DOEpatents

Hapstack, M.; Talarek, T.R.; Zollinger, W.T.; Heckendorn, F.M. II; Park, L.R.

1994-02-15

An instrument carriage for inspection of piping comprises front and rear leg assemblies for engaging the interior of the piping and supporting and centering the carriage therein, and an instrumentation arm carried by a shaft system running from the front to rear leg assemblies. The shaft system has a screw shaft for moving the arm axially and a spline gear for moving the arm azimuthally. The arm has a pair of air cylinders that raise and lower a plate in the radial direction. On the plate are probes including an eddy current probe and an ultrasonic testing probe. The ultrasonic testing probe is capable of spinning 360[degree] about its axis. The instrument carriage uses servo motors and pressurized air cylinders for precise actuation of instrument components and precise, repeatable actuation of position control mechanisms. 8 figures.

Piping inspection instrument carriage with precise and repeatable position control and location determination

DOEpatents

Hapstack, Mark; Talarek, Ted R.; Zollinger, W. Thor; Heckendorn, II, Frank M.; Park, Larry R.

1994-01-01

An instrument carriage for inspection of piping comprises front and rear leg assemblies for engaging the interior of the piping and supporting and centering the carriage therein, and an instrumentation arm carried by a shaft system running from the front to rear leg assemblies. The shaft system has a screw shaft for moving the arm axially and a spline gear for moving the arm azimuthally. The arm has a pair of air cylinders that raise and lower a plate in the radial direction. On the plate are probes including an eddy current probe and an ultrasonic testing probe. The ultrasonic testing probe is capable of spinning 360.degree. about its axis. The instrument carriage uses servo motors and pressurized air cylinders for precise actuation of instrument components and precise, repeatable actuation of position control mechanisms.

Oral language supports early literacy: a pilot cluster randomized trial in disadvantaged schools.

PubMed

Snow, Pamela C; Eadie, Patricia A; Connell, Judy; Dalheim, Brenda; McCusker, Hugh J; Munro, John K

2014-10-01

This study examined the impact of teacher professional development aimed at improving the capacity of primary teachers in disadvantaged schools to strengthen children's expressive and receptive oral language skills and early literacy success in the first 2 years of school. Fourteen low-SES schools in Victoria, Australia were randomly allocated to a research (n = 8) or control arm (n = 6), resulting in an initial sample of 1254 students, (n = 602 in research arm and n = 652 in control arm). The intervention comprised 6 days of teacher and principal professional development (delivered by language and literacy experts), school-based continuing contact with the research team and completion by one staff member of each research school of a postgraduate unit on early language and literacy. Schools in the control arm received standard teaching according to state auspiced curriculum guidelines. Full data were available on 979 students at follow-up (time 2). Students in the research arm performed significantly better on Test of Language Development: Primary (Fourth Edition) sub-tests (p ≤ .002) and the Reading Progress Test (F = 10.4(1); p = .001) than students in the control arm at time 2. Narrative scores were not significantly different at time 2, although students in research schools showed greater gains. Findings provide "proof of concept" for this approach, and are discussed with respect to implications for teacher professional development and pre-service education concerning the psycholinguistic competencies that underpin the transition to literacy.

Effects of a Home-Based Upper Limb Training Program in Patients With Multiple Sclerosis: A Randomized Controlled Trial.

PubMed

Ortiz-Rubio, Araceli; Cabrera-Martos, Irene; Rodríguez-Torres, Janet; Fajardo-Contreras, Waldo; Díaz-Pelegrina, Ana; Valenza, Marie Carmen

2016-12-01

To evaluate the effects of a home-based upper limb training program on arm function in patients with multiple sclerosis (MS). Additionally, the effects of this program on manual dexterity, handgrip strength, and finger prehension force were analyzed. Randomized, single-blind controlled trial. Home based. Patients with a clinical diagnosis of MS acknowledging impaired manual ability (N=37) were randomized into 2 groups. Patients in the experimental group were included in a supervised home-based upper limb training program for 8 weeks twice a week. Patients in the control group received information in the form of a leaflet with a schedule of upper limb exercise training. The primary outcome measure was arm function (motor functioning assessed using the finger tapping test and a functional measure, the Action Research Arm Test). The secondary outcome measures were manual dexterity assessed with the Purdue Pegboard Test and handgrip strength and finger prehension force evaluated with a handgrip and a pinch dynamometer, respectively. After 8 weeks, a significant between-group improvement (P<.05) was found on the Action Research Arm Test bilaterally and the finger tapping test in the most affected upper limb. The secondary outcomes also improved in the most affected limb in the experimental group. An 8-week home-based intervention program focused on upper limbs twice a week improved arm function and physiologic variables with a primary focus on the more affected extremity in patients with MS compared with the control group. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Building research capacity in Botswana: a randomized trial comparing training methodologies in the Botswana ethics training initiative.

PubMed

Barchi, Francis H; Kasimatis-Singleton, Megan; Kasule, Mary; Khulumani, Pilate; Merz, Jon F

2013-02-01

Little empirical data are available on the extent to which capacity-building programs in research ethics prepare trainees to apply ethical reasoning skills to the design, conduct, or review of research. A randomized controlled trial was conducted in Botswana in 2010 to assess the effectiveness of a case-based intervention using email to augment in-person seminars. University faculty and current and prospective IRB/REC members took part in a semester-long training program in research ethics. Participants attended two 2-day seminars and were assigned at random to one of two on-line arms of the trial. Participants in both arms completed on-line international modules from the Collaborative Institutional Training Initiative. Between seminars, intervention-arm participants were also emailed a weekly case to analyze in response to set questions; responses and individualized faculty feedback were exchanged via email. Tests assessing ethics knowledge were administered at the start of each seminar. The post-test included an additional section in which participants were asked to identify the ethical issues highlighted in five case studies from a list of multiple-choice responses. Results were analyzed using regression and ANOVA. Of the 71 participants (36 control, 35 intervention) enrolled at the first seminar, 41 (57.7%) attended the second seminar (19 control, 22 intervention). In the intervention arm, 19 (54.3%) participants fully completed and 8 (22.9%) partially completed all six weekly cases. The mean score was higher on the post-test (30.3/40) than on the pre-test (28.0/40), and individual post- and pre-test scores were highly correlated (r = 0.65, p < 0.0001). Group assignment alone did not have an effect on test scores (p > 0.84), but intervention-arm subjects who completed all assigned cases answered an average of 3.2 more questions correctly on the post-test than others, controlling for pre-test scores (p = 0.003). Completion of the case-based intervention improved respondents' test scores, with those who completed all six email cases scoring roughly 10% better than those who failed to complete this task and those in the control arm. There was only suggestive evidence that intensive case work improved ethical issue identification, although there was limited ability to assess this outcome due to a high drop-out rate.

Building research capacity in Botswana: a randomized trial comparing training methodologies in the Botswana ethics training initiative

PubMed Central

2013-01-01

Background Little empirical data are available on the extent to which capacity-building programs in research ethics prepare trainees to apply ethical reasoning skills to the design, conduct, or review of research. A randomized controlled trial was conducted in Botswana in 2010 to assess the effectiveness of a case-based intervention using email to augment in-person seminars. Methods University faculty and current and prospective IRB/REC members took part in a semester-long training program in research ethics. Participants attended two 2-day seminars and were assigned at random to one of two on-line arms of the trial. Participants in both arms completed on-line international modules from the Collaborative Institutional Training Initiative. Between seminars, intervention-arm participants were also emailed a weekly case to analyze in response to set questions; responses and individualized faculty feedback were exchanged via email. Tests assessing ethics knowledge were administered at the start of each seminar. The post-test included an additional section in which participants were asked to identify the ethical issues highlighted in five case studies from a list of multiple-choice responses. Results were analyzed using regression and ANOVA. Results Of the 71 participants (36 control, 35 intervention) enrolled at the first seminar, 41 (57.7%) attended the second seminar (19 control, 22 intervention). In the intervention arm, 19 (54.3%) participants fully completed and 8 (22.9%) partially completed all six weekly cases. The mean score was higher on the post-test (30.3/40) than on the pre-test (28.0/40), and individual post- and pre-test scores were highly correlated (r = 0.65, p < 0.0001). Group assignment alone did not have an effect on test scores (p > 0.84), but intervention-arm subjects who completed all assigned cases answered an average of 3.2 more questions correctly on the post-test than others, controlling for pre-test scores (p = 0.003). Conclusions Completion of the case-based intervention improved respondents’ test scores, with those who completed all six email cases scoring roughly 10% better than those who failed to complete this task and those in the control arm. There was only suggestive evidence that intensive case work improved ethical issue identification, although there was limited ability to assess this outcome due to a high drop-out rate. PMID:23368699

Community-randomised controlled trial embedded in the Anishinaabek Cervical Cancer Screening Study: human papillomavirus self-sampling versus Papanicolaou cytology

PubMed Central

Zehbe, Ingeborg; Jackson, Robert; Wood, Brianne; Weaver, Bruce; Escott, Nicholas; Severini, Alberto; Krajden, Mel; Bishop, Lisa; Morrisseau, Kyla; Ogilvie, Gina; Burchell, Ann N; Little, Julian

2016-01-01

Objectives The incidence of cervical cancer is up to 20-fold higher among First Nations women in Canada than the general population, probably due to lower participation in screening. Offering human papillomavirus (HPV) self-sampling in place of Papanicolaou (Pap) testing may eventually increase screening participation and reduce cervical cancer rates in this population. Design A community-randomised controlled screening trial. Setting First Nations communities in Northwest Ontario, Canada. Participants Women aged between 25 and 69, living in Robinson Superior Treaty First Nations. The community was the unit of randomisation. Interventions Women were asked to complete a questionnaire and have screening by HPV self-sampling (arm A) or Pap testing (arm B). Primary outcome measures The number of women who participated in cervical screening. Randomisation Community clusters were randomised to include approximately equivalent numbers of women in each arm. Results 6 communities were randomised to arm A and 5 to arm B. One community withdrew, leaving 5 communities in each group (834 eligible women). Participation was <25%. Using clustered intention-to-treat (ITT) analysis, initial and cumulative averaged uptakes in arm A were 1.4-fold (20% vs 14.3%, p=0.628) and 1.3-fold (20.6% vs 16%, p=0.694) higher compared to arm B, respectively. Corresponding per protocol (PP) analysis indicates 2.2-fold (22.9% vs 10.6%, p=0.305) and 1.6-fold (22.9% vs 14.1%, p=0.448) higher uptakes in arm A compared to arm B. Screening uptake varied between communities (range 0–62.1%). Among women who completed a questionnaire (18.3% in arm A, 21.7% in arm B), the screening uptake was 1.8-fold (ITT; p=0.1132) or 3-fold (PP; p<0.01) higher in arm A versus arm B. Conclusions Pap and HPV self-sampling were compared in a marginalised, Canadian population. Results indicated a preference for self-sampling. More research on how to reach underscreened Indigenous women is necessary. Trial registration number ISRCTN84617261. PMID:27855089

The effect of an arm sling used for shoulder support on gait efficiency in hemiplegic patients with stroke using walking aids.

PubMed

Jeong, Yeon-Gyu; Jeong, Yeon-Jae; Koo, Jung-Wan

2017-06-01

The effects of an arm sling on the physiological costs of walking are not known. Even though a previous study reported that an arm sling can improve gait efficiency, its entrance criteria was only hemiparetic patients able to walk without walking aids independently. The aim of this study was to investigate the effect of shoulder support by an arm sling on gait efficiency in hemiplegic stroke patients using walking aids. Randomized crossover design. Rehabilitation department of a university hospital. A total of 57 hemiplegic patients with shoulder subluxation dependent on canes were grouped into single cane (N.=30) and quad cane groups (N.=27) as walking aids. All patients performed a walk with their own walking aid with and without an arm sling in randomized order, on the same day. We measured the energy cost and energy expenditure using a portable gas analyzer and heart rate during a 6-minutes Walk Test and a 10-m Walk Test. We analyzed all outcomes measures with and without an arm sling between the patients who were grouped according to their walking aids using 2-way repeated ANOVA. The energy cost (0.068±0.023 mL/kg/m) and oxygen expenditure (8.609±2.155 mL/kg/minutes) were lower with the arm sling (P<0.05) than without the arm sling (0.074±0.029 mL/kg/m, and 9.109±2.406 mL/kg/minutes, respectively), and the walking endurance (138.942±47.043 m) were longer (P<0.05) with the arm sling among the hemiplegic patients with single cane. Among the hemiplegic patients with a single cane, the walking endurance achieved with an arm sling significantly improved than those achieved without an arm sling, and the energy expenditure and energy cost was significantly lower. The hemiplegic arm support with an arm sling may be beneficial for gait efficiency in hemiplegic patients using a single cane, which lead to decreased oxygen use at a given speed.

Informatics in radiology: use of a C-arm fluoroscopy simulator to support training in intraoperative radiography.

PubMed

Bott, Oliver Johannes; Dresing, Klaus; Wagner, Markus; Raab, Björn-Werner; Teistler, Michael

2011-01-01

Mobile image intensifier systems (C-arms) are used frequently in orthopedic and reconstructive surgery, especially in trauma and emergency settings, but image quality and radiation exposure levels may vary widely, depending on the extent of the C-arm operator's knowledge and experience. Current training programs consist mainly of theoretical instruction in C-arm operation, the physical foundations of radiography, and radiation avoidance, and are largely lacking in hands-on application. A computer-based simulation program such as that tested by the authors may be one way to improve the effectiveness of C-arm training. In computer simulations of various scenarios commonly encountered in the operating room, trainees using the virtX program interact with three-dimensional models to test their knowledge base and improve their skill levels. Radiographs showing the simulated patient anatomy and surgical implants are "reconstructed" from data computed on the basis of the trainee's positioning of models of a C-arm, patient, and table, and are displayed in real time on the desktop monitor. Trainee performance is signaled in real time by color graphics in several control panels and, on completion of the exercise, is compared in detail with the performance of an expert operator. Testing of this computer-based training program in continuing medical education courses for operating room personnel showed an improvement in the overall understanding of underlying principles of intraoperative radiography performed with a C-arm, with resultant higher image quality, lower overall radiation exposure, and greater time efficiency. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.313105125/-/DC1. Copyright © RSNA, 2011.

Facilities Enhancement for IPY at Barrow

NASA Astrophysics Data System (ADS)

Sheehan, G.; Brown, J.; Coakley, B.; Zak, B.

2007-12-01

In connection with the International Polar Year, research facilities at Barrow have been markedly enhanced. On June 1st, Sen. Ted Stevens cut the ribbon at the Grand Opening of the Barrow Arctic Research Center (BARC). The BARC currently covers 18,000 sq. ft, with future phases anticipated, including 8 research labs, a necropsy lab for animal studies, freezers for biological samples, a state-of-the-art-data system, a planned Internet II connection, meeting spaces, and offices. There is a platform on the roof of the facility for instrumentation, and a communications tower to provide WIFI connections to remote instrumentation located on the adjacent Barrow Environmental Observatory (BEO). The BEO, which consists of 11 square miles of tundra and coastline set aside for environmental and ecological research, has also seen recent enhancements. A power line and a hard- surfaced trail now provide easy access to the interior of the BEO. Users of the BEO (and others) also have access to many different data sets continuously collected at the NOAA Global Monitoring Division Barrow Station and the DOE ARM (Atmospheric Radiation Measurement) Climate Research Facility (see http://www.esrl.noaa.gov/gmd/obop/brw.html and http://www.arm.gov/sites/nsa.stm respectively) also adjacent to the BEO. The National Weather Service Barrow Station also provides data of interest. Researchers submitting proposals to the National Science Foundation can include a request for the use of BARC and BEO facilities in their proposals. ARM facilities, recently augmented, can also be made available, but through arrangements made directly with ARM (BDZak@sandia.gov; 505-845-8631 or MDIvey@sandia.gov; 505-284-9092). BARC, BEO and ARM facilities are available to other agency and international users as well. For more information, see http://www.arcticscience.org, or contact Glenn Sheehan (907-852-4881, basc@arcticscience.org). The BEO consists of land owned by Ukpeagvik Inupiat Corporation, which is owned by the native people of Barrow. The BEO is administered by the Barrow Arctic Science Consortium (BASC) under a Cooperative Agreement with the National Science Foundation. BASC is a non-profit entity set up to serve the logistical needs of scientists doing research on the North Slope of Alaska.

The Use of an Imagery Mnemonic to Teach the Krebs Cycle

ERIC Educational Resources Information Center

Morisaki, Ryoma; Bon, Charles; Levitt, Jacob O.

2016-01-01

The Krebs Cycle is a highly taught biochemical pathway that is traditionally difficult to learn. Twenty-seven undergraduate students were randomized to a rote memorization arm or to a mnemonic arm. They were given a pre-test, then shown a lecture corresponding to their assigned method, and then given an immediate Week 0 post-test and a Week 4…

Sex Differences in a Human Analogue of the Radial Arm Maze: The ''17-Box Maze Test''

ERIC Educational Resources Information Center

Rahman, Q.; Abrahams, S.; Jussab, F.

2005-01-01

This study investigated sex differences in spatial memory using a human analogue of the Radial Arm Maze: a revision on the Nine Box Maze originally developed by Abrahams, Pickering, Polkey, and Morris (1997) called the 17-Box Maze Test herein. The task encourages allocentric spatial processing, dissociates object from spatial memory, and…

Dietary Influences on Alpha-Methylacyl-CoA Racemase (AMACR) Expression in the Prostate

DTIC Science & Technology

2008-04-01

calculated from the point where each curve crossed the threshold line (Ct) using the following equation : Rel. value = 2[Ct(control) Ct(test)]test...pancreatic cancer. J Hum Genet 2005;50:159–67. 41. Armes JE, Hammet F, de Silva M, et al. Candidate tumor-suppressor genes on chromosome arm 8p in early

Crimped braided sleeves for soft, actuating arm in robotic abdominal surgery.

PubMed

Elsayed, Yahya; Lekakou, Constantina; Ranzani, Tommaso; Cianchetti, Matteo; Morino, Mario; Arezzo, Alberto; Menciassi, Arianna; Geng, Tao; Saaj, Chakravarthini M

2015-01-01

This paper investigates different types of crimped, braided sleeve used for a soft arm for robotic abdominal surgery, with the sleeve required to contain balloon expansion in the pneumatically actuating arm while it follows the required bending, elongation and diameter reduction of the arm. Three types of crimped, braided sleeves from PET (BraidPET) or nylon (BraidGreyNylon and BraidNylon, with different monofilament diameters) were fabricated and tested including geometrical and microstructural characterisation of the crimp and braid, mechanical tests and medical scratching tests for organ damage of domestic pigs. BraidPET caused some organ damage, sliding under normal force of 2-5 N; this was attributed to the high roughness of the braid pattern, the higher friction coefficient of polyethylene terephthalate (PET) compared to nylon, and the high frequency of the crimp peaks for this sleeve. No organ damage was observed for the BraidNylon, attributed to both the lower roughness of the braid pattern and the low friction coefficient of nylon. BraidNylon also required the lowest tensile force during its elongation to similar maximum strain as that of BraidPET, translating to low power requirements. BraidNylon is recommended for the crimped sleeve of the arm designed for robotic abdominal surgery.

Relationships between maximal anaerobic power of the arms and legs and javelin performance.

PubMed

Bouhlel, E; Chelly, M S; Tabka, Z; Shephard, R

2007-06-01

The aim of this study was to examine relationships between maximal anaerobic power, as measured by leg and arm force-velocity tests, estimates of local muscle volume and javelin performance. Ten trained national level male javelin throwers (mean age 19.6+/- 2 years) participated in this study. Maximal anaerobic power, maximal force and maximal velocity were measured during leg (Wmax-L) and arm (Wmax-A) force-velocity tests, performed on appropriately modified forms of Monark cycle ergometer. Estimates of leg and arm muscle volume were made using a standard anthropometric kit. Maximal force of the leg (Fmax-L) was significantly correlated with estimated leg muscle volume (r=0.71, P<0.05). Wmax-L and Wmax-A were both significantly correlated with javelin performance (r=0.76, P<0.01; r=0.71, P <0.05, respectively). Maximal velocity of the leg (Vmax-L) was also significantly correlated with throwing performance (r=0.83; P<0.001). Wmax of both legs and arms were significantly correlated with javelin performance, the closest correlation being for Wmax-L; this emphasizes the importance of the leg muscles in this sport. Fmax-L and Vmax-L were related to muscle volume and to javelin performance, respectively. Force-velocity testing may have value in regulating conditioning and rehabilitation in sports involving throwing.

Improving arm function in chronic stroke: a pilot study of sensory amplitude electrical stimulation via glove electrode during task-specific training.

PubMed

Sullivan, Jane; Girardi, Madeline; Hensley, Melissa; Rohaus, Jordan; Schewe, Clay; Whittey, Colby; Hansen, Piper; Muir, Kimberly

2015-06-01

To investigate the effects of sensory amplitude electrical stimulation (SES) delivered by glove electrode during task-specific exercise on arm movement, function, and sensation in chronic stroke. The design was an intervention pilot study, pre-test, post-test, follow-up design. The settings used were a university research laboratory and home-based intervention. Participants comprised of 11 individuals with chronic stroke (7.2 ± 4.1 years post onset) and moderate arm paresis, 10.82/20 ± 2.27 on the Stroke Rehabilitation Assessment of Movement (STREAM) - Arm Subscale. Participants were seven males and four females (mean age: 59 years). Participants were recruited from university-based database. Intervention- Participants engaged in task-specific training at home for 30 min, twice daily, for 5 weeks, while receiving SES via glove electrode. Participants received supervised task practice at least twice during intervention period for 1 hour. Main outcome measures- Jebsen-Taylor Hand Function Test (JTHFT), STREAM - Arm Subscale, Motor Activity Log-14 (MAL-14) - Amount and Quality Subscales, and Nottingham Stereognosis Assessment (NSA). Significant changes were found in group mean pre- and post-test comparisons on the NSA (P = 0.042), MAL amount subscale (P = 0.047), and JTHFT (with writing item 29 excluded) (P = 0.003) and in pre-test to follow-up comparisons on NSA (P = 0.027) and JTHFT (writing item excluded) (P = 0.009). There was no significant change on the STREAM (P = 1.0). Individuals with a greater baseline motor capacity determined by STREAM scores (P = 0.048) and more recent stroke (P = 0.014) had significantly greater improvements. Combining task-specific training with glove-based SES in chronic stroke resulted in changes in arm sensation and function that were maintained at 3-month follow-up.

Comparison of Survival Outcomes Among Cancer Patients Treated In and Out of Clinical Trials

PubMed Central

2014-01-01

Background Clinical trials test the efficacy of a treatment in a select patient population. We examined whether cancer clinical trial patients were similar to nontrial, “real-world” patients with respect to presenting characteristics and survival. Methods We reviewed the SWOG national clinical trials consortium database to identify candidate trials. Demographic factors, stage, and overall survival for patients in the standard arms were compared with nontrial control subjects selected from the Surveillance, Epidemiology, and End Results program. Multivariable survival analyses using Cox regression were conducted. The survival functions from aggregate data across all studies were compared separately by prognosis (≥50% vs <50% average 2-year survival). All statistical tests were two-sided. Results We analyzed 21 SWOG studies (11 good prognosis and 10 poor prognosis) comprising 5190 patients enrolled from 1987 to 2007. Trial patients were younger than nontrial patients (P < .001). In multivariable analysis, trial participation was not associated with improved overall survival for all 11 good-prognosis studies but was associated with better survival for nine of 10 poor-prognosis studies (P < .001). The impact of trial participation on overall survival endured for only 1 year. Conclusions Trial participation was associated with better survival in the first year after diagnosis, likely because of eligibility criteria that excluded higher comorbidity patients from trials. Similar survival patterns between trial and nontrial patients after the first year suggest that trial standard arm outcomes are generalizable over the long term and may improve confidence that trial treatment effects will translate to the real-world setting. Reducing eligibility criteria would improve access to clinical trials. PMID:24627276

Family Access to a Dentist Study (FADS): A Multi-Center Randomized Controlled Trial

PubMed Central

Nelson, Suchitra; Riedy, Christine; Albert, Jeffrey M; Lee, Wonik; Slusar, Mary Beth; Curtan, Shelley; Ferretti, Gerald; Cunha-Cruz, Joana; Milgrom, Peter

2015-01-01

Introduction Many low-income parent/caregivers do not understand the importance of cavity-free primary (baby) teeth and the chronic nature of dental caries (tooth decay). As a consequence, dental preventive and treatment utilization is low even when children are screened in schools and referred for care. This study aims to test a referral letter and Dental Information Guide (DIG) designed using the Common-Sense Model of Self-Regulation (CSM) framework to improve caregivers’ illness perception of dental caries and increase utilization of care by children with restorative dental needs. Methods A multi-site randomized controlled trial with caregivers of Kindergarten to 4th grade children in urban Ohio and rural Washington State will compare five arms: (1) CSM referral letter alone; (2) CSM referral letter + DIG; (3) reduced CSM referral letter alone; (4) reduced CSM referral letter + DIG; (5) standard (control) referral. At baseline, children will be screened at school to determine restorative dental needs. If in need of treatment, caregivers will be randomized to study arms and an intervention packet will be sent home. The primary outcome will be dental care based on a change in oral health status by clinical examination 7 months post-screening (ICDAS sealant codes 1 and 2; restoration codes 3–8; extraction). Enrollment commenced summer 2015 with results in summer 2016. Conclusion This study uses the CSM framework to develop and test behavioral interventions to increase dental utilization among low-income caregivers. If effective this simple intervention has broad applicability in clinical and community-based settings. PMID:26500170

Family Access to a Dentist Study (FADS): A multi-center randomized controlled trial.

PubMed

Nelson, Suchitra; Riedy, Christine; Albert, Jeffrey M; Lee, Wonik; Slusar, Mary Beth; Curtan, Shelley; Ferretti, Gerald; Cunha-Cruz, Joana; Milgrom, Peter

2015-11-01

Many low-income parent/caregivers do not understand the importance of cavity-free primary (baby) teeth and the chronic nature of dental caries (tooth decay). As a consequence, dental preventive and treatment utilization is low even when children are screened in schools and referred for care. This study aims to test a referral letter and Dental Information Guide (DIG) designed using the Common-Sense Model of Self-Regulation (CSM) framework to improve caregivers' illness perception of dental caries and increase utilization of care by children with restorative dental needs. A multi-site randomized controlled trial with caregivers of Kindergarten to 4th grade children in urban Ohio and rural Washington State will compare five arms: (1) CSM referral letter alone; (2) CSM referral letter+DIG; (3) reduced CSM referral letter alone; (4) reduced CSM referral letter+DIG; and (5) standard (control) referral. At baseline, children will be screened at school to determine restorative dental needs. If in need of treatment, caregivers will be randomized to study arms and an intervention packet will be sent home. The primary outcome will be dental care based on a change in oral health status by clinical examination 7 months post-screening (ICDAS sealant codes 1 and 2; restoration codes 3-8; extraction). Enrollment commenced summer 2015 with results in summer 2016. This study uses the CSM framework to develop and test behavioral interventions to increase dental utilization among low-income caregivers. If effective this simple intervention has broad applicability in clinical and community-based settings. Copyright © 2015 Elsevier Inc. All rights reserved.

Video on Diet Before Outpatient Colonoscopy Does Not Improve Quality of Bowel Preparation: A Prospective, Randomized, Controlled Trial.

PubMed

Rice, Sean C; Higginbotham, Tina; Dean, Melanie J; Slaughter, James C; Yachimski, Patrick S; Obstein, Keith L

2016-11-01

Successful outpatient colonoscopy (CLS) depends on many factors including the quality of a patient's bowel preparation. Although education on consumption of the pre-CLS purgative can improve bowel preparation quality, no study has evaluated dietary education alone. We have created an educational video on pre-CLS dietary instructions to determine whether dietary education would improve outpatient bowel preparation quality. A prospective randomized, blinded, controlled study of patients undergoing outpatient CLS was performed. All patients received a 4 l polyethylene glycol-based split-dose bowel preparation and standard institutional pre-procedure instructions. Patients were then randomly assigned to an intervention arm or to a no intervention arm. A 4-min educational video detailing clear liquid diet restriction was made available to patients in the intervention arm, whereas those randomized to no intervention did not have access to the video. Patients randomized to the video were provided with the YouTube video link 48-72 h before CLS. An attending endoscopist blinded to randomization performed the CLS. Bowel preparation quality was scored using the Boston Bowel Preparation Scale (BBPS). Adequate preparation was defined as a BBPS total score of ≥6 with all segment scores ≥2. Wilcoxon rank-sum and Pearson's χ 2 -tests were performed to assess differences between groups. Ninety-two patients were randomized (video: n=42; control: n=50) with 47 total video views being tallied. There were no demographic differences between groups. There was no statistically significant difference in adequate preparation between groups (video=74%; control=68%; P=0.54). The availability of a supplementary patient educational video on clear liquid diet alone was insufficient to improve bowel preparation quality when compared with standard pre-procedure instruction at our institution.

Effectiveness of Population Health Management Using the Propeller Health Asthma Platform: A Randomized Clinical Trial.

PubMed

Merchant, Rajan K; Inamdar, Rubina; Quade, Robert C

2016-01-01

Telehealth strategies for asthma have focused primarily on adherence to controller medications. Telemonitoring of short-acting β-agonist (SABA) focuses on patterns of use and may allow more timely action to avert exacerbations. Studies assessing this approach are lacking. This pragmatic controlled study was designed to measure real-world effectiveness of the Propeller Health Asthma Platform to reduce use of SABA and improve asthma control. A total of 495 patients were enrolled in parallel arms (1:1) for 12 months of monitoring SABA use. Intervention group (IG) patients received access to and feedback from the Propeller Health system. Routine care (RC) patients were outfitted with sensors but did not receive feedback. Physicians were able to monitor the status of their patients in the IG and receive proactive notifications. The daily mean number of SABA uses per person decreased by 0.41 for the IG and by 0.31 for RC between the first week and the remainder of the study period (P < .001 for the difference between groups). Similarly, the proportion of SABA-free days increased 21% for the IG and 17% for RC (P < .01 for the difference between groups). Asthma Control Test (ACT) scores were not significantly different between arms in the entire study population, but adults with initially uncontrolled ACT scores showed a significantly larger improvement in the proportion with controlled asthma in IG versus RC (63% controlled in the study period vs 49%, respectively; P < .05 comparing the 2 improvements). Compared with RC, the study arm monitoring SABA use with the Propeller Health system significantly decreased SABA use, increased SABA-free days, and improved ACT scores (the latter among adults initially lacking asthma control). Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Shamba Maisha: Randomized controlled trial of an agricultural and finance intervention to improve HIV health outcomes in Kenya

PubMed Central

WEISER, Sheri D.; BUKUSI, Elizabeth A.; STEINFELD, Rachel L.; FRONGILLO, Edward A.; WEKE, Elly; DWORKIN, Shari L.; PUSATERI, Kyle; SHIBOSKI, Stephen; SCOW, Kate; BUTLER, Lisa M.; COHEN, Craig R.

2015-01-01

Objectives Food insecurity and HIV/AIDS outcomes are inextricably linked in sub-Saharan Africa. We report on health and nutritional outcomes of a multisectoral agricultural intervention trial among HIV-infected adults in rural Kenya. Design Pilot cluster randomized controlled trial Methods The intervention included a human-powered water pump, a microfinance loan to purchase farm commodities, and education in sustainable farming practices and financial management. Two health facilities in Nyanza Region, Kenya were randomly assigned as intervention or control. HIV-infected adults 18 to 49 years old who were on antiretroviral therapy and had access to surface water and land were enrolled beginning in April 2012 and followed quarterly for one year. Data were collected on nutritional parameters, CD4 T lymphocyte counts, and HIV RNA. Difference in difference fixed-effects regression models were used to test whether patterns in health outcomes differed over time from baseline between the intervention and control arms. Results We enrolled 72 and 68 participants in the intervention and control groups, respectively. At 12 months follow-up, we found a statistically significant increase in CD4 cell counts (165 cells/mm3, p<0.001) and proportion virologically suppressed in the intervention arm compared to the control arm (comparative improvement in proportion of 0.33 suppressed, OR 7.6, 95% CI: 2.2–26.8). Intervention participants experienced significant improvements in food security (3.6 scale points higher, p<0.001) and frequency of food consumption (9.4 times per week greater frequency, p=0.013) compared to controls. Conclusion Livelihood interventions may be a promising approach to tackle the intersecting problems of food insecurity, poverty and HIV/AIDS morbidity. PMID:26214684

Shamba Maisha: randomized controlled trial of an agricultural and finance intervention to improve HIV health outcomes.

PubMed

Weiser, Sheri D; Bukusi, Elizabeth A; Steinfeld, Rachel L; Frongillo, Edward A; Weke, Elly; Dworkin, Shari L; Pusateri, Kyle; Shiboski, Stephen; Scow, Kate; Butler, Lisa M; Cohen, Craig R

2015-09-10

Food insecurity and HIV/AIDS outcomes are inextricably linked in sub-Saharan Africa. We report on health and nutritional outcomes of a multisectoral agricultural intervention trial among HIV-infected adults in rural Kenya. This is a pilot cluster randomized controlled trial. The intervention included a human-powered water pump, a microfinance loan to purchase farm commodities, and education in sustainable farming practices and financial management. Two health facilities in Nyanza Region, Kenya were randomly assigned as intervention or control. HIV-infected adults 18 to 49 years' old who were on antiretroviral therapy and had access to surface water and land were enrolled beginning in April 2012 and followed quarterly for 1 year. Data were collected on nutritional parameters, CD4 T-lymphocyte counts, and HIV RNA. Differences in fixed-effects regression models were used to test whether patterns in health outcomes differed over time from baseline between the intervention and control arms. We enrolled 72 and 68 participants in the intervention and control groups, respectively. At 12 months follow-up, we found a statistically significant increase in CD4 cell counts (165 cells/μl, P < 0.001) and proportion virologically suppressed in the intervention arm compared with the control arm (comparative improvement in proportion of 0.33 suppressed, odds ratio 7.6, 95% confidence interval: 2.2-26.8). Intervention participants experienced significant improvements in food security (3.6 scale points higher, P < 0.001) and frequency of food consumption (9.4 times per week greater frequency, P = 0.013) compared to controls. Livelihood interventions may be a promising approach to tackle the intersecting problems of food insecurity, poverty and HIV/AIDS morbidity.

Moment arms of the human neck muscles in flexion, bending and rotation.

PubMed

Ackland, David C; Merritt, Jonathan S; Pandy, Marcus G

2011-02-03

There is a paucity of data available for the moment arms of the muscles of the human neck. The objective of the present study was to measure the moment arms of the major cervical spine muscles in vitro. Experiments were performed on five fresh-frozen human head-neck specimens using a custom-designed robotic spine testing apparatus. The testing apparatus replicated flexion-extension, lateral bending and axial rotation of each individual intervertebral joint in the cervical spine while all other joints were kept immobile. The tendon excursion method was used to measure the moment arms of 30 muscle sub-regions involving 13 major muscles of the neck about all three axes of rotation of each joint for the neutral position of the cervical spine. Significant differences in the moment arm were observed across sub-regions of individual muscles and across the intervertebral joints spanned by each muscle (p<0.05). Overall, muscle moment arms were larger in flexion-extension and lateral bending than in axial rotation, and most muscles had prominent moment arms in at least 2 out of the 3 joint motions investigated. This study emphasizes the importance of detailed representation of a muscle's architecture in prediction of its torque capacity about the individual joints of the cervical spine. The dataset produced may be useful in developing and validating computational models of the human neck. Copyright © 2010 Elsevier Ltd. All rights reserved.

[Child Soldiers as Refugees in Germany].

PubMed

Zito, Dima

2016-12-01

Child Soldiers as Refugees in Germany How do former child soldiers cope with their potentially traumatic experiences, and how do the living conditions as refugees influence these coping processes? A dissertation at the faculty of human and social sciences at the University of Wuppertal, based on biographical-narrative interviews with 15 young refugees from six African countries, describes the characteristics of the traumatic sequences in the countries of origin and in exile, and elaborates typical coping processes. In order to survive a situation of absolute subjection within armed groups, children develop forms of adequate adaptation to the context like regulation and detachment of emotions e.g. with the use of drugs, assimilation to an idea of "hard masculinity" etc. They become victims, witnesses and often perpetrators of extreme violence (man-made-disaster), respectively traumatic processes can be seen in all sequences. After leaving the armed groups there is no way back into the families and communities destroyed by armed conflict, so they become refugees. In Germany, they are subjected to a bureaucratic and excluding asylum system, in which decisions on all relevant areas of life (age determination, place and right of residence, form of accommodation, access to education, etc.) are imposed on them. Especially the insecure right of residence and the living conditions in refugee camps are severe risk factors, impeding stabilization. Social support, e. g. by competent professionals, access to trauma- and culture-sensitive psychotherapy, societal inclusion, but also personal resilience are essential for coping with trauma and developing new future perspectives.

Doppler ultrasound exam of an arm or leg

MedlinePlus

... page: //medlineplus.gov/ency/article/003775.htm Doppler ultrasound exam of an arm or leg To use ... this page, please enable JavaScript. This test uses ultrasound to look at the blood flow in the ...

78 FR 52781 - 30-Day Notice of Proposed Information Collection: Disclosure of Adjustable Rate Mortgages (ARMs...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... INFORMATION CONTACT: Colette Pollard, Reports Management Officer, QDAM, Department of Housing and Urban... telephone 202-402-3400. Persons with hearing or speech impairments may access this number through TTY by.... Colette Pollard, Department Reports Management Officer, Office of the Chief Information Officer. [FR Doc...

The Value of Continuing Education

ERIC Educational Resources Information Center

Schejbal, David; Wilson, David

2008-01-01

Higher education--and continuing education as one arm of that enterprise--is not just an economic engine; it contributes directly and in a multifaceted fashion to the common good. It generates and makes accessible a great deal of the knowledge that drives the economy; it helps develop an understanding of the society and the world for millions of…